Prenatal Women Research Articles

Effect of Hourly Rounds Implementation on Women’s Perceptions of Nursing Care

ObjectiveTo evaluate the effect of implementing hourly rounds on a mother–baby unit (MBU) on the perception of care by women admitted to the hospital for birth or with pregnancy complications. DesignRetrospective, quantitative, before–after study. Setting/Local ProblemThe MBU of a large metropolitan hospital in the northeastern United States was the setting. With considerable resources allocated to hourly rounding implementation, there was a need to examine whether hourly rounds influenced the perception of communication with nurses by women admitted to the hospital for prenatal care and women's likelihood to recommend the hospital. ParticipantsWomen ages 18 years and older discharged from the MBU. Intervention/MeasurementsHospital Consumer Assessment of Healthcare Providers and Services (HCAHPS) survey responses collected from women at discharge, before and after hourly rounds implementation on the MBU, were compared. Aggregate data were retrieved from Press Ganey reports. ResultsNo significant change in women’s perceptions of nursing care and communication was found when comparing pre- and postintervention samples. ConclusionAlthough we found no statistically significant change in perception of care, we have identified opportunities for future research. More research is need to explore what approaches for hourly rounds implementation and sustainability are most effective. Additionally, there is a need to study whether vital aspects of care identified by pregnant women admitted to the hospital are similar or different compared with other populations.

Abstract # 3197 Stressful life events and inflammatory gene expression in the third trimester of pregnancy

Objectives. To test whether preconception and prenatal stress predicts inflammatory gene expression in a manner consistent with risk for inflammation-linked pregnancy complications, particularly preterm birth. Methods. Stressful life events that occurred over the previous year were assessed at 6 months preconception and during the third trimester of pregnancy in 116 women recruited from 5 US sites by the Community Child and Health Network. Third trimester dried blood spots were assayed for genome-wide transcriptional profiles using RNAseq. Bioinformatics analyses assessed activity of pro-inflammatory transcription factors adjusting for age, race/ethnicity, pre-pregnancy BMI and prenatal infection. Results. Women who had more than two prenatal stressful life events (high stress) had higher expression of a 19-gene pro-inflammatory composite score, b=.204 log2 mRNA ± SE.058, corresponding to 15% elevation, p=.003, compared to women with two or fewer (low stress). Bioinformatic analyses of 387 gene transcripts showing >1.5-fold difference in expression between high vs. low prenatal stress women implicated increased activity of pro-inflammatory transcription factors, NF-kB (2.28-fold ± .15-fold, p .073. Conclusions. Prenatal stress was associated with up-regulated inflammatory gene expression in the third trimester of pregnancy, but preconception stress was not. Such effects may represent one pathway by which stress might contribute to increased risk for inflammation-linked, adverse pregnancy outcomes, such as preterm birth.

Difference in forearm and upper arm blood pressure measurements in prenatal women

Background: In health-care services, when bare upper arm blood pressure (BP) measurement is impractical, the forearm may be used as a surrogate for traditional upper arm BP. Objective: This exploratory study aimed to determine the significant difference and correlation between the upper versus forearm BP measurements among low-risk prenatal women. SMaterials and Methods: A total of 156 low-risk prenatal women in the third trimester of pregnancy attending antenatal clinics at Municipal Maternity Corporation Hospitals, Bengaluru, were recruited by purposive sampling. Upper and forearm noninvasive BP (NIBP) measurements obtained by mercury sphygmomanometer, thrice at an interval of 15 min were averaged. The main outcome measures were the significant difference and correlation between the upper arm and forearm BP measurements. Results: The mean systolic BP (SBP) (117.14 ± 3.041 mmHg) and diastolic BP (DBP) (69.31 ± 8.461 mmHg) in the forearm was significantly higher than the upper arm SBP (111.72 ± 5.53; P = 0.002) and DBP (61.46 ± 6.014 mmHg; P = 0.016). The mean difference in SBP between upper and forearm was 5.42 ± 2.016 mmHg and in DBP 7.85 ± 3.204 mmHg. Upper versus forearm BP measurements had revealed a significant positive linear correlation in SBP (r = 0.849; P = 0.013) and DBP (r = 0.816; P = 0.021) by Pearson product-moment correlation coefficient. Clinically 94 (72.31%) had a significant BP measurements difference in forearm versus upper arm by approximately 6–10 mmHg. None of the maternal characteristics were independent predictors for the mean difference in SBP and DBP measurement. Conclusion: Forearm NIBP measurements are higher than the BP obtained at the upper arm location. This must be taken into consideration whenever the forearm is used as an alternative site for the upper arm BP.

Enhancing Accessibility of Physical Activity During Pregnancy: A Pilot Study on Women's Experiences With Integrating Yoga Into Group Prenatal Care.

Introduction:Health guidelines suggest that pregnant women should participate in daily physical activity, yet rarely do they meet these guidelines. Means to enhance accessibility of physical activity for pregnant women are required, and yoga has been suggested as a possible method to enhance women’s sense of confidence and competence with physical activity. In this pilot study, our primary aim is to evaluate pregnant women’s perceptions about their lived experience of an intervention which integrates a low-intensity form of physical activity, yoga, into prenatal care; our secondary aim is to evaluate changes in participants’ self-efficacy for physical activity and time spent in physical activity over time.Methods:Held in an outpatient obstetrics department of an urban hospital system in the United States, this pilot study enrolled 16 pregnant women to participate in the intervention throughout their pregnancy. We explored participants’ lived experience of the intervention using qualitative methods (phenomenology). Means, variances, and covariances were calculated for the 2 measures (self-efficacy and time spent in physical activity) over the intervention period.Results:Qualitative findings from focus groups suggest that it is acceptable for prenatal yoga to be integrated into group prenatal care classes and women reported increased confidence with physical activity during pregnancy. Participants did not consider the intervention to fit within the traditional definition of exercise. Women reported increased amounts of time spent in physical activity from baseline to the end of pregnancy, but there were no statistically significant changes in self-efficacy over time.Discussion:The integration of gentle physical activity into the group prenatal care model warrants further attention for potential benefits with regard to maternal physical and mental wellness.

Sexual health and its related factors among Iranian pregnant women: A review study

Introduction: Sexual health is an important dimension of health. Pregnancy is a critical stage in women’s lives and can affect couples’ sexual health and matrimonial life due to physiological, anatomical and psychological changes in pregnancy. This review was conducted on Iranian studies to assess sexual health dimensions and influencing factors in Iranian pregnant women. Methods: This narrative review was carried out by performing a search in Iranian scientific articles published between 2000 and 2018, which considered the dimensions of sexual. Electronic databases including Magiran, Scientific information database (SID), web of science, PubMed, Scopus, and google scholar search engine were searched using the following keywords; sexual health, awareness, belief, attitude, sexual activity, sexual violence, prenatal, pregnancy, and pregnant women. Full text cross-sectional or cohort articles in Persian or English that were related to the field of sexual health of Iranian pregnant women were included in the review. Results: Among the initially identified 1383 articles, 63 met the inclusion criteria. Sexual health of pregnant women was examined and categorized into awareness, attitude, belief-activity, performance-satisfaction, quality of sexual life-sexual violence domains. Majority of studies assessed sexual violence (33 studies), followed by sexual function (24 studies), sexual satisfaction and quality of life (4 studies), and knowledge and attitudes about sexuality in pregnancy (4 studies). Main Conclusion: The review of published studies revealed that the level of awareness and attitude of Iranian pregnant women about sexual activity was low, while the level of sexual dysfunction and sexual violence in pregnancy was high. Therefore, the quality of purposeful care and counseling that have been provided hitherto in order to maintain and improve sexual health during pregnancy and even before pregnancy, should be improved. Further longitudinal and meta-analytic studies on the dimensions of sexual health, including sexual activity and sexual satisfaction are recommended.

Level and determinants of birth preparedness and complication readiness among pregnant women: A cross sectional study in a rural area in Bangladesh.

BackgroundIncreasing the level of birth preparedness and complication readiness (BP/CR) is one of the key interventions to promote optimal utilization of skilled maternal health services. It is therefore essential to determine the women’s ability to recognize the danger signs and the level of BP/CR. This information can be used to design more effective health interventions.ObjectivesThis study was conducted to determine the knowledge in recognition of maternal complications, and the level and factors associated with BP/CR in rural Matlab, Bangladesh.MethodsA community-based cross-sectional survey was conducted from June- October 2015 on a randomly selected 2262 women who delivered live or stillbirth during the year 2014. A pretested and structured questionnaire was used for data collection. Descriptive and analytical statistical methods were used.ResultsThe proportion of study participants with “good knowledge”, measured by the ability to recognise three or more danger signs, in pregnancy and delivery were 26% and 23%, respectively. Out of four BP/CR components, about 15% women saved money, 12% women identified facility for delivery, 9.6% women planned to deliver by skilled birth attendant and 5.3% of women arranged transport. About 12% of women were “well prepared”, measured by planning of at least two components, for skilled childbirth and emergency obstetric complications. In the multivariable logistic regression analysis, asset index, antenatal care (ANC) visits and knowledge of danger signs during pregnancy and delivery were associated with BP/CR. The adjusted odds ratio (OR) of “well prepared” was 4.09 (95% confidence interval [CI]: 2.45–6.82) among women with an asset index of five (richest), compared with women in the asset index of one (poorest). The odds of “well prepared” was six times (OR 5.98, 95% CI: 3.85–9.28) higher for women with four or more ANC visits, compared to women with none or one ANC visit. In comparison to women with “poor knowledge” on maternal danger signs during pregnancy and delivery, the odds ratio of “well prepared” among women with good knowledge during pregnancy and in delivery were 1.95 (95% CI: 1.44–2.63) and 1.74 (95% CI: 1.28–2.36), respectively.ConclusionThe study revealed a low level of maternal knowledge of danger signs and BP/CR among pregnant women. Further, low socioeconomic status, fewer ANC visits and poor knowledge in recognition of dangers signs on maternal health were associated with low BP/CR. More emphasis should be placed on the quality of information offered to the pregnant women during the prenatal contact and women from low socio-economic gradient should be prioritized to optimize the impact of future BP/CR interventions.

Evaluation of radiation protection principles and 10-day rule observance for women prone to pregnancy at imaging centers of S emnan University of medical sciences

Introduction: Today, the spread of the use of ionizing radiation and its vital role in the diagnosis and treatment of diseases has been identified. Therefore, protecting pregnant women from ionizing radiation is essential and is considered as the standard criterion for Medical Radiation center. The aim of this study was to investigate the observance of protective principles and The law of 10 days in imaging of susceptible women in Semnan University of Medical Sciences imaging centers has examined the risk of fetal radiation and the transmission of genetic damage to future generation. Materials and Methods: Firstly, by interviews with patients who were under radiography, they were asked about the knowledge of the Radiographers and the doctor related about the 10-day rule. Then a questionnaire was given to the Radiographers. Finally, the existence or absence of written protection guidelines was determined by direct observation. Data were analyzed by SPSS software and data were analyzed using descriptive statistics. Results: Based on the findings of the first part the study of patients about pregnancy is not done in about 21% of cases. The mean score for the knowledge of hospital personnel was 14.47. On the other hand, there was no observance of the instructions regarding pregnant women and the law for 10 days in Amiralmomenin and Velayat and Imam Hossein hospitals. Conclusion: Since genetic damage not thresholds dose and it is possible even at low doses, so attention to radiation in pregnant and prenatal women can lead to the risk of fetal radiation and the transmission of genetic damage to future generations to Too much to overcome. Therefore, the necessity of using the latest radiation protection methods is mandatory.

Transformation of quality of life in prenatal women with nausea and vomiting

ProblemNausea and vomiting not only cause physical discomfort in pregnant women but also impact their quality of life. BackgroundFew longitudinal studies have been conducted to investigate QOL of women over the course of pregnancy. AimTo examine the transformation of health-related QOL and related factors among pregnant women with NV during three trimesters. MethodsA longitudinal research design with convenience sampling was used. A structural questionnaire was used to repeatedly measure the data of 101 pregnant women with NV during the first, second, and third trimesters. A generalized estimating equation (GEE) was used to analyze the collecting data. FindingsThe results showed significant differences in symptom distress, prenatal stress, and health-related QOL among the three trimesters in pregnant women with NV (p<0.001). The scores of symptom distress, prenatal stress, and health-related QOL in the first trimester were significantly higher than those in the second and third trimesters (p<0.001). The GEE indicated that the trimester of pregnancy, severity of NV, symptom distress, and prenatal stress were key factors for the transformation of health-related QOL of women with NV during pregnancy. DiscussionThe findings of this study are seminal in terms of understanding the relationships between symptom distress, prenatal stress and health-related QOL in pregnant women with NV over the course of a pregnancy. ConclusionThis study can serve as a reference for designing interventions (i.e., professional support) for women in different pregnancy stages to improve their health-related QOL during pregnancy.

The Prenatal Rating of Efficacy in Preparation to Breastfeed Scale: A New Measurement Instrument for Prenatal Breastfeeding Self-efficacy.

Breastfeeding self-efficacy and breastfeeding intention are two modifiable factors that influence rates of breastfeeding initiation. (1) To develop a scale to measure prenatal breastfeeding self-efficacy, and (2) test its psychometric properties by determining the internal consistency and reliability, and (3) assess the relationships between prenatal breastfeeding self-efficacy and breastfeeding intention. Cross-sectional prospective one-group survey design was used. A convenience sample of pregnant patients attending an obstetrics and gynecology clinic ( N=124) completed a survey at the recruitment site that assessed demographics, breastfeeding intention, and breastfeeding self-efficacy theory constructs. Retest surveys ( n=14) were taken home and returned to the researcher by mail after completion. Cronbach's alpha for the 39-item scale was .98 (test) and .97 (retest) with an item-to-total correlation range of .54 to .78. A four-factor solution for the scale was retained. Test-retest indicated each factor was significant and highly correlated: Individual Processes (.88, p < .001), Interpersonal Processes (.893, p < .001), Professional Advice (.919, p < .001), and Social Support (.880, p < .001). Overall prenatal breastfeeding self-efficacy score was highly correlated (.610, p <.001) with breastfeeding intention scores. The Prenatal Rating of Efficacy in Preparation to Breastfeed Scale is a valid and reliable measure of a prenatal women's self-efficacy in preparation to breastfeed. Measuring the level of self-efficacy could alert prenatal women and health professionals to individual skill sets.

PIH22 - Prenatal Healthcare Expenditure and Health Services in India: an Analysis of Nsso Data

In India, around 77,000 women die from preventable pregnancy related health problems annually. Access to prenatal care (PNC) is necessary to prevent these deaths. Higher expenditure for PNC poses a critical barrier in receiving quality PNC. India aims to achieve 100% coverage for prenatal care for the entire woman in the country. It is vital to study the health system delivery factors that lead to higher health expenditures for PNC. Social consumption and health data from the National Sample Survey Organization (NSSO) Round 71 from the Ministry of Statistics and Implementation of the Government of India was used. A General Linear Model was used to study the effects of various determinants on expenditure for prenatal care in India using STATA version 14.1. A sample of 19,483 prenatal women was studied. Average expenditure for PNC in India is INR 3368.72. Majority (n=18,629) of women received Tetanus Toxoid vaccination and Iron and Folic Acid during pregnancy. Most women received PNC from public hospitals (24.47%), followed by private hospitals (23.13%), health worker (20.64%), private doctor (14.77%), and Primary Health Centers-PHC (9.73%). About 3.2% women followed traditional medicine, while 89.21% followed allopathic medicine, and 7.59% followed both traditional and allopathic medicine. Compared with women who used sub-centers, women using private hospitals spent the most INR 4782.56 (CI: 4459.21-5105.91), followed by women receiving PNC in private clinics INR3426.36 (CI: 3061.51-3791.21), and women utilizing public hospitals INR 547.83 (CI; 227.53-868.14). To reduce health expenditures, India needs to improve the availability and accessibility of quality public health services at grass roots level. Government of India provides free PNC at PHC, however utilization of PHCs is low, due to poor quality. Insurance coverage for women in private care settings coupled with improved PNC at the sub-center level represent feasible options for health systems improvements.

Psychotherapeutic Treatments for Depression During Pregnancy.

Depression during pregnancy is a significant public health problem that is associated with adverse consequences for women and children. Despite the availability of treatment options, depression during pregnancy is often undertreated. Most pregnant women prefer nonpharmacological interventions over antidepressant medications. We review the evidence base for psychotherapeutic treatment approaches to depression during pregnancy. Treatments reviewed include interpersonal therapy, cognitive-behavioral therapy, behavioral activation, and mindfulness-based cognitive therapy. We review both traditional face-to-face delivery and digital interventions. We conclude with recommendations for treatment preferences, collaborative decision-making, and strategies to improve uptake of such services among prenatal women.

The relationship of dietary diversity score with depression and anxiety among prenatal and post-partum women.

The objective of the study is to explore the relationship between the dietary diversity score (DDS) and anxiety and depression of perinatal women. The Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS) and the dietary recall questionnaire were used to measure the status of depression, anxiety and dietary diversity at T1 (first trimester), T2 (second trimester), T3 (third trimester) and T4 (post-partum). The association of dietary diversity and food groups with depression and anxiety status were estimated by linear and logistic regression models. The prevalence of depression and anxiety status were the highest at T1, which were 35.58% and 22.57%, respectively. Cross-sectional and longitudinal association of DDS with SDS and SAS was estimated by ordinary or multilevel linear or logistic model. In the cross-sectional analysis, high dietary status (>6) was negatively associated with depression status [T1: OR (95% CI) = 0.56 (0.46, 0.69); T2: 0.55 (0.36, 0.84); T3: 0.45 (0.31, 0.65); T4: 0.58 (0.34, 0.99)] and anxiety status [T1: OR (95% CI) = 0.70 (0.56, 0.88); T2: 0.42 (0.27, 0.65)]. In the longitudinal analysis, it was demonstrated that the DDS level was negatively associated with SDS [β(se) = -0.99 (0.09), P = <0.0001] and SAS scores [β(se) = -0.37 (0.08), P = <0.0001] throughout pregnancy. There was a negative relationship between some food groups and SDS or SAS scores at different periods. A negative relationship between DDS and depression as well as anxiety was found among prenatal and post-partum women.

Culture, bathing and hydrotherapy in labor: An exploratory descriptive pilot study

ObjectiveThough bathing (hydrotherapy) is widely used during labor to decrease anxiety and pain and to promote relaxation, the influence of cultural beliefs about bathing by parturients is virtually unknown. This pilot study explored pregnant women's experiences of bathing, bathing in labor, and cultural beliefs about bathing. DesignAn exploratory, descriptive design. SettingLow risk obstetrical clinics. ParticipantsHealthy Hispanic, Black, White, American-Indian and Asian women (N = 41) at >37 weeks gestation. MethodsDuring a routine prenatal visit women responded to a brief openended questionnaire on the use of bathing. Data was captured using a modified ethnographic method involving observation and note taking with thematic analysis and quantification of percent response rates. FindingsForty-six percent (N = 41) of women used bathing for purposes other than hygiene but only 4.9% (N = 41) of these women bathed during a previous labor. The women described bathing as relaxing, easing, calming, and efficacious for relief of menstrual cramps and labor contractions. Ten percent of women reported cultural beliefs about bathing. ConclusionsWomen who bathe, report relief of anxiety, menstrual and labor pain and promotion of mental and physical relaxation. The findings do not support the view that bathing is associated with identifiable cultural beliefs; rather, they suggest that bathing is a self-care measure used by women. This practice is likely transmitted from generation to generation by female elders through the oral tradition. Assumptions that race or ethnicity precludes the use of bathing may be faulty. Cautionary instructions should be given to pregnant women who are <37 completed weeks of gestation, to avoid bathing for relief of cramping or contractions and to seek immediate health care evaluation. Study of culturally intact groups may uncover additional themes related to bathing in labor and as a self-care measure for dysmenorrhea.

Determining Clinically Relevant Cutoff Scores for the Iowa Infant Feeding Attitude Scales Among Prenatal Women in Canada.

The original 17-item Iowa Infant Feeding Attitude Scale (IIFAS) has been validated and widely used to assess attitudes toward breastfeeding. A reduced 13-item version of the IIFAS was recently validated in a Canadian setting. However, cutoff scores for categorization of infant feeding attitudes on both scales have not yet been established. Research Aim: The aim of this study was to determine optimal cut-ff scores predicting infant feeding attitudes and outcomes for the original and reduced IIFASs. A population-based prospective cohort study was undertaken in the Canadian province of Newfoundland and Labrador. A sample of 658 pregnant women were followed up to 1 month postpartum. The receiver operating curve and Youden index were assessed to identify the sensitivity and specificity of cutoff scores. The magnitude at which these scores predicted postpartum feeding outcomes was evaluated using linear regression. Scores of ≤60 (sensitivity = 0.81, specificity = 0.87) and ≤45 (sensitivity = 0.84, specificity = 0.83) for the 17-item and 13-item IIFASs, respectively, were found to be optimal cutoff scores for predicting negative breastfeeding attitudes. The cutoff score for the reduced IIFAS version maintained its ability to predict women who formula-fed at 1 month postpartum (adjusted odds ratio = 6.32, 95% confidence interval = 1.84-11.61) compared with the original scale (adjusted odds ratio = 4.62, 95% confidence interval = 2.42-16.52). The proposed cutoff scores for the original and reduced IIFASs have excellent predictive ability to determine infant feeding attitudes and outcomes. The classification of scores enhances the use and applicability of the IIFAS.

Prevalence of prenatal and postpartum depression and associated factors among HIV-infected women in public primary care in rural South Africa: a longitudinal study

ABSTRACTThis study aimed to assess the longitudinal prevalence of prenatal and postnatal depression and associated factors among HIV-infected women in rural South Africa. In a longitudinal, cluster-randomized, prevention of mother to child transmission (PMTCT) intervention trial, 681 HIV-infected prenatal women in 12 community health centres in Mpumalanga province, South Africa, were recruited in 2015 by consecutive sampling at 8–24 weeks pregnancy and followed up at 32 weeks prenatally, and 6 and 12 months postpartum (retention rate = 59.2%). Results indicate that at baseline, 48.7% of the women screened positive for depression (scores of ≥13 on the “Edinburgh Postnatal Depression Scale 10”), while postnatally (at 12 months) the prevalence was 35.6%. Mothers who did not have depression before or after were 205 (50.1%), those who had depression before and after were 58 (14.4%), those who had depression only before were 81 (20.1%), and those who had depression only after were 59 (14.6%). In multinominal logistic regression analyses, less education and physical and psychological intimate partner violence were associated with sustained perinatal depression. Participation in the PMTCT intervention was associated with remitting depression while alcohol use was associated with the onset of postnatal depression. Using generalized linear mixed models in longitudinal analyses, psychological partner violence, lack of male involvement during pregnancy and non-adherence to antiretroviral treatment were associated with depression. In conclusion, a high pre- and postnatal prevalence of depression was found highlighting the utility of interventions to address prevention and treatment of perinatal depression.

Prenatal smoking and postpartum depression: a meta-analysis

Objectives: Postpartum depression (PPD) is a common emotional distress among many women in diversified cultures. The aim of this study was to examine the relationship between prenatal smoking and PPD.Methods: We systematically searched PubMed, ISI Web of Science, EMBASE, Elsevier ScienceDirect, OVID and Springer databases up to 15 March 2017. The pooled odds ratio (OR) of PPD was compared between prenatal smoking women and the ones who did not smoke during pregnancy. The fixed effect model or random effect models were chosen according to heterogeneity between studies.Results: A total of 13 studies with 1,476,922 women were included in the meta-analysis. The average incidence of PPD was 3.0% (1717/57,997) in women with smoke exposure and 1.3% (6571/488,225) in women without smoke exposure. The pooled OR was 2.325 (95% CI 1.925–2.808; Z = 8.76, p < .0001) by random-effect model. The funnel plot was symmetrical, and either the Begg’s test (Z = 0.92, p=.360) or the Egger’s test (t = 0.04, p = .9700) suggested no publication bias among included studies. Sensitivity analysis indicated that the result was robust.Conclusion: Our meta-analysis indicated that prenatal smoking was associated with postpartum depression.

Fertility intentions of prenatal and postpartum HIV-positive women in primary care in Mpumalanga province, South Africa: a longitudinal study

IntroductionThis study aimed to assess fertility intentions (planning to have more children in the future) and associated factors among pregnant and postpartum HIV positive women in rural South Africa.MethodsIn a longitudinal study, as part of a prevention of mother to child transmission (PMTCT) intervention trial, 699 HIV positive prenatal women, were systematically recruited and followed up at 6 months and 12 months postpartum (retention rate = 59.5%).ResultsAt baseline, 32.9% of the women indicated fertility intentions and at 12 months postnatal, 120 (28.0%) reported fertility intentions. In longitudinal analyses, which included time-invariant baseline characteristics predicting fertility intention over time, not having children, having a partner with unknown/HIV-negative status, and having disclosed their HIV status to their partner, were associated with fertility intentions. In a model with time-varying covariates, decreased family planning knowledge, talking to a provider about a future pregnancy, and increased male involvement were associated with fertility intentions.ConclusionResults support ongoing perinatal family planning and PMTCT education.

Effect of garment on the arm under the auscultatory manometer cuff among primigravidae

Context: Although Perinatal guidelines recommend blood pressure (BP) should be measured on bare arms among pregnant women, BP is measured over garments in primary health care settings among prenatal women. Aim: To identify the discrepancies in BP measurements with garments under the manometer cuff versus bare arm among normotensive primigravidae. Setting and Design: An exploratory study was conducted among n = 95 normal low risk normotensive primigravidae at mid trimester attending antenatal clinic at rural PHC. Materials and Methods: With the auscultatory sphygmomanometer, BP were measured thrice with garments versus bare arms to rule out differences. Results were compared with Paired t-test and SPSS version 20 was used for analysis. Results: There were insignificant differences in mean systolic BP and diastolic BP between the garments covered versus bare arm. The mean garments thickness was less than 5 mm and it was not a significant predictor for mean differences of BP in garments vs bare on arm. Conclusions: Measuring blood pressure on arms with garments violates long-established perinatal guidelines and the decision to measure accurate BP with sleeves on among pregnant women depends on the discretion of the clients and the professionals.

Impact of Group Prenatal Care Support on Breastfeeding Initiation Rates and Other Maternal and Perinatal Outcomes

Group prenatal care support has been studied in order to increase maternal and neonatal benefits, such as breastfeeding initiation rates, in front of standard care. In our area, especially in some high risk sub-groups, it could be an important intervention to improve individual care. The aim of the pilot initiative is to compare the effect of group prenatal care support versus only standard individual care on breastfeeding initiation rates and other perinatal outcomes. A retrospective cohort study was made analyzing all deliveries at Hospital del Mar in Barcelona during 1 year. All pregnant women were compared depending on whether they had received the group prenatal care support by midwifes or only standard care. 1383 women gave birth at Hospital del Mar in Barcelona in 2015. 207 received group prenatal care support (15% of total). In group prenatal care there significantly were more nulliparous and native women. Breastfeeding initiation rate was higher in group prenatal care women (94.2% vs. 86.7%, p=0.01). Other outcomes like cesarean section rates, prematurity and low birth weight rates also improved in group prenatal care support in front of standard care. Our study suggests that group prenatal care support improves breastfeeding initiation rates and some other maternal and perinatal outcomes.

Amazing Things Happen When Student Nurses Are Given Birth Doula Training.

At the Duke University School of Nursing, accelerated BSN students participate in a free Doulas of North America birth doula training to learn support of prenatal, intrapartum, and postpartum women and their families. They learn to participate as team members providing continuous physical and emotional support to women in the perinatal period and to appreciate how hormones support physiologic labor and birth. This training complements classroom information and clinical experiences.