Birth Plan Research Articles

Hubungan Antara Paritas Ibu Dengan Pelaksanaan Program Perencanaan Persalinan Dan Pencegahan Komplikasi (P4K)

Program Planning of Birth and Prevention of Komplikasi (P4K) represent a program with aim to increase knowledge, attitude, behavioral of pregnant mother, family and husband about the importance of planning of copy. Parity represent result of reproduction from a woman which is being by to the number of borne by child is life during a period of/to reproduction. Ms. with high parity more owning experience of dalan face copy. And efficacy or do not from the experience will influence storey;level compliance of them to health workers.Objective : to find out the relationship between maternal parity and the implementation of the planning and prevention program for complicationsMethods: This research of analytic method use with approach of sectional cross, election of sampel with type sampling probability of simple sampling random with amount 46 responden. obtained data use last questioner later, then with test of statistic SPSS square chi.Results: Test of statistic SPSS square chi got by result of p = 0,001 smaller than = 0,05. Hence decided by Ho refused and H1 accepted by hence its meaning there is relation between mother parity with execution of P4K in work region Puskesmas Sawahan.Conclusion: At this research is obtained by conclusion that mother parity excecution progressively lower behavior of health of mother. And for expected to next researcher to conduct furthermore research about execution of P4K with more complex factor.

Assessment of anxiety and depression, and coping mechanisms during COVID-19 lockdown among pregnant women

BackgroundCOVID-19 lockdown was associated with disruption of daily life, economy, essential health services including maternal health service, and psychological reflexes such as panic, sleep disorders, fear, anxiety, and depression. AimTo assess the perception of pregnant women on the COVID-19 pandemic lockdown and the prevalence of common mental health disorders (CMHD) among pregnant women. MethodsA cross-sectional study was conducted among 380 pregnant women at the University College Hospital (UCH) Ibadan; participants were enrolled using a simple random sampling technique. Data was collected using pretested interviewer-administered questionnaire. Information obtained – sociodemographic and obstetric characteristics, perception and reaction to the COVID-19 pandemic and lockdown, effect on ANC, coping mechanisms, and presence of CMHD (anxiety and depression) were measured using Hospital Anxiety and Depression Scale (HADS). Data were analysed using STATA 16.0 Software. Descriptive and bivariate statistics were performed. The level of significance was p-value < 0.05. ResultsThe mean age was 32 ± 4.78 years, most respondents were <35 years (75%), married (97.1%), had a higher education (89%) and multiparous (70%). About 43.9% were worried that COVID-19 would affect pregnancy care, 42.9% reported it affected care and 81.6% were not worried it would affect the delivery care. Among respondents, 96.6% were able to cope with the effects of the pandemic and 96.8% enjoyed good social support. Respondents did not have CMHD (88.16%), 7.9% had CMHD (4.74% had depression and 3.16% had anxiety) and 3.95% had co-morbid depression and anxiety. On multinomial regression analysis, relative to anxiety or depression only, respondents with combined depression and anxiety had higher odds of having no delivery plan and thought COVID-19 may affect their delivery. ConclusionOnly a few women reported anxiety and depression symptoms during the lockdown and those with anxiety or combined symptoms of anxiety and depression had no birth plan and believed that COVID-19 would affect their delivery.

Using a scheduled caesarean birth plan: A cross-sectional exploration of women’s perspectives

ProblemThere is minimal evidence regarding the role or impact of birth plans from the perspective of women experiencing scheduled caesarean birth. BackgroundQuality maternity care requires respect for women’s preferences. Evidence suggests birth plans enable communication of women’s preferences and may enhance agency when vaginal birth is intended, however there is limited evidence of how this translates in the perioperative environment where caesarean birth is the intended outcome. AimExplore the experiences and perspectives of women who had utilised a scheduled caesarean birth plan at an Australian tertiary maternity hospital. MethodsA cross-sectional design was used; 294 participants completed the survey within two weeks post-birth. Descriptive statistics were used to analyse quantitative data, qualitative responses were analysed using content analysis. FindingsOver half of the women requested lowering of the surgical-screen at birth, most requested immediate skin-to-skin with their babies; around two-thirds of these preferences were met. Use of a birth plan for scheduled caesarean section supported women’s ability to communicate their desires and choices, enhancing agency and reinforcing the significance of the caesarean birth experience. Qualitative data revealed two main categories: Perceptions and experiences; and Recommendations for improvement, with corresponding sub-categories. DiscussionFindings provide unique opportunities to consider the provision of woman-centred care within the highly technocratic perioperative environment. ConclusionAll women, regardless of birth mode, have a right to respectful maternity care that prioritises their wishes and agency. This study provides evidence for the positive utility of birth plans in caesarean birth, local adaptation is encouraged.

Second Victims in Maternity Care – The Hidden Fallout of Parental Birth Plans

In an era in which we strive for patient-centred care and shared-decision making, it is important to still consider provider perceptions and attitudes toward birth plans. In this case report, we describe maternity care providers as the Second Victim when non-standard birth plans are enacted and discuss the emotional and psychological turmoil of forced professional passivity. We present the fallout of contemporary, patient-empowered decision-making when a mother’s right to refuse care recommendations is inviolate. Care providers have become unable to do what they know they should; the things they are trained for and know are expected of them by peers and principles of best practice, and yet, by default, must still participate, and share responsibility for whatever outcome ensues.

Effectiveness of birth plan counselling based on shared decision making: A cluster randomized controlled trial (APLANT).

A birth plan (BP) is a written document in which the pregnant woman explains her wishes and expectations about childbirth to the health professionals and aims to facilitate her decision-making. Midwives' support to women during the development of the BP is essential, but it's unknown if shared decision making (SDM) is effective in birth plan counselling. We hypothesized that women who receive counselling based on SDM during their pregnancy are more likely to present their BP to the hospital, more satisfied with the childbirth experience, and have better obstetric outcomes than women who receive standard counselling. We also aimed to identify if women who presented BP to the hospital have better obstetric outcomes and more satisfied with the childbirth experience. This was a randomised cluster trial involving four Primary Care Units. Midwives provided BP counselling based on SDM to the women in the intervention group (IG) during their pregnancy, along with a leaflet with evidence-based recommendations. Women in the control group (CG) only received the standard birth plan counselling from midwives. The primary outcomes were birth plan presentation to the hospital, obstetrics outcomes and satisfaction with childbirth experience. The Mackey Satisfaction with Childbirth Scale (MCSRS) was used to measure childbirth satisfaction. A total of 461 (95.5%) pregnant women received BP counselling (IG n = 214 and CG n = 247). Fewer women in the intervention group presented their BP to the hospital compared to those in the control group (57.8% vs 75.1%; p <0.001). Mean satisfaction with childbirth experience was high in the IG as well as the CG: 150.2 (SD:22.6) vs. 153.4 (SD:21.8); p = 0.224). The information received about childbirth during pregnancy was high in both groups (95.1% vs 94.8%; p = 1.0). Fewer women in the IG used analgesia epidural compared to those in the CG (84.7% vs 91.7%; p = 0.034); women who combined non-pharmacological and pharmacological methods for pain relief were more in number in the IG (48.9% vs 29.5%; p = 0.001) and women who began breastfeeding in the delivery room were more in number in the IG (83.9% vs 66.3%; p = 0.001). Women who presented their BP had a greater probability of using combined non-pharmacological and pharmacological methods for pain relief aOR = 2.06 (95% CI: 1.30-4.30) and early skin-to-skin contact aOR = 2.08 (95% CI: 1.07-4.04). This counselling intervention was not effective to increase the presentation of the BP to the hospital and women's satisfaction with childbirth; however, it was related to a lower usage of analgesia epidural, a higher combination of pharmacological and non-pharmacological methods for pain relief and the initiation of breastfeeding in the delivery room. Presenting the BP to the hospital increased the likelihood of using pharmacological and non-pharmacological methods for pain relief, and early skin-to-skin contact.

O19 - Planning for caesarean: supporting woman-centred care through a formal birth plan

The use of birth plans as a mechanism to communicate preferences, particularly in labour and birth, is commonplace in contemporary maternity care. There is little evidence regarding the role of birth plans in elective caesarean birth. This study aimed to explore insights from women who utilised hospital-initiated birth plans for their scheduled caesarean section and from the midwives who provided care to women using the plans. A cross-sectional survey was undertaken between September 2019 and July 2020; 294 women and 18 midwives responded. Quantitative data were analysed using descriptive statistics and qualitative data were analysed using content/template analysis. Women responded to a series of discrete choices such as music playing in theatre, screen being lowered on request and skin-to-skin post-birth. Most indicated they received the care requested. Qualitative responses provided insight into the utility of the plan to facilitate communication with professionals, which improved women’s experience of being in control, exercising choice and emphasising the importance of their special day. Midwives indicated the value of the plan to provide advocacy for women’s choices; while systemic factors that inhibited full implementation of a plan were highlighted. Using a formal plan to communicate requests when preparing for elective caesarean birth has utility in supporting women to effect choice and control, especially when not receiving care in a continuity model. A plan enables the responsibility for awareness and implementation of each woman’s wishes to rest with the whole multidisciplinary team. Scheduled caesarean birth requires the same individualised approaches to woman-centred care that is the hallmark of midwifery. Findings of this novel study are useful to consider education, multidisciplinary practice changes and policy support for ways of respecting the uniqueness of caesarean birth for each woman and her family.

Maintaining Continuity of Care for Expectant Mothers in Kenya During the COVID-19 Pandemic: A Study of MomCare.

In Kenya, early coronavirus disease (COVID-19) modeling studies predicted that disruptions in antenatal care and hospital services could increase indirect maternal and neonatal deaths and stillbirths. As the Kenyan government enforced lockdowns and a curfew, many mothers-to-be were unable to safely reach hospital facilities, especially at night. Fear of contracting COVID-19, increasing costs of accessing care, stigma, and falling incomes forced many expectant mothers to give birth at home. MomCare, which primarily serves communities in remote areas and urban slums, links mothers-to-be with payers and health care providers, following a standardized pregnancy program based on World Health Organization guidelines at a predetermined cost and quality. Expectant mothers gain access to care through a mobile wallet on their feature phone (voice, text, and basic internet), and providers are paid after appropriate care is given. Within the first 3 weeks of the pandemic in Kenya, the following services were added to the MomCare bundle: emergency ambulance services during curfew hours, extended bed allowances to encourage early care, phone calls to check on mothers approaching their delivery dates and to promote the generation of a birth plan, SMS messages to inform mothers of open facilities and COVID-19 protocols, and training for clinic staff in managing COVID-19 patients and infection prevention. We compare data collected through the MomCare platform during the 6 months before the first confirmed COVID-19 case in Kenya (September 2019-February 2020) with data collected during the 6 months that followed. This study shows that care-seeking behaviors (enrollment, antenatal/postnatal care, skilled deliveries) increased for mothers-to-be enrolled in MomCare during the COVID-19 lockdowns, while quality of care and outcomes were maintained. Public health practitioners can promote interactive, patient-driven technology like MomCare to augment traditional responses, quickly linking payments with patients and providers in times of crisis.

Patient-centered perinatal palliative care: family birth plans, outcomes, and resource utilization in a diverse cohort

Perinatal palliative care is an emerging concept in fetal medicine that offers quality-of-life options and anticipatory grief management for families of fetuses with complex conditions. Few perinatal palliative care outcomes are detailed in peer-reviewed literature. This study aimed to describe outcomes of perinatal palliative care at the Fetal Center of the University of Texas Health Science Center at Houston and Women's Center at Children's Memorial Hermann Hospital. This was a retrospective cohort of families receiving perinatal palliative care for life-limiting fetal diagnosis, such as trisomy 13 or 18 and some major structural anomalies between 2016 and 2020. The primary outcome was whether delivery events matched families' birth plans, including fetal/neonatal clinical course matching expectations described by consultant notes. Secondary outcomes included maternal safety outcomes, use of perinatal interventions, delivery outcomes, and resource utilization outcomes. Of 187 perinatal palliative care consults, delivery events matched families' plans and clinicians' expectations in 89% of cases (165/185); 39% (73/187) of families requested some perinatal interventions, 64% of whom planned postnatal comfort care even while choosing antenatal interventions. Demographics and median income were similar between families who chose some interventions and those who chose comfort care. Patients choosing any interventions had more mismatches between their plans and delivery events (19% vs 2%; P<.001), were more likely to change their plans (24% vs 6%; P=.001), and unsurprisingly used more healthcare resources. They were also more likely to have intraamniotic infection or postpartum hemorrhage (9% vs 22%; P=.02), but this was associated with mode of delivery and not choice of interventions. Most families' perinatal experiences matched birth plans and expectations in this perinatal palliative care program. Families who desired interventions used more healthcare resources, but often did so with plans for postnatal comfort care, demonstrating insight into neonatal prognosis but achieving value-consistent goals, such as meeting a live neonate. Perinatal palliative care was safe for maternal patients and equitable across racial, ethnic, and income groups. Perinatal palliative care and some perinatal interventions are options for care of the whole family in complex fetal medicine cases.

THE EFFECT OF COUNSELING USING LABOR PREPARATION MODULE ON INCREASING KNOWLEDGE AND ATTITUDE OF PREGNANT MOTHERS

Background: The birth of a baby is the most impressive, enjoyable, and even life-changing life experience for a woman. Every woman wants every birth plan according to her hopes and desires. Birth planning is a simple, clear statement of a woman's preferences for childbirth. The current weakness is that providers often plan births according to their wishes. But less in support as desired by every mother. One alternative in preparing for childbirth is to provide counseling through the provision of modules. The delivery preparation module contains information about a fun delivery guide, it is hoped that every mother can develop a coveted birth plan&#x0D; The purpose of the study was to determine the effect of counseling using the delivery preparation module on the knowledge and attitudes of pregnant women in the third trimester of childbirth.&#x0D; Methods: Quantitative research, quasi-experimental type with pre-test-post-test control group design. The subjects of this study were 3rd trimester pregnant women. Sampling was done by randomized assignment method, the treatment group was in the Pasar Rebo Health Center area and the control group was at the Ciracas District Health Center. Data were analyzed using Wilcoxon test, independent t test and Mann Whitney test.&#x0D; Results: there was a significant difference in the mean score of knowledge (p= 0.0001) and attitude (p= 0.0001) of third trimester pregnant women in post-test-pre-test measurements between the treatment group and the control group. There is a higher difference in scores for the knowledge and attitudes of third trimester mothers who are given intensive counseling using the delivery preparation module in readiness for childbirth&#x0D; Conclusion: the knowledge and attitudes scores of mothers who were given intensive counseling using the delivery preparation module were significantly higher than those who were not given intensive counseling.

Obstetric services in the UK during the COVID-19 pandemic: A national survey

BackgroundThe management of obstetric patients with coronavirus disease 2019 (COVID-19) due to human-to-human transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) requires unique considerations. Many aspects of labour and delivery practice required adaptation in response to the global pandemic and were supported by guidelines from the Royal College of Obstetrics and Gynaecologists. The adoption and adherence to these guidelines is unknown. MethodsParticipating centres in “Quality of Recovery in Obstetric Anaesthesia study—a multicentre study” (ObsQoR) completed an electronic survey based on the provision of services and care related to COVID-19 in October 2021. The survey was designed against the Royal College of Obstetricians and Gynaecologists COVID-19 guidelines. ResultsOne hundred and five of the 107 participating centres completed the survey (98% response rate representing 54% of all UK obstetric units). The median [IQR] annual number of deliveries among the included sites was 4389 [3000–5325]. Ninety-nine of the 103 (94.3%) sites had guidelines for the management of peripartum women with COVID-19. Sixty-one of 105 (58.1%) sites had specific guidance for venous thromboembolism (VTE) prophylaxis. Thirty-seven of 104 (35.6%) centres restricted parturient birthing plans if a positive diagnosis of COVID-19 was made. A COVID-19 vaccination referral pathway encouraging full vaccination for all pregnant women was present in 63/103 centres (61.2%). ConclusionWe found variability in care delivered and adherence to guidelines related to COVID-19. The clinical implications for this related to quality of peripartum care is unclear, however there remains scope to improve pathways for immunisation, birth plans and VTE prophylaxis.

Changes in prenatal care and vaccine willingness among pregnant women during the COVID-19 pandemic

IntroductionConcerns about SARS-CoV-2 infection risk in health care settings have resulted in changes in prenatal care and birth plans, such as shifts to in-person visits and increased Cesarean delivery. These changes may affect quality of care and limit opportunities for clinicians to counsel pregnant individuals, who are at higher risk of severe COVID-19 disease and adverse pregnancy outcomes, about prevention and vaccination.MethodsWe conducted a cross-sectional online survey of United States adults on changes in prenatal care, COVID-19 vaccine willingness, and reasons for unwillingness to receive a vaccine. We summarized changes in access to care and examined differences in vaccine willingness between pregnant and propensity-score matched non-pregnant controls using chi-squared tests and multivariable conditional logistic regression.ResultsBetween December 15–23, 2020, 8481 participants completed the survey, of which 233 were pregnant. Three-quarters of pregnant women (n = 186) experienced a change in prenatal care, including format of care (n = 84, 35%) and reduced visits (n = 69, 24%). Two-thirds experienced a change in birth plans, from a hospital birth to home birth (n = 45, 18%) or vaginal birth to a Cesarean delivery (n = 42, 17%). Although 40% of pregnant women (n = 78) were unwilling to receive COVID-19 vaccination, they had higher, though non-significant, odds of reporting willingness to receive vaccination compared to similar non-pregnant women (aOR 1.38, 95% CI: 0.95, 2.00).ConclusionTo support pregnant women through the perinatal care continuum, maternity care teams should develop protocols to foster social support, patient-centered education around infection prevention that focuses on improved risk perception, expected changes in care due to COVID-19, and vaccine effectiveness and safety.

“Well Duh, That’s How You Raise a Kid”: Gender-Open Parenting in a (Non)Binary World

While parenting practices that resist traditional gender norms for children are not new, the advent of “gender-open parenting” in recent years poses a new and understudied phenomenon in childhood socialization. Assisted by new “nonbinary” gender possibilities and pronouns, these parents: do not assign a sex/gender to their child, keep their child’s anatomy private, and use they/them pronouns until the child can express their own sense of gender. Using interview data from 21 parents and 11 grandparents, this study presents foundational insights on their gender-open practices, including their educating others, birth plans, and gender-neutral language. Discussion and analysis employs Risman’s concept of “gender as a social structure” to map these practices onto broader dimensions of our social structure, exposing their potential for significant social change. Parents’ efforts reflect the multi-dimensional nature of gender in society, where all levels are engaged to resist cisgender norms and ideologies—including individual, interactional, and institutional. Conclusion addresses implications for educators, clinicians, and policymakers, as well as future research.

Incidence and risk factors for surgical wound complications in women with body mass index >30 kg/m2 following cesarean delivery: a secondary analysis

BACKGROUNDSurgical wound complications are common and occur in between 3% and 12% of obese women after cesarean delivery. An understanding of the risk factors for wound complications may inform potential areas for clinical care improvement.OBJECTIVEThis study aimed to identify the incidence and predictors of surgical wound complications in obese women after cesarean delivery.STUDY DESIGNThis was a secondary analysis of the ADding negative pRESSure to improve healING, or DRESSING, randomized controlled trial conducted at 4 maternity hospitals in Australia. A total of 2035 women with a prepregnancy body mass index ≥30 kg/m2 undergoing cesarean delivery were included. Data were collected between October 2015 and December 2019 using self-reporting of signs and symptoms, the research nurses’ direct observation of the surgical site, and medical records. Independent blinded outcome assessors ascertained wound outcomes on the basis of self-reported data and medical records. Multivariable logistic regression models were used to identify independent risk factors for wound complications and surgical wound dehiscence. The 30-day cumulative incidence of wound complications and surgical wound dehiscence was calculated.RESULTSOf the 2035 women, 317 (15.6%) developed a wound complication, whereas 211 (10.4%) developed surgical wound dehiscence. The predictors of a wound complication included 1 previous cesarean delivery (odds ratio, 1.41; 95% confidence interval, 1.05–1.90; P=.02) and ruptured membranes >12 hours (odds ratio, 1.69; 95% confidence interval, 1.08–2.66; P=.02). The odds of developing any wound complication decreased by 45% with vaginal cleansing (odds ratio, 0.55; 95% confidence interval, 0.42–0.72; P<.001) and by 59% for low transverse incision (odds ratio, 0.41; 95% confidence interval, 0.18–0.94; P=.04). The predictors of surgical wound dehiscence included 1 previous cesarean delivery (odds ratio, 1.62; 95% confidence interval, 1.14–2.31; P=.008) and ruptured membranes >12 hours (odds ratio, 1.85; 95% confidence interval, 1.10–3.12; P=.02). The odds of developing surgical wound dehiscence decreased by 50% for vaginal cleansing (odds ratio, 0.50; 95% confidence interval, 0.36–0.69; P<.001) and by 42% for using a double-layer uterine closure (odds ratio, 0.58; 95% confidence interval, 0.35–0.97; P=.04).CONCLUSIONWound complications and surgical wound dehiscence in this population are high. The predictors observed herein would assist in identifying high-risk women. Such information may guide patient-centered decision-making in the planning of surgical births and individualized postoperative care.

Propagating Superior-Quality Singleton Children as Anticipatory Modernization: Contextualizing Western Perspectives on Chinese Transnational Adoption

ABSTRACT We conducted a relational dialectics analysis of 259 Chinese birth planning policy propaganda. We identified a coalition of five discourses animating the texts. We found the coalition created conditions of monologic wholeness, characterized by simultaneous dialogic expansion and dialogic contraction. Dialogic expansion promised a utopic, future China in exchange for birth parents’ childbirth sacrifices and creation of a generation of superior-quality singleton Chinese children. Dialogic contraction reified superior-quality singletons as irrefutable antecedent for China’s modernization. This study holds both academic and practical significance. Academically, this study accelerates family communication’s critical theoretical turn, highlights complexities of studying monologue, expands the area’s dataset boundaries, and furthers diversity efforts. Practically, this study promises transformation of acontextual Western perspectives on China’s birth planning program. The study’s non-Western perspective is timely, given increasing momentum within the Chinese transnational adoption birth family search and reunion movement.

Implementation of assistance for one pregnant woman one cadre (OPOC) in Banjarnegara District, Central Java Province, Indonesia.

The high maternal mortality rate caused by late detection of risk factors for pregnant women is a major health problem in Banjarnegara District. One of the efforts made to overcome this problem is the implementation of assistance for one pregnant woman by one cadre (OPOC). The application of OPOC consists of four mentoring activities, namely reminders about antenatal care schedule, detecting risk factors, monitoring fetal movements, and carrying out delivery planning and handling complications. Therefore, this study aims to describe the implementation of OPOC as well as to evaluate cadres' performance in Banjarnegara District. A quantitative cross-sectional design was used, where a total of 200 cadres were selected as respondents using a representative purposive sampling method. The results showed that reminding mothers about their antenatal care schedule, detecting risk factors, monitoring of fetal health through movements, and making commitments for birth planning and complications prevention were carried out by 199 (99.49%), 129 (64.84%), 138 (69.05%), and 159 (79.42%) respondents, respectively. More than 92% of them know their duties and responsibilities as companions for pregnant women, but only 28% have knowledge about the benefits of assisting. Furthermore, 93% often carry out OPOC assistance. The knowledge of cadres about OPOC assistance was good, but some of them are not knowledgeable about its benefits. These findings show that they need guidance, training, and motivation from public health centers.

Childbirth experience, risk of PTSD and obstetric and neonatal outcomes according to antenatal classes attendance

Antenatal classes have evolved considerably and include now a discussion of the parents' birth plan. Respecting this plan normally results in a better childbirth experience, an important protective factor of post-traumatic stress disorder following childbirth (PTSD-FC). Antenatal class attendance may thus be associated with lower PTSD-FC rates. This cross-sectional study took place at a Swiss university hospital. All primiparous women who gave birth to singletons from 2018 to 2020 were invited to answer self-reported questionnaires. Data for childbirth experience, symptoms of PTSD-FC, neonatal, and obstetrical outcomes were compared between women who attended (AC) or not (NAC) antenatal classes. A total of 794/2876 (27.6%) women completed the online questionnaire. Antenatal class attendance was associated with a poorer childbirth experience (p = 0.03). When taking into account other significant predictors of childbirth experience, only induction of labor, use of forceps, emergency caesarean, and civil status remained in the final model of regression. Intrusion symptoms were more frequent in NAC group (M = 1.63 versus M = 1.11, p = 0.02). Antenatal class attendance, forceps, emergency caesarean, and hospitalisation in NICU remained significant predictors of intrusions for PTSD-FC. Use of epidural, obstetrical, and neonatal outcomes were similar for AC and NAC.

The Effect of Childbirth Education and Birth Plan on Childbirth Self-Efficacy: A Randomized Controlled Trial

Aim: The aim of this study is to investigate the effect of birth education given to pregnant women and the birth plan applied together with the education on birth self-efficacy. Methods: The study was conducted as a randomised controlled trial at seven Family Health Centers in Turkey. The pregnant women in the sample were divided into three groups. Group 1 received only childbirth education (Group Education-Group-ED), Group 2 received childbirth education and a birth plan (Group Education &amp;amp; Plan-Group-ED&amp;amp;P), and Group 3 was the control group, all of which included 51 pregnant women. The childbirth education was divided into two sessions of 40-50 minutes each. The Personal Information Form and the Childbirth Self-Efficacy Inventory were used to collect the data between April and September 2017. Results: When the pregnant women's intragroup self-efficacy mean scores were compared after the intervention, it was determined that the pregnant women's birth self-efficacy levels in Group ED and Group ED&amp;amp;P increased significantly (P&amp;lt;0.05), whereas there was no statistically significant increase in the pregnant women's self-efficacy levels in the control group (P&amp;gt;0.05). When the pregnant women's intergroup self-efficacy mean scores were compared after the intervention, it was discovered that Group ED's childbirth self-efficacy level was higher than that of the control group (P&amp;lt;0.05). It was also determined that the pregnant women in Group ED&amp;amp;P had similar levels of childbirth self-efficacy to those in the control and Group ED (P&amp;gt;0.05). Conclusion: The findings show that providing only childbirth education during pregnancy is the most effective method for increasing the childbirth self-efficacy of pregnant women. (Clinical trials number: NCT04525430)

Prenatal distress, access to services, and birth outcomes during the COVID-19 pandemic: Findings from a longitudinal study

Background/aimsDuring the COVID-19 pandemic, pregnant people have experienced disruptions to prenatal care, as well elevated rates of mental health problems and distress. The current longitudinal study aims to understand how different forms of prenatal distress (mental health problems, COVID-19 stressful experiences, and access to prenatal services) impact infant birth outcomes during the pandemic. MethodsParticipants were 265 pregnant individuals from Ontario, Canada. Maternal depression, pregnancy-related anxiety, COVID-related stressors (i.e., financial difficulties, social isolation), and disruptions to prenatal and health services were assessed during pregnancy. Delivery experiences and birth outcomes were assessed in the early postpartum period. Associations between pregnancy stressors and birth outcomes were assessed using path analyses. ResultsParticipants reported experiencing substantial changes to their prenatal care due to COVID-19; 23.0 % had prenatal appointments cancelled, 47.9 % had difficulty accessing prenatal classes, and 60.8 % reported changes to their birth plans. Results of path analyses showed a unique effect of pregnancy-related anxiety during the pandemic on lower birth weight, younger gestational age at birth, and more infant birth problems. Further, multi-group path analysis revealed these effects were more pronounced in male infants. ConclusionsFindings demonstrate that pregnant individuals in Ontario, Canada have experienced considerable disruptions to services during pregnancy. In addition, pregnancy-related anxiety was uniquely linked to elevated risk for adverse birth outcomes, which more heavily impacted male infants. These findings underscore the need for additional mental health support and access to services for pregnant people and their infants, to reduce long-term adverse maternal and fetal health outcomes.

The association between self-compassion in the postnatal period and difficult experiences with COVID-19 pandemic-related changes during pregnancy: An observational study for women at 1-month postnatal in Japan.

AimThis observational study aimed to describe the rate and degree of difficult experiences with COVID‐19 pandemic‐related changes (DE) during pregnancy, clarify the relationship between DE and self‐compassion of women postnatally, and investigate the influence of compassion from a partner (CP) and compassion from the woman's mother (CM) on this relationship.MethodsData from 46 1‐month postnatal women in Japan were collected through a self‐report questionnaire from October to December 2020. Self‐compassion was measured using the Japanese version of the Self‐Compassion Scale; DE, CP, and CM were measured using original questions based on prior studies.ResultsAlmost all participants (97.8%) experienced more than one DE during pregnancy. Data analyses revealed that DE in maternity hospitals (d = 0.76), DE in social support (d = 0.53), and CM (d = 0.64) were associated with self‐compassion. A two‐way analysis of variance suggested that CM moderated the relationship between self‐compassion and DE in preparation for the baby (η 2 = 0.11) and the birth plan (η 2 = 0.11), whereas CP moderated the relationship between self‐compassion and DE in social support (η 2 = 0.07).ConclusionsOur findings suggest that self‐compassion negatively correlates with DE in maternity hospitals and social support. Additionally, CM may buffer the influence of DE in preparation for the baby and the birth plan on self‐compassion; moreover, CP may buffer the influence of DE in social support on self‐compassion. This study highlights the importance of supporting perinatal women to adapt to COVID‐19‐related changes through cooperation with their families, which may increase self‐compassion.

Maternal mortality study in the Eastern Democratic Republic of the Congo

BackgroundThe reduction of maternal mortality in developing countries such as the Democratic Republic of Congo (DRC) still raises many questions. Indeed, this large country in the heart of Africa ranks 4th among the eight countries that alone account for more than 50% of maternal deaths in the world, behind India, Nigeria and Pakistan. However, there is no up-to-date data on maternal mortality in eastern DRC. This study measures the mortality rate rate in health facilities in eastern DRC and identifies the associated risk factors.MethodsThis analytical epidemiological study was based on retrospective data materna deaths recorded in 59 health facilities, in three health zones in the southern part of Maniema province in east DRC. The study was conducted from July 1, 2015 to June 30, 2020. Descriptive, bi and multivariate analyses were used.ResultsThe maternal mortality rate was estimated at 620 deaths per 100,000 live births, of which 46% of maternal deaths were related to a parturients’ delayed decision in seeking healthcare in time (first delay). Maternal deaths were significantly associated with extreme ages (≤ 19 years and ≥ 40 years: p = < 0.001), patient parity (in primigravidas and in large multiparas: p = 0.001), complications such as hemorrhagic, (p = < 0.001), uterine ruptures:(p = < 0.001), infections, (p = < 0.001), and dystocia (p = < 0.001).ConclusionDespite the efforts made by the DRC and its partners in the fight against maternal mortality, women continue to lose their lives when they decide to give birth. The results imply that it is imperative to strengthen both women and health professionals’ knowledge about pregnancy and maternal health and their power to reduce instances of first delay by supporting women in formulating their birth plans.