Childbirth Preparation Research Articles

Wybrane zagadnienia położnicze: stosowanie leczenia tokolitycznego po przedwczesnym przerwaniu błon płodowych oraz znaczenie oceny długości szyjki macicy w przezpochwowym badaniu ultrasonograficznym

In our health care system, family doctor is the first physician that patients have contact with. Family medicine provides basic health care. In his daily work, family doctor independently consults both children and adults regardless of the reason of visit, if necessary, cooperating with consulting physicians working in outpatient specialist centers or referring patients for diagnosis and treatment in specialist centers (hospitals). This also applies to pregnant women. Two specific issues requiring consultation with gynecology clinics are discussed: tocolytic treatment after premature rupture of membranes and the importance of assessing cervical length in transvaginal ultrasound. When discussing obstetric problems from the family doctor’s perspective, the importance of education should be emphasized. The basis of prenatal education for pregnant women, including high-risk pregnant women, consists of an education plan developed by a midwife working in the Primary Health Care Center. The plan is an integral part of the patient’s medical record and includes both practical and theoretical preparation for childbirth, puerperium, breastfeeding and parenting (also in case of group services).

Effects of spouses’ involvement in pregnancy on fear of childbirth in nulliparous women

Background: Maternal request for caesarean section due to fear of normal vaginal delivery is one of the main reasons for the high rate of caesarean section. Objective: The aim of this study was to examine the effect of the presence of spouse in preparation class of delivery on fear of parturition in the nulliparous women. Methods: This controlled randomized trial was conducted in 152 pregnant women nulliparous referred to delivery preparation class in Qazvin. We received informed consent from participants. The samples were randomly assigned to intervention (n=76) and control groups (n=76). Eight sessions of the childbirth preparation classes were held for the intervention and control groups with or without the spouse respectively. Data collection tools were demographic characteristics and childbirth attitude questionnaire. Statistical testes such as T-test, and repeated measure were used for analysis. Findings: The mean age of the mothers participating in the study was 25.85±4.42 years. The decrease in mean of fear scores in the intervention group was significantly higher than the control group (28.58±6.47 and 32.82±5.79, respectively) (P<0.001). A significant difference was also observed between two groups in the rate of selection of normal vaginal delivery (P<0.001). Conclusion: The results of the study showed that the presence of a spouse in preparation class of delivery reduces the amount of childbirth fear and is suggested as one of the methods of implementing pregnant women's education program. Keywords: Nulliparous women, Childbirth, Pregnancy, Men's participation

Changes in emotions and personal goals in primiparous pregnant women during group intervention for fear of childbirth

The changes in emotions, subjective fear of childbirth, and personal goals were examined during a group intervention to treat fear of childbirth (FOC). The objective was to gain a more detailed understanding of the changes occurring during the group intervention of FOC. The changes in emotions, subjective FOC, and personal goals were studied in primiparous pregnant women with severe FOC participating in a group intervention (n = 105). The group intervention contained six sessions during pregnancy and one after childbirth. At every session, the participants filled in a questionnaire regarding their experiences of current positive and negative emotions and the subjective FOC. The participants also set and reported their personal goals in their preparation for childbirth and parenthood. The negative emotions decreased from the beginning of the intervention. The change became significant after the fourth session. The amount of positive emotions increased but became statistically significant only after the delivery. The subjective FOC decreased significantly from the beginning of the intervention. Personal goals shifted from being mainly self-related to being mostly related to parenthood. The group intervention decreased FOC and promoted changes in emotions and personal goals that foster emotional preparedness for childbirth. It seems that the decrease in FOC was made possible through gaining a better capacity to regulate emotions, especially negative emotions. As negative emotions and fear decreased, personal goals simultaneously changed in the direction known to be adaptive for the new life situation as a parent of a newborn.

Hubungan Dukungan Suami dan Budaya Dengan Pemilihan Tempat Persalinan

Birth assistance in health facilities is one of the most effective ways to reduce maternal mortality. The skilled birth attendants can provide prompt and appropriate services in case of complications for the mother and baby. For this purpose, midwives should disseminate appropriate information so that the mother can have birth in the health facility. The objective of this study was to determine the relationship of husband and cultural support to the choice of birth place in the working area of Berseri Pangkalan Kerinci Health Center of Palalawan District. This retrospective study used a quantitative approach with a total sample of 87 respondents selected with cluster sampling technique. Data were obtained through questionnaires. The data analysis used univariate and bivariate with chi-square statistic test. There was a relationship of a husband's support to the choice of birth place and with a p value of 0.000 and there was a relationship of culture to the choice of birth place with a p value of 0.028. Therefore, the health personnel should disseminate and improve P4K programs to optimize community participation in the preparation of childbirth, including a choice of birth place.

Prenatal care: preparation for childbirth in primary healthcare in the south of Brazil.

To evaluate the relationship between prenatal care and delivery guidelines In Primary Health Care. This is a cross-sectional study, with 358 puerperal women of a public maternity from the south of Brazil. The data collection was performed from July to October of 2013, with prenatal card data transcription and a structured interview. The data has been analyzed through the use of the Chi-square test (p≤0.05). The prenatal care had a high coverage (85,5%) and early start by 71,8% of the women, however, 52% of them did not receive orientation for the childbirth. There was a statistical association between receiving orientation for the childbirth and fewer visits (p=0.028), longer interval between the last prenatal visit and the childbirth (p=0.002), and the classification of the prenatal care as intermediate and inadequate (p=0.024). Despite of the ideal number of visits, the quality of care has been classified as intermediate or inadequate, besides that, precarious access to the orientation for the childbirth during the prenatal care has been evidenced.

Effect of normal physiologic childbirth program in mother-friendly hospitals on duration of labor

Introduction:Normal physiologic childbirth program was implemented in mother-friendly hospitals of Iran after 2008. The aim of present study is to assess the effect of normal physiologic childbirth program in a mother-friendly hospital on duration of active phase and second stage of labor.Methods:This study was a clinical trial that was conducted at the Sina and Ommolbanin mother-friendly hospitals in Ahvaz, Mashhad, Iran, in 2016. The intervention group of 77 women was offered the childbirth preparation classes during pregnancy and normal physiologic childbirth program during labor and the control group of 77 women received routine care.Results:The results showed that after controlling the confounding factors, the active phase and second stage of labor were significantly shorter in the intervention group (p<0.001).Conclusion:Complete implementation of normal physiologic childbirth program can reduce the duration of labor.

Doğuma Hazırlık Eğitimi Alan Gebelerin Doğum Şekli, İlk Emzirme Zamanı ve Ten Tene Temas Tercihleri

Doğuma Hazırlık Eğitimi Alan Gebelerin Doğum Şekli, İlk Emzirme Zamanı ve Ten Tene Temas Tercihleri

Implementation of a childbirth preparation program in the maternal and child health centres in Jordan

ObjectiveTo investigate the feasibility and outcomes of introducing childbirth preparation programs in a sample of Maternal and Child Health centres in Jordan. DesignAn exploratory, descriptive design, and practice- research engagement was used to implement and evaluate the proposed childbirth preparation program. Face to face interviews and field notes were used to collect data. Outcomes of pregnancy and birth were collected from interviews with women using a structured format. Setting and participantsThree Maternal and Child Health centres were randomly selected from the three main regions of Jordan. A convenience sample of 107 primigravid women was recruited for the implementation process. Six health staff (3 doctors and 3 midwives) also participated. FindingsThe practice- research engagement approach assisted the researchers and care providers in dealing with problems that arose during the implementation of the program. Out of the 107 women initially recruited, only 36 women completed the implementation program, with attrition rate of 65%. The main reasons for poor attendance included: difficulty in keeping contact with participants, transportation difficulties, duration of the program, health problems, antenatal follow up at a private clinic, and not having permission from husbands to attend. The effectiveness of the program was noticed through some improved pregnancy outcomes for the participants and the high satisfaction of the health professionals and women who participated.The program was effective in increasing knowledge and understanding of women regarding the different aspects of pregnancy, birth, and postnatal periods. It helped promote a trusting relationship between health professionals and women; and increased staff self confidence in providing specific and essential information to women. Women seemed to have an increased sense of control over the childbirth process, and it reinforced benefits and duration of breastfeeding and knowledge of family planning. Challenges identified by health professionals and women included: women's commitment and capacity to attend the scheduled sessions and shortage of qualified staff. Key conclusionsImplementing a childbirth preparation program in a developing country appears possible, successful, and effective if logistical and cultural requirements can be better addressed. This was evidenced with a high rate of participants’ satisfaction (women and health care providers), and suggestions of improved pregnancy outcomes. Implications for practiceIt is necessary to address some logistical issues of delivery and recognise the importance and limitations of current human resources. Policy makers in the Ministry of Health should consider implementation of a childbirth preparation program, as there are no existing programs. Clinical leaders, supported by researchers, should jointly consider reframing the program into a shorter more logistically acceptable delivery mode. This could be tested and evaluated.

PREVENTION AND TREATMENT OF HYPOGALACTIA. THE ROLE OF LACTOGENIC AGENTS

According to the literature, hypogalactia is the main reason for premature termination of breastfeeding. The prevention and treatment of hypogalactia can significantly prolong breastfeeding. The article describes the hypogalactia preventing practice by delivering the lecturing courses for pregnant women during antenatal classes and preparation for childbirth, which led to significant differences in the duration of breastfeeding: 62% of women who attended the lectures and only 37% of women who did not attend courses on their own initiative (p &lt;0.001) were breastfeeding up to 1.5 years. Thus, antenatal prevention of hypogalactia, informing pregnant women about WHO guidelines (frequent breastfeeds, skin-to-skin contact, night feeding and expression of breast milk) can significantly prolong breastfeeding. In addition, the use of lactogenic agents can be useful. The article gives an overview of modern information on the efficacy and administration of lactogenic agents, both herbal and pharmacological in different countries. Special attention is paid to herbs: fennel, anise, nettle and cumin, which form a part of Lactaphytol® herbal tea that is widely used in Russia.

Perspective of Women in the Northern Netherlands on Support During Labor (of Childbirth) and the First Hours After Childbirth

AIMSTo quantify the preferences and preparations for support during labor and the first hours after childbirth of pregnant women and the specific preference for continuous support. To investigate the association with parity and the intended place of birth.DESIGNCross-sectional survey.METHODSTwelve midwifery practices in the northern Netherlands recruited pregnant women.Measurements of the structured questionnaire were preparation for childbirth and preference for support (timing, including continuous support, provider, and type of support)RESULTSTwo hundred and five of the 247 eligible women participated. Nulliparae, significantly more often than multiparae, aimed to prepare themselves by attending prenatal classes (63% vs. 21%) and by creating a birth plan (59% vs. 40%). Women preferred to receive various types of support during childbirth from their partner (100%), midwife (95%), Maternity Care Assistant (29%), and nurse (15%). The women preferred the midwife to be present from the moment the midwife (48%) or the woman herself (22%) indicated a need for the midwife. Among the participants, 10% of the women preferred continuous support from 4 cm dilation.CONCLUSIONWe consider the best approach to continuous support to be that it should be available on request rather than either not being available or being the standard care.

The effect of pregnancy Pilates-assisted childbirth preparation training on childbirth fear and neonatal outcomes: a quasi-experimental/quantitative research

This research aims to determine the effect pregnancy Pilates-assisted childbirth preparation training for primiparous women has on the fear of childbirth and neonatal outcomes. Fear of childbirth is very common among women and has negative effects on the birth process and neonatal outcomes. The study was designed as quasi-experimental/non-randomised/quantitative and prospective. Primiparous women presenting to the antenatal clinic of a hospital between 27.2.2015 and 01.03.2016 constituted the study population (reached 149 women). The study sample included 108 women, 54 of whom were in the experimental group and 54 of whom were in the control group. The sample had agreed to participate in the study and had met the sample criteria. In collecting the data, the Wijma Delivery Expectancy/Experience Questionnaire Version A, the birth outcomes data collection form were used. The data were analyzed using means calculation, Fisher’s Exact Test, Pearson’s Chi Square Test and T Test. The study found that the experimental group had a moderate level of childbirth fear prior to the training and a low level of childbirth fear following the training (p < 0.05). The study was determined that the experimental group, as compared to the control group, was positively affected by the training, in terms of childbirth fear, mode of the birth, planned or unplanned cesarean birth, the Apgar score and body weight of the newborn, and problems in the development of the newborn, the first contact time with newborn, and the first time breastfeeding (p < 0.05). The childbirth preparation program had a positive effect on fear of childbirth and neonatal outcomes.

Оценка эффективности подготовки к родам у первородящих

The analysis of the effectiveness of preparation for childbirth in primiparas was carried out. It was found that the use of complex physiopsychoprophylactic preparation for childbirth has positive effects on the psychoemotional status of the primipara, including optimization of the levels of situational and personal anxiety. Classes in school pregnant women increase the probability of forming the optimal type of psychological component of the gestational dominant (OR = 1.58) in patients and contribute to a greater satisfaction with the quality of life (RR = 1.30).

Role of physical therapy during pregnancy for childbirth preparation

Role of physical therapy during pregnancy for childbirth preparation

Childbirth and parenting preparation in antenatal classes

Objectivesto describe topics (1) presented by midwives’ during antenatal classes and the amount of time spent on these topics and (2) raised and discussed by first-time parents and the amount of time spent on these topics. Designqualitative; data were gathered using video or tape recordings and analysed using a three-pronged content analysis approach, i.e., conventional, summative, and directed analyses. Setting and participants3 antenatal courses in 2 antenatal units in a large Swedish city; 3 midwives; and 34 course participants. Findingsclass content focused on childbirth preparation (67% of the entire antenatal course) and on parenting preparation (33%). Childbirth preparation facilitated parents’ understanding of the childbirth process, birthing milieu, the partner's role, what could go wrong during delivery, and pain relief advantages and disadvantages. Parenting preparation enabled parents to (i) plan for those first moments with the newborn; (ii) care for/physically handle the infant; (iii) manage breastfeeding; (iv) manage the period at home immediately after childbirth; and (v) maintain their relationship. During the classes, parents expressed concerns about what could happened to newborns. Parents’ questions to midwives and discussion topics among parents were evenly distributed between childbirth preparation (52%) and parenting preparation (48%). Key conclusionschildbirth preparation and pain relief consumed 67% of course time. Parents particularly reflected on child issues, relationship, sex, and anxiety. Female and male participants actively listened to the midwives, appeared receptive to complex issues, and needed more time to ask questions. Parents appreciated the classes yet needed to more information for managing various post-childbirth situations. Implications for practicewhile midwifery services vary among hospitals, regions, and countries, midwives might equalise content focus, offer classes in the second trimester, provide more time for parents to talk to each other, allow time in the course plan for parents to bring up new topics, and investigate: (i) ways in which antenatal course development and planning can improve; (ii) measures for evaluating courses; (iii) facilitator training; and (iv) parent satisfaction surveys.

Prevalence of Fear of Childbirth and Its Associated Factors in Primigravid Women: A Cross- Sectional Study

Background and Objectives: Fear of childbirth is a common concern among pregnant women, which is why many women request Cesarean section. Therefore, this study aimed at determining the prevalence of fear of childbirth and its associated factors in primigravid women in Khorramabad, Lorestan province, Iran. Methods: This cross-sectional study was conducted on 400 primigravid women (gestational age: 18 - 32 weeks), who referred to the health centers and stations of Khorramabad in 2014 for routine prenatal care. The participants were selected through multistage cluster sampling method. Childbirth attitude questionnaire (CAQ), demographic characteristics and pregnancy characteristics questionnaires, and Northouse social support questionnaire were used to collect data. The data were analyzed using chi-square test, t test, Mann-Whitney test, and multivariate logistic regression. Results: The mean score for the fear of childbirth was 37.86 (± 9.44), and the prevalence of fear of childbirth was 80.8% (CAQ ≥ 28). According to the results of multivariate logistic regression analysis, lack of sufficient income for living expenses (P = 0.020), not participating in childbirth preparation classes (P = 0.040), and preference for mode of delivery (vaginal delivery) (P < 0.001) were predictive factors for the fear of childbirth. Conclusions: According to the results of this study, most primigravid women had experienced the fear of childbirth. Therefore, it is required the health care providers pay special attention to the fear of childbirth during pregnancy and the factors associated with it.

Relação entre morbilidade psicológica, variáveis sociodemográficas e clínicas, perceção de intimidade relacional, satisfação conjugal e preocupações sentidas durante a gravidez

Objectives: to assess the relationship between sociodemographic and clinical variables, relationship intimacy, marital satisfaction, worries during pregnancy and psychological morbidity (anxiety, depression and stress). Type of study: observational, cross-sectional. Location: ACES in the northern zone of the country (Barcelos/Esposende- ACES of Cavado III). Population: women in the second and third trimester of pregnancy. Methods: the sample was collected during childbirth preparation consultations in the ACES of Cavado III and women completed the questionnaires after the childbirth preparation class. Results: Greater worries were associated with more psychological morbidity, less perception of relationship intimacy and of marital satisfaction were associated with more psychological morbidity. The perception of relationship intimacy was positively associated with marital satisfaction and negatively associated with worries during pregnancy. Conclusions: pregnancy can hold considerable risks to the mental health of the woman.

Сlinical Evaluation of the Influence of Osteopathic Prenatal Care on the Birth Process

Introduction. In recent years there has been an increase in the frequency of obstetric operations and surgical deliveries. A high percentage of obstetric complications in labor has been recorded. These complications often require surgical interventions. Traumatism of parturient women and newborns require a comprehensive approach in order to prevent this undesirable phenomena. In this case, one of the methods that can improve the state of the birth canal and of the woman’s body as a whole is osteopathic correction. Objective. To evaluate the influence of osteopathic prenatal care on the birth process. Methods. 103 pregnant women who had more than 13 weeks of pregnancy, took part in the study. They had no severe extragenital pathologies and no aggravated obstetric anamnesis. All the women were divided into two groups by randomization method. The main group ( n =53) included women who received osteopathic treatment during the preparation for childbirth. In the control group ( n =50), no osteopathic treatment was performed. The parturient women were assessed according to the way of labor, the frequency of complications and the duration of labor. Results. It has been discovered that the parturient women who received osteopathic treatment of the somatic dysfunctions presented a statistically significant decrease in the number of deliveries by cesarean section ( p <0,05), a decrease in the frequency of perineal injuries ( p <0,05) and a higher incidence of labor with a normal duration ( p <0,05) in comparison with the control group.Conclusion. Osteopathic correction of somatic dysfunctions can be recommended to pregnant women in order to prevent labor complications.

Promotion of Birth Preparedness Plan in Zambia: Impact of Male Partner Involvement on Childbirth Preparation as Strategy to Improve Maternal Health Care

Promotion of Birth Preparedness Plan in Zambia: Impact of Male Partner Involvement on Childbirth Preparation as Strategy to Improve Maternal Health Care

Impact of work place psychological hazards upon nurse midwives quality of care at delivery rooms in Maternity Hospitals in Thi-Qar Governorate

To assess nurse-midwives exposures to psychological health hazards, and to find out the impact of work place psychological health hazards on nurse midwives care quality. A descriptive study was conducted on a “purposive” sample of 80 nurses midwives at five hospitals in Thi-Qar Governorate from the period of 3rd June until 3rd July 2016. The questionnaire consisted of three parts: socio-demographical & general information, health problems (chronic diseases and psychological hazards), and childbirth preparation environment. Reliability was determined through pilot study. A descriptive and inferential statistics were used to analyze the data. The highest percentage within the age group (17–27), good educational levels, married, and have less than five years of experience in midwifery, morning period practice time, and having hypertension. Results indicate that psychological hazards are assigned low assessment, and all main domains regarding childbirth preparation environment had a moderate and high assessment status, since two items had a high assessment 2(25%), while leftover reported moderate assessment 6(75%). Weak relationships with no significant differences at P > 0.05 between psychological health hazard, and socio-demographic characteristics, except with work practice time, highly significant at P 0.05 between childbirth preparation environment and socio-demographic characteristics, except with age groups, marital status and work practice time. Psychological hazards faced at work place upon nurse midwives reported weak impact on their quality of care. The study concludes that “Childbirth Preparation Environment” of nurses staff midwives are reported moderate quality of care.

Causes and frequency of tocophobia - own experiences.

The phenomenon of tocophobia (pathological fear of labor) has not been fully explored. Currently, there are no diagnostic criteria that would enable its detection or make it recognizable as a disease entity. The aim of study was to determine the degree of anxiety/tocophobia as well as to learn about and analyze the causes of this phenomenon in Polish pregnant women. The prospective study included 120 pregnant women in the third trimester of gestation from February to May 2016. The study was performed with the use of a standardized and revised version of the Labor Anxi-ety Questionnaire (KLP II) designed by Putyński and Paciorek (1997) as well as a proprietary interview questionnaire and structured data documentation form. In 6.7% of the subjects, the level of labor anxiety was very high (> 18 in KLP II). It was the highest in women over 30 years of age (Pearson's chi squared test = 0.00422; p < 0.05). It has been shown that successive childbirths have an im-pact on the degree of anxiety (p = 0.04217).The highest level of anxiety was noted in primiparous women. In 85% of the subjects, anxiety was caused by fear of labor pain. 56.7% of the tested women did not use any professional help in the preparation for childbirth and motherhood. Primiparas and women over 30 years of age experience very high levels of fear significantly more frequently. The lack of proper preparation for childbirth determines the occurrence of tocophobia. Ante-natal classes and prenatal education based on standards of obstetric care should be promoted in order to reduce or eliminate fear of natural labor.