WorldWideScience

Sample records for prepared childbirth classes

  1. Introducing Emergency Preparedness in Childbirth Education Classes

    OpenAIRE

    DeWald, Lauren; Fountain, Lily

    2006-01-01

    In the wake of recent natural and man-made disasters and emergency situations, pregnant women are especially vulnerable. The authors of this column encourage childbirth educators to include disaster preparedness instruction and emergency childbirth techniques in their class content.

  2. An Investigation into Breastfeeding Characteristics of Mothers Attending Childbirth Education Classes

    Directory of Open Access Journals (Sweden)

    Samiye Mete, PhD

    2010-12-01

    Conclusions: On the basis of the study results it could be argued that attending childbirth preparation class with the husband has a positive effect over breastfeeding. Childbirth education classes will greatly contribute to the health of the society by affecting breastfeeding positively.

  3. Paternal engagement during childbirth depending on the manner of their preparation.

    Science.gov (United States)

    Sioma-Markowska, Urszula; Poręba, Ryszard; Machura, Mariola; Skrzypulec-Plinta, Violetta

    2016-01-01

    The analysis of the forms of paternal activity depending on the manner of their preparation, including stages of labor. A prospective survey-based study involved 250 fathers who participated in their child's birth. The fathers included in the study were present during all stages of family-assisted natural labor. The study was conducted one day after childbirth with the use of a survey prepared by the authors. Statistical calculations were conducted using the Statistica PL software. The frequency of individual qualitative features (non-measurable) was assessed by means of a non-parametric χ² (chi-squared) test. The statistical significance level was p fathers included in the study (52.4%) participated in childbirth with no prior preparation. The dominant form of preparation involved self-education from books, magazines and the Internet (24%). 23.6% of fathers participated in ante-natal classes. The study demonstrated that fathers prepared for childbirth in ante-natal classes more often engaged in the supportive role, provided nursing care and carried out instrumental monitoring during each stage of childbirth. The fathers prepared for childbirth in ante-natal classes more often engage in the supportive role, provide nursing care and carry out instrumental control during each stage of childbirth. Ante-natal classes should be promoted as an optimal form of preparation for active participation in childbirth. Moreover, other forms of paternal ante-natal education as well as continued education in a delivery room should be developed.

  4. The effect of exercise and childbirth classes on fear of childbirth and locus of labor pain control.

    Science.gov (United States)

    Guszkowska, Monika

    2014-01-01

    This study sought to track changes in intensity of fear of childbirth and locus of labor pain control in women attending an exercise program for pregnant women or traditional childbirth classes and to identify the predictors of these changes. The study was longitudinal/non-experimental in nature and run on 109 healthy primigravidae aged from 22 to 37, including 62 women participating in an exercise program for pregnant women and 47 women attending traditional childbirth classes. The following assessment tools were used: two scales developed by the present authors - the Fear of Childbirth Scale and the Control of Birth Pain Scale, three standardized psychological inventories for the big five personality traits (NEO Five Factors Inventory), trait anxiety (State-Trait Anxiety Inventory) and dispositional optimism (Life Oriented Test-Revised) and a questionnaire concerning socioeconomic status, health status, activities during pregnancy, relations with partners and expectations about childbirth. Fear of childbirth significantly decreased in women participating in the exercise program for pregnant women but not in women attending traditional childbirth classes. Several significant predictors of post-intervention fear of childbirth emerged: dispositional optimism and self-rated health (negative) and strength of the belief that childbirth pain depends on chance (positive).

  5. The childbirth and breastfeeding experiences of primigravidas who attended childbirth education classes

    Directory of Open Access Journals (Sweden)

    Irmin B Segeel

    2006-11-01

    Full Text Available Knowledge brings with it power, confidence and courage. It is important to prepare for childbirth not only physically, but also emotionally and psychologically. Opsomming Kennis gaan gepaard met mag, selfvertroue en dapperheid. Dit is dus belangrik om nie net fisiek nie, maar ook emosioneel en sielkundig op die bevalling voor te berei. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

  6. Using The Official Lamaze Guide in Childbirth Education Classes

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    Hotelling, Barbara A.

    2006-01-01

    Normal birth has long been promoted by Lamaze International in its mission and vision statements and by the Lamaze Institute for Normal Birth. The Official Lamaze Guide: Giving Birth with Confidence, a book by Judith Lothian and Charlotte DeVries, can be used by birth educators to alter the focus from learning what to expect when one fears the worst to empowering women to understand that birth is usually a healthy, normal process. In this column, the author suggests ways in which childbirth educators can use The Official Lamaze Guide in their classes. PMID:17541460

  7. Plot and irony in childbirth narratives of middle-class Brazilian women.

    Science.gov (United States)

    O'Dougherty, Maureen

    2013-03-01

    Brazil's rate of cesarean deliveries is among the highest in the world and constitutes the majority of childbirths in private hospitals. This study examines ways middle-class Brazilian women are exercising agency in this context. It draws from sociolinguistics to examine narrative structure and dramatic properties of 120 childbirth narratives of 68 low- to high-income women. Surgical delivery constituted 62% of the total. I focus on 20 young middle-class women, of whom 17 had C-sections. Doctors determined mode of childbirth pre-emptively or appeared to accommodate women's wishes, while framing the scenario as necessitating surgical delivery. The women strove to imbue C-section deliveries with value and meaning through staging, filming, familial presence, attempting induced labor, or humanized childbirth. Their stories indicate that class privilege does not lead to choice over childbirth mode. The women nonetheless struggle over the significance of their agency in childbirth. © 2013 by the American Anthropological Association.

  8. Preparation for pain management during childbirth: the psychological aspects of coping strategy development in antenatal education.

    Science.gov (United States)

    Escott, Diane; Slade, Pauline; Spiby, Helen

    2009-11-01

    During childbirth, in addition to or in place of analgesia, women manage pain using a range of coping strategies. Antenatal education provides an opportunity prior to birth to help women to prepare for an often painful event. However, this is usually carried out with little reference to the literature regarding psychological factors which influence the experience of pain. This review seeks to consider how recent developments in psychological knowledge could enhance care. Areas identified include range of coping strategies and factors influencing their efficacy and implementation. This draws on both the literature on management of acute pain in other scenarios and the limited literature related to childbirth related pain. The following recommendations for systematic evaluation in the context of antenatal education are made: (i) Increase the range of coping strategies currently utilized to include cognitive based strategies. (ii) Help women to identify and understand the nature of their own coping styles and preferences, including any unhelpful patterns of pain catastrophizing. (iii) Help women to develop their own unique set of coping strategies for labor. (iv) Strengthen feelings of coping self-efficacy by practice in class and reinforcement by the class teacher. (v) Develop implementation intentions which account for the changing context of childbirth and (vi) Actively develop prompting and reinforcement of use of identified coping strategies by birth partners.

  9. Benefits of preparing for childbirth with mindfulness training: a randomized controlled trial with active comparison

    OpenAIRE

    Duncan, Larissa G.; Cohn, Michael A.; Chao, Maria T.; Cook, Joseph G.; Riccobono, Jane; Bardacke, Nancy

    2017-01-01

    Background Childbirth fear is linked with lower labor pain tolerance and worse postpartum adjustment. Empirically validated childbirth preparation options are lacking for pregnant women facing this problem. Mindfulness approaches, now widely disseminated, can alleviate symptoms of both chronic and acute pain and improve psychological adjustment, suggesting potential benefit when applied to childbirth education. Methods This study?, the Prenatal Education About Reducing Labor Stress (PEARLS) s...

  10. Promoting Healthy Pregnancies Through Perinatal Groups: A Comparison of CenteringPregnancy® Group Prenatal Care and Childbirth Education Classes

    OpenAIRE

    Walker, Deborah S.; Worrell, Renee

    2008-01-01

    CenteringPregnancy® group prenatal care is growing in popularity and has commonalities with childbirth education classes. In order for leaders of childbirth education classes to best serve their clients' needs, it is important to be aware of new, emerging models of prenatal care such as CenteringPregnancy. This article provides an overview of CenteringPregnancy and similarities and differences between CenteringPregnancy and childbirth education classes. Providers of prenatal education, whethe...

  11. Benefits of preparing for childbirth with mindfulness training: a randomized controlled trial with active comparison.

    Science.gov (United States)

    Duncan, Larissa G; Cohn, Michael A; Chao, Maria T; Cook, Joseph G; Riccobono, Jane; Bardacke, Nancy

    2017-05-12

    Childbirth fear is linked with lower labor pain tolerance and worse postpartum adjustment. Empirically validated childbirth preparation options are lacking for pregnant women facing this problem. Mindfulness approaches, now widely disseminated, can alleviate symptoms of both chronic and acute pain and improve psychological adjustment, suggesting potential benefit when applied to childbirth education. This study, the Prenatal Education About Reducing Labor Stress (PEARLS) study, is a randomized controlled trial (RCT; n = 30) of a short, time-intensive, 2.5-day mindfulness-based childbirth preparation course offered as a weekend workshop, the Mind in Labor (MIL): Working with Pain in Childbirth, based on Mindfulness-Based Childbirth and Parenting (MBCP) education. First-time mothers in the late 3rd trimester of pregnancy were randomized to attend either the MIL course or a standard childbirth preparation course with no mind-body focus. Participants completed self-report assessments pre-intervention, post-intervention, and post-birth, and medical record data were collected. In a demographically diverse sample, this small RCT demonstrated mindfulness-based childbirth education improved women's childbirth-related appraisals and psychological functioning in comparison to standard childbirth education. MIL program participants showed greater childbirth self-efficacy and mindful body awareness (but no changes in dispositional mindfulness), lower post-course depression symptoms that were maintained through postpartum follow-up, and a trend toward a lower rate of opioid analgesia use in labor. They did not, however, retrospectively report lower perceived labor pain or use epidural less frequently than controls. This study suggests mindfulness training carefully tailored to address fear and pain of childbirth may lead to important maternal mental health benefits, including improvements in childbirth-related appraisals and the prevention of postpartum

  12. Antenatal education in small classes may increase childbirth self-efficacy

    DEFF Research Database (Denmark)

    Brixval, Carina S; Axelsen, Solveig F; Thygesen, Lau C

    2016-01-01

    Antenatal education in small classes may increase childbirth self-efficacy. In this randomised trial we assessed the effect of a structured antenatal programme versus auditorium-based lectures on childbirth self-efficacy measured by three single items. We found that women in the intervention group...... reported statistically significant higher levels of confidence in their ability to cope at home during labour compared to the control group. Likewise, the intervention had a positive effect on the women's confidence in own ability to handle the birth process....

  13. Effects of natural childbirth preparation versus standard antenatal education on epidural rates, experience of childbirth and parental stress in mothers and fathers: a randomised controlled multicentre trial

    Science.gov (United States)

    Bergström, M; Kieler, H; Waldenström, U

    2009-01-01

    Objective To examine the effects of antenatal education focussing on natural childbirth preparation with psychoprophylactic training versus standard antenatal education on the use of epidural analgesia, experience of childbirth and parental stress in first-time mothers and fathers. Design Randomised controlled multicentre trial. Setting Fifteen antenatal clinics in Sweden between January 2006 and May 2007. Sample A total of 1087 nulliparous women and 1064 of their partners. Methods Natural group: Antenatal education focussing on natural childbirth preparation with training in breathing and relaxation techniques (psychoprophylaxis). Standard care group: Standard antenatal education focussing on both childbirth and parenthood, without psychoprophylactic training. Both groups: Four 2-hour sessions in groups of 12 participants during third trimester of pregnancy and one follow-up after delivery. Main outcome measures Epidural analgesia during labour, experience of childbirth as measured by the Wijma Delivery Experience Questionnaire (B), and parental stress measured by the Swedish Parenthood Stress Questionnaire. Results The epidural rate was 52% in both groups. There were no statistically significant differences in the experience of childbirth or parental stress between the randomised groups, either in women or men. Seventy percent of the women in the Natural group reported having used psychoprophylaxis during labour. A minority in the Standard care group (37%) had also used this method, but subgroup analysis where these women were excluded did not change the principal findings. Conclusion Natural childbirth preparation including training in breathing and relaxation did not decrease the use of epidural analgesia during labour, nor did it improve the birth experience or affect parental stress in early parenthood in nulliparous women and men, compared with a standard form of antenatal education. PMID:19538406

  14. The influence of the systematic birth preparation program on childbirth satisfaction.

    Science.gov (United States)

    Akca, Aysu; Corbacioglu Esmer, Aytul; Ozyurek, Eser Sefik; Aydin, Arife; Korkmaz, Nazli; Gorgen, Husnu; Akbayir, Ozgur

    2017-05-01

    The primary purpose of this study was to assess the influence of a systematic multidisciplinary birth preparation program on satisfaction with childbirth experience. A secondary aim was to detect factors that affect the childbirth satisfaction. In this prospective study, 77 pregnant women who completed the 4-month birth preparation program (Group 1) and 75 women in the control group (Group 2) were asked to fill out two questionnaires with face-to-face interviews within 48 h after labor. One of the questionnaires was the translated form of Salmon's Item List German (SIL-Ger), and SIL-Ger scores ≥70 was accepted as a satisfactory experience. There was no statistically significant difference between the groups in terms of sociocultural and intrapartum characteristics, and obstetric outcome parameters. The women who received antenatal education experienced significantly less pain (p = 0.01), had a better communication with midwife or obstetrician during delivery (p = 0.001), and participated more actively in decision-making before, during, and after childbirth (p women had a SIL score ≥70 (96.1 vs 73.3%, p women to communicate better with healthcare providers and to participate in decision-making during labor, as well as by decreasing the perception of labor pain.

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

    Science.gov (United States)

    Gonçalves, Mariana Faria; Teixeira, Érica Mairene Bocate; Silva, Márcia Aparecida Dos Santos; Corsi, Nathalia Maciel; Ferrari, Rosângela Aparecida Pimenta; Pelloso, Sandra Marisa; Cardelli, Alexandrina Aparecida Maciel

    2018-03-12

    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.

  16. Special features of health services and register based trials – experiences from a randomized trial of childbirth classes

    Directory of Open Access Journals (Sweden)

    Sevón Tiina

    2008-06-01

    Full Text Available Abstract Background Evaluating complex interventions in health services faces various difficulties, such as making practice changes and costs. Ways to increase research capacity and decrease costs include making research an integral part of health services and using routine data to judge outcomes. The purpose of this article is to report the feasibility of a pilot trial relying solely on routinely collected register data and being based on ordinary health services. Methods The example intervention was education to public health nurses (PHN (childbirth classes to reduce caesarean section rates via pre-delivery considerations of pregnant women. 20 maternity health centers (MHC were paired and of each 10 pairs, one MHC was randomly allocated to an intervention group and the other to a control; 8 pairs with successful intervention were used in the analyses (1601 mothers. The women visiting to the study maternity centers were identified from the Customer Register of Helsinki City. A list of the study women was made using the mother's personal identification number, visit date, the maternity center code, birth date and gestation length. The mode of delivery and health outcomes were retrieved from the Finnish Medical Birth Register (MBR. Process data of the intervention are based on observations, written feedback and questionnaires from PHNs, and project correspondence. Results It took almost two years to establish how to obtain permissions and to actually obtain it for the trial. Obtaining permissions for the customer and outcome data and register linkages was unproblematic and the cluster randomization provided comparable groups. The intervention did not succeed well. Had the main aim of the trial been to cause a change in PHNs behavior, we would have very likely intensified the intervention during the trial. Conclusion Our experiences encourage the use of trials that obtain their outcomes from registers. Changing the behavior of ordinary health

  17. Mother’s Views about Efficacy of Prenatal Educational Classes to Prepare for Normal Vaginal Delivery, Postpartum and Breastfeeding

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    ّSomayeh Bahrami

    2016-12-01

    Full Text Available Background and Objective: Prenatal educations focusing on physical, emotional and mental preparation for delivery, health promotion and improving lifestyle behaviors in families during the reproductive years. In this education, parents achieve data about physical, emotional and mental changes during pregnancy delivery and postpartum and overcome skills. Aim of this study was to determine Comments mothers about efficacy prenatal education classes to prepare for normal vaginal delivery, postpartum and breastfeeding in women referring to Dezful health Centers, 2015Materials and Methods: The descriptive study using quota sampling was performed. A total of 250 women consented to participant at study. A questionnaire was provided by content validity. It is reliability was confirmed by Test re-test. A questionnaire was used in 4 Part: demographics, knowledge toward mode of delivery and Comments mothers about efficacy prenatal education classes to prepare for normal vaginal delivery, postpartum and breastfeeding. Data using SPSS statistics software and analyzes were performed.Results: More women (54.2% were moderate knowledge level. The majority of patients believed that prenatal classes aided there in preparation for natural childbirth (93.6%, the postpartum period (75.6%, and preparation for lactation (100%Conclusion: The study showed that prenatal education has an important role on choosing the mode of delivery and preparing for vaginal delivery. So that approach this training and prenatal care to all pregnant women is recommended.

  18. Preparing for motherhood: authoritative knowledge and the undercurrents of shared experience in two childbirth education courses in Cagliari, Italy.

    Science.gov (United States)

    Ketler, S K

    2000-06-01

    This article compares the social settings and teaching organization of two differently structured childbirth education courses in Cagliari, Italy, in order to understand how social processes and contexts work to negotiate authoritative knowledge. Although the explicit goal of both courses was to transmit biomedical knowledge, knowledge based in women's experience nonetheless dominated some course sessions. Thus, I examine the social processes and interactions that enabled women's experiential knowledge to dominate discussions and subsequently share in the authority of biomedical knowledge in some situations. Because few existing studies do so, this article also addresses a gap in our current understanding by exploring not only how experiential knowledge comes to share authority with biomedical knowledge, but also, why it is important that it does. Focusing on the efficacy of differently structured courses, this article informs the planning of future childbirth education courses in similar settings.

  19. INDONESIAN COLLEGE STUDENTS’ PERCEPTIONS OF TOEFL PREPARATION CLASS

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    Siti Masfufah

    2018-02-01

    Full Text Available This is the report of a pilot study of a dissertation. This study investigated what Indonesian students perceived of the TOEFL Preparation class.  The researcher interviewed 11 students of Economics. The students’ age ranged from 18 – 23 years old.  Seven of them had a job. Three of them were planning to have a job. The other one was a full-time student. This research revealed that the majority of the students were satisfied with the TOEFL Preparation class. The teacher helped them understand English compared to their knowledge before taking the TOEFL class. However, the students suggest that the duration for each meeting should be at least 120 minutes. Beside, the teacher should provide group work activities and homework. In addition, the teacher should come to class on time. Some recommendations of the findings are discussed in this paper.

  20. Women's choice of childbirth setting.

    Science.gov (United States)

    Mackey, M C

    1990-01-01

    As part of a larger study on women's views of the childbirth experience, this study was focused on women's choice of childbirth setting. Sixty-one Lamaze-prepared, married multigravidae between the ages of 21 and 37 and experiencing a normal pregnancy were interviewed twice: at 36-38 weeks gestation in their homes and during their postpartum stay in the hospital. Data were collected using (a) two semistructured interview guides consisting of open-ended questions about choosing a caregiver and the place of birth and about describing the actual childbirth experience, (b) a self-administered sociodemographic questionnaire, and (c) an obstetrical and infant data form. The tape-recorded interviews were transcribed verbatim. Qualitative data analysis was focused on reasons for choosing a hospital and a physician, reasons for choosing or not choosing a birthing room, and the outcomes of the decisions. An understanding of women's childbirth needs as reflected in their choices can suggest areas where flexibility might be built into maternity care programs.

  1. Factors Related to Women's Childbirth Satisfaction in Physiologic and Routine Childbirth Groups.

    Science.gov (United States)

    Jafari, Elham; Mohebbi, Parvin; Mazloomzadeh, Saeideh

    2017-01-01

    Women's satisfaction with childbirth is an important measure of the quality of maternity care services. This study aims to address factors related to women's childbirth satisfaction in physiological and routine childbirth groups. This descriptive-analytical study was conducted among 340 women in physiological and routine childbirth groups in 2012. Women were selected through convenience sampling method in the routine group and by census in the physiological group. Data were collected using a 5-part questionnaire composed of demographic and obstetrics details, Mackey's Childbirth Satisfaction Rating Scale (CSRS), satisfied with birth setting, Labor Agentry Scale (LAS), and Visual Analogue Scale (VAS), which was completed by interview 24 hours after childbirth. Data were analyzed using the Statistical Package for the Social Sciences version 18 software using Pearson correlation test, independent t -test, analysis of variance, and linear, multivariate regression model at the significant level of P toward the recent pregnancy ( P = 0.007), and perceived severity of pain ( P = 0.016). However, in the routine group, satisfaction was related only to intentional pregnancy ( P = 0.002). In neither group, satisfaction was related to demographic characteristics, maternal parity, and participation in pregnancy and childbirth classes or maternal feelings toward the onset of childbirth ( P > 0.05). Improved physical structure and setting of birth room, nonmedical pain relief, mothers' involvement in the process of labor, and sense of being in control are associated with mothers' satisfaction.

  2. The Relationship between Perceived Social Support in the First Pregnancy and Fear of Childbirth.

    Science.gov (United States)

    Azimi, Masoomeh; Fahami, Fariba; Mohamadirizi, Soheila

    2018-01-01

    Numerous empirical evidences have shown that social and environmental circumstances and social relations have an important impact on pregnancy outcomes, women's ability to cope with stressful situations, and childbirth pain management. The present study was conducted to determine the relationship between perceived social support and fear of childbirth. The present descriptive correlational study was conducted on 270 nulliparous pregnant women who referred for pregnancy care in 2016. The subjects were selected through convenience sampling method. The data collection tools were a demographic characteristics form, the Multidimensional Scale of Perceived Social Support (MSPSS), and the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ). The collected data were analyzed using descriptive and inferential statistics tests. The mean perceived social support score of the participants was 77.90 and a significant correlation was observed between the perceived social support score and fear of childbirth score (β = -0.18, p = 0.004). The participants' mean score of fear of childbirth was 36.8. The results of study after the evaluation of the effect of predictive variables on the fear of childbirth are as follows: pregnancy preparation classes: ( β = 3.50, p = 0.220); observation of natural childbirth videos: ( β = 5.26, p = 0.040); and use of educational software: ( β =5.82, p = 0.080). In order to reduce the fear of childbirth, women's social support structure during pregnancy should be assessed. Moreover, demographic characteristics form the structure and determine the extent of individuals' social network and, through the evaluation of these characteristics during pregnancy, the rate of effective support can be predicted in individuals.

  3. The effects of antenatal education on fear of childbirth, maternal self-efficacy and post-traumatic stress disorder (PTSD) symptoms following childbirth: an experimental study.

    Science.gov (United States)

    Gökçe İsbir, Gözde; İnci, Figen; Önal, Hatice; Yıldız, Pelin Dıkmen

    2016-11-01

    Fear of birth and low childbirth self-efficacy is predictive of post-traumatic stress disorder symptoms following childbirth. The efficacy of antenatal education classes on fear of birth and childbirth self-efficacy has been supported; however, the effectiveness of antenatal classes on post-traumatic stress disorder symptoms after childbirth has received relatively little research attention. This study examined the effects of antenatal education on fear of childbirth, maternal self-efficacy and post-traumatic stress disorder symptoms following childbirth. Quasi-experimental study. The study was conducted in a city located in the Middle Anatolia region of Turkey and data were collected between December 2013 and May 2015. Two groups of women were compared-an antenatal education intervention group (n=44), and a routine prenatal care control group (n=46). The Wijma Delivery Expectancy/Experience Questionnaire, Version A and B, Childbirth Self-efficacy Inventory and Impact of Event Scale-Revised was used to assess fear of childbirth, maternal self-efficacy and PTSD symptoms following childbirth. Compared to the control group, women who attended antenatal education had greater childbirth self-efficacy, greater perceived support and control in birth, and less fear of birth and post-traumatic stress disorder symptoms following childbirth (all comparisons, ppost-traumatic stress disorder symptoms after childbirth. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Fear of childbirth in expectant fathers, subsequent childbirth experience and impact of antenatal education: subanalysis of results from a randomized controlled trial.

    Science.gov (United States)

    Bergström, Malin; Rudman, Ann; Waldenström, Ulla; Kieler, Helle

    2013-08-01

    To explore if antenatal fear of childbirth in men affects their experience of the birth event and if this experience is associated with type of childbirth preparation. Data from a randomized controlled multicenter trial on antenatal education. 15 antenatal clinics in Sweden between January 2006 and May 2007. 762 men, of whom 83 (10.9%) suffered from fear of childbirth. Of these 83 men, 39 were randomized to psychoprophylaxis childbirth preparation where men were trained to coach their partners during labor and 44 to standard care antenatal preparation for childbirth and parenthood without such training. Experience of childbirth was compared between men with and without fear of childbirth regardless of randomization, and between fearful men in the randomized groups. Analyses by logistic regression adjusted for sociodemographic variables. Self-reported data on experience of childbirth including an adapted version of the Wijma Delivery Experience Questionnaire (W-DEQ B). Men with antenatal fear of childbirth more often experienced childbirth as frightening than men without fear: adjusted odds ratio 4.68, 95% confidence interval 2.67-8.20. Men with antenatal fear in the psychoprophylaxis group rated childbirth as frightening less often than those in standard care: adjusted odds ratio 0.30, 95% confidence interval 0.10-0.95. Men who suffer from antenatal fear of childbirth are at higher risk of experiencing childbirth as frightening. Childbirth preparation including training as a coach may help fearful men to a more positive childbirth experience. Additional studies are needed to support this conclusion. © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

  5. Qualitative Analysis of Animation versus Reading for Pre-Class Preparation in a "Flipped" Classroom

    Science.gov (United States)

    Persky, Adam M.

    2015-01-01

    The "flipped" classroom model, including such approaches as team-based learning (TBL), stresses pre-class preparation. For three years in a pharmacokinetics course within a pharmacy curriculum, students had the choice of using reading material or a fully animated module to prepare for class. Qualitative methods were used to analyze…

  6. A Class to Prepare Students to Manage Educational Debt.

    Science.gov (United States)

    Popik, Roberta S.; And Others

    1986-01-01

    A counseling program prepared for Georgetown University School of Dentistry is described. It trains students in concepts associated with short- and long-term financial planning, banking relationships, credit, business planning and structuring debt into an individual student's lifestyle. (MLW)

  7. Economics of childbirth.

    Science.gov (United States)

    Fahy, Michael; Doyle, Orla; Denny, Kevin; McAuliffe, Fionnuala M; Robson, Michael

    2013-05-01

    Increasing birth rates have raised questions for policy makers and hospital management about the economic costs of childbirth. The purpose of this article is to identify and review all existing scientific studies in relation to the economic costs of alternative modes of childbirth delivery and to highlight deficiencies in the existing scientific research. We searched Cochrane, Centre for Reviews and Dissemination, EconLit, the Excerpta Medica Database, the Health Economic Evaluations Database, MEDLINE and PubMed. Thirty articles are included in this review. The main findings suggest that there is no internationally acceptable childbirth cost and clinical outcome classification system that allows for comparisons across different delivery modes. This review demonstrates that a better understanding and classification of the costs and associated clinical outcomes of childbirth is required to allow for valid comparisons between maternity units, and to inform policy makers and hospital management. © 2013 The Authors Acta Obstetricia et Gynecologica Scandinavica © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

  8. Remote State Preparation of a Greenberger-Horne-Zeilinger Class State

    International Nuclear Information System (INIS)

    Zhan Youbang

    2005-01-01

    In this paper, we propose a scheme for the remote preparation of a three-particle Greenberger-Horne-Zeilinger class state by a two-particle entangled state and a three-particle entangled state. It is shown that, by this scheme, only two classical bits and one two-particle projective measurement are enough for such preparation.

  9. Antenatal education for childbirth-epidural analgesia.

    Science.gov (United States)

    Cutajar, Lisa; Cyna, Allan M

    2018-05-07

    The language structures used by antenatal educators have not been previously researched in the context of antenatal childbirth classes. Epidural analgesia for labour is a common, and a frequently asked about, component of antenatal education for parents in hospitals providing maternity care. We aimed to identify the way information is described and presented by childbirth educators to assess content and determine which language structures such as metaphor, suggestion, information and storytelling are utilized. This observational study of antenatal education was conducted at a single tertiary referral center for maternity care in Western Sydney, Australia. All three childbirth educators agreed to be video recorded whilst providing information to parents during antenatal classes. Audio data was subsequently transcribed and then analysed by two researchers, independently categorising the various language structures and types of information provided. For the purposes of the current study, data concerning a single topic was used for the analysis-'epidural analgesia for labour'. Language structures used were highly variable between educators, as was the content and time taken for the information being provided. Our findings represent a first attempt to identify baseline information used in the clinical setting of antenatal education in order to categories communication structures used. This study has identified areas for further improvements and consistency in the way educators provide information to parents and has important implications for future midwifery practice, education and research. Copyright © 2018 Elsevier Ltd. All rights reserved.

  10. Personality and fear of childbirth.

    Science.gov (United States)

    Ryding, Elsa Lena; Wirfelt, Eva; Wängborg, Ing-Britt; Sjögren, Berit; Edman, Gunnar

    2007-01-01

    Socioeconomic factors and previous experiences of delivery are known to influence pregnant women's fear of childbirth. The aim of this study was to investigate the associations between stable personality traits, fear of childbirth during late pregnancy, and experience of the delivery. Self-report questionnaires were completed twice, during gestation week 34-37, and at 1-week postpartum. Comparisons were made between 85 women who had sought help from a fear-of-childbirth team, and a group (n=177) from routine antenatal care. Correlations between fear of childbirth, personality variables and experience of childbirth were calculated. The women who had sought help tended to be more anxiety-prone, more short-tempered, and lower in socialisation, although within the normal range. In spite of counselling, they reported more intense fear of delivery and fear of pain compared with the comparison group. Women with intense fear of childbirth, who were low in socialisation and high in psychasthenia, had a more negative experience of their current childbirth. Women with intense fear of childbirth differ from other pregnant women also in personality. Methods for treating fear of childbirth should be further developed in order to diminish the risk of a negative birth experience.

  11. Conceitualização pelas enfermeiras de preparação para o parto Conceptualización de los enfermeros de preparación para el parto Nurses' conceptualization on childbirth preparation

    Directory of Open Access Journals (Sweden)

    Germano Rodrigues Couto

    2006-04-01

    procedimientos técnicos, educativos, de relación y informativos de gran importancia para la embarazada y para la enfermera, desenrollándose desde el inicio del embarazo hasta el puerperio, como un medio de alterar comportamientos erróneos con vista a un resultado esperado que mejore la salud de la embarazada y la de su familia.Descriptive, exploratory and qualitative study, carried out through the Delphi Technique, with a sample of 32 obstetrics specialist nurses working in 3 hospitals and 9 primary health care centers in the district of Oporto, Northern Portugal. The purposes of this work were: 1. to identify a group of nurses' ideas and consensual conceptions about Childbirth Preparation; 2. to know which information sources are consensually more used by nurses; 3. to know how they accept Childbirth Preparation programs as a way for pregnant women to have an active delivery. Results revealed that Childbirth Preparation is, according to the participants, an educational moment toward health, involving technical, educational, relational and informative procedures of great importance to pregnant women and nurses. This involves the period from the start of pregnancy to the puerperium, as a means of changing wrong behaviors with a view to achieving an expected goal of health gains for pregnant women and their family.

  12. Antenatal hypnosis training and childbirth experience

    DEFF Research Database (Denmark)

    Werner, Anette; Uldbjerg, Niels; Zachariae, Robert

    2013-01-01

    Childbirth is a demanding event in a woman's life. The aim of this study was to explore whether a brief intervention in the form of an antenatal course in self-hypnosis to ease childbirth could improve the childbirth experience.......Childbirth is a demanding event in a woman's life. The aim of this study was to explore whether a brief intervention in the form of an antenatal course in self-hypnosis to ease childbirth could improve the childbirth experience....

  13. Reading Comprehension in Test Preparation Classes: An Analysis of Teachers' Pedagogical Content Knowledge in TESOL

    Science.gov (United States)

    Irvine-Niakaris, Christine; Kiely, Richard

    2015-01-01

    This article examines the pedagogical content knowledge which underpins the practices in reading lessons of experienced teachers in test preparation classes. It takes as a starting point the assumption that practice is shaped by teacher cognitions, which are established through professional training and classroom experience. Thus, the study…

  14. Influence of Professional Preparation and Class Structure on HIV, STD, and Pregnancy Prevention Education

    Science.gov (United States)

    Rhodes, Darson L.; Jozkowski, Kristen N.; Hammig, Bart J.; Ogletree, Roberta J.; Fogarty, Erin C.

    2014-01-01

    Objective: The purpose of this study was to determine if education about human immunodeficiency virus (HIV)/sexually transmitted disease (STD) and pregnancy prevention is dependent on professional preparation and/or class structure. Design: A secondary data analysis of the 2006 School Health Policies and Programmes Study (SHPPS) was conducted.…

  15. Home childbirth: progress or retrocession?

    Directory of Open Access Journals (Sweden)

    Clara Fróes de Oliveira SANFELICE

    Full Text Available Giving birth at home represents a rising modality of delivery care in the Brazilian society, although in unrepresentative proportion when compared to the number of hospital childbirths. In Brazil, the topic has been broadly discussed by different professional categories, highlighting the safety issue involved in the process. The aim of this theoretical and reflective study was to present a brief overview of the overall care related to home childbirth, also questioning the reality of the contemporary Brazilian obstetric scenario. The scientific literature presents both obstetric and neonatal outcomes as favorable to home childbirth; similar risks when compared to hospital childbirth and higher rates of maternal satisfaction, and these both factors justify its practice. Therefore, a movement of women who are deeply unhappy with the current model of obstetric care is currently observed and they have been opting for home childbirth as a response to institutional violence, fragmentation and depersonalization of hospital care.

  16. [Home childbirth: progress or retrocession?].

    Science.gov (United States)

    de Sanfelice, Clara Fróes Oliveira; Shimo, Antonieta Keiko Kakuda

    2014-03-01

    Giving birth at home represents a rising modality of delivery care in the Brazilian society, although in unrepresentative proportion when compared to the number of hospital childbirths. In Brazil, the topic has been broadly discussed by different professional categories, highlighting the safety issue involved in the process. The aim of this theoretical and reflective study was to present a brief overview of the overall care related to home childbirth, also questioning the reality of the contemporary Brazilian obstetric scenario. The scientific literature presents both obstetric and neonatal outcomes as favorable to home childbirth; similar risks when compared to hospital childbirth and higher rates of maternal satisfaction, and these both factors justify its practice. Therefore, a movement of women who are deeply unhappy with the current model of obstetric care is currently observed and they have been opting for home childbirth as a response to institutional violence,fragmentation and depersonalization of hospital care.

  17. Top-selling childbirth advice books: a discourse analysis.

    Science.gov (United States)

    Kennedy, Holly Powell; Nardini, Katrina; McLeod-Waldo, Rebecca; Ennis, Linda

    2009-12-01

    Recent evidence suggests that one-third of women receive information about pregnancy and childbirth through books. Messages about what characteristics are normal (or expected) in childbirth are disseminated in a variety of ways, including popular childbirth education books, but little study of them has been conducted. The purpose of this investigation is to address that gap by examining the discussions about childbirth in the 10 top-selling books in the United States. Discourse analysis (relating to the public, personal, and political discussions about a specific phenomenon) was used to study 10 best-selling United States childbirth advice books marketed to childbearing women during the first week of November 2007. Book styles ranged from clinical descriptions of pregnancy and birth primarily offering reassurance, self-help information, and danger signs to more folksy and humorous commentaries. Presentation of scientific evidence to support recommendations was uneven and at times inaccurate. Five focal areas of discourse included body image, labor and birth, pain, power and control, and life preparation for motherhood. Top-selling books shine an interesting light on the current state of United States maternity practices. Women and health professionals should assess them carefully and engage with each other about their recommendations and implications for childbirth.

  18. The influence of fitball-aerobics classes on the level of female-students physical preparation.

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    Chernenko E. E.

    2011-04-01

    Full Text Available The article analyses the peculiarities of fitball-aerobics classes on the level of 17-20 years old female-students physical preparation. The results received in the process of the carried out experimental investigation, give a chance to state that under the influence of classes the results of female-students became better almost in all test exercises, the exception is the result of the test "Bending of the arms in the emphasis lying". The greatest relative gain of the results was fixed in the tests, characterizing the level of flexibility improvement and functions of equilibrium.

  19. [Father involvement in childbirth].

    Science.gov (United States)

    Villalón, H; Toro, R; Riesco, I; Pinto, M; Silva, C

    2014-10-01

    Recent initiatives have promoted the participation of fathers in the early care of their children. To assess the results of a program to encourage parental involvement in childbirth. Parents of healthy term newborns were randomly allocated to participate either in the birth experience or control. The protocol included: to dry the skin, umbilical cord cutting off, weight, height, and finally give him/her to the mother for the skin-to-skin contact. Heart rate (HR), respiratory (RR) and temperature were evaluated one hour later. In the first outpatient clinic assessment, mothers completed a questionnaire. 127 fathers participated either in the birth experience or control. 62 followed the protocol and 65 the control. Both newborn groups were comparable. Also were fathers in age, education and rurality; mothers in primiparity. Significant differences: night care (37/62, 10/65 59.6% vs 15.4%, pfathers at birth, even belonging to a discouraging socio cultural environment.

  20. Classical Communication and Entanglement Cost in Preparing a Class of Multi-qubit States

    International Nuclear Information System (INIS)

    Pan Guixia; Liu Yimin; Zhang Zhanjun

    2008-01-01

    Recently, several similar protocols [J. Opt. B 4 (2002) 380; Phys. Lett. A 316 (2003) 159; Phys. Lett. A 355 (2006) 285; Phys. Lett. A 336 (2005) 317] for remotely preparing a class of multi-qubit states (i.e, α|0...0> + β|1...1>) were proposed, respectively. In this paper, by applying the controlled-not (CNOT) gate, a new simple protocol is proposed for remotely preparing such class of states. Compared to the previous protocols, both classical communication cost and required quantum entanglement in our protocol are remarkably reduced. Moreover, the difficulty of identifying some quantum states in our protocol is also degraded. Hence our protocol is more economical and feasible.

  1. Salivary Hormones Response to Preparation and Pre-competitive Training of World-class Level Athletes

    Science.gov (United States)

    Guilhem, Gaël; Hanon, Christine; Gendreau, Nicolas; Bonneau, Dominique; Guével, Arnaud; Chennaoui, Mounir

    2015-01-01

    This study aimed to compare the response of salivary hormones of track and field athletes induced by preparation and pre-competitive training periods in an attempt to comment on the physiological effects consistent with the responses of each of the proteins measured. Salivary testosterone, cortisol, alpha-amylase, immunoglobulin A (IgA), chromogranin A, blood creatine kinase activity, and profile of mood state were assessed at rest in 24 world-class level athletes during preparation (3 times in 3 months) and pre-competitive (5 times in 5 weeks) training periods. Total mood disturbance and fatigue perception were reduced, while IgA (+61%) and creatine kinase activity (+43%) increased, and chromogranin A decreased (−27%) during pre-competitive compared to preparation period. A significant increase in salivary testosterone (+9 to +15%) and a decrease in testosterone/cortisol ratio were associated with a progressive reduction in training load during pre-competitive period (P athletics training. PMID:26635619

  2. Of Pain and Childbirth.

    Science.gov (United States)

    Lyerly, Anne Drapkin

    2017-01-01

    Childbirth is often understood as a paradigmatically "happy" event where good outcomes are expected and the process anticipated as a reason for celebration. Yet the narratives in this volume reflect sadness and grief, even when a healthy child is born. In this essay, I interrogate the genesis of and our relationship to grief in birth. To the extent such grief is a product of the chasm between the imagined ideal and what women experience, we may redress such grief by orienting around a more robust and woman-centered notion of the "good birth". Yet there is a way in which grief is also intrinsic to birth, and turning away from the loss that birth by its nature entails may compound the suffering of childbearing women. Beginning with the observation that the one narrative in which grief is accepted and attended to-a full term stillbirth-also stands out for the exemplary care provided, I consider the possibility that making space for grief in births, including those with good outcomes, will lead us to better ways of thinking about birth and providing care for childbearing women.

  3. Coronal microleakage of four temporary restorative materials in Class II-type endodontic access preparations

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    Sang-Mi Yun

    2012-02-01

    Full Text Available Objectives The purpose of this study was to evaluate the microleakage of 4 temporary materials in teeth with Class II-type endodontic access preparations by using a glucose penetration model. Materials and Methods Glucose reaction test was performed to rule out the presence of any reaction between glucose and temporary material. Class II-type endodontic access preparations were made in extracted human premolars with a single root (n = 10. Each experimental group was restored with Caviton (GC, Spacer (Vericom, IRM (Dentsply-Caulk, or Fuji II(GC. Microleakage of four materials used as temporary restorative materials was evaluated by using a glucose penetration model. Data were analyzed by the one-way analysis of variance followed by a multiple-comparison Tukey test. The interface between materials and tooth were examined under a scanning electron microscope (SEM. Results There was no significant reaction between glucose and temporary materials used in this study. Microleakage was significantly lower for Caviton and Spacer than for Fuji II and IRM. SEM observation showed more intimate adaptation of tooth-restoration interfaces in Caviton and Spacer than in IRM and Fuji II. Conclusions Compared to IRM and Fuji II, Caviton and Spacer can be considered better temporary sealing materials in Class II-type endodontic access cavities.

  4. Hypnosis Antenatal Training for Childbirth (HATCh: a randomised controlled trial [NCT00282204

    Directory of Open Access Journals (Sweden)

    Baghurst Peter

    2006-03-01

    Full Text Available Abstract Background Although medical interventions play an important role in preserving lives and maternal comfort they have become increasingly routine in normal childbirth. This may increase the risk of associated complications and a less satisfactory birth experience. Antenatal hypnosis is associated with a reduced need for pharmacological interventions during childbirth. This trial seeks to determine the efficacy or otherwise of antenatal group hypnosis preparation for childbirth in late pregnancy. Methods/design A single centre, randomised controlled trial using a 3 arm parallel group design in the largest tertiary maternity unit in South Australia. Group 1 participants receive antenatal hypnosis training in preparation for childbirth administered by a qualified hypnotherapist with the use of an audio compact disc on hypnosis for re-enforcement; Group 2 consists of antenatal hypnosis training in preparation for childbirth using an audio compact disc on hypnosis administered by a nurse with no training in hypnotherapy; Group 3 participants continue with their usual preparation for childbirth with no additional intervention. Women > 34 and Discussion If effective, hypnosis would be a simple, inexpensive way to improve the childbirth experience, reduce complications associated with pharmacological interventions, yield cost savings in maternity care, and this trial will provide evidence to guide clinical practice.

  5. Men, masculine identities and childbirth.

    Science.gov (United States)

    Dolan, Alan; Coe, Christine

    2011-11-01

    In recent years, fathers' experiences during childbirth have attracted much research and policy interest. However, little of this work has been grounded in the first-hand accounts of men and there is a lack of theory-based research to help understand men's thoughts and practices around childbirth. This paper is based on qualitative research undertaken with first-time fathers and healthcare professionals. It draws on Connell's (1995) conceptualisation of hegemonic masculinity to explore how men construct masculine identities within the context of pregnancy and childbirth and also how healthcare professionals construct masculinity. The paper demonstrates the ways in which men can find themselves marginalised within the context of pregnancy and childbirth, but are still able to draw on identifiable markers of masculine practice which enable them to enact a masculine form congruent with dominant masculinity. It also illustrates how healthcare professionals' constructions of masculinity enable them to predict how men will behave and allow them to position men in ways that involve minimum disruption to their own practice. The paper also highlights how men's marginal status is embedded in the dynamics of the social structure, which produce and reproduce dominant masculine identities within the context of childbirth. © 2011 The Authors. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

  6. Prevention of postnatal distress or depression: an evaluation of an intervention at preparation for parenthood classes.

    Science.gov (United States)

    Matthey, Stephen; Kavanagh, David J; Howie, Pauline; Barnett, Bryanne; Charles, Margaret

    2004-04-01

    To determine the effectiveness of a psychosocial intervention, provided to expectant couples in routine antenatal classes, on the postpartum psychosocial adjustment of women and men. A 3*3 between subjects randomised control design was utilised. The two factors were condition and self-esteem. Preparation for Parenthood programs were randomly allocated to one of three conditions: usual service ('control'), experimental ('empathy'), or non-specific control ('baby-play'). The latter condition controlled for the non-specific effects of the intervention, these being: the provision of an extra class; asking couples to consider the early postpartum weeks; and receiving booster information after the antenatal class, and again shortly after the birth. Women and men were categorised into three levels of self-esteem, as measured antenatally: low, medium and high. 268 participants were recruited antenatally. Interview data and self-report information was collected from 202 of these women at 6 weeks postpartum, and 180 women at 6 months postpartum. The intervention consisted of a session focusing on psychosocial issues related to becoming first-time parents. Participants discussed possible postpartum concerns in separate gender groups for part of the session, and then discussed these issues with their partners. Hypothetical scenarios depicting stressful situations in the early postpartum weeks for women and men were discussed, with solutions that parents have found useful given to the participants. In the non-specific control condition, the session focused on the importance of play with a baby, with videotapes and discussion around how parents can play with infants. At 6 weeks postpartum there was a significant interaction effect between condition and self-esteem on maternal adjustment. Women with low self-esteem, who had received the intervention, were significantly better adjusted on measures of mood and sense of competence than low-self-esteem women in either of the two

  7. Application of the PEE Model to essay composition in an IELTS preparation class

    Directory of Open Access Journals (Sweden)

    Ender Orlando Velasco Tovar

    2015-01-01

    Full Text Available Based on two case studies, this study investigates the application of the Point, Explanation, Example (PEE model to essay composition in a multi-lingual IELTS preparation class. This model was incorporated into an eight-week programme of instruction to ESL adults in London, England. Students preparing for the IELTS exam were asked to write pre and post instruction essays on a given topic within 40 minutes. Employing the IELTS band descriptors (IELTS, 2013b and analyses of coherence and cohesion in line with Systemic Functional Linguistic concepts (Halliday and Matthiessen, 2004; McCarthy, 1991, samples of students’ writing were analysed. Data from students’ pre and post instruction interviews was also gathered and analysed. The findings of this study suggest that the PEE model is to some extent effective in improving the essay composition performance of IELTS students, in particular in the area of cohesion and coherence. Students find the PEE model useful in regard to the clarity and structure that the model seems to add to their essays.

  8. [Association between the intensity of childbirth pain and the intensity of postpartum blues].

    Science.gov (United States)

    Boudou, M; Teissèdre, F; Walburg, V; Chabrol, H

    2007-10-01

    The aim of this study was to highlight a link between childbirth pain and mood disorders in the immediate postpartum. We met 43 women at three days postpartum in a maternity unit in Toulouse (France) between January and April 2004. The mean age of the mothers was 30 years (S.D., 4.8 years; range, 18-39 years). Mothers were excluded if they did not speak French, if they had past psychiatric history, and if their baby was premature, ill, or stillborn. Pain was measured using a French version of the McGill pain questionnaire (Melzack, 1975) [Br J Psychiatry 171 (1997) 550-555]. This questionnaire called questionnaire douleur Saint-Antoine (QDSA) is composed of 58 words and 16 classes (Boureau et at., 1984) [Thérapie 39 (1984) 119-129]. Classes 1-9 provide data on the sensory qualities of pain while Classes 10-16 reflect affective characteristics. Blues symptoms was assessed with the French version of the maternity blues questionnaire of Kennerley and Gath (1989) [Br J Psychiatry 145 (1984) 620-625]. For each 28 items women have to decide how much change there is from their usual self, by ticking one choice out of five, from "much less than usual" to "much more than usual". We used the French version of the EPDS (Cox et al., 1987) [Br J Psychiatry 150 (1987) 782-786]. This scale was used to assess the intensity of depressive mood. The results revealed a significant positive correlation between the pain scores and the "maternity blues" questionnaire scores, and between pain scores and EPDS score at three days postpartum. This study shows a stronger association between intensity of postpartum blues and affective aspect of childbirth pain (r=0.48; pdepressive mood was found to be associated with affective (r=0.32; pchildbirth pain (r=0.28; pdepressive mood, we entered the same predictors. This model accounted for 20% of the variance of blues intensity (F3,39=3.26, p=0.03). Age was the only significant predictor (beta=-0.31, p=0.04). These results confirm our hypothesis

  9. Fear of childbirth: mothers' experiences of team-midwifery care - a follow-up study.

    Science.gov (United States)

    Lyberg, Anne; Severinsson, Elisabeth

    2010-05-01

    The aim of this study was to illuminate mothers' fear of childbirth and their experiences of the team-midwifery care model during pregnancy, childbirth and the postnatal period. Maternal anxiety and fear of childbirth lead to emotional suffering and affected women's well-being. A previous negative experience of childbirth may result in postnatal depression or avoidance of future pregnancies. This hermeneutic study comprised interviews with 13 women, which were audio-taped and transcribed verbatim, after which interpretative content analysis was performed. Ethical approval was granted. The findings revealed one main theme: The woman's right to ownership of the pregnancy, childbirth and postnatal care as a means of maintaining dignity and three themes; Being aware of barriers and reasons for fear; Being prepared for childbirth and Being confirmed and treated with dignity by the midwife. Each theme contained several sub-themes. The findings contribute insights into how midwives can be educated to reduce fear of childbirth and promote positive birth experiences, despite the existence of negative memories of previous births. In order to achieve continuity and a trusting relationship it is necessary to organise leadership and to adopt models that are flexible and support women's health.

  10. [Post-traumatic stress disorder after childbirth].

    Science.gov (United States)

    Korábová, I; Masopustová, Z

    2016-01-01

    The aim of this paper is to introduce the issue of post-traumatic stress disorder after childbirth to health care professionals. The text focuses on the diagnostic definition of post-traumatic stress disorder after childbirth, symptoms, physiological background, prevalence, course, risk factors and consequences of post-traumatic stress disorder after childbirth for a woman, her child and her partner. Options for interventions and therapy are outlined as well.

  11. Childbirth in aristocratic households of Heian Japan.

    Science.gov (United States)

    Andreeva, Anna

    2014-01-01

    This paper focuses on childbirth in Japan's aristocratic households during the Heian period (794-1185). Drawing on various sources, including court diaries, visual sources, literary records, and Japan's first medical collection, with its assortment of gynaecological and obstetric prescriptions, as well as Buddhist and other ritual texts, this short excursion into the cultural history of childbirth offers an insight into how childbirth was experienced and managed in Heian Japan. In particular, it addresses the variety of ideas, knowledge systems and professionals involved in framing and supporting the process of childbirth in elite households. In so doing, it casts light on the complex background of early Japanese medicine and healthcare for women.

  12. Revisiting the Classics in Childbirth Education

    Science.gov (United States)

    Shilling, Teri; Bingham, Stacie

    2010-01-01

    In celebration of Lamaze International's 50th anniversary, reviewers share their thoughts on some classic Lamaze resource materials and how their content relates to today's viewpoints on birth and childbirth education. Although some of the material may be outdated, all of the resources offer timeless insights as well as a unique view on the history of childbirth education. The following topics are addressed: past cultural views of birth; advocacy for change in birth practices; Lamaze method; pioneers in childbirth; importance of childbirth education; and birth advocacy. PMID:21629386

  13. Strategies to improve quality of childbirth care

    Directory of Open Access Journals (Sweden)

    farahnaz Changaee

    2015-01-01

    Full Text Available Background: Access to affordable and quality health care is one of the most important ways for reducing maternal and child mortality. The purpose of this study was to provide strategies to promote the quality of care during childbirth in Lorestan province in 2011. Materials and Methods: This research was a mixed method (quantitative, qualitative, study in which quality of 200 care during childbirth in hospitals of Lorestan Province were evaluated. Data gathered through self-made tools (Checklists prepared according to the guidelines of the ministry of health. Descriptive statistics and SPSS software were used to data analysis.In the second part of the study which was qualitative, interview with service providers, hospital officials and high-ranking officials of Lorestan university of medical sciences (decision makers was used to discuss strategies to improve the quality of care. Results: The results showed that the care of the first stage delivery in %54.5, second stage %57 and third stage 66% were in accordance with the desired status and care in this three stages was of moderate quality. Based on the interviews, the officials who are in charge of Lorestan university of medical sciences, proposed strategies such as financial incentives and in-service training of midwives as suitable strategies to improve quality of services. Conclusion: According to the results, strategies such as financial incentives, increased use of private sector services to reduce the workload of the public sector and increase of quality and use of more in-service training, to improve the quality of services, are recommended.

  14. Resolution of pain after childbirth.

    Science.gov (United States)

    Eisenach, James C; Pan, Peter; Smiley, Richard M; Lavand'homme, Patricia; Landau, Ruth; Houle, Timothy T

    2013-01-01

    Chronic pain after surgery occurs in 10-40% of individuals, including 5-20% of women after cesarean delivery in previous reports. Pain and depression 2 months after childbirth are independently associated with more severe acute post-delivery pain. Here we examine other predictors of pain at 2 months and determine the incidence of pain at 6 and 12 months after childbirth. Following Institutional Review Board approval, 1228 women were interviewed within 36 h of delivery. Of these, 937 (76%) were successfully contacted by telephone at 2 months, and, if they had pain, at 6 and 12 months after delivery. The primary outcome measure was presence of pain which began at the time of delivery. We also generated a model of severity of acute post-delivery pain and 2 month pain and depression. Pain which began at the time of delivery was remarkably rare 6 and 12 months later (1.8% and 0.3% [upper 95% confidence limit, 1.2%], respectively). Past history of pain and degree of tissue damage at delivery accounted for 7.0% and 16.7%, respectively, of one aspect in the variability in acute post-delivery pain. Neither of these factors was associated with incidence of pain 2 months later. Using a definition of new onset pain from delivery, we show a remarkably low incidence of pain 1 yr after childbirth, including those with surgical delivery. Additionally, degree of tissue trauma and history of chronic pain, risk factors for pain 2 months after other surgery, were unimportant to pain 2 months after cesarean or vaginal delivery.

  15. Hypnosis Antenatal Training for Childbirth (HATCh): a randomised controlled trial [NCT00282204].

    Science.gov (United States)

    Cyna, Allan M; Andrew, Marion I; Robinson, Jeffrey S; Crowther, Caroline A; Baghurst, Peter; Turnbull, Deborah; Wicks, Graham; Whittle, Celia

    2006-03-05

    Although medical interventions play an important role in preserving lives and maternal comfort they have become increasingly routine in normal childbirth. This may increase the risk of associated complications and a less satisfactory birth experience. Antenatal hypnosis is associated with a reduced need for pharmacological interventions during childbirth. This trial seeks to determine the efficacy or otherwise of antenatal group hypnosis preparation for childbirth in late pregnancy. A single centre, randomised controlled trial using a 3 arm parallel group design in the largest tertiary maternity unit in South Australia. Group 1 participants receive antenatal hypnosis training in preparation for childbirth administered by a qualified hypnotherapist with the use of an audio compact disc on hypnosis for re-enforcement; Group 2 consists of antenatal hypnosis training in preparation for childbirth using an audio compact disc on hypnosis administered by a nurse with no training in hypnotherapy; Group 3 participants continue with their usual preparation for childbirth with no additional intervention. Women > 34 and training as near as possible to 37 weeks gestation. Treatment allocations are concealed from treating obstetricians, anaesthetists, midwives and those personnel collecting and analysing data. Our sample size of 135 women/group gives the study 80% power to detect a clinically relevant fall of 20% in the number of women requiring pharmacological analgesia - the primary endpoint. We estimate that approximately 5-10% of women will deliver prior to receiving their allocated intervention. We plan to recruit 150 women/group and perform sequential interim analyses when 150 and 300 participants have been recruited. All participant data will be analysed, by a researcher blinded to treatment allocation, according to the "Intention to treat" principle with comprehensive pre-planned cost- benefit and subgroup analyses. If effective, hypnosis would be a simple, inexpensive

  16. Bioethics, Human Rights, and Childbirth.

    Science.gov (United States)

    Erdman, Joanna

    2015-06-11

    The global reproductive justice community has turned its attention to the abuse and disrespect that many women suffer during facility-based childbirth. In 2014, the World Health Organization released a statement on the issue, endorsed by more than 80 civil society and health professional organizations worldwide.The statement acknowledges a growing body of research that shows widespread patterns of women's mistreatment during labor and delivery-physical and verbal abuse, neglect and abandonment, humiliation and punishment, coerced and forced care-in a range of health facilities from basic rural health centers to tertiary care hospitals. Moreover, the statement characterizes this mistreatment as a human rights violation. It affirms: "Every woman has the right to the highest attainable standard of health, which includes the right to dignified, respectful health care throughout pregnancy and childbirth."The WHO statement and the strong endorsement of it mark a critical turn in global maternal rights advocacy. It is a turn from the public health world of systems and resources in preventing mortality to the intimate clinical setting of patient and provider in ensuring respectful care. Copyright 2015 Erdman. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

  17. Measuring nursing support during childbirth.

    Science.gov (United States)

    Gale, J; Fothergill-Bourbonnais, F; Chamberlain, M

    2001-01-01

    To examine the amount of support being provided by nurses to women during childbirth and factors that influence the provision of support. Exploratory, descriptive. Work sampling method was used to determine the percentage of time nurses spend in supportive care activities. Twelve nurses were observed over six nonconsecutive day shifts on a birthing unit of a Canadian teaching hospital in Quebec. A total of 404 observations were made. Nurses were also interviewed to determine their perceptions of what constitutes supportive nursing care and the factors that facilitate or inhibit the provision of this care. Nurses spent only 12.4% of their total time providing supportive care to laboring women. Interviews with nurses suggested that perceptions of the components of supportive care were comparable to this study's operational definition of support, namely: physical, emotional, and instructional/informational support and advocacy. Barriers to providing support identified by nurses included lack of time and insufficient staff. However, further content analysis of the interview data revealed that healthcare providers had a pervasive sense of control over laboring women and their partners. Although nursing support has been identified as an important aspect of nursing care in childbirth, this study demonstrated an incongruity between what nurses perceived as being supportive care and the amount of support that was actually provided. Barriers to the provision of supportive care in the practice setting as well as suggestions for its enhancement are discussed.

  18. Women's experiences of coping with pain during childbirth: a critical review of qualitative research.

    Science.gov (United States)

    Van der Gucht, Natalie; Lewis, Kiara

    2015-03-01

    professionals to maintain a continuous presence throughout childbirth and support a social model of care that promotes continuity of care and an increasing acceptance of pain as part of normal childbirth. It is suggested future research regarding the role of antenatal provision for instilling such a viewpoint in preparation of birth be undertaken to inform policy makers. The need for a shift in societal norms is also suggested to disseminate expectations and positive or negative views of what the role of pain during childbirth should be to empower women to cope with childbirth and embrace this transition to motherhood as part of a normal process. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Improving Tanzanian childbirth service quality.

    Science.gov (United States)

    Jaribu, Jennie; Penfold, Suzanne; Green, Cathy; Manzi, Fatuma; Schellenberg, Joanna

    2018-04-16

    Purpose The purpose of this paper is to describe a quality improvement (QI) intervention in primary health facilities providing childbirth care in rural Southern Tanzania. Design/methodology/approach A QI collaborative model involving district managers and health facility staff was piloted for 6 months in 4 health facilities in Mtwara Rural district and implemented for 18 months in 23 primary health facilities in Ruangwa district. The model brings together healthcare providers from different health facilities in interactive workshops by: applying QI methods to generate and test change ideas in their own facilities; using local data to monitor improvement and decision making; and health facility supervision visits by project and district mentors. The topics for improving childbirth were deliveries and partographs. Findings Median monthly deliveries increased in 4 months from 38 (IQR 37-40) to 65 (IQR 53-71) in Mtwara Rural district, and in 17 months in Ruangwa district from 110 (IQR 103-125) to 161 (IQR 148-174). In Ruangwa health facilities, the women for whom partographs were used to monitor labour progress increased from 10 to 57 per cent in 17 months. Research limitations/implications The time for QI innovation, testing and implementation phases was limited, and the study only looked at trends. The outcomes were limited to process rather than health outcome measures. Originality/value Healthcare providers became confident in the QI method through engagement, generating and testing their own change ideas, and observing improvements. The findings suggest that implementing a QI initiative is feasible in rural, low-income settings.

  20. Experiences of childbirth in Natal Indian women

    Directory of Open Access Journals (Sweden)

    H.B. Brookes

    1991-09-01

    Full Text Available Through fifteen in-depth case studies of primipara, Natal Indian women’s experiences of childbirth have been described Common problems were identified, including lack of a family support person throughout labour, lithotomy position for delivery, episiotomies and their sequelae, breast-feeding difficulties and lack of professional support in the early puerperium at home. Preparation for common medical interventions in labour, breast-feeding and parenting appeared inadequate. Pertinent sociocultural aspects have been identified. These include continuing family support and culturally prescribed behaviour pertaining most importantly to the early puerperium and affecting the maternal-neonatal dyad. In the early adaptation to motherhood informants continued their role as daughter or daughter-in-law and would only actively continue their role as wife later or at the end of the puerperium. These traditional patterns of behaviour persist despite marked changes in educational level, language spoken and employment status. In the light of this research and founded on scientific evidence, a number of recommendations are made and areas for further research are identified

  1. [A gender perspective on medicalized childbirth].

    Science.gov (United States)

    Kuo, Su-Chen

    2015-02-01

    Gender mainstreaming is a worldwide issue. The United Nations and the World Health Organization have emphasized the importance of incorporating gender perspectives and gender equity into government policy decisions. Different cultures have different attitudes toward the management of childbirth and these attitudes influence the feelings and needs of women and their partners. These needs must be better understood and satisfied. The widely held technocratic values of obstetricians influence the birthing experience of women significantly. This article uses a gender perspective to describe the medicalization of childbirth, the pharmacological pain-relief oppression of women, the prevalence of blaming women for decisions to conduct Caesarean sections, and the exclusion of men from involvement in the childbirth process. This article may be used as reference to enhance gender equality childbirth care for women.

  2. The Lived Experience of Knowing in Childbirth

    OpenAIRE

    Savage, Jane Staton

    2006-01-01

    Research on knowing in childbirth has largely been a quantitative process. The purpose of this study was to understand the ways first-time mothers learn about birth. A phenomenological approach, using a feminist view, was used to analyze two in-depth interviews and journals to understand nine first-time expectant mothers' experiences of knowing in childbirth. The findings demonstrated a range of knowledge that contributed to issues of control and conflict. The participants also described an i...

  3. Pregnancy and childbirth: is the doctor necessary?

    Science.gov (United States)

    Llewellyn-Jones, D

    1979-05-01

    The changing fashions in childbirth over the past 200 years are related to the present demand by women and their partners for "participatory" childbirth, including homebirth. The argument is advanced that doctors must be responsive to these changes. The opinion is made that home birth is currently inappropriate, but that hospitals should provide "birth centres"; and that obstetrics should be conducted by a "team", in which nurse-midwives and family doctors play as important a role as specialist obstetricians.

  4. A Study of Faculty Views of Statistics and Student Preparation beyond an Introductory Class

    Science.gov (United States)

    Doehler, Kirsten; Taylor, Laura; Smith, Jessalyn

    2013-01-01

    The purpose of this research is to better understand the role of statistics in teaching and research by faculty from all disciplines and their perceptions of the statistical preparation of their students. This study reports the findings of a survey administered to faculty from seven colleges and universities regarding the use of statistics in…

  5. Marginal microleakage evaluation in class V composite restorations of deciduous teeth prepared conventionally and using Er:YAG laser

    International Nuclear Information System (INIS)

    Pulga, Neusa Vieira Galvao

    2001-01-01

    The evaluation of marginal microleakage in class V restorations of deciduous teeth prepared using Er:laser and comparison to the ones observed when conventionally prepared, using two photopolimerizable materials, composite resin and glass ionomer cement, was the subject of this study. Twenty eight complete deciduous teeth were divided into four groups Group 1 (G1) prepared with high speed drill + composite resin; Group 2 (G2) prepared with high speed drill + glass ionomer cement; Group 3 (G3) prepared using Er:YAG laser (2.94 μm), 300 mJ, 3 Hz, handpiece 2051, energy density 86 mJ/cm 2 + composite resin; Group 4 (G4) prepared using Er:YAG laser (2.94 μm), 300 mJ, 3 Hz, handpiece 2051, energy density 86 J / cm 2 + glass ionomer cement. After the preparation and restoration the specimens where stored at 37 deg C for 24 hours, thermally stressed, immersed in 50% aqueous solution of silver nitrate for 24 hours while kept in the dark. The specimens were rinsed in water, soaked in photodeveloping solution and exposed to fluorescent light for 6 hours. After this process the samples were sectioned and observed by stereomicroscopy. For comparison the groups were divided into occlusive and cervical microleakage. The results were analysed under the Kruskal-Wallis test. For the occlusive microleakage the statistical significance was 5% among the groups and the average comparison showed higher microleakage for G1 (M=35.1) than for G2 (M=24.0) as well as compared to G3 (M=22.3). The other groups did not present statistical differences among them. For the cervical microleakage the Kruskal-Wallis test did not present any statistical difference. Comparing the occlusive and cervical microleakage data, for every group, using the Wilcoxon test, no statistical differences were observed. Concluding, this study showed the Er:YAG laser to be effective for class V restorations and to result in a smaller microleakage degree using the composite resin. These results indicate the viability

  6. Experiences of Primiparous Mothers Regarding Natural Childbirth Problems (A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Tahereh Boryri

    2016-07-01

    Full Text Available Women experience several problems during the childbirth process which always remain with them throughout their lives. These problems affect the health of the mother and the child, the emotional relationship between them, the sexual activity and the desire to have her next child in the future. This qualitative study is designed to explore the experiences of primiparous women about natural childbirth problems. This qualitative study is conducted on primiparous women who referred to the health center of Imam Javad in Zahedan. The sample selection is based on objective; the data are collected using semi-structured interviews with 18 primiparous mothers who had healthy natural childbirth. The data are collected through an interview that is done in the first visit within 72 hours after the childbirth, and the data are analyzed through content analysis. After analysis of the data, four themes associated with the problem of the first natural childbirth are extracted. The first is the fear and stress of the labor pain that most participants expressed as the major problem of natural childbirth. The second theme is lack of awareness and lack of information about the process of labor and the delivery room environment; this means that participants of this study are mostly unfamiliar with the process of labor and the delivery room environment and this leads to their fear and pain. The other two themes are the need for protection and support of the mothers by the midwives, their family and their friends. Based on the results of this study, the problems of human resources are stated as being more serious than the problems regarding the environment and modern equipment. This leads to the increase of attention of the midwives and other medical staff on psychological and spiritual needs of mothers and supporting them during the labor in addition to the physical health of the mother and the fetus. In this regard, childbirth classes are recommended in outlining the

  7. Evaluation of the temperature rise in pulp chamber during class V preparation with Er:YAG laser

    International Nuclear Information System (INIS)

    Picinini, Leonardo Santos

    2001-01-01

    One of the major concerns regarding laser irradiation in the dentistry field is the overheating in dental tissue, specially pulpal tissue. A temperature raise over 5.5 deg C is considered to be harmful to its vitality. The current study evaluated the temperature increase in the pulp chamber, during class V preparation, performed with the laser Er:YAG in 36 bovine incisive extracted teeth. The samples were eroded on the outer side of the vestibular wall to obtain the dentinal thickness of 2.0 mm (group I), 1.0 mm (group II) and 0.5 mm (group III). Thermocouples were fixed to the inner part of the vestibular wall using thermal paste, through the palatine opening of the samples. Class V cavities were prepared in the vestibular side only in 1 mm 2 thick dentins. Irradiation parameters used were: 500 mJ/10 Hz, 850 mJ/10 Hz and 1 000 mJ/10 Hz for all the groups. The results were processed by a microcomputer. This study showed that the temperature increased into the pulpal cavity reached around 3 deg C for the groups I (2,0 mm thick dentine) and II (1.0 mm thick dentine). In the group III (0.5 mm thick) temperature was around 5.5 deg C. Thus, the parameters used for cavity preparation, using Er:YAG laser, were safe in relation to the temperature raise for dentinal thickness of 1,0 and 2,0 mm; in 0.5 mm thick dentins, temperature increase reached 5.5 deg C and an appropriate correction in the laser parameters was necessary. (author)

  8. A woman-centred childbirth model | Maputle | Health SA Gesondheid

    African Journals Online (AJOL)

    A model for woman-centred childbirth was developed through four phases in accordance with the objectives of the study, namely, a description of mothers' experiences of childbirth and that of attending midwives of managing mothers during childbirth concept analysis of woman-centred care, model development, and an ...

  9. Childbirth Self-Efficacy Inventory and Childbirth Attitudes Questionnaire: psychometric properties of Thai language versions.

    Science.gov (United States)

    Tanglakmankhong, Kamonthip; Perrin, Nancy A; Lowe, Nancy K

    2011-01-01

    This paper is a report of the psychometric properties of the Thai language versions of the Childbirth Self-Efficacy Inventory and the Childbirth Attitudes Questionnaire, and the equivalence of the Thai and English versions of these instruments. The Childbirth Self-Efficacy Inventory and the Childbirth Attitudes Questionnaire were developed to measure women's abilities to cope with labour and fear of childbirth. Consistent with Bandura's Self-Efficacy Theory, women who have greater confidence in their ability to cope with labour have reported having less fear in childbirth. However, research is needed to validate the measures and this relationship in countries other than the United States of America, where the tools were developed. Back-translation was used. Content validity was examined by experts. The psychometric properties were estimated with internal consistency reliability, construct validity, contrasted groups and criterion-related validity with 148 pregnant women at a hospital in Thailand in 2008. Both measures were shown to have high internal consistency. Contrasting group and criterion-related validity were consistent with self-efficacy theory and findings in the United States. Differences between the stages of labour across expectancies in the Childbirth Self-Efficacy inventory were found only for second stage. Support for good validity and reliability of the instruments when used with Thai women was demonstrated. It may be appropriate for Thai women to use The Childbirth Self-Efficacy Inventory only in relation to the second stage of labour. © 2010 The Authors. Journal of Advanced Nursing © 2010 Blackwell Publishing Ltd.

  10. “Pinklining” and Childbirth Education

    OpenAIRE

    2000-01-01

    Domestic violence in a family is often found to have begun during a pregnancy. “Pinklining” is denying insurance to victims of domestic violence. Both domestic violence and pinklining are concepts with which the childbirth educator should be familiar, including the relevant laws and resources.

  11. Resumption Of Sexual Relationship After Childbirth: Preliminary ...

    African Journals Online (AJOL)

    Resumption Of Sexual Relationship After Childbirth: Preliminary Observations On Husband\\'s Attitude. ... An open-ended questionnaire developed by the authors was used to elicit information on relevant aspects of husbands' reproductive behaviour. We found that husbands' preferred time of resumption of sexual ...

  12. Subsequent childbirth after a previous traumatic birth.

    Science.gov (United States)

    Beck, Cheryl Tatano; Watson, Sue

    2010-01-01

    Nine percent of new mothers in the United States who participated in the Listening to Mothers II Postpartum Survey screened positive for meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for posttraumatic stress disorder after childbirth. Women who have had a traumatic birth experience report fewer subsequent children and a longer length of time before their second baby. Childbirth-related posttraumatic stress disorder impacts couples' physical relationship, communication, conflict, emotions, and bonding with their children. The purpose of this study was to describe the meaning of women's experiences of a subsequent childbirth after a previous traumatic birth. Phenomenology was the research design used. An international sample of 35 women participated in this Internet study. Women were asked, "Please describe in as much detail as you can remember your subsequent pregnancy, labor, and delivery following your previous traumatic birth." Colaizzi's phenomenological data analysis approach was used to analyze the stories of the 35 women. Data analysis yielded four themes: (a) riding the turbulent wave of panic during pregnancy; (b) strategizing: attempts to reclaim their body and complete the journey to motherhood; (c) bringing reverence to the birthing process and empowering women; and (d) still elusive: the longed-for healing birth experience. Subsequent childbirth after a previous birth trauma has the potential to either heal or retraumatize women. During pregnancy, women need permission and encouragement to grieve their prior traumatic births to help remove the burden of their invisible pain.

  13. The Lived Experience of Knowing in Childbirth

    Science.gov (United States)

    Savage, Jane Staton

    2006-01-01

    Research on knowing in childbirth has largely been a quantitative process. The purpose of this study was to understand the ways first-time mothers learn about birth. A phenomenological approach, using a feminist view, was used to analyze two in-depth interviews and journals to understand nine first-time expectant mothers' experiences of knowing in childbirth. The findings demonstrated a range of knowledge that contributed to issues of control and conflict. The participants also described an increased dependency on their mothers and a lack of their own intuition contiguous to the birth process. These findings contribute understanding to how expectant mothers know birth, suggesting that their knowing does not diminish conflict surrounding the event and may even exacerbate it when not combined with learning skills to manage conflict. Childbirth educators may want to include instruction on negotiating power differential in relationships encountered during childbirth in order to strengthen a first-time mother's ability to receive the care she wants. Educators may also want to assess the expectant mother's view of birth and her expectations for birth. Schools of nursing should consider the inclusion of women-centered care curricula at both the undergraduate and graduate levels. The mothers' responses in this study clearly reveal that the politics surrounding birthing remain in place and must be removed in order to provide a supportive environment for normal birth. PMID:17541456

  14. Posttraumatic stress following childbirth: A review

    NARCIS (Netherlands)

    Olde, E.; Hart, O. van der; Kleber, R.J.; Son, M.J.M. van

    To assess the empirical basis of prevalence and risk factors of childbirth-related posttraumatic stress symptoms and PTSD in mothers, the relevant literature was critically reviewed. A MEDLINE and PSYCHLIT search using the key words bposttraumatic stressQ, bPTSDQ, bchildbirthQ and btraumatic

  15. Factors related to women's childbirth satisfaction in physiologic and routine childbirth groups

    Directory of Open Access Journals (Sweden)

    Elham Jafari

    2017-01-01

    Full Text Available Background: Women's satisfaction with childbirth is an important measure of the quality of maternity care services. This study aims to address factors related to women's childbirth satisfaction in physiological and routine childbirth groups. Materials and Methods: This descriptive-analytical study was conducted among 340 women in physiological and routine childbirth groups in 2012. Women were selected through convenience sampling method in the routine group and by census in the physiological group. Data were collected using a 5-part questionnaire composed of demographic and obstetrics details, Mackey's Childbirth Satisfaction Rating Scale (CSRS, satisfied with birth setting, Labor Agentry Scale (LAS, and Visual Analogue Scale (VAS, which was completed by interview 24 hours after childbirth. Data were analyzed using the Statistical Package for the Social Sciences version 18 software using Pearson correlation test, independent t-test, analysis of variance, and linear, multivariate regression model at the significant level of P 0.05. Conclusions: Improved physical structure and setting of birth room, nonmedical pain relief, mothers' involvement in the process of labor, and sense of being in control are associated with mothers' satisfaction.

  16. Childbirth and Trauma, 1940s-1980s.

    Science.gov (United States)

    Michaels, Paula A

    2018-01-01

    This article analyzes trauma in mid-twentieth century hospital births, focusing on the United States, but with additional evidence drawn from Great Britain and France. As many as half of women today experience childbirth as traumatic and no evidence suggests that the figure was lower a half-century ago. Drawing on women's birth narratives and psychiatric literature, this article highlights the striking consistency over time in how women describe their experiences of traumatic birth. By the 1970s, however, women proved less ready to accept their trauma as the product of their own psychological shortcomings. Under the sway of second-wave feminism, they pushed back against care they defined as inhumane in both conventional maternity care and in natural childbirth. Psychiatry too demonstrates change over time. Hegemonic at midcentury, Freudian thinking began to yield to critiques that questioned gender norms and the preeminence of the subconscious. Based on private letters to maternity caregivers and between physicians, as well as a wide array of medical journal articles, popular magazines, and newsletters from childbirth education and birth advocacy organizations, this article argues that, despite different approaches to trauma in birth and clarity about how best to minimize it, contemporary maternity care has to date proven unable to heed the lessons of history. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  17. Sources, responses and moderators of childbirth fear in Australian women: a qualitative investigation.

    Science.gov (United States)

    Fenwick, J; Toohill, J; Creedy, D K; Smith, J; Gamble, J

    2015-01-01

    around 20% of women suffer childbirth fear causing them significant distress and often leading to requests for caesarean section. In Sweden, fearful pregnant women are offered counselling; however, in Australia, no dedicated service caters for the specific needs of these women. Indeed scant research has been conducted in Australia and little is known about women's concerns and if these align to those reported in the international literature. to describe the sources, responses and moderators of childbirth fear in a group of pregnant women assessed as having high levels of childbirth fear. comparative analysis was used to identify common concepts and generate themes that represented women's perspectives of childbirth fear. Data consisted of 43 tape recorded telephone conversations with highly fearful pregnant women who were participating in a large randomised controlled trial known as BELIEF (Birth Emotions, Looking to Improve Expectant Fear). women's fears were conceptualised into three themes: fear stimuli; fear responses; and fear moderators. Lack of confidence to birth, fear of the unknown, internalising other women's negative stories, perineal tearing and labour pain were common concerns for first time mothers. For multiparous women, not having had personal feelings resolved following their previous birth and negative experiences of last birth influenced current expectations for their upcoming birth. Themes common to both groups were: unmet information and support needs, feelings of loss of control and lack of input in to decision-making. Some women however, chose to avoid birth planning in order to cope during pregnancy. Australian women had similar childbirth concerns to those reported in the international literature. However unique to this study was finding two opposing discourses; one of preoccupation with negative events and the other; avoidance of planning for labour and birth. Provision of woman centred maternity models that minimise obstetric

  18. Disrespect and abuse during pregnancy, labour and childbirth: a ...

    African Journals Online (AJOL)

    Disrespect and abuse during pregnancy, labour and childbirth: a qualitative study from four primary healthcare centres of Amhara and Southern Nations Nationalities and People's Regional States, Ethiopia.

  19. A comparative study of expectant parents ' childbirth expectations.

    Science.gov (United States)

    Kao, Bi-Chin; Gau, Meei-Ling; Wu, Shian-Feng; Kuo, Bih-Jaw; Lee, Tsorng-Yeh

    2004-09-01

    The purpose of this study was to understand childbirth expectations and differences in childbirth expectations among expectant parents. For convenience sampling, 200 couples willing to participate in this study were chosen from two hospitals in central Taiwan. Inclusion criteria were at least 36 weeks of gestation, aged 18 and above, no prenatal complications, and willing to consent to participate in this study. Instruments used to collect data included basic demographic data and the Childbirth Expectations Questionnaire. Findings of the study revealed that (1) five factors were identified by expectant parents regarding childbirth expectations including the caregiving environment, expectation of labor pain, spousal support, control and participation, and medical and nursing support; (2) no general differences were identified in the childbirth expectations between expectant fathers and expectant mothers; and (3) expectant fathers with a higher socioeconomic status and who had received prenatal (childbirth) education had higher childbirth expectations, whereas mothers displayed no differences in demographic characteristics. The study results may help clinical healthcare providers better understand differences in expectations during labor and birth and childbirth expectations by expectant parents in order to improve the medical and nursing system and promote positive childbirth experiences and satisfaction for expectant parents.

  20. Effects of low-intensity GaAlAs laser radiation (λ=660 nm) on dentine-pulp interface after class I cavity preparation

    International Nuclear Information System (INIS)

    Godoy, Bruno Miranda

    2003-01-01

    The aim of this study was to investigate the effects of low-intensity irradiation with GaAlAs laser (red emission) on the ultrastructure of dentine-pulp interface after conventionally prepared class I cavity preparation. Two patients with 8 premolars for extraction indicated for orthodontic reasons. Class I cavities were prepared in these teeth that were then divided into two groups. The first group received a treatment with laser with continuous emission, λ=660 nm, with maximum power output of 30 mW. The dosimetry applied was of approximately 2J/cm 2 , directly and perpendicularly into the cavity in only one section. After the irradiation, the cavities were filled with composite resin. The second group received the same treatment, except by the laser therapy. Twenty-eight days after the preparation, the teeth were extracted and were processed for transmission electron microscopy analysis. Two sound teeth, without any preparation, were also studied. The irradiated group presented odontoblastic processes in higher contact with the extracellular matrix and the collagen fibers appeared more aggregated and organized than those of control group. These results were also observed in the healthy-teeth. Thus, we suggest that laser irradiation accelerates the recovery of the dental structures involved in the cavity preparation at the pre-dentine level. (author)

  1. Age at First Childbirth and Hypertension in Postmenopausal Women.

    Science.gov (United States)

    Park, Sangshin

    2017-05-01

    Whether age at first childbirth has an effect on hypertension incidence is unclear. The objectives of this study were to examine the relationship between age at first childbirth and hypertension and to examine whether degree of obesity, measured as body mass index, mediates age at first childbirth-related hypertension in postmenopausal women. This study analyzed 4779 postmenopausal women data from the Korea National Health and Nutrition Examination Survey 2010 to 2012. Logistic regression analyses were used to investigate relationship between age at first childbirth and hypertension. Mediation analysis was performed to examine the contribution of body mass index to age at first childbirth-related hypertension. Mean of participants' age at first childbirth and current age were 23.8 and 63.4 years, respectively. The prevalence of hypertension was 51.1%. Age at first childbirth was significantly associated with the prevalence of hypertension (odds ratio, 0.963; 95% confidence interval, 0.930-0.998; P =0.036). Women with age at first childbirth ≤19 years had significantly higher risk of hypertension (odds ratio, 1.61; 95% confidence interval, 1.17-2.23; P =0.004) compared with those >19 years. Multivariable-adjusted prevalence of hypertension was significantly lower in women who delivered the first infant at 20 to 24 (45.5%), 25 to 29 (46.1%), and ≥30 (39.9%) years compared with those at ≤19 years (58.4%). Body mass index completely mediated age at first childbirth-hypertension relationship (indirect effect: odds ratio, 0.992; 95% confidence interval, 0.987-0.998; P =0.008). Age at first childbirth was significantly associated with hypertension in postmenopausal women. Body mass index mediated the effects of age at first childbirth on hypertension. © 2017 American Heart Association, Inc.

  2. The Effect of Childbirth Self-Efficacy on Perinatal Outcomes

    Science.gov (United States)

    Tilden, Ellen L.; Caughey, Aaron B.; Lee, Christopher S.; Emeis, Cathy

    2016-01-01

    Objective To synthesize and critique the quantitative literature on measuring childbirth self-efficacy and the effect of childbirth self-efficacy on perinatal outcomes. Data Sources Eligible studies were identified through searching MEDLINE, CINAHL, Scopus, and Google Scholar databases. Study Selection Published research using a tool explicitly intended to measure childbirth self-efficacy and also examining outcomes within the perinatal period were included. All manuscripts were in English and published in peer-reviewed journals. Data Extraction First author, country, year of publication, reference and definition of childbirth self-efficacy, measurement of childbirth self-efficacy, sample recruitment and retention, sample characteristics, study design, interventions (with experimental and quasi-experimental studies), and perinatal outcomes were extracted and summarized. Data Synthesis Of 619 publications, 23 studies published between 1983 and 2015 met inclusion criteria and were critiqued and synthesized in this review. Conclusions There is overall consistency in how childbirth self-efficacy is defined and measured among studies, facilitating comparison and synthesis. Our findings suggest that increased childbirth self-efficacy is associated with a wide variety of improved perinatal outcomes. Moreover, there is evidence that childbirth self-efficacy is a psychosocial factor that can be modified through various efficacy-enhancing interventions. Future researchers will be able to build knowledge in this area through: (a) utilization of experimental and quasi-experimental design; (b) recruitment and retention of more diverse samples; (c) explicit reporting of definitions of terms (e.g. ‘high risk’); (d) investigation of interventions that increase childbirth self-efficacy during pregnancy; and, (e) investigation regarding how childbirth self-efficacy enhancing interventions might lead to decreased active labor pain and suffering. Exploratory research should

  3. Survival of self-etch adhesive Class II composite restorations using ART and conventional cavity preparations in primary molars.

    NARCIS (Netherlands)

    Eden, E.; Topaloglu-Ak, A.; Frencken, J.E.F.M.; Hof, M.A. van 't

    2006-01-01

    PURPOSE: To test the null-hypothesis that there was no difference in the survival percentages of Class II composite restorations in primary teeth produced through either ART or conventional approaches after 2 years. METHODS: 157 children with 325 Class II cavitated dentin lesions were included in a

  4. Beliefs, practices, and experiences of Korean women in relation to childbirth.

    Science.gov (United States)

    Park, K J; Peterson, L M

    1991-01-01

    Korean women's health beliefs and childbirth experiences in the United States were examined. A convenience sampling procedure was used, and face-to-face interviews were conducted in Korean. Interviews were audiotaped, typed, and translated from Korean to English. These women had a holistic concept of health. Some practices were influence by ancient Chinese medicine. Childbirth experiences indicated that language is a barrier requiring specific interventions. Recommendations include (a) development of an assessment tool with which health-care professionals can identify individual health beliefs early in pregnancy; (b) development of a bilingual pamphlet about medical terms and the U.S. health-care system; (c) development of a short bilingual dictionary of common foods for use in menu selection during hospitalization; and (d) provision of English practice periods based on anticipatory guidance principles to prepare women to ask for specific assistance.

  5. Antenatal hypnosis training and childbirth experience: a randomized controlled trial.

    Science.gov (United States)

    Werner, Anette; Uldbjerg, Niels; Zachariae, Robert; Wu, Chun Sen; Nohr, Ellen A

    2013-12-01

    Childbirth is a demanding event in a woman's life. The aim of this study was to explore whether a brief intervention in the form of an antenatal course in self-hypnosis to ease childbirth could improve the childbirth experience. In a randomized, controlled, single-blinded trial, 1,222 healthy nulliparous women were allocated to one of three groups during pregnancy: A hypnosis group participating in three 1-hour sessions teaching self-hypnosis to ease childbirth, a relaxation group receiving three 1-hour lessons in various relaxation methods and Mindfulness, and a usual care group receiving ordinary antenatal care only. Wijmas Delivery Expectancy/Experience Questionnaire (W-DEQ) was used to measure the childbirth experience 6 weeks postpartum. The intention-to-treat analysis indicated that women in the hypnosis group experienced their childbirth as better compared with the other two groups (mean W-DEQ score of 42.9 in the Hypnosis group, 47.2 in the Relaxation group, and 47.5 in the Care as usual group (p = 0.01)). The tendency toward a better childbirth experience in the hypnosis group was also seen in subgroup analyses for mode of delivery and for levels of fear. In this large randomized controlled trial, a brief course in self-hypnosis improved the women's childbirth experience. © 2013, Copyright the Authors Journal compilation © 2013, Wiley Periodicals, Inc.

  6. Choice of place for childbirth: prevalence and correlates of utilization ...

    African Journals Online (AJOL)

    Independent predictors for utilisation of a health facility were place of last childbirth, and knowledge that traditional birth attendants (TBAs) are given none food items (excluding money) after assisting delivery. Compared to mothers who delivered their last pregnancy at a health facility, mothers who had their last childbirth at ...

  7. Long-term effects of childbirth in MS

    NARCIS (Netherlands)

    D'hooghe, M.B.; Nagels, G.; Uitdehaag, B.M.J.

    2010-01-01

    Background: The uncertainty about long-term effects of childbirth presents MS patients with dilemmas. Methods: Based on clinical data of 330 female MS patients, the long-term effects of childbirth were analysed, using a cross-sectional study design. Four groups of patients were distinguished: (1)

  8. The effect of gingival wall location on the marginal seal of class ii restorations prepared with a flowable bulk-fill resin-based composite.

    Science.gov (United States)

    Segal, P; Candotto, V; Ben-Amar, A; Eger, M; Matalon, S; Lauritano, D; Ormianer, Z

    2018-01-01

    SureFil SDR is a flowable resin-based composite that allows a single incremental bulk placement. The marginal seal of SureFil SDR at the gingival margins of class II restorations located apical to the cemento-enamel-junction (CEJ) has not been adequately evaluated compared to those located occlusal to the CEJ. Forty class II cavities were prepared in human molars. The gingival margins of 20 preparations were located 0.5 mm occlusal to the CEJ, and the other 20 preparations were located 0.5 mm apical to the CEJ. The cavities surfaces were bonded with XenoV dental adhesive and filled with SDR in one bulk increment up to 4 mm, after which they were covered with CeramX. The teeth were subjected to thermo-and load-cycling, and their gingival margins were exposed to 0.5% basic-fuchsin solution. The specimens were sectioned mesio-distally and scored for microleakage. A Wilcoxon test for pairwise comparison was performed to determine significance. Dye penetration was observed in 30% of the 20 restorations with cavo-surface margins located occlusal to the CEJ and in 55% of the 20 restorations with cavo-surface margins located apical to the CEJ. The bulk-fill flowable resin base SureFil SDR with XenoV dental adhesive provided a better marginal seal in class II restorations with gingival margins above the CEJ compared to restorations with gingival margins below the CEJ. SDR should not be recommended for class II cavity preparations with gingival margins located below the CEJ.

  9. Barriers to spousal contribution to childbirth pain relief in Nigeria.

    Science.gov (United States)

    Emelonye, A U; Pitkäaho, T; Aregbesola, A; Vehviläinen-Julkunen, K

    2017-12-01

    The aim of this study was to investigate the barriers inhibiting the use of spousal presence for childbirth pain relief in health facilities and recommendations from three perspectives: the midwife, the woman, and the spouse. Spousal presence is a non-invasive, participatory and inexpensive technique used in pain management during childbirth. Although it contributes to a large extent in relieving childbirth pain, it is underutilized in Nigerian hospitals. Overcoming the challenges impeding spousal presence and participation during childbirth will improve maternal outcome, satisfaction and midwifery care practices. A cross-sectional survey conducted in four hospitals in Nigeria involving midwives (n = 100), women (n = 142) and their spouses (n = 142) from June to December 2014 using pretested questionnaires. Five themes were identified: poor infrastructural facility, lack of adequate pain management policy, lack of midwife pain management practices, midwives' attitudes towards spousal presence during childbirth and feelings about spousal presence during childbirth pain relief. Infrastructural defects in the health facilities resulting in the lack of privacy in maternity units for both spouses and partners negatively influence the presence of a spouse during childbirth and pain relief. Adopting effective strategies such as good infrastructural facilities, staff training and spouse-friendly hospital policies will encourage spouses to fully participate in and contribute to childbirth pain relief. This study identified poor staff attitudes towards pain relief and spousal presence during childbirth as barriers. Providing adequate policies on pain management, continuous staff education and orientation on spousal relationship will improve active spousal participation and maternal satisfaction during childbirth. © 2016 International Council of Nurses.

  10. Marginal microleakage in vitro study on class V cavities prepared with Er:YAG laser and etched with acid or etched with Er:YAG laser and acid

    International Nuclear Information System (INIS)

    Tavares, Henrique Dutra Simoes

    2001-01-01

    Microleakage at the interface between the teeth and the restorative materials remains a problem with composite resin restorations. Microleakage at the gingival margins of class V cavities restorations still challenge as they are usually placed in dentin and/or cementum. Previous studies have shown that the cavity preparation with Er:YAG laser is possible. It has been reported that Er:YAG laser has ability to create irregular surface providing micromechanical retention for adhesive dental restorative materials and to improve marginal sealing. The purpose of this in vitro study was to evaluate the marginal microleakage on class V cavities prepared with Er:YAG laser and etched with acid or with Er:YAG laser and acid, in compared to those prepared and etched conventionally. Thirty human molars were divided into three groups, namely: group I - prepared with Er:YAG laser (KaVo KEY Laser II - Germany) and etched with 37% phosphoric acid; group II - prepared with Er:YAG laser and etched with Er:YAG laser and 37% phosphoric acid; group III (control group) - prepared with high speed drill and etched with 37% phosphoric acid. All cavities were treated with same adhesive system (Single Bond - 3M) and restored with the composite resin (Z100 - 3M), according to the manufacturer's instructions. The specimens were stored at 37 deg C in water for 24 hours, polished with Sof-Lex discs (3M), thermally stressed, sealed with a nail polish coating except for the area of the restoration and 1 mm around it, and immersed in a 50% aqueous solution of silver nitrate for 24 hours. After that, the specimens were rinsed in water, soaked in a photodeveloping solution and exposed to a fluorescent light for 8 hours. The teeth were embedded in an autopolymerizing resin and sectioned longitudinally using a diamond saw microtome under running water. The sections were photographed. The microleakage at the occlusal cavity and at the gingival margins of each specimen was evaluated with scores (0-3) by

  11. [Change of care model in natural childbirth: Implementation in La Ribera delivery room].

    Science.gov (United States)

    Camacho-Morell, F; Romero-Martín, M J

    To assess knowledge, wish for inclusion and implementation of normal childbirth care protocols at La Ribera University Hospital, the reason why they are not applied, and to assess the attendance at antepartum training activities. Cross-sectional descriptive study. They were carried out 186 surveys by convenience sampling to pregnant women attending fetal well-being control at hospital between 2014 and 2015. They were collected data about knowledge, wish for inclusion, compliance of protocols and reasons for non-compliance, and attendance at antepartum training activities. Percentages and confidence intervals were calculated. Chi-square test was used to compare categorical variables. They were collected percentages of knowledge (77%, CI95%: 75,5-78,5) and wish for inclusion (84,6%, CI 95% : 82,5-86,7). Protocol compliance ranged from 6% (nitrous oxide administration) to 91% (skin-to-skin contact). The main reasons for non-compliance were due to circumstances of childbirth process (56,3%, CI 95% : 51,1-61,5). Attendance at maternal education classes was 62%, mainly primiparous women (p=0,0001) with medium or high education level (p=0,001). Pregnant women have a high knowledge and wish for inclusion of normal childbirth care protocols. Attendance at antepartum training activities could by improved and the main reason for non-attendance is lack of information. Compliance is good enough in most protocols; when they are not applied is due to childbirth circumstances. Remaining tasks include the introduction of additional protocols and to involve pregnant women in decision-making. Copyright © 2017 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. How does materiality shape Childbirth? An explorative journey into evidence, childbirth practices & Science and Technology Studies

    DEFF Research Database (Denmark)

    Clausen, Jette Aaroe

    2010-01-01

    " for those positioned in evidence based medicine and midwifery about the use of technology in childbirth. The empirical material is developed during a field study at a maternity ward. Noisy stories about the use of epidurals and fetal monitors are used as resources. Noisy stories are stories that do......The randomized controlled trial (RCT) is the golden standard in evidence based medicine (EBM), it is used to address the problem of intervention and the use of technology in childbirth. This dissertation discusses the relationship between RCTs and everyday birthing practices. The point of departure...... is Science and Technology Studies (STS). (Post) Actor Network Theory and postphenomenology is used as theoretical resources to help formulate questions to EBM, midwifery and birthing practices. A central theoretical resource is the Dutch Philosopher Annemarie Mol’s concept of mul-tiplicity. Mol argues...

  13. Childbirth experience according to a group of Brazilian primiparas.

    Science.gov (United States)

    Nakano, Ana Márcia Spanó; Homsi Jorge Ferreira, Cristine; de Almeida, Ana Maria; Gomes, Flávia Azevedo

    2012-12-01

    to understand the meaning of the childbirth experience for Brazilian primiparas in the postpartum period. a qualitative approach using semi-structured interviews. Content analysis was used to derive the two themes that emerged from the discourses. participants were recruited at four primary-level health-care units in Ribeirão Preto, Brazil. After providing written informed consent, an appointment was made for an interview at the participants' homes. 20 primiparas in the postpartum period, aged 15-26 years old, who attended the health-care units to vaccinate their infants and test for phenylketonuria. two thematic categories emerged from the interviews: the meaning attributed to childbirth (with four subcategories) and perceptions of care. Among the participants, the childbirth experience was marked by the 'fear of death' and 'losing the child'. The pain of giving birth was expected, and the moment of childbirth was associated with pain of high intensity. childbirth is considered synonymous with physical and emotional suffering, pain, fear and risk of death. this research indicates the need to break the current mechanistic model of care on which health professionals' actions are based. Care during childbirth must be guided by the foundation that women are the subjects of childbirth actions, in an attempt to emphasise actions that grant them with the autonomy and empowerment needed to experience the situation. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. The Gelation of Polyvinyl Alcohol with Borax: A Novel Class Participation Experiment Involving the Preparation and Properties of a "Slime."

    Science.gov (United States)

    Casassa, E. Z.; And Others

    1986-01-01

    Background information, procedures used, and typical results obtained are provided for an experiment in which students prepare and study the characteristics of a "slime." A list of general, inorganic, and polymer chemistry concepts fostered in the experiment is included. (JN)

  15. A Violent Birth: Reframing Coerced Procedures During Childbirth as Obstetric Violence.

    Science.gov (United States)

    Borges, Maria TR

    2018-01-01

    In the United States, women are routinely forced to undergo cesarean sections, episiotomies, and the use of forceps, despite their desire to attempt natural vaginal delivery. Yet, the current American legal system does little to provide redress for women coerced to undergo certain medical procedures during childbirth. Courts and physicians alike are prepared to override a woman's choice of childbirth procedure if they believe this choice poses risks to the fetus, and both give little value to the woman's right to bodily autonomy. This Note proposes a solution for addressing the problem of coerced medical procedures during childbirth by importing a framework created in Venezuela and Argentina that characterizes this issue as "obstetric violence." First, this Note contains an overview of the shortcomings of the existing American legal framework to address the problem. Second, it explains the advantages of the obstetric violence framework and argues that its adoption in the United States would address many of the failures of the existing system. And third, this Note introduces a few legislative and litigation strategies that can be used to implement this framework in the United States and briefly addresses some of the challenges these strategies may pose.

  16. Customs and Desirable after Childbirth, in Islam

    Directory of Open Access Journals (Sweden)

    Gholamreza Khademi

    2016-01-01

    Full Text Available Children are a precious gift from God, and the blessing of a child is a special time in a person's life. All cultures and religious traditions have certain ways of welcoming a newborn child into the community; also, each culture and religion has its own customs and traditions for the birth of a child. During and after the birth of a Muslim child, there are certain rituals the mother and father must perform. Some of these traditions are culturally inspired, and others are performed according to passages in the Nobel Quran that detail the appropriate actions after childbirth. We explain some of these customs which include: Birth customs (the Adhan, Male circumcision, Aqiqah, Shaving the hair, Congratulate and Walīmah; Muslim baby names and Breastfeeding. There are a number of birth customs common to Muslims, an appreciation of which provides unique insights into the lives of Muslims.

  17. Marginal microleakage evaluation in class V composite restorations of deciduous teeth prepared conventionally and using Er:YAG laser; Avaliacao da microinfiltracao marginal em cavidades classe V de dentes deciduos preparados com laser Er:YAG e alta rotacao

    Energy Technology Data Exchange (ETDEWEB)

    Pulga, Neusa Vieira Galvao

    2001-07-01

    The evaluation of marginal microleakage in class V restorations of deciduous teeth prepared using Er:laser and comparison to the ones observed when conventionally prepared, using two photopolimerizable materials, composite resin and glass ionomer cement, was the subject of this study. Twenty eight complete deciduous teeth were divided into four groups Group 1 (G1) prepared with high speed drill + composite resin; Group 2 (G2) prepared with high speed drill + glass ionomer cement; Group 3 (G3) prepared using Er:YAG laser (2.94 {mu}m), 300 mJ, 3 Hz, handpiece 2051, energy density 86 mJ/cm{sup 2} + composite resin; Group 4 (G4) prepared using Er:YAG laser (2.94 {mu}m), 300 mJ, 3 Hz, handpiece 2051, energy density 86 J / cm{sup 2} + glass ionomer cement. After the preparation and restoration the specimens where stored at 37 deg C for 24 hours, thermally stressed, immersed in 50% aqueous solution of silver nitrate for 24 hours while kept in the dark. The specimens were rinsed in water, soaked in photodeveloping solution and exposed to fluorescent light for 6 hours. After this process the samples were sectioned and observed by stereomicroscopy. For comparison the groups were divided into occlusive and cervical microleakage. The results were analysed under the Kruskal-Wallis test. For the occlusive microleakage the statistical significance was 5% among the groups and the average comparison showed higher microleakage for G1 (M=35.1) than for G2 (M=24.0) as well as compared to G3 (M=22.3). The other groups did not present statistical differences among them. For the cervical microleakage the Kruskal-Wallis test did not present any statistical difference. Comparing the occlusive and cervical microleakage data, for every group, using the Wilcoxon test, no statistical differences were observed. Concluding, this study showed the Er:YAG laser to be effective for class V restorations and to result in a smaller microleakage degree using the composite resin. These results indicate

  18. Teaching childbirth with high-fidelity simulation. Is it better observing the scenario during the briefing session?

    Science.gov (United States)

    Cuerva, Marcos J; Piñel, Carlos S; Martin, Lourdes; Espinosa, Jose A; Corral, Octavio J; Mendoza, Nicolás

    2018-02-12

    The design of optimal courses for obstetric undergraduate teaching is a relevant question. This study evaluates two different designs of simulator-based learning activity on childbirth with regard to respect to the patient, obstetric manoeuvres, interpretation of cardiotocography tracings (CTG) and infection prevention. This randomised experimental study which differs in the content of their briefing sessions consisted of two groups of undergraduate students, who performed two simulator-based learning activities on childbirth. The first briefing session included the observations of a properly performed scenario according to Spanish clinical practice guidelines on care in normal childbirth by the teachers whereas the second group did not include the observations of a properly performed scenario, and the students observed it only after the simulation process. The group that observed a properly performed scenario after the simulation obtained worse grades during the simulation, but better grades during the debriefing and evaluation. Simulator use in childbirth may be more fruitful when the medical students observe correct performance at the completion of the scenario compared to that at the start of the scenario. Impact statement What is already known on this subject? There is a scarcity of literature about the design of optimal high-fidelity simulation training in childbirth. It is known that preparing simulator-based learning activities is a complex process. Simulator-based learning includes the following steps: briefing, simulation, debriefing and evaluation. The most important part of high-fidelity simulations is the debriefing. A good briefing and simulation are of high relevance in order to have a fruitful debriefing session. What do the results of this study add? Our study describes a full simulator-based learning activity on childbirth that can be reproduced in similar facilities. The findings of this study add that high-fidelity simulation training in

  19. Effects of extended childbirth education by midwives on the childbirth fear of first-time mothers: an RCT.

    Science.gov (United States)

    Haapio, Sari; Kaunonen, Marja; Arffman, Martti; Åstedt-Kurki, Päivi

    2017-06-01

    This study evaluates how extended childbirth education intervention affects first-time mothers' fear of childbirth and its manifestation during pregnancy. A randomised controlled trial was conducted. A total of 659 first-time mothers were recruited before week 14 of gestation during the first ultrasound screening at the hospital's maternity outpatient clinic. The mothers were randomly assigned into an intervention group (n = 338) or a control group (n = 321). The control group received all available regular childbirth education. In addition, the intervention group received an enhanced 2-hour childbirth education at the maternity hospital. The objects of childbirth fears (childbirth-related fear, fear for the mother's and the child's well-being, fear related to Caesarean section) were the primary outcomes. The manifestations of childbirth fears (everyday life, stress symptoms and the wish to have a Caesarean section) were the secondary outcomes. These outcomes were measured over 34 weeks of gestation using two parts of the instrument 'Feelings of Fear and Security Associated with Pregnancy and Childbirth'. Logistic and ordinal linear regression models were used to model the effect of the intervention on the outcomes. The mothers in the intervention group had less childbirth-related fear than those in the control group [odds ratio (OR) 0.58, 95% confidence level (CL) 0.38-0.88]. Also, fear influenced the mothers in the intervention group less in everyday life than it did the mothers in the control group [OR 0.64, 95% CL 0.44-0.94]. The effectiveness of the intervention can be considered moderate: one of three objects and one of three manifestations of fears were reduced. The intervention proved most efficient in alleviating relatively limited objects of fears. © 2016 Nordic College of Caring Science.

  20. Audit of Childbirth Emergency Referrals by Trained Traditional Birth ...

    African Journals Online (AJOL)

    Medicine, Enugu State University of Science and Technology, 5Department of Obstetrics and ... Aim: The aim was to audit childbirth emergency referrals by trained TBAs to a ..... training of TBAs has been documented by previous African.

  1. Choosing the right health care provider for pregnancy and childbirth

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000596.htm Choosing the right health care provider for pregnancy and childbirth To use the sharing features on this page, please enable JavaScript. ...

  2. Healthcare professionals' perspectives on traumatic childbirth - interpreting the data

    DEFF Research Database (Denmark)

    Schrøder, Katja; Jørgensen, Jan Stener; Lamont, Ronald F

    2016-01-01

    We would like to thank Cauldwell and Bewley (1) for their encouraging comments regarding our recent manuscript 'Blame and guilt - a mixed methods study of obstetricians' and midwives' experiences and existential considerations after involvement in traumatic childbirth' (2). The manuscript...

  3. Computer Assisted Educational Material Preparation for Fourth Grade Primary School Students' English Language Class in Teaching Numbers

    Science.gov (United States)

    Yüzen, Abdulkadir; Karamete, Aysen

    2016-01-01

    In this study, using ADDIE instructional design model, it is aimed to prepare English language educational material for 4th grade primary students to teach them numbers. At the same time, ARCS model of motivation's attention, relevance and satisfaction phases are also taken into consideration. This study also comprises of Design Based Research…

  4. Evaluation of the temperature rise in pulp chamber during class V preparation with Er:YAG laser; Avaliacao da temperatura na camara pulpar durante preparo classe V com laser de Erbio:YAG

    Energy Technology Data Exchange (ETDEWEB)

    Picinini, Leonardo Santos

    2001-07-01

    One of the major concerns regarding laser irradiation in the dentistry field is the overheating in dental tissue, specially pulpal tissue. A temperature raise over 5.5 deg C is considered to be harmful to its vitality. The current study evaluated the temperature increase in the pulp chamber, during class V preparation, performed with the laser Er:YAG in 36 bovine incisive extracted teeth. The samples were eroded on the outer side of the vestibular wall to obtain the dentinal thickness of 2.0 mm (group I), 1.0 mm (group II) and 0.5 mm (group III). Thermocouples were fixed to the inner part of the vestibular wall using thermal paste, through the palatine opening of the samples. Class V cavities were prepared in the vestibular side only in 1 mm{sup 2} thick dentins. Irradiation parameters used were: 500 mJ/10 Hz, 850 mJ/10 Hz and 1 000 mJ/10 Hz for all the groups. The results were processed by a microcomputer. This study showed that the temperature increased into the pulpal cavity reached around 3 deg C for the groups I (2,0 mm thick dentine) and II (1.0 mm thick dentine). In the group III (0.5 mm thick) temperature was around 5.5 deg C. Thus, the parameters used for cavity preparation, using Er:YAG laser, were safe in relation to the temperature raise for dentinal thickness of 1,0 and 2,0 mm; in 0.5 mm thick dentins, temperature increase reached 5.5 deg C and an appropriate correction in the laser parameters was necessary. (author)

  5. Childbirth in ancient Rome: from traditional folklore to obstetrics.

    Science.gov (United States)

    Todman, Donald

    2007-04-01

    In ancient Rome, childbirth was a hazardous event for both mother and child with high rates of infant and maternal mortality. Traditional Roman medicine centred on folklore and religious practices, but with the development of Hippocratic medicine came significant advances in the care of women during pregnancy and confinement. Midwives or obstetrices played an important role and applied rational scientific practices to improve outcomes. This evolution from folklore to obstetrics was a pivotal point in the history of childbirth.

  6. Patient satisfaction with childbirth after external cephalic version.

    Science.gov (United States)

    Bogner, Gerhard; Hammer, Barbara Eva; Schausberger, Christiane; Fischer, Thorsten; Reisenberger, Klaus; Jacobs, Volker

    2014-03-01

    To assess acceptance and impact of external cephalic version (ECV) for breech presentation at term on maternal satisfaction with childbirth. Retrospective study on n = 131 women with breech presentation comparing maternal satisfaction after ECV and consecutive childbirth (n = 66; 50.4% of these successful attempts in n = 33; 50%) against the group without ECV and primary caesarean section (CS) (n = 65; 49.6%) instead using a questionnaire. Women with successful ECV tolerated side effects of the intervention better than after unsuccessful ECV (pain, tocolytics, mental and physical state, for all p version were more satisfied with childbirth than women with planned CS (p = 0.05). Women with version attempts tend to perceive childbirth as being less problematic with fewer complications (9.5 vs. 19%, p = 0.12). Unsuccessful ECVs had no negative impact on satisfaction with childbirth (p = 0.072). Attempting ECV seems to be an option for increasing the rate of vaginal births with breech presentation without negative impact on maternal satisfaction regarding consecutive childbirth.

  7. Post-traumatic stress disorder due to childbirth: the aftermath.

    Science.gov (United States)

    Beck, Cheryl Tatano

    2004-01-01

    Childbirth qualifies as an extreme traumatic stressor that can result in post-traumatic stress disorder. The reported prevalence of post-traumatic stress disorder after childbirth ranges from 1.5% to 6%. The aim of this phenomenologic study was to describe the essence of mothers' experiences of post-traumatic stress disorder after childbirth. The qualitative research design used for this study was descriptive phenomenology. The main recruitment approach was via the Internet through the help of Trauma and Birth Stress, a charitable trust in New Zealand. Purposive sampling was used and resulted in 38 mothers participating from the countries of New Zealand, the United States, Australia, and the United Kingdom. The participants were asked to describe their experiences with post-traumatic stress disorder after childbirth. Their stories were analyzed using Colaizzi's method of data analysis. Mothers with post-traumatic stress disorder attributable to childbirth struggle to survive each day while battling terrifying nightmares and flashbacks of the birth, anger, anxiety, depression, and painful isolation from the world of motherhood. This glimpse into the lives of mothers with post-traumatic stress disorder attributable to childbirth provides an impetus to increase research efforts in this neglected area.

  8. 5V-class bulk-type all-solid-state rechargeable lithium batteries with electrode-solid electrolyte composite electrodes prepared by aerosol deposition

    Science.gov (United States)

    Iriyama, Yasutoshi; Wadaguchi, Masaki; Yoshida, Koki; Yamamoto, Yuta; Motoyama, Munekazu; Yamamoto, Takayuki

    2018-05-01

    Composite electrodes (∼9 μm in thickness) composed of 5V-class electrode of LiNi0.5Mn1.5O4 (LNM) and high Li+ conductive crystalline-glass solid electrolyte (LATP, Ohara Inc.) were prepared at room temperature by aerosol deposition (AD) on platinum sheets. The resultant LNM-LATP composite electrodes were combined with LiPON and Li, and 5V-class bulk-type all-solid-state rechargeable lithium batteries (SSBs) were prepared. The crystallnity of the LNM in the LNM-LATP composite electrode was improved by annealing. Both thermogravimetry-mass spectroscopy analysis and XRD analysis clarified that the side reactions between the LNM and the LATP occurred over 500 °C with oxygen release. From these results, annealing temperature of the LNM-LATP composite electrode system was optimized at 500 °C due to the improved crystallinity of the LNM with avoiding the side-reactions. The SSBs with the composite electrodes (9 μm in thickness, 40 vol% of the LNM) annealed at 500 °C delivered 100 mAh g-1 at 10 μA cm-2 at 100 °C. Degradation of the discharge capacity with the repetition of the charge-discharge reactions was observed, which will originate from large volume change of the LNM (∼6.5%) during the reactions.

  9. Hypnosis for pain management during labour and childbirth.

    Science.gov (United States)

    Madden, Kelly; Middleton, Philippa; Cyna, Allan M; Matthewson, Mandy; Jones, Leanne

    2016-05-19

    This review is one in a series of Cochrane reviews investigating pain management for childbirth. These reviews all contribute to an overview of systematic reviews of pain management for women in labour, and share a generic protocol. This review updates an earlier version of the review of the same title. To examine the effectiveness and safety of hypnosis for pain management during labour and childbirth. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2015) and the reference lists of primary studies and review articles. Randomised controlled trials (RCTs) and quasi-RCTS comparing preparation for labour using hypnosis and/or use of hypnosis during labour, with or without concurrent use of pharmacological or non-pharmacological pain relief methods versus placebo, no treatment or any analgesic drug or technique. Two review authors independently extracted data and assessed trial quality. Where possible we contacted study authors seeking additional information about data and methodology. We included nine trials randomising a total of 2954 women. The risk of bias in trials was variable, there were several well-designed large trials and some trials where little was reported about trial design. Although eight of the nine trials assessed antenatal hypnotherapy, there were considerable differences between these trials in timing and technique. One trial provided hypnotherapy during labour. In this updated review we compared hypnosis interventions with all control groups (main comparison) and also with specific control conditions: standard care (nine RCTs), supportive counselling (two RCTs) and relaxation training (two RCTs).In the main comparison, women in the hypnosis group were less likely to use pharmacological pain relief or analgesia than those in the control groups, (average risk ratio (RR) 0.73, 95% CI 0.57 to 0.94, eight studies, 2916 women; very low-quality evidence; random-effects model). There were no clear differences between

  10. The impact of childbirth on female sexuality

    Directory of Open Access Journals (Sweden)

    Isabel Leal

    Full Text Available Objective: To compare variables related to sexual functioning, namely: sexual desire, arousal, orgasm, pain, sexual satisfaction and sexual function in women during the pregnancy and 3 months after delivery. Methods: This is an exploratory and descriptive, quantitative study. A non-probability, convenience sample of 62 women in the first stage, and of 52 women in the second stage, was used. The two groups were not significantly different regarding socio-demographic aspects. The main outcome measures used were the female sexual function as assessed by the Female Sexual Function Index (FSFI and a Socio-demographic and Clinical Questionnaire. Results: The women presented higher mean levels of sexual satisfaction after birth, than during the pregnancy presenting statistically significant differences. Also they had lower mean levels of sexual desire, sexual arousal and vaginal lubrication after delivery. Regarding the orgasm, they presented higher mean levels in the postpartum period. The overall sexual function after childbirth did not present significant differences when comparing the pregnancy period to the postpartum, but presented higher mean levels during the pregnancy. Pain levels were higher during the pregnancy. Conclusion: We found no significant differences between the two groups, in most of the studied variables. However, Sexual Arousal and Sexual Satisfaction presented statistically significant differences.

  11. Relational factors in psychopathological responses to childbirth.

    Science.gov (United States)

    Cigoli, Vittorio; Gilli, Gabriella; Saita, Emanuela

    2006-06-01

    Childbirth can represent for women the time of greatest vulnerability experience, often associated with being out of control, loneliness or sadness. One hundred and sixty women who had 'normal' births were assessed within 48 hours on potential predictive measures and at 3-6 months post-partum for PTSD. Symptoms of depression, anxiety, perceived and desired support by family members, friends, medical personnel were also assessed. t-Test and chi-square were used to analyze, differences between 'risk group' and 'non-risk group'. Few women (1.25%) showed questionnaire responses suggesting clinically significant levels on PTSD; other women (28.75%) reported clinically significant symptoms for at least one subscale. Being at the first delivery experience, together with perceptions of low levels of support from family members and medical personnel, were found to be related to experience of post-traumatic stress symptoms. Anxiety for the child and previous depression are also related to such symptoms. Moreover, anxiety and depression are related to a difficult recognition of the support received, as well as to the desire for more support, in the care of the newborn, from medical professionals.

  12. Evaluation of microleakage occurred in class V restoration prepared with Er:YAG laser and also with high speed, restored using composite

    International Nuclear Information System (INIS)

    Junqueira, Angelo Maercio Finochio

    2002-01-01

    The microleakage is one of the great problems found in restoring dentistry. In spite of adhesive system evolution, several materials have been studied intending to minimize or to eliminate the microleakage occurred between the tooth and restorative material. The objective of this in vitro study was to evaluate and compare the marginal microleakage in class V cavities prepared by Er:YAG laser or high speed and restored with composite resin. One of the groups received the sodium bicarbonate jet while the other group have not received. Twenty teeth third extracted molars were sectioned in the sense medial-distal being obtained forty samples that were divided in four groups: Group I (G1): prepared with Er:YAG laser (2940 nm), E= 350 mJ/p, F=2 Hz, fluency of 112,5 J/cm 2 . Preparing occlusion margin slice with 250 mJ/p, F=2 Hz, fluency of 80,3 J/cm 2 . The prepared total area was irradiated with E=80 mJ/p, F=2 Hz and fluency of 25,75 J/cm 2 . Every prepared area was finally submitted to sodium bicarbonate jet. Group 2 (G2): it was employed the same parameters used on group 1, except the sodium carbonate jet application. Group 3 (G3): the cavities' prepare were executed with high speed rotation using diamond cylindrical point. The slice confection has been made with the same point with 45 degrees inclined, utilizing also the sodium carbonate jet in all prepared area. Group 4 (G4): it was executed similarly prepared to group 3, without the sodium bicarbonate jet. In all the groups the cavities were washed with water spray and drought with air jet. Dentin and enamel surfaces have been conditioned with phosphoric acid at 35%. All the samples of all groups were restored using the single bond system adhesive and composite resin Z250, kept at 37 deg C in stove during 24 hours, thermally stressed, immersed in silver nitrate solution at 50% for 24 hours while kept in darkness. The specimens were soaked in photo developing solution and exposed to fluorescent light for 6 hours

  13. Fatherhood in focus, sexual activity can wait: new fathers' experience about sexual life after childbirth.

    Science.gov (United States)

    Olsson, Ann; Robertson, Eva; Björklund, Anders; Nissen, Eva

    2010-12-01

    Becoming a parent is overwhelming for most men and women and alters the sexual relationship for many couples. To describe fathers' experience about sexual life after childbirth within the first 6 months after childbirth. A descriptive design, using content analysis with a qualitative approach, based on focus group discussions and one-to-one interviews. Eight first-time and two subsequent fathers participated. Three subthemes were identified: Struggling between stereotypes and personal perceptions of male sexuality during transition to fatherhood; new frames for negotiating sex; a need to feel safe and at ease in the new family situation. The overarching theme emerged as 'transition to fatherhood brings sexual life to a crossroads' and guided us to a deeper understanding of the difficulties men experience during the transition to fatherhood. To get sexual life working, a number of issues had to be resolved, such as getting involved in the care of the baby and the household and getting in tune with their partners in regard to sexual desire. The men needed to be reassured and prepared for this new situation by health care professionals. New fathers in our study put the baby in focus in early parenthood and were prepared to postpone sex until both parties were ready, although they needed reassurance to feel at ease with the new family situation. The fathers' perceptions of sexual life extended to include all kinds of closeness and touching, and it deviated from the stereotype of male sexuality. This is important information for health care providers and midwives to be aware of for their encounters with men (and women) during the transition to fatherhood, and parenthood and can contribute to caring science with a gender perspective on adjustment of sexual life after childbirth. © 2010 The Authors. Scandinavian Journal of Caring Sciences © 2010 Nordic College of Caring Science.

  14. Interval among childbirths in livestock Chinese Creole Santandereano

    International Nuclear Information System (INIS)

    Lopez Perez, A.C; Munar Gonzalez, A.R; Hernandez Boada, G.

    1989-01-01

    All project of rescue of the Creole races should include the study of its productive characteristics. One of them, the fertility of the cows is, without a doubt, that of more economic importance. This characteristic is measured, among other forms, by means of the interval among childbirths, which is very affected by environmental factors. Therefore, it is of a lot of interest to study the effect of this factor with the purpose of making a strategic handling of the reproduction of the herd. The objective of this work was to study the influence of the year of childbirth, time of the childbirth, age of the cow, sex of the calf; race of the bull and insemination type (natural or artificial) in the interval among childbirths of a herd of cattle of cows Chinese Creoles Santandereano. The data were analyzed by the minimum squares method (G.L.M. of S.A.S. with sum of square type III). It was found that the effects of year of the childbirth, age of the cow and insemination type were significant (smaller P that 0.01) the general average of interval among childbirths was of 435.4 days; while it stops artificial insemination it was of 534.1 days. With a single exception, one observes a continuous decrease of the intervals among childbirths from the cows smaller than 3 years (525.4 days) until those smaller than 10 years (432.8 days). The exception, the cows of 3 to 4 years showed an average of 530.4 day

  15. Support from a prenatal instructor during childbirth is associated with reduced rates of caesarean section in a Mexican study.

    Science.gov (United States)

    Campero, Lourdes; Hernández, Bernardo; Osborne, Jomo; Morales, Sara; Ludlow, Teresa; Muñoz, Christian

    2004-12-01

    to assess the association between non-clinical factors and the incidence of caesarean section (CS); to estimate the effect of a prenatal instructor's presence during childbirth on birth outcome (vaginal or CS). cross-sectional study from a register of women who attended prenatal classes. Multivariate logistic regression was used to measure the effects of each variable on whether the birth was vaginal or CS. Mexico City, Mexico. 992 births to 847 women from the register of the Birth Education Centre (CEPAPAR) between 1987 and 2000. the incidence of CS was 33%. The most commonly reported (by the women) reason for performing a CS was dystocia (53%). Most women were middle or upper-middle class professionals, and 85% of the women gave birth in private institutions. Odds of having a CS were higher among women who gave birth in a large hospital, women who were over 25 years of age, primigravidae, and women who were not supported by a prenatal instructor during childbirth. non-clinical factors considerably affect the type of birth outcome (vaginal vs. CS). A system in which a prenatal instructor provided support to the woman during childbirth could contribute significantly to reducing initial and repeat CS.

  16. Continuous support for women during childbirth.

    Science.gov (United States)

    Bohren, Meghan A; Hofmeyr, G Justus; Sakala, Carol; Fukuzawa, Rieko K; Cuthbert, Anna

    2017-07-06

    Historically, women have generally been attended and supported by other women during labour. However, in hospitals worldwide, continuous support during labour has often become the exception rather than the routine. The primary objective was to assess the effects, on women and their babies, of continuous, one-to-one intrapartum support compared with usual care, in any setting. Secondary objectives were to determine whether the effects of continuous support are influenced by:1. Routine practices and policies in the birth environment that may affect a woman's autonomy, freedom of movement and ability to cope with labour, including: policies about the presence of support people of the woman's own choosing; epidural analgesia; and continuous electronic fetal monitoring.2. The provider's relationship to the woman and to the facility: staff member of the facility (and thus has additional loyalties or responsibilities); not a staff member and not part of the woman's social network (present solely for the purpose of providing continuous support, e.g. a doula); or a person chosen by the woman from family members and friends;3. Timing of onset (early or later in labour);4. Model of support (support provided only around the time of childbirth or extended to include support during the antenatal and postpartum periods);5. Country income level (high-income compared to low- and middle-income). We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 October 2016), ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP) (1 June 2017) and reference lists of retrieved studies. All published and unpublished randomised controlled trials, cluster-randomised trials comparing continuous support during labour with usual care. Quasi-randomised and cross-over designs were not eligible for inclusion. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We sought

  17. Pain relief in childbirth: changing historical and feminist perspectives.

    Science.gov (United States)

    Skowronski, G A

    2015-07-01

    Pain during human childbirth is ubiquitous and severe. Opium and its derivatives constitute the oldest effective method of pain relief and have been used in childbirth for several thousand years, along with numerous folk medicines and remedies. Interference with childbirth pain has always been criticised by doctors and clergy. The 19th century saw the introduction of three much more effective approaches to childbirth pain; diethyl ether, chloroform and nitrous oxide. Access to pain relief was demanded by the first wave of feminist activists as a woman's right. They popularised the use of 'twilight sleep', a combination of morphine and scopolamine, which fell into disrepute as its adverse effects became known. From the 1960s, as epidural analgesia became more popular, a second wave of feminists took the opposite position, calling for a return to non-medicalised, female-controlled, 'natural' childbirth and, in some cases, valorising the importance of the pain experience as empowering for women. However, from the 1990s, a third wave of feminist thought has begun to emerge, revalidating a woman's right to choose a 'technological', pain-free birth, rather than a 'natural' one, and regarding this as a legitimate feminist position.

  18. Traumatic Childbirth from the Perspective of the Healthcare Professional

    DEFF Research Database (Denmark)

    Schrøder, Katja; Jørgensen, Jan Stener; la Cour, Karen

    in Denmark, adding up to a total of 2400. The overall aim of the survey is to identify the proportion of midwives and obstetricians who have been involved in one or more traumatic childbirths. Subsequently the aim is to investigate the correlation between traumatic childbirths and work-related mental health...... problems among midwives and obstetricians and finally to explore the coping strategies of the midwives and obstetricians related to their personal values, faith and convictions. Qualitative interviews The qualitative part of the study will consist of 16-20 individual semi-structured interviews, equally...... and obstetricians experience being involved in traumatic childbirths will serve to improve the management of the aftermath of the traumatic events from the perspective of the healthcare professionals. Such improvements could be important in the effort to prevent work-related mental health problems amongst midwives...

  19. Fear of childbirth in nulliparous and multiparous women

    DEFF Research Database (Denmark)

    Räisänen, S; Lehto, S M; Nielsen, H S

    2014-01-01

    OBJECTIVE: To identify risk factors for fear of childbirth (FOC) according to parity and socioeconomic status, and to evaluate associations between FOC and adverse perinatal outcomes. DESIGN: A cohort study. SETTING: The Finnish Medical Birth Register. POPULATION: All 788 317 singleton births...... during 1997-2010 in Finland. METHODS: Fear of childbirth was defined according to the International Classification of Diseases code O99.80, and its associations with several risk factors and perinatal outcomes were analysed by multivariable logistic regression. MAIN OUTCOME MEASURES: Prevalence of, risk...... factors for and outcomes of FOC. RESULTS: Fear of childbirth was experienced by 2.5% of nulliparous women and 4.5% of multiparous women. The strongest risk factors for FOC in nulliparous women were depression [adjusted odds ratio (aOR), 6.35; 95% confidence interval (CI), 5.25-7.68], advanced maternal age...

  20. Preparation, in-vitro and in-vivo evaluation of spray-dried ternary solid dispersion of biopharmaceutics classification system class II model drug.

    Science.gov (United States)

    Paidi, Sharan K; Jena, Sunil K; Ahuja, Bhupesh K; Devasari, Naresh; Suresh, Sarasija

    2015-05-01

    The objective of this study was to investigate the impact of a novel spray-dried ternary solid dispersion (TSD) on the dissolution rate and bioavailability of a biopharmaceutics classification system (BCS) class II model drug, atorvastatin calcium trihydrate (ATC), and evaluate its in-vitro and in-vivo performance. TSD of ATC was prepared by spray-drying method employing ethanol/water solvent systems. The TSD formulations, composed of hydroxypropyl methylcellulose (HPMC E5) and nicotinamide, were optimized by rotatable central composite design. Physicochemical characterization along with dissolution, stability and pharmacokinetic study of optimized TSD was evaluated. The optimized TSD was found to be amorphous with spherical shape morphology. It exhibited a fourfold increase in dissolution rate in comparison to ATC, with a considerable enhancement in oral bioavailability (relative bioavailability of 134.11%). Physicochemical characterization and dissolution study of optimized TSD at the end of stability studies clearly indicated that the stability of optimized TSD was due to hydrogen bonding between drug and HPMC E5 and nicotinamide. This bonding remained unaffected even under stressful conditions of high temperature and humidity. The TSD exhibits a significant increase in dissolution rate, and for this reason should be useful as an efficacious tool to enhance the bioavailability of BCS class II drug molecule, ATC. © 2015 Royal Pharmaceutical Society.

  1. Promoting childbirth companions in South Africa: a randomised pilot study

    Directory of Open Access Journals (Sweden)

    Smith Helen

    2007-04-01

    Full Text Available Abstract Background Most women delivering in South African State Maternity Hospitals do not have a childbirth companion; in addition, the quality of care could be better, and at times women are treated inhumanely. We piloted a multi-faceted intervention to encourage uptake of childbirth companions in state hospitals, and hypothesised that lay carers would improve the behaviour of health professionals. Methods We conducted a pilot randomised controlled trial of an intervention to promote childbirth companions in hospital deliveries. We promoted evidence-based information for maternity staff at 10 hospitals through access to the World Health Organization Reproductive Health Library (RHL, computer hardware and training to all ten hospitals. We surveyed 200 women at each site, measuring companionship, and indicators of good obstetric practice and humanity of care. Five hospitals were then randomly allocated to receive an educational intervention to promote childbirth companions, and we surveyed all hospitals again at eight months through a repeat survey of postnatal women. Changes in median values between intervention and control hospitals were examined. Results At baseline, the majority of hospitals did not allow a companion, or access to food or fluids. A third of women were given an episiotomy. Some women were shouted at (17.7%, N = 2085, and a few reported being slapped or struck (4.3%, N = 2080. Despite an initial positive response from staff to the childbirth companion intervention, we detected no difference between intervention and control hospitals in relation to whether a companion was allowed by nursing staff, good obstetric practice or humanity of care. Conclusion The quality and humanity of care in these state hospitals needs to improve. Introducing childbirth companions was more difficult than we anticipated, particularly in under-resourced health care systems with frequent staff changes. We were unable to determine whether the presence

  2. Promoting childbirth companions in South Africa: a randomised pilot study

    Science.gov (United States)

    Brown, Heather; Hofmeyr, G Justus; Nikodem, V Cheryl; Smith, Helen; Garner, Paul

    2007-01-01

    Background Most women delivering in South African State Maternity Hospitals do not have a childbirth companion; in addition, the quality of care could be better, and at times women are treated inhumanely. We piloted a multi-faceted intervention to encourage uptake of childbirth companions in state hospitals, and hypothesised that lay carers would improve the behaviour of health professionals. Methods We conducted a pilot randomised controlled trial of an intervention to promote childbirth companions in hospital deliveries. We promoted evidence-based information for maternity staff at 10 hospitals through access to the World Health Organization Reproductive Health Library (RHL), computer hardware and training to all ten hospitals. We surveyed 200 women at each site, measuring companionship, and indicators of good obstetric practice and humanity of care. Five hospitals were then randomly allocated to receive an educational intervention to promote childbirth companions, and we surveyed all hospitals again at eight months through a repeat survey of postnatal women. Changes in median values between intervention and control hospitals were examined. Results At baseline, the majority of hospitals did not allow a companion, or access to food or fluids. A third of women were given an episiotomy. Some women were shouted at (17.7%, N = 2085), and a few reported being slapped or struck (4.3%, N = 2080). Despite an initial positive response from staff to the childbirth companion intervention, we detected no difference between intervention and control hospitals in relation to whether a companion was allowed by nursing staff, good obstetric practice or humanity of care. Conclusion The quality and humanity of care in these state hospitals needs to improve. Introducing childbirth companions was more difficult than we anticipated, particularly in under-resourced health care systems with frequent staff changes. We were unable to determine whether the presence of a lay carer impacted

  3. Life satisfaction, general well-being and costs of treatment for severe fear of childbirth in nulliparous women by psychoeducative group or conventional care attendance.

    Science.gov (United States)

    Rouhe, Hanna; Salmela-Aro, Katariina; Toivanen, Riikka; Tokola, Maiju; Halmesmäki, Erja; Saisto, Terhi

    2015-05-01

    Fear of childbirth is a common reason for seeking cesarean section. It is important to consider outcomes and costs associated with alternative treatment and delivery mode. We compared well-being and costs of group psychoeducation and conventional care for fear of childbirth. Randomized controlled trial. A total of 371 nulliparous women scoring over the 95th centile in the Wijma Delivery Expectancy Questionnaire (W-DEQ) during the first trimester. Finland, data from obstetrical patient records and questionnaires. Randomization to group psychoeducation with relaxation (six sessions during pregnancy, one after childbirth, n = 131), or surveillance and referral on demand (n = 240). All costs in maternity care during pregnancy, delivery and postnatally according to Diagnoses Related Groups. Life satisfaction and general well-being 3 months after childbirth (by a Satisfaction with Life Scale and Well-being Visual Analogue Scale). The groups did not differ in total direct costs (€3786/woman in psychoeducative group and €3830/woman in control group), nor in life satisfaction or general well-being. Although only 76 (30%) of the women assigned to the surveillance were referred to special maternity care and 36 (15%) attended advanced prenatal classes, costs in the psychoeducation group did not exceed the costs of the controls, mostly because of the greater number of uncomplicated vaginal deliveries (63% vs. 47%, p = 0.005). Through an association with safer childbirth and equal well-being after delivery, psychoeducative group treatment for nulliparous women with fear of childbirth can be a recommended choice for the same overall costs as conventional treatment. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  4. Childbirth expectations and correlates at the final stage of pregnancy in Chinese expectant parents

    Directory of Open Access Journals (Sweden)

    Xian Zhang

    2014-06-01

    Conclusion: This study adds to understanding of the childbirth expectations of Chinese expectant parents. It is suggested that maternity healthcare providers pay close attention to the childbirth expectations of expectant parents, and improve the nursing care service to promote positive childbirth experiences and satisfaction of expectant parents.

  5. A WOMAN-CENTRED CHILDBIRTH MODEL

    African Journals Online (AJOL)

    2009-10-27

    Oct 27, 2009 ... Enhance self-esteem, self-determination and self-reliance when the mother .... was conducted in order to identify the characteristics of the concept .... medical definitions surrounding birth and on preparing mothers for hospital ...

  6. Complications of the natural childbirth: assistance of nurses obstetras

    Directory of Open Access Journals (Sweden)

    Zulmerinda Meira Oliveira

    2009-01-01

    Full Text Available The moment of the natural childbirth is a complex and dynamic event that demands assistance from the health professional that joins the humanized execution of procedures and actions respecting the singularity of the woman. In this way, the objectives of this study were: to know the main occurred complications at the moment of the natural childbirth and the assistance given by the nurse. It’s an exploratory research, in which the scene was a public hospital in the city of Jequié-Ba. The sampling consisted of five persons with specialization in obstetric nursing, and the used instrument for the data collection was the half-structuralized interview. After the data collection, the gotten information were submitted to the content analysis Bardin. Therefore, it’s possible to infer that the obstetric nurse faces in a positive way the complications lived deeply during the natural childbirth, through the exercise of a humanized and distinguished assistance as techniques/procedures endorsed by the literature. Thus, this can make us reflect the importance of this professional in the childbirth room as an executor and promoter of a worthy and welcoming assistance

  7. Assessment of Maternal Satisfaction with Facility-based Childbirth ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    In Senegal, only 60% of mothers in rural areas deliver in health facilities. ... experience is one of the factors in their choosing to deliver in such facilities in ... maternal satisfaction with childbirth care and 23 standard care survey items was assessed. .... cost*. 0.64. Cheap. 30 (11.6). Affordable. 140 (54.1). Expensive. 68 (26.3).

  8. AHP 10: CHILDBIRTH AND CHILDCARE IN RDO SBIS TIBETAN TOWNSHIP

    Directory of Open Access Journals (Sweden)

    Klu mo tshe ring ཀླུ་མོ་ཚེ་རིང་།

    2011-06-01

    Full Text Available Rdo sbis (Daowei 道帏 Tibetan Autonomous Township, Xunhua 循化 Salar Autonomous County, Haidong 海东 Region, is located in eastern Qinghai 青海 Province, PR China. Knowledge, beliefs, and behavior associated with childbirth, midwifery, and childcare in Rdo sbis Township Tibetan communities are described, focusing on a single village as a case-study.

  9. Assessment of Maternal Satisfaction with Facility-based Childbirth ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    maternal satisfaction with childbirth care and 23 standard care survey items ... soins de l'accouchement basé sur la perception des mères contribue au degré de la satisfaction maternelle. ..... model 4 had the smallest value and was regarded.

  10. Use of eucational workshop to promote mobility during childbirth ...

    African Journals Online (AJOL)

    Use of eucational workshop to promote mobility during childbirth. H Smith, H Lugina, R Mlay. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians ...

  11. The obstetrical and postpartum benefits of continuous support during childbirth.

    Science.gov (United States)

    Scott, K D; Klaus, P H; Klaus, M H

    1999-12-01

    The purpose of this article is to review the evidence regarding the effectiveness of continuous support provided by a trained laywoman (doula) during childbirth on obstetrical and postpartum outcomes. Twelve individual randomized trials have compared obstetrical and postpartum outcomes between doula-supported women and women who did not receive doula support during childbirth. Three meta-analyses, which used different approaches, have been performed on the results of the clinical trials. Emotional and physical support significantly shortens labor and decreases the need for cesarean deliveries, forceps and vacuum extraction, oxytocin augmentation, and analgesia. Doula-supported mothers also rate childbirth as less difficult and painful than do women not supported by a doula. Labor support by fathers does not appear to produce similar obstetrical benefits. Eight of the 12 trials report early or late psychosocial benefits of doula support. Early benefits include reductions in state anxiety scores, positive feelings about the birth experience, and increased rates of breastfeeding initiation. Later postpartum benefits include decreased symptoms of depression, improved self-esteem, exclusive breastfeeding, and increased sensitivity of the mother to her child's needs. The results of these 12 trials strongly suggest that doula support is an essential component of childbirth. A thorough reorganization of current birth practices is in order to ensure that every woman has access to continuous emotional and physical support during labor.

  12. Negotiated Boundaries: Conceptual Locations of Pregnancy and Childbirth

    Science.gov (United States)

    Houvouras, Shannon

    2006-01-01

    Dominant notions of reproduction perceive childbearing as physical processes that take place within womens bodies. This perception undermines non-physical components and removes men from the process. This project uses social constructionism to explore the locations women describe pregnancy and childbirth taking place in their childbearing…

  13. Satisfaction Determinants of Women during Childbirth in Health ...

    African Journals Online (AJOL)

    This article presents the results of the literature review performed on the main conceptual models used in the measurement of the satisfaction of women during childbirth in health facilities and the main determinants of their satisfaction. The review focused on PubMed, Google scholar and Public Health data. Several ...

  14. Family Responsive Policies and Employee Retention Following Childbirth.

    Science.gov (United States)

    Glass, Jennifer L.; Riley, Lisa

    1998-01-01

    Among 324 employed women in Indiana, followed from pregnancy through 12 months postpartum, job attrition after childbirth was significantly decreased by employer policies, particularly length of maternity leave and ability to avoid mandatory overtime upon return, and was also decreased by supervisor and coworker social support, greater educational…

  15. Preventing traumatic childbirth experiences: 2192 women's perceptions and views

    NARCIS (Netherlands)

    Hollander, M.H.; Hastenberg, E. van; Dillen, J. van; Pampus, M.G. van; Miranda, E. de; Stramrood, C.A.I.

    2017-01-01

    The purpose of this study is to explore and quantify perceptions and experiences of women with a traumatic childbirth experience in order to identify areas for prevention and to help midwives and obstetricians improve woman-centered care. A retrospective survey was conducted online among 2192 women

  16. Labour force transitions around first childbirth in the Netherlands

    NARCIS (Netherlands)

    Begall, K.; Grunow, D.

    2015-01-01

    This study analyses labour market transitions of women in the time around first childbirth. Two employment decisions are considered: exiting the labour force and a reduction in work hours. We assess change in these transitions in the Netherlands between 1970 and 2008. We test whether policy changes,

  17. Low rates of PTSD in men attending childbirth: a preliminary study.

    Science.gov (United States)

    Bradley, Rachel; Slade, Pauline; Leviston, Angela

    2008-09-01

    To investigate whether men experience symptoms of post-traumatic stress disorder (PTSD) after attending their partner's labour and delivery and the prevalence and predictors of symptoms of PTSD, anxiety, and depression. This quantitative study involved a large sample, within-participants design with questionnaires completed at recruitment and six weeks follow-up. Within 72 hours of attending their partner giving birth, 199 men provided demographic details and completed questions about their partner's pregnancy, labour and delivery. Six weeks later they completed a second questionnaire booklet containing measures of symptoms of post-traumatic stress, anxiety, and depression. No men reported symptoms at significant levels on all three dimensions of PTSD (intrusions, avoidance, and hyperarousal) although 12% reported clinically significant symptoms on at least one dimension. The dimension with the highest frequency was hyperarousal. Linear regression indicated more PTSD symptoms were predicted by trait anxiety, fewer children, the pregnancy being unplanned, being present at actual delivery, and feeling less confident about coping, less prepared, and more distressed during the process of childbirth. Prevalence of clinically significant symptoms of depression and anxiety was 8 and 7%, respectively, and was predicted by higher trait anxiety. In this sample there was little evidence for the full constellation of PTSD in men attending their partner giving birth. Using a trauma perspective in this context may not be supported. Those symptoms most commonly reported could be viewed primarily as anxiety and were linked with less previous experience of attending childbirth. Attendance at actual delivery was a key predictor of symptoms.

  18. Women's authority during childbirth and Safe Motherhood in Yemen.

    Science.gov (United States)

    Kempe, Annica; Noor-Aldin Alwazer, Fatoom A; Theorell, Töres

    2010-11-01

    In the effort to increase utilization of professional care during childbirth in low-income countries, few studies have taken a holistic approach to investigating women's perspective of safety and the link to perceived own authority at birth. The aim of the study was to examine women's authority at birth with reference to the intrapartum factors, the level of training of staff and the social and demographic background of women. A multistage (stratified-purposive-random) sampling process was used. We interviewed 220 women with childbirth experience in urban/rural Yemen. We performed bivariate chi-square tests and multiple logistic regression analysis. Women who had their questions answered and requests met during childbirth had 83% higher probability (95% CI 1.66-2.02) to perceive own authority. Women who reported skin-to-skin contact/newborn in arms had 28% higher (95% CI 1.03-1.59) and those who had more distant contact 15% lower (95% CI 0.75-0.95) probability. A graded negative association was found between the perceived authority of the woman in childbirth and the level of biomedical training of staff (pauthority at birth. This paper argues that supporting Yemeni women to exercise their own authority during childbirth would significantly facilitate their ability to give birth successfully and with personal satisfaction. In a country where women are routinely disempowered, their personal empowerment at birth is very important to them. Skilled birth assistants often, in women's perceptions, work against their personal power and authority, most especially MDs but also midwives. This failure results in women failing to seek medical care when needed. Supporting women to experience their own authority at birth would facilitate the accomplishment of both the Millennium Development Goals and those of the Safe Motherhood Initiative. We call for increased cooperation between modern and traditional methods of care. Copyright © 2010 Elsevier B.V. All rights reserved.

  19. Pregnant women's expectations about pain intensity during childbirth and their attitudes towards pain management: Findings from an Icelandic national study.

    Science.gov (United States)

    Karlsdottir, Sigfridur Inga; Sveinsdottir, Herdis; Olafsdottir, Olof Asta; Kristjansdottir, Hildur

    2015-12-01

    Pregnant women expect childbirth to be painful. However, little is known about their expectations of the intensity of pain in childbirth (EIPC) and their attitudes to pain management. The design was a cross-sectional survey, with self-reported questionnaires used to collect data from low-risk pregnant women (N = 1111) early in pregnancy at 26 of the largest primary health care centres in Iceland. This consecutive national sample was stratified by residency. The mean score for the EIPC was 5.58 (SD = 1.38) measured on a 7 point scale. The strongest predictors of a high EIPC score were: negative attitude to the impending childbirth (OR = 2.39), low manifestation of a sense of security (OR = 1.80), and a positive attitude to pain management with medication (OR = 1.63). Women living outside the capital area were less likely to have a high EIPC (OR = 0.68). Most women (77%) had a positive attitude towards pain management without medication and 35% had a positive attitude to pain management with medication. The study detected multiple predictors of women's EIPC and attitude to pain management. Early and throughout pregnancy, midwives and health care professionals need to address these predictors in order to assist women to prepare themselves for the pain of labour. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Group psychoeducation with relaxation for severe fear of childbirth improves maternal adjustment and childbirth experience--a randomised controlled trial.

    Science.gov (United States)

    Rouhe, Hanna; Salmela-Aro, Katariina; Toivanen, Riikka; Tokola, Maiju; Halmesmäki, Erja; Ryding, Elsa-Lena; Saisto, Terhi

    2015-01-01

    Previous studies on the treatment of women with fear of childbirth have focused on the delivery mode. Women with fear of childbirth often suffer from anxiety and/or depression, and treatment therefore also needs to target postnatal psychological well-being and the early mother-infant relationship. Three hundred and seventy-one nulliparous women out of 4575 scored ≥100 in prospective screening (Wijma Delivery Expectancy Questionnaire, W-DEQ-A), indicating severe fear of childbirth. These women were randomised to psychoeducative group intervention with relaxation (n = 131; six sessions during pregnancy, one postnatal) or to conventional care (n = 240) by community nurses (referral if necessary). Psycho-emotional and psychosocial evaluations [Edinburgh Postnatal Depression Scale (EPDS), social support, Maternal Adjustment and Attitudes (MAMA), Traumatic Events Scale (TES) and the Wijma Delivery Experience Questionnaire (W-DEQ-B)] were completed twice during pregnancy and/or 3 months postpartum. Postnatal maternal adjustment (MAMA mean score 38.1 ± 4.3 versus 35.7 ± 5.0, p = 0.001) and childbirth experience (mean W-DEQ-B sum score 63.0 ± 29 versus 73.7 ± 32, p = 0.008) were better in the intervention group compared with controls. In hierarchical regression, social support, participating in intervention, and less fearful childbirth experience predicted better maternal adjustment. The level of postnatal depressive symptoms was significantly lower in the intervention group (mean sum score 6.4 ± 5.4 versus 8.0 ± 5.9 p = 0.04). There were no differences in the frequency of post-traumatic stress symptoms between the groups. In nulliparous women with severe fear of childbirth, participation in a targeted psychoeducative group resulted in better maternal adjustment, a less fearful childbirth experience and fewer postnatal depressive symptoms, compared with conventional care.

  1. Psychoprophylaxis - Antenatal preparation and actual use during labour

    OpenAIRE

    Bergström, Malin

    2010-01-01

    The aim of this thesis was to study the effects of a model of antenatal education, focusing on natural childbirth preparation by including psychoprophylaxis, breathing and relaxation techniques to cope with labour pain, and the actual use of psychoprophylaxis during labour. Satisfaction with antenatal education and experiences of a subgroup of men with antenatal fear of childbirth were also explored. The principal design was a randomised controlled trial where the new mo...

  2. Fathers’ engagement in pregnancy and childbirth: evidence from a national survey

    Science.gov (United States)

    2013-01-01

    Background Early involvement of fathers with their children has increased in recent times and this is associated with improved cognitive and socio-emotional development of children. Research in the area of father’s engagement with pregnancy and childbirth has mainly focused on white middle-class men and has been mostly qualitative in design. Thus, the aim of this study was to understand who was engaged during pregnancy and childbirth, in what way, and how paternal engagement may influence a woman’s uptake of services, her perceptions of care, and maternal outcomes. Methods This study involved secondary analysis of data on 4616 women collected in a 2010 national maternity survey of England asking about their experiences of maternity care, health and well-being up to three months after childbirth, and their partners’ engagement in pregnancy, labour and postnatally. Data were analysed using descriptive statistics, chi-square, binary logistic regression and generalised linear modelling. Results Over 80% of fathers were ‘pleased or ‘overjoyed’ in response to their partner’s pregnancy, over half were present for the pregnancy test, for one or more antenatal checks, and almost all were present for ultrasound examinations and for labour. Three-quarters of fathers took paternity leave and, during the postnatal period, most fathers helped with infant care. Paternal engagement was highest in partners of primiparous white women, those living in less deprived areas, and in those whose pregnancy was planned. Greater paternal engagement was positively associated with first contact with health professionals before 12 weeks gestation, having a dating scan, number of antenatal checks, offer and attendance at antenatal classes, and breastfeeding. Paternity leave was also strongly associated with maternal well-being at three months postpartum. Conclusions This study demonstrates the considerable sociodemographic variation in partner support and engagement. It is

  3. Resources for Childbirth Educators and Expectant Parents

    OpenAIRE

    Shilling, Teri

    2006-01-01

    In this column, reviewers offer perspectives and comments on Hit the Ground Crawling: The Essential Guide for New Fathers, a book by Greg Bishop; The Simple Guide to Having a Baby, a book by Janet Whalley, Penny Simkin, and Ann Keppler; Preparing for Multiples—The Family Way, a book by Cindy Carter, with Jeanne Green and Debby Amis; Hospital to Home: A Security Blanket for New Parents, a DVD released by Injoy Videos; When Survivors Give Birth: Understanding and Healing the Effects of Early Se...

  4. Human rights in childbirth, narratives and restorative justice: a review.

    Science.gov (United States)

    Lokugamage, A U; Pathberiya, S D C

    2017-02-02

    This review describes the emerging global debate on the role of human rights childbirth. It is also tailored to a UK perspective in view of the Montgomery v. Lanarkshire [2015] legal ruling and it implications to practice. We can never underestimate the power of humane care on health. The compassion and evidence based medicine agenda in healthcare is interconnected with human rights in healthcare, feeding into the principles of decision making and patient centred care. When this has not happened and there is been healthcare conflict, the power of storytelling serves to connect disparate parties to their common humanity. Narratives are an important aspect of restorative justice processes and we suggest that this could be beneficial in the field of human rights in childbirth.

  5. Postpartum Depression: How Childbirth Educators Can Help Break the Silence

    Science.gov (United States)

    Zauderer, Cheryl

    2009-01-01

    The voices of women suffering from postpartum depression are often silent. Women are reluctant to reveal to others that they are unhappy after the birth of their babies. Much has been written on possible causes, risk factors, and treatments for postpartum depression, but little has been done to investigate why women take so long to seek help. Early detection and treatment are key to a full recovery. Childbirth educators are in the position to offer anticipatory guidance on possible complications of the postpartum period, including postpartum depression. This article explores why women with postpartum depression choose to suffer in silence and suggests how childbirth educators can help new mothers find their voices. PMID:20190853

  6. Traumatic Childbirth from the Perspective of the Healthcare Professional

    DEFF Research Database (Denmark)

    Schrøder, Katja

    2016-01-01

    , but it accentuates the natural unpredictability of childbirths and it gives voice to the midwife and obstetrician who go to work with no intention to cause harm. I have investigated the perspective of the involved healthcare professional from an individual approach, based on the existential-humanistic traditions...... was to explore to what extent and in what way midwives and obstetricians feel guilt or have existential considerations in relation to these events. Feeling guilty seemed to play a pivotal part in the narratives of being involved in a traumatic childbirth as a healthcare professional, and even in cases...... health and wellbeing in the aftermath. In study II, we formed five categories during the comparative mixed methods analysis: i) the pa-tient; ii) clinical peers; iii) official complaints; iv) guilt and v) existential considerations. Although blame from patients, peers or official authorities was feared...

  7. The longitudinal course of post-traumatic stress after childbirth.

    Science.gov (United States)

    Söderquist, Johan; Wijma, Barbro; Wijma, Klaas

    2006-06-01

    Post-traumatic stress was assessed in early and late pregnancy, and 1, 4, 7, and 11 months postpartum by means of questionnaires among 1224 women. Thirty-seven women (3%) had post-traumatic stress (meeting criteria B, C, and D for PTSD) at least once within 1-11 months postpartum. In pregnancy, depression, severe fear of childbirth, 'pre'-traumatic stress, previous counseling related to pregnancy/childbirth, and self-reported previous psychological problems were associated with an increased risk of having post-traumatic stress within 1-11 months postpartum. Sum-scores of post-traumatic stress did not decrease over time among women who at least once had post-traumatic stress (criteria B, C, and D) within 1-11 months postpartum. Women with post-traumatic stress also showed a decrease in perceived social support over time postpartum.

  8. Analgesia and anaesthesia in childbirth: obscurantism and obfuscation.

    Science.gov (United States)

    Mander, R

    1998-07-01

    The terms 'analgesia' and 'anaesthesia' have been defined by emphasizing differing aspects of their effects. The distinction between these interventions has not been clarified by their definitions. The historical remedies for pain were similarly unclear. This lack of clarity is apparent in the introduction of chloroform in childbirth, which has much in common with the introduction and effects of epidural analgesia. The reasons for and benefits of this lack of clarity are examined.

  9. Predictors of Early Childbirth Among Female Adolescents in Foster Care.

    Science.gov (United States)

    King, Bryn; Van Wert, Melissa

    2017-08-01

    Placement into foster care is driven by a number of factors, many of which are associated with adolescent childbirth. Yet, there are few studies that identify the experiences and characteristics that predict adolescent childbirth among girls who spend time in foster care. A longitudinal, population-based data set was constructed by probabilistically matching California child protective service records for female foster youth to maternal information available on vital birth records for children born between 2001 and 2010. Rates of childbirth among girls in foster care after their 10th birthday were generated. Chi-square tests assessed differences and survival models were specified to determine the rate of childbearing across key characteristics. Among the 30,339 girls who spent time in foster care as adolescents, 18.3% (5,567) gave birth for the first time before their 20th birthday. At a bivariate level, significant differences (p foster care placement experiences. In the fully adjusted survival model, the highest birth rates were observed among girls who entered care between ages 13 and 16 years; had been in care for relatively short periods of time; lived in congregate care at the estimated date of conception; had a history of running away; and were Latina, black, or Native American. The results suggest that there are identifiable risk factors associated with early childbirth among girls in foster care, which can help determine the timing and location of reproductive health services to minimize unintended pregnancy and maximize adolescent health and well-being. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  10. Coping with Childbirth: Brain Structural Associations of Personal Growth Initiative

    Directory of Open Access Journals (Sweden)

    Judith Mangelsdorf

    2017-10-01

    Full Text Available Major life events require psychological adaptations and can be accompanied by brain structural and functional changes. The goal of the current study was to investigate the association of personal growth initiative (PGI as a form of proactive coping strategy before childbirth, with gray matter volume after delivery. Childbirth is one of the few predictable major life events, which, while being one of the most positive experiences for many, is also accompanied by multidimensional stress for the mother. Previous research has shown that high stress is associated with reductions in gray matter volume in limbic cortices as well as the prefrontal cortex (PFC. We hypothesized that PGI before childbirth is positively related to gray matter volume after delivery, especially in the ventromedial PFC (vmPFC. In a prospective study, 22 first-time mothers answered questionnaires about their PGI level 1 month before birth (T1 and 1 month after delivery (T2. Four months after giving birth, a follow-up assessment was applied with 16 of these mothers (T3. Structural brain data were acquired at both postpartal measurement occasions. Voxel-based morphometry was used to correlate prenatal PGI levels with postpartal gray matter volume. Higher PGI levels before delivery were positively associated with larger gray matter volume in the vmPFC directly after childbirth. Previous structural neuroimaging research in the context of major life events focused primarily on pathological reactions to stress (e.g., post-traumatic stress disorder; PTSD. The current study gives initial indications that proactive coping may be positively associated with gray matter volume in the vmPFC, a brain region which shows volumetric reductions in PTSD patients.

  11. Renal colic and childbirth pain: female experience versus male perception

    Directory of Open Access Journals (Sweden)

    Miah S

    2017-07-01

    Full Text Available Saiful Miah,1,2 Charlotte Gunner,3 Lucy Clayton,4 Suresh Venugopal,5 Nigel R Boucher,5 Bo Parys61Division of Surgery and Interventional Science, University College London, London, UK; 2Urology Department, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK; 3Urology Department, Raigmore Hospital, Inverness, UK; 4Psychiatry Department, Highbury Hospital, Nottingham, UK; 5Urology Department, Chesterfield Royal Infirmary, Chesterfield, UK; 6Urology Department, Rotherham General Hospital, Rotherham, UKIntroductionRenal colic is often described by patients as the worst pain ever experienced.1 Pain during childbirth is also similarly described.2 To date, no study has comparatively evaluated the pain of renal colic to that of childbirth in female patients who have experienced both. Furthermore, no such study has evaluated the perception that men with renal colic have with respect to the pain experienced during childbirth. Here we present our cross-sectional observational study to address these questions. The primary objectives of our study were to answer these questions and highlight the severity of renal colic which is not always faced and treated aggressively.  

  12. Posttraumatic stress following childbirth in homelike- and hospital settings.

    Science.gov (United States)

    Stramrood, Claire A I; Paarlberg, K Marieke; Huis In 't Veld, Elisabeth M J; Berger, Leonard W A R; Vingerhoets, Ad J J M; Schultz, Willibrord C M Weijmar; van Pampus, Maria G

    2011-06-01

    To assess the prevalence of posttraumatic stress disorder (PTSD) following childbirth in homelike versus hospital settings and to determine risk factors for the development of posttraumatic stress symptoms. METHODS.: Multi-center cross-sectional study at midwifery practices, general hospitals and a tertiary (university) referral center. An unselected population of 907 women was invited to complete questionnaires on PTSD, demographic, psychosocial, and obstetric characteristics 2 to 6 months after delivery. Prevalence of PTSD was based on women who met all criteria of the diagnostic and statistical manual of mental disorders, 4th edition (DSM-IV), whereas risk factors were determined using the severity (sum-score) of posttraumatic stress symptoms. PTSD following childbirth was found in 1.2% of the respondents (5/428 women, response rate 47%), while 9.1% of women (39/428) had experienced the delivery as traumatic. Posttraumatic stress symptoms were associated with unplanned cesarean section, low sense of coherence (coping skills), and high intensity of pain. Initial differences in posttraumatic stress symptoms between home and hospital deliveries disappeared after taking into account the (by definition) uncomplicated nature of home births. In this Dutch study, 1 in 100 women had PTSD following childbirth, with no differences between home- and hospital deliveries after controlling for complications and interventions. Emergency cesarean section, severe labor pain, and poor coping skills were associated with more posttraumatic stress symptoms.

  13. Flexible work arrangements and work-family conflict after childbirth.

    Science.gov (United States)

    Grice, Mira M; McGovern, Patricia M; Alexander, Bruce H

    2008-10-01

    Previous research has revealed that work-family conflict negatively influences women's health following childbirth. To examine if flexible work arrangements were associated with work-family conflict among women, 1 year after childbirth. Employed women, aged >or=18, were recruited while hospitalized for childbirth. Flexible work arrangements were measured at 6 months and work-family conflict was measured at 12 months. General linear models estimated the association between flexible work arrangements and work-family conflict. Of 1157 eligible participants, 522 were included in this analysis giving a 45% response rate. Compared to women who reported that taking time off was very hard, those who reported it was not too hard (beta = -0.80, SE = 0.36, P hours was associated with greater home spillover (beta = 0.46, SE = 0.18, P work home was associated with increased home spillover (beta = 0.35, SE = 0.14, P work hours and the ability to take work home were associated with increased home spillover to work. The ability to take time off was associated with decreased job spillover to home. Additional research is needed to examine the intentional and unintentional consequences of flexible work arrangements.

  14. Fear of childbirth in pregnant women: External and internal factors.

    Directory of Open Access Journals (Sweden)

    Kashshapova, E. V.

    2015-07-01

    Full Text Available Fear of childbirth (FOC is an important psychological problem that is studied worldwide because it affects the well-being of pregnant women. However, in Russia, this problem does not receive adequate attention among researchers. The purpose of the present study was to investigate the conditionality of fear of childbirth (FOC in pregnant women by external and internal factors, which we assumed were the reasons for this fear. As external factors, we considered socio-demographic indicators (e.g., age, marital status, level of education, housing, and the attitude of relatives towards pregnancy as well as indicators of gynecological history (e.g., the term of pregnancy, the outcome of previous pregnancies, and pregnancy complications. As internal (psychological factors of the fear of childbirth, we considered personal anxiety as well as general inclination towards and negative consequences of different fears (20 types of fears and phobias were examined. The study was conducted with a Russian sample of 76 women at different stages of pregnancy and with different socio-demographic indicators and gynecological histories. The analysis of the results showed the absence of significant differences between women who were pregnant with FOC and those without this fear in terms of the external factors considered in this study. According to the study’s data, a general inclination of women to fear is associated with fear of childbirth. However, the findings for the women with FOC did not indicate significant positive correlations between the level of this fear and exposure to any of the 20 types of fear and phobias measured in the study. Furthermore, the results did not detect relationships between the FOC level and women’s personal anxiety. The results allow us to conclude that FOC is a separate phenomenon that is not dependent on other phobias and fears. Fear of childbirth has a subjective and highly individual genesis. It is not a direct consequence of

  15. Effect of Maternal Age at Childbirth on Obesity in Postmenopausal Women

    OpenAIRE

    We, Ji-Sun; Han, Kyungdo; Kwon, Hyuk-Sang; Kil, Kicheol

    2016-01-01

    Abstract The object of this study was to assess the obesity in postmenopausal women, according to age at childbirth. We analyzed the association between age at first childbirth, age at last childbirth, parity, and subject obesity status (general obesity; BMI?>25?kg/m2, nongeneral obesity; BMI ?25?kg/m2, abdominal obesity; waist circumference?>85?cm, nonabdominal obesity; waist circumference ?85?cm), using data from a nationwide population-based survey, the 2010 to 2012 Korean National Health ...

  16. Post-traumatic stress disorder after childbirth: the phenomenon of traumatic birth

    OpenAIRE

    Reynolds, J L

    1997-01-01

    CHILDBIRTH CAN BE A VERY PAINFUL EXPERIENCE, often associated with feelings of being out of control. It should not, therefore, be surprising that childbirth may be traumatic for some women. Most women recover quickly post partum; others appear to have a more difficult time. The author asserts that post-traumatic stress disorder (PTSD) may occur after childbirth. He calls this variant of PTSD a "traumatic birth experience." There is very little literature on this topic. The evidence available ...

  17. Emotional Distress Following Childbirth: An Intervention to Buffer Depressive and PTSD Symptoms

    OpenAIRE

    Paola Di Blasio; Sarah Miragoli; Elena Camisasca; Angela Maria Di Vita; Rosalia Pizzo; Laura Pipitone

    2015-01-01

    Childbirth for some women is a negative experience associated with depressive and post-traumatic symptoms. The preventive actions focusing on helping mothers to cope with negative emotions experienced after childbirth are strongly recommended. It is also recommended both to intervene early and on all women to avoid the risk that these symptoms can worsen in the months after childbirth. The intervention described in the current study is focalized on the elaboration of post-partum negative thou...

  18. 'Birthgasm': A Literary Review of Orgasm as an Alternative Mode of Pain Relief in Childbirth.

    Science.gov (United States)

    Mayberry, Lorel; Daniel, Jacqueline

    2016-12-01

    Childbirth is a fundamental component of a woman's sexual cycle. The sexuality of childbirth is not well recognized in Western society despite research showing that some women experience orgasm(s) during labor and childbirth. Current thinking supports the view that labor and childbirth are perceived to be physically painful events, and more women are relying on medical interventions for pain relief in labor. This review explores the potential of orgasm as a mode of pain relief in childbirth and outlines the physiological explanations for its occurrence. Potential barriers to sexual expression during childbirth and labor, including the influence of deeply held cultural beliefs about sexuality, the importance of privacy and intimacy in facilitating orgasmic birth experiences, and the value of including prospective fathers in the birthing experience, are discussed. The role of midwives and their perceptions of the use of complementary and alternative therapies for pain relief in labor are examined. While there are indications of widespread use of complementary and alternative therapies such as hydrotherapy, herbal remedies, and breathing techniques for pain relief in childbirth, orgasm was not among those mentioned. Lack of recognition of the sexuality of childbirth, despite findings that orgasm can attenuate the effects of labor pain, suggests the need for greater awareness among expectant parents, educators, and health professionals of the potential of orgasm as a means of pain relief in childbirth. © The Author(s) 2015.

  19. [Nonregular Employment in a Society with a Decreasing Birthrate: Workers' Marriage, Childbirth, and Childcare].

    Science.gov (United States)

    Nishikitani, Mariko; Inoue, Mariko; Tsurugano, Shinobu

    2018-01-01

    In this paper, we examine the trend in Japan towards nonregular employment and its effects on marriage, childbirth, and childcare from the viewpoint of a decreasing societal birthrate. Although the decision to marry includes personal values and preferences, socioeconomic status factors such as income and employment type are also associated with the determinants of marriage. Nonregular employment workers have a lower rate and motivation for marriage than regular workers. Thus, socioeconomic disparity caused by employment needs to be minimized through governmental measures and policies. Nonregular employment is increasing among younger generations, and for them, maternity and childcare leave are especially vital. Employee insurance coverage should be expanded to function as a form of income security during these leaves of absence, such that nonregular workers are also covered. During the childcare period, which lasts more than 10 years, it is necessary to cover childrearing costs and also the time required to spend with children. If a single working parent is involved in childcare alone, there is the burden of both work and childcare. Additionally, long work hours can also impact workers that are not involved in childcare. This is a dilemma: a stable and regular employment is often necessary to achieve a higher education; however, it is difficult for nonregular employees to take care of and prepare children for higher education owing to limited financial means. Properly designed measures and policies are necessary to break this chain. Importantly, considerations about life and work are important for all workers, including nonregular workers, who are especially affected in terms of marriage, childbirth, and childcare.

  20. Effects of low-intensity GaAlAs laser radiation ({lambda}=660 nm) on dentine-pulp interface after class I cavity preparation; Efeitos da radiacao laser GaAlAs ({lambda}=660 nm) em baixa intensidade na interface dentina-polpa pos-preparo cavitario classe 1

    Energy Technology Data Exchange (ETDEWEB)

    Godoy, Bruno Miranda

    2003-07-01

    The aim of this study was to investigate the effects of low-intensity irradiation with GaAlAs laser (red emission) on the ultrastructure of dentine-pulp interface after conventionally prepared class I cavity preparation. Two patients with 8 premolars for extraction indicated for orthodontic reasons. Class I cavities were prepared in these teeth that were then divided into two groups. The first group received a treatment with laser with continuous emission, {lambda}=660 nm, with maximum power output of 30 mW. The dosimetry applied was of approximately 2J/cm{sup 2}, directly and perpendicularly into the cavity in only one section. After the irradiation, the cavities were filled with composite resin. The second group received the same treatment, except by the laser therapy. Twenty-eight days after the preparation, the teeth were extracted and were processed for transmission electron microscopy analysis. Two sound teeth, without any preparation, were also studied. The irradiated group presented odontoblastic processes in higher contact with the extracellular matrix and the collagen fibers appeared more aggregated and organized than those of control group. These results were also observed in the healthy-teeth. Thus, we suggest that laser irradiation accelerates the recovery of the dental structures involved in the cavity preparation at the pre-dentine level. (author)

  1. Preventing traumatic childbirth experiences: 2192 women's perceptions and views.

    Science.gov (United States)

    Hollander, M H; van Hastenberg, E; van Dillen, J; van Pampus, M G; de Miranda, E; Stramrood, C A I

    2017-08-01

    The purpose of this study is to explore and quantify perceptions and experiences of women with a traumatic childbirth experience in order to identify areas for prevention and to help midwives and obstetricians improve woman-centered care. A retrospective survey was conducted online among 2192 women with a self-reported traumatic childbirth experience. Women were recruited in March 2016 through social media, including specific parent support groups. They filled out a 35-item questionnaire of which the most important items were (1) self-reported attributions of the trauma and how they believe the traumatic experience could have been prevented (2) by the caregivers or (3) by themselves. The responses most frequently given were (1) Lack and/or loss of control (54.6%), Fear for baby's health/life (49.9%), and High intensity of pain/physical discomfort (47.4%); (2) Communicate/explain (39.1%), Listen to me (more) (36.9%), and Support me (more/better) emotionally/practically (29.8%); and (3) Nothing (37.0%), Ask for (26.9%), or Refuse (16.5%) certain interventions. Primiparous participants chose High intensity of pain/physical discomfort, Long duration of delivery, and Discrepancy between expectations and reality more often and Fear for own health/life, A bad outcome, and Delivery went too fast less often than multiparous participants. Women attribute their traumatic childbirth experience primarily to lack and/or loss of control, issues of communication, and practical/emotional support. They believe that in many cases, their trauma could have been reduced or prevented by better communication and support by their caregiver or if they themselves had asked for or refused interventions.

  2. Questions never asked. Positive family outcomes of extremely premature childbirth

    DEFF Research Database (Denmark)

    Lou, Hanne; Pedersen, Birthe D; Hedegaard, Morten

    2009-01-01

    OBJECTIVE: To explore positive aspects of family life after extremely premature childbirth, thereby supplementing current literature on long-term family outcome. DESIGN: Semi-structured, qualitative research interviews were analysed according to the editing strategy described by Miller and Crabtree....... SETTING: Denmark, Europe. PARTICIPANTS: Nine fathers and 11 mothers of 14 children born before 28 completed weeks of gestation at a tertiary centre were interviewed when their children were 7-10 years old. RESULTS: Whereas developmental delay, functional limitations, family burden, and parental distress...

  3. 'Not enough people to look after you': an exploration of women's experiences of childbirth in the Republic of Ireland.

    LENUS (Irish Health Repository)

    Larkin, Patricia

    2012-02-01

    Women\\'s experiences of childbirth have far reaching implications for their health and that of their babies. This paper describes an exploration of women\\'s experiences of childbirth in the Republic of Ireland.

  4. Development of the Childbirth Perception Scale (CPS) : Perception of delivery and the first postpartum week

    NARCIS (Netherlands)

    Truijens, Sophie E. M.; Wijnen, Hennie A.; Pommer, Antoinette M.; Oei, S. Guid; Pop, Victor J. M.

    2014-01-01

    Some caregivers suggest a more positive experience of childbirth when giving birth at home. Since properly developed instruments that assess women’s perception of delivery and the early postpartum are missing, the aim of the current study is to develop a Childbirth Perception Scale (CPS). Three

  5. Effect of Implementing a Birth Plan on Womens' Childbirth Experiences and Maternal & Neonatal Outcomes

    Science.gov (United States)

    Farahat, Amal Hussain; Mohamed, Hanan El Sayed; Elkader, Shadia Abd; El-Nemer, Amina

    2015-01-01

    Childbirth satisfaction represents a sense of feeling good about one's birth. It is thought to result from having a sense of control, having expectations met, feeling empowered, confident and supported. The aim of this study was to implement a birth plan and evaluate its effect on women's childbirth experiences and maternal, neonatal outcomes. A…

  6. [The positive psychological impact of rich childbirth experiences on child-rearing].

    Science.gov (United States)

    Takehara, Kenji; Noguchi, Makiko; Shimane, Takuya; Misago, Chizuru

    2009-05-01

    The purpose of this study was to investigate the psychological implications of emotionally enriching childbirth experiences for problems such as awareness of motherhood, postnatal depression, and parenting stress among women after childbirth. All women who gave birth at five study centers (four birthing homes and one maternity hospital) during May 2002 and August 2003 were asked to participate in the cohort study. All 2314 women were approached and 1004 eligible women agreed to take part. Analyses were conducted using a baseline survey and four follow-up surveys conducted at 4 months, 9 months, 2 and a half years, and 3 years after childbirth. The questionnaire included four scales to evaluate the subjects' childbirth experiences, awareness of motherhood, postnatal depression, and parenting stress and difficulties. Data were collected via structured interviews and transcription from medical records. Bivariate and multivariate analysis indicated that women who had good childbirth experiences had positive feelings concerning motherhood and parenting stress and anxiety were lower. Bivariate analysis also indicated that childbirth experience had an inverse relationship with postnatal depression. This study revealed that having good childbirth experiences inhibits negative awareness of motherhood and abusive behavior towards children. These results show that it is important for mothers to be provided with appropriate care during pregnancy and labor for preventing child abuse and parenting stress and anxiety. More research is needed to identify the determinants of childbirth

  7. Childhood abuse and fear of childbirth--a population-based study

    DEFF Research Database (Denmark)

    Lukasse, Mirjam; Vangen, Siri; Øian, Pål

    2010-01-01

    Childhood abuse affects adult health. The objective of this study was to examine the association between a self-reported history of childhood abuse and fear of childbirth.......Childhood abuse affects adult health. The objective of this study was to examine the association between a self-reported history of childhood abuse and fear of childbirth....

  8. Effect of psychoprophylaxis (Lamaze preparation) on labor and delivery in primiparas.

    Science.gov (United States)

    Scott, J R; Rose, N B

    1976-05-27

    To investigate whether "prepared-childbirth" courses offer measurable physical advantages, we compared the labor and delivery characteristics of 129 primiparas who had completed ante-partum Lamaze-training psychoprophylaxis classes with an equal number of matched controls who had not. The former were given narcotics less frequently during labor (P less than 0.001), received conduction anesthesia less often (P less than 0.001), and had a higher frequency of spontaneous vaginal deliveries (P less than 0.001) than the control patients. However, these differences had no apparent effects on the length of labor, number or type of maternal complications, frequency of fetal distress, mean Apgar scored, or neonatal problems.

  9. Doctors, pregnancy, childbirth and abortion during the Third Reich.

    Science.gov (United States)

    Chelouche, Tessa

    2007-03-01

    This paper does not attempt to deal with the legitimate ethical or moral debate on abortion. Utilizing abortion as a subject I will show how science and medicine in general, and abortion in particular, were used as weapons of mass destruction by Nazi physicians in their zeal to comply with the political climate of the time. Nazi policy on abortion and childbirth was just one of the methods devised and designed to ensure the extermination of those whom the Nazis deemed had "lives not worth living." Physicians implemented these policies, not with the fate of their patients in mind, but rather in the name of the "state." When discussing pregnancy, abortion and childbirth during the Holocaust it is imperative to include an essay of how these issues affected the Jewish prisoner doctors in the ghettos and camps. Nazi policy dictated their actions too. From an extensive search of their testimonies, I conclude that for these doctors ethical discourse comprised a fundamental component of their functioning. I do not propose to judge them in any way and one should not, in my opinion, argue whether their behavior was or was not morally acceptable under such duress; nevertheless, unlike their Nazi counterparts, a key theme in their testimonies was to "keep their medical values."

  10. [Qualitative evidence of monitoring by doulas during labor and childbirth].

    Science.gov (United States)

    Silva, Raimunda Magalhães da; Barros, Nelson Filice de; Jorge, Herla Maria Furtado; Melo, Laura Pinto Torres de; Ferreira Junior, Antonio Rodrigues

    2012-10-01

    The objective of this study was to conduct a metasynthesis of evidence of the work of doulas assisting women in labor and during childbirth. Articles between 2000 and 2009 were located in the Medline, PubMed, SciELO, and Lilacs databases using the key search words: doulas, gestation, labor, and alternative therapy. Seven articles were selected for the study and four categories were created: the support provided by doulas; the birth mother's experiences; professional relationship: and opinions and experiences of professionals. The doulas offered physical, emotional, spiritual and social support. Experiments showed that the professionals stimulated the mother/child relationship, oriented towards successful breastfeeding, and contributed to the prevention of post-partum depression. Controversy was observed among professionals regarding acceptance of the role of the doula as a member of the obstetrics team. The doula's care was considered innovative, calming, encouraging, and attended all the needs of the pregnant woman. The conclusion is that qualitative studies on the work of doulas are recent, incipient, but revealing as to the important possibility of humanizing labor and childbirth.

  11. Natural childbirth ideology is endangering women and babies.

    Science.gov (United States)

    Dietz, Hans Peter; Exton, Lynda

    2016-10-01

    Natural childbirth ideology has become dominant across much of the developed world. This ideology increasingly clashes with the reality of modern obstetrics, which is dealing with a demographic that is getting older and more obese, hence more complicated, and it has become a danger to the health of women and babies. The most visible expression of these trends is the focus on caesarean section rates which have become a key performance indicator of obstetric services. This trend is resulting in increasingly obvious negative consequences for morbidity and mortality, as chronicled in the Morecambe Bay Report, published in the UK last year. At the same time, there is mounting emphasis on patient autonomy in obstetric decision-making, which mandates informed consent. A 2015 Supreme Court decision in the UK (Montgomery vs Lanarkshire) is likely to impact on obstetric management in Australia and New Zealand. The 'paternalism in a skirt' of natural childbirth ideology is already exposing obstetricians and services to an ever-increasing degree of medicolegal risk. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  12. The Childbirth Experience Questionnaire (CEQ) - validation of its use in a Danish population

    DEFF Research Database (Denmark)

    Boie, Sidsel; Glavind, Julie; Uldbjerg, Niels

    experience is lacking. The Childbirth Experience Questionnaire (CEQ) was developed in Sweden in 2010 and validated in Swedish women, but never validated in a Danish setting, and population. The purpose of our study was to validate the CEQ as a reliable tool for measuring the childbirth experience in Danish......Title The Childbirth Experience Questionnaire (CEQ) - validation the use in a Danish population Introduction Childbirth experience is arguably as important as measuring birth outcomes such as mode of delivery or perinatal morbidity. A robust, validated, Danish tool for evaluating childbirth...... index of agreement between the two scores. Case description (mandatory for Clinical Report) Results (mandatory for Original Research) Face validity: All respondents stated that it was easy to understand and complete the questionnaire. Construct validity: Statistically significant higher CEQ scores were...

  13. Post-Traumatic Stress Disorder (PTSD) Following Childbirth: Prevalence and Contributing Factors.

    Science.gov (United States)

    Shaban, Zainab; Dolatian, Mahrokh; Shams, Jamal; Alavi-Majd, Hamid; Mahmoodi, Zohreh; Sajjadi, Homeira

    2013-03-01

    Childbirth might be a traumatic event for some women. This study was conducted with the objective of investigating the prevalence of Post-Traumatic Stress Disorder (PTSD) following childbirth. The study was designed using a descriptive correlation scheme. The participants were selected from the women referred to the healthcare centers affiliated with Zahedan University of Medical Sciences, Zahedan, Iran. Personal interviews were conducted with 600 women who were 6-8 weeks postpartum and had been undergone to this center for postpartum and child care. One hundred and three (17. 2%) women had symptoms of PTSD following childbirth based on the PTSD Symptom Scale (PSS). The results of logistic regression analysis revealed a significant correlation between maternal occupation (P = 0.01), depression level (P childbirth. PTSD from childbirth occurs in some women. Early identification of risk factors should lead to early therapeutic intervention in the mothers at risk of PTSD.

  14. Effect of childbirth on the course of Crohn's disease; results from a retrospective cohort study in the Netherlands

    NARCIS (Netherlands)

    Smink, M.; Lotgering, F.K.; Albers, L.; Jong, D.J. de

    2011-01-01

    BACKGROUND: Pregnant women with Crohn's disease needs proper counselling about the effect of pregnancy and childbirth on their disease. However, Literature about the effect of childbirth on Crohn's disease is limited. This study examined the effect of childbirth on the course of Crohn's disease and

  15. Basic copyright law for use of materials in childbirth education classes.

    Science.gov (United States)

    Philipsen, Nayna C

    2005-01-01

    Copyright is federal law that creates a monopoly to protect the property rights of authors and creators and their original works. Copyright law creates an exception for classroom use, but educators must always give full attribution for any work they use in teaching.

  16. What makes or mars the facility-based childbirth experience: thematic analysis of women's childbirth experiences in western Kenya.

    Science.gov (United States)

    Afulani, Patience A; Kirumbi, Leah; Lyndon, Audrey

    2017-12-29

    Sub-Saharan Africa accounts for approximately 66% of global maternal deaths. Poor person-centered maternity care, which emphasizes the quality of patient experience, contributes both directly and indirectly to these poor outcomes. Yet, few studies in low resource settings have examined what is important to women during childbirth from their perspective. The aim of this study is to examine women's facility-based childbirth experiences in a rural county in Kenya, to identify aspects of care that contribute to a positive or negative birth experience. Data are from eight focus group discussions conducted in a rural county in western Kenya in October and November 2016, with 58 mothers aged 15 to 49 years who gave birth in the preceding nine weeks. We recorded and transcribed the discussions and used a thematic approach for data analysis. The findings suggest four factors influence women's perceptions of quality of care: responsiveness, supportive care, dignified care, and effective communication. Women had a positive experience when they were received well at the health facility, treated with kindness and respect, and given sufficient information about their care. The reverse led to a negative experience. These experiences were influenced by the behavior of both clinical and support staff and the facility environment. This study extends the literature on person-centered maternity care in low resource settings. To improve person-centered maternity care, interventions need to address the responsiveness of health facilities, ensure women receive supportive and dignified care, and promote effective patient-provider communication.

  17. Two years survival rate of class II composite resin restorations prepared by ART with and without a chemomechanical caries removal gel in primary molars.

    NARCIS (Netherlands)

    Topaloglu-Ak, A.; Eden, E.; Frencken, J.E.F.M.; Oncag, O.

    2009-01-01

    The aim was to test the null hypotheses that there is no difference: (1) in carious lesion development at the restoration margin between class II composite resin restorations in primary molars produced through the atraumatic restorative treatment (ART) with and without a chemomechanical caries

  18. Marginal microleakage in vitro study on class V cavities prepared with Er:YAG laser and etched with acid or etched with Er:YAG laser and acid; Estudo in vitro da microinfiltracao marginal em cavidades classe V preparadas com laser de Er:YAG e condicionadas com acido ou com laser de Er:YAG e acido

    Energy Technology Data Exchange (ETDEWEB)

    Tavares, Henrique Dutra Simoes

    2001-07-01

    Microleakage at the interface between the teeth and the restorative materials remains a problem with composite resin restorations. Microleakage at the gingival margins of class V cavities restorations still challenge as they are usually placed in dentin and/or cementum. Previous studies have shown that the cavity preparation with Er:YAG laser is possible. It has been reported that Er:YAG laser has ability to create irregular surface providing micromechanical retention for adhesive dental restorative materials and to improve marginal sealing. The purpose of this in vitro study was to evaluate the marginal microleakage on class V cavities prepared with Er:YAG laser and etched with acid or with Er:YAG laser and acid, in compared to those prepared and etched conventionally. Thirty human molars were divided into three groups, namely: group I - prepared with Er:YAG laser (KaVo KEY Laser II - Germany) and etched with 37% phosphoric acid; group II - prepared with Er:YAG laser and etched with Er:YAG laser and 37% phosphoric acid; group III (control group) - prepared with high speed drill and etched with 37% phosphoric acid. All cavities were treated with same adhesive system (Single Bond - 3M) and restored with the composite resin (Z100 - 3M), according to the manufacturer's instructions. The specimens were stored at 37 deg C in water for 24 hours, polished with Sof-Lex discs (3M), thermally stressed, sealed with a nail polish coating except for the area of the restoration and 1 mm around it, and immersed in a 50% aqueous solution of silver nitrate for 24 hours. After that, the specimens were rinsed in water, soaked in a photodeveloping solution and exposed to a fluorescent light for 8 hours. The teeth were embedded in an autopolymerizing resin and sectioned longitudinally using a diamond saw microtome under running water. The sections were photographed. The microleakage at the occlusal cavity and at the gingival margins of each specimen was evaluated with scores (0-3) by

  19. Marginal microleakage in vitro study on class V cavities prepared with Er:YAG laser and etched with acid or etched with Er:YAG laser and acid; Estudo in vitro da microinfiltracao marginal em cavidades classe V preparadas com laser de Er:YAG e condicionadas com acido ou com laser de Er:YAG e acido

    Energy Technology Data Exchange (ETDEWEB)

    Tavares, Henrique Dutra Simoes

    2001-07-01

    Microleakage at the interface between the teeth and the restorative materials remains a problem with composite resin restorations. Microleakage at the gingival margins of class V cavities restorations still challenge as they are usually placed in dentin and/or cementum. Previous studies have shown that the cavity preparation with Er:YAG laser is possible. It has been reported that Er:YAG laser has ability to create irregular surface providing micromechanical retention for adhesive dental restorative materials and to improve marginal sealing. The purpose of this in vitro study was to evaluate the marginal microleakage on class V cavities prepared with Er:YAG laser and etched with acid or with Er:YAG laser and acid, in compared to those prepared and etched conventionally. Thirty human molars were divided into three groups, namely: group I - prepared with Er:YAG laser (KaVo KEY Laser II - Germany) and etched with 37% phosphoric acid; group II - prepared with Er:YAG laser and etched with Er:YAG laser and 37% phosphoric acid; group III (control group) - prepared with high speed drill and etched with 37% phosphoric acid. All cavities were treated with same adhesive system (Single Bond - 3M) and restored with the composite resin (Z100 - 3M), according to the manufacturer's instructions. The specimens were stored at 37 deg C in water for 24 hours, polished with Sof-Lex discs (3M), thermally stressed, sealed with a nail polish coating except for the area of the restoration and 1 mm around it, and immersed in a 50% aqueous solution of silver nitrate for 24 hours. After that, the specimens were rinsed in water, soaked in a photodeveloping solution and exposed to a fluorescent light for 8 hours. The teeth were embedded in an autopolymerizing resin and sectioned longitudinally using a diamond saw microtome under running water. The sections were photographed. The microleakage at the occlusal cavity and at the gingival margins of each specimen was evaluated with scores (0

  20. Supply kits for antenatal and childbirth care: a systematic review.

    Science.gov (United States)

    Aleman, Alicia; Tomasso, Giselle; Cafferata, María Luisa; Colomar, Mercedes; Betran, Ana Pilar

    2017-12-13

    It is critical to increase the uptake of interventions proven to be effective to improve maternal and perinatal outcomes. Supply kits have been suggested to be a feasible strategy designed to ensure timely availability and effective follow-up of care. We conducted a systematic review to summarize the evidence on the uptake, effectiveness and safety of supply kits for maternal care. MEDLINE, the Cochrane Pregnancy and Childbirth Group's Trials Register, Campbell Collaboration, Lilacs, Embase and unpublished studies were searched. Studies that reported the efficacy, safety and use of supply kits for maternal healthcare were eligible. Participants were pregnant women or in childbirth. Supply kits were defined as a collection of medicines, supplies or instruments packaged together with the aim of conducting a healthcare task. Two reviewers independently performed the screening, data extraction, and methodological and quality assessment. 24 studies were included: 4 of them were systematic reviews and 20 primary studies. Eighteen studies evaluated a so-called "clean delivery kit". In all but two studies, the kits were used by more than half of the participants. A meta-analysis was deemed inappropriate due to the heterogeneity in study design, in the components of the interventions implemented, in the content of the kits, and in outcomes. Nine studies assessed neonatal outcomes and found statistically significant reductions in cord infection, sepsis and tetanus-related mortality in the intervention group. Three studies showed evidence of reduced neonatal mortality (OR 0.52, 0.60 and 0.71) with statistically significant confidence intervals in all cases. Four studies reported odd ratios for maternal mortality, but only one showed evidence of a statistically significant decrease in this outcome but it was ascribed to hand washing prior to childbirth and not with the use of kits. This review suggests potential benefits in the use of supply kits to improve maternal and

  1. Dependent Classes

    DEFF Research Database (Denmark)

    Gasiunas, Vaidas; Mezini, Mira; Ostermann, Klaus

    2007-01-01

    of dependent classes and a machine-checked type soundness proof in Isabelle/HOL [29], the first of this kind for a language with virtual classes and path-dependent types. [29] T.Nipkow, L.C. Poulson, and M. Wenzel. Isabelle/HOL -- A Proof Assistant for Higher-Order Logic, volume 2283 of LNCS, Springer, 2002......Virtual classes allow nested classes to be refined in subclasses. In this way nested classes can be seen as dependent abstractions of the objects of the enclosing classes. Expressing dependency via nesting, however, has two limitations: Abstractions that depend on more than one object cannot...... be modeled and a class must know all classes that depend on its objects. This paper presents dependent classes, a generalization of virtual classes that expresses similar semantics by parameterization rather than by nesting. This increases expressivity of class variations as well as the flexibility...

  2. A time for psycho-spiritual transcendence: The experiences of Iranian women of pain during childbirth.

    Science.gov (United States)

    Taghizdeh, Z; Ebadi, A; Dehghani, M; Gharacheh, M; Yadollahi, P

    2017-12-01

    The description of women's experiences of childbirth improves our understandings of the nature of childbirth, women's suffering and pain during childbirth. This study aimed to explore women's experiences of pain during childbirth. A qualitative study was conducted using a conventional content analysis method proposed by Graneheim and Lundman (2004). In-depth face to face semi-structured interviews were held with 17 women who met inclusion criteria for participation in this study. The women's experiences of pain during childbirth was described as 'a time for psycho-spiritual transcendence'. Categories developed during the data analysis were 'conflicting emotions towards pain', 'new insight towards labor pain', 'self-actualization' and 'spiritual development'. Most participants had positive experiences and attitudes towards pain during childbirth influenced by cultural, context and religious factors. According to this study, 'transcendental progression' was an eminent feeling that created positive inner feelings along with self-actualization in women. This provides a new insight on labor pain and helps healthcare providers understand the effect of pain during childbirth on women's spiritual, mental and psychological needs. Copyright © 2017. Published by Elsevier Ltd.

  3. She Said, She Said: Interruptive Narratives of Pregnancy and Childbirth

    Directory of Open Access Journals (Sweden)

    Alison Happel-Parkins

    2017-03-01

    Full Text Available In this article, we explore narrative inquiry data we collected with women who attempted to have a natural, drug-free childbirth for the birth of their first child. The data presented come from semi-structured life story interviews with six women who live in a metropolitan city in the mid-southern United States. Using creative analytic practice (CAP, the women's experiences are presented as a composite poem. The (representation of the women's narratives in the poem emphasizes the tensions between what women desired and planned for in contrast to what they actually experienced during pregnancy and birth. The poem illustrates the politics of agency, the ways in which consent is bypassed or assumed in some medical institutions in the United States, and the resilience of the women. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs170290

  4. Mode of childbirth and neonatal outcome after external cephalic version: A prospective cohort study.

    Science.gov (United States)

    Rosman, A N; Vlemmix, F; Ensing, S; Opmeer, B C; Te Hoven, S; Velzel, J; de Hundt, M; van den Berg, S; Rota, H; van der Post, J A M; Mol, B W J; Kok, M

    2016-08-01

    to assess the mode of childbirth and adverse neonatal outcomes in women with a breech presentation with or without an external cephalic version attempt, and to compare the mode of childbirth among women with successful ECV to women with a spontaneous cephalic presentation. prospective matched cohort study. 25 clusters (hospitals and its referring midwifery practices) in the Netherlands. Data of the Netherlands perinatal registry for the matched cohort. singleton pregnancies from January 2011 to August 2012 with a fetus in breech presentation and a childbirth from 36 weeks gestation onwards. Spontaneous cephalic presentations (selected from national registry 2009 and 2010) were matched in a 2:1 ratio to cephalic presentations after a successful version attempt. Matching criteria were maternal age, parity, gestational age at childbirth and fetal gender. Main outcomes were mode of childbirth and neonatal outcomes. of 1613 women eligible for external cephalic version, 1169 (72.5%) received an ECV attempt. The overall caesarean childbirth rate was significantly lower compared to women who did not receive a version attempt (57% versus 87%; RR 0.66 (0.62-0.70)). Women with a cephalic presentation after ECV compared to women with a spontaneous cephalic presentation had a decreased risk for instrumental vaginal childbirth (RR 0.52 (95% CI 0.29-0.94)) and an increased risk of overall caesarean childbirth (RR 1.7 (95%CI 1.2-2.5)). women who had a successful ECV are at increased risk for a caesarean childbirth but overall, ECV is an important tool to reduce the caesarean rate. ECV is an important tool to reduce the caesarean section rates. Copyright © 2016. Published by Elsevier Ltd.

  5. Childbirth experience questionnaire (CEQ: development and evaluation of a multidimensional instrument

    Directory of Open Access Journals (Sweden)

    Bergqvist Liselotte

    2010-12-01

    Full Text Available Abstract Background Negative experiences of first childbirth increase risks for maternal postpartum depression and may negatively affect mothers' attitudes toward future pregnancies and choice of delivery method. Postpartum questionnaires assessing mothers' childbirth experiences are needed to aid in identifying mothers in need of support and counselling and in isolating areas of labour and birth management and care potentially in need of improvement. The aim of this study was to develop and evaluate a questionnaire for assessing different aspects of first-time mothers' childbirth experiences. Methods Childbirth domains were derived from literature searches, discussions with experienced midwives and interviews with first-time mothers. A draft version of the Childbirth Experience Questionnaire (CEQ was pilot tested for face validity among 25 primiparous women. The revised questionnaire was mailed one month postpartum to 1177 primiparous women with a normal pregnancy and spontaneous onset of active labor and 920 returned evaluable questionnaires. Exploratory factor analysis using principal components analysis and promax rotation was performed to identify dimensions of the childbirth experience. Multitrait scaling analysis was performed to test scaling assumptions and reliability of scales. Discriminant validity was assessed by comparing scores from subgroups known to differ in childbirth experiences. Results Factor analysis of the 22 item questionnaire yielded four factors accounting for 54% of the variance. The dimensions were labelled Own capacity, Professional support, Perceived safety, and Participation. Multitrait scaling analysis confirmed the fit of the four-dimensional model and scaling success was achieved in all four sub-scales. The questionnaire showed good sensitivity with dimensions discriminating well between groups hypothesized to differ in experience of childbirth. Conclusion The CEQ measures important dimensions of the first

  6. Fear of childbirth in primiparous Italian pregnant women: The role of anxiety, depression, and couple adjustment.

    Science.gov (United States)

    Molgora, Sara; Fenaroli, Valentina; Prino, Laura Elvira; Rollè, Luca; Sechi, Cristina; Trovato, Annamaria; Vismara, Laura; Volpi, Barbara; Brustia, Piera; Lucarelli, Loredana; Tambelli, Renata; Saita, Emanuela

    2018-04-01

    The prevalence of fear of childbirth in pregnant women is described to be about 20-25%, while 6-10% of expectant mothers report a severe fear that impairs their daily activities as well as their ability to cope with labour and childbirth. Research on fear of childbirth risk factors has produced heterogeneous results while being mostly done with expectant mothers from northern Europe, northern America, and Australia. The present research investigates whether fear of childbirth can be predicted by socio-demographic variables, distressing experiences before pregnancy, medical-obstetric factors and psychological variables with a sample of 426 Italian primiparous pregnant women. Subjects, recruited between the 34th and 36th week of pregnancy, completed a questionnaire packet that included the Wijma Delivery Expectancy Questionnaire, the Edinburgh Postnatal Depression Scale, the State-Trait Anxiety Inventory, the Dyadic Adjustment Scale, the Multidimensional Scale of Perceived Social Support, as well as demographic and anamnestic information. Fear of childbirth was treated as both a continuous and a dichotomous variable, in order to differentiate expectant mothers as with a severe fear of childbirth. Results demonstrate that anxiety as well as couple adjustment predicted fear of childbirth when treated as a continuous variable, while clinical depression predicted severe fear of childbirth. Findings support the key role of psychological variables in predicting fear of childbirth. Results suggest the importance of differentiating low levels of fear from intense levels of fear in order to promote adequate support interventions. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  7. Barriers to Institutional Childbirth in Rumbek North County, South Sudan: A Qualitative Study.

    Directory of Open Access Journals (Sweden)

    Calistus Wilunda

    Full Text Available South Sudan has one of the world's poorest health indicators due to a fragile health system and a combination of socio-cultural, economic and political factors. This study was conducted to identify barriers to utilisation of institutional childbirth services in Rumbek North County.Data were collected through 14 focus group discussions with 169 women and 45 men, and 18 key informant interviews with community leaders, staff working in health facilities, traditional birth attendants, and the staff of the County Health Department. Data were analysed using inductive content analysis.The barriers to institutional childbirth were categorised under four main themes: 1 Issues related to access and lack of resources: long distance to health facilities, lack of transportation means, referral problems, flooding and poor roads, and payments in health facilities; 2 Issues related to the socio-cultural context and conflict: insecurity, influence of the husband, lack of birth preparedness, domestic chores of women, influence of culture; 3 Perceptions about pregnancy and childbirth: perceived benefit of institutional childbirth, low childbirth risk perception, and medicalisation of childbirth including birth being perceived to be natural, undesirable birth practices, privacy concerns, and fear of caesarean section; and 4 Perceptions about the quality of care: inadequate health facility infrastructure and perceived neglect during admission.Multiple factors hinder institutional childbirth in Rumbek North. Some of the factors such as insecurity and poor roads are outside the scope of the health sector and will require a multi-sectoral approach if childbirth services are to be made accessible to women. Detailed recommendations to increase utilisation of childbirth services in the county have been suggested.

  8. Balancing work and family after childbirth: a longitudinal analysis.

    Science.gov (United States)

    Grice, Mira M; McGovern, Patricia M; Alexander, Bruce H; Ukestad, Laurie; Hellerstedt, Wendy

    2011-01-01

    in the United States, women with young children have dramatically increased their participation in the workforce, resulting in greater potential conflict between work and family roles. However, few studies have examined postpartum work-family conflict. This study examined associations between work-family conflict and women's health after childbirth. employed women, 18 years of age and older, were recruited while hospitalized for childbirth and followed for 18 months (n = 541; 66% response rate). Health outcomes were measured using the Short Form 12, version 2. Longitudinal fixed-effects models estimated the associations between work-family conflict (modeled as job and home spillover) and health. women who reported high levels of job spillover to home had mental health scores slightly, but significantly, worse than women who reported low levels of spillover (β = -1.26; SE = 0.47). Women with medium and high levels of home spillover to job also reported worse mental health (β = -0.81, SE = 0.30; and β = -1.52, SE = 0.78) relative to those with low spillover. Women who reported medium (versus low) levels of home spillover reported slightly improved physical health (β = 0.64, SE = 0.30). There was no significant association between job spillover and physical health. this study focused exclusively on employed postpartum women. Results illustrate that job and home spillover are associated with maternal mental and physical health. Findings also revealed that flexible work arrangements were associated with poorer postpartum mental health scores, which may reflect unintended consequences, such as increasing the amount of work brought home. 2011 Jacobs Institute of Women's Health. Published by Elsevier Inc.

  9. Male appropriation and medicalization of childbirth: an historical analysis.

    Science.gov (United States)

    Cahill, H A

    2001-02-01

    This paper aims to explore through historical analysis some of the means by which medicine successfully appropriated and medicalized pregnancy and childbirth and to consider the impact that this has had on women's experiences within maternity care. The appropriation and medicalization of pregnancy and childbirth by men are rooted in a patriarchal model that has been centuries in the making. A model that perceives women as essentially abnormal, as victims of their reproductive systems and hormones, it is also one that defines pregnancy as inherently pathological - a clinical crisis worthy of active intervention. In both law and medicine men have used their power to define reproduction as a biological defect (LeMoncheck L. 1996 Journal of Clinical Ethics 7, 160--176), requiring both legal regulation and medical intervention, whilst feminist writers have long argued that women's experiences within the health care system at least to some extent reflects their social position. Male justifications of female inferiority have been developed and nurtured through professional discourses and socialization processes inherent within medical education and practice (Cahill H. 1999 MA Thesis, University of Keele). These assumptions are internalized and reproduced to shape quite profoundly, the nature of doctors' interactions with women in their care. Perhaps more fundamentally, such discursive explanations of women's bodies as inherently defective continue to shape women's position in society. Maternity care is a key area in which women's ability to exercise real choice and make informed decisions is limited and where doctor-patient interactions are themselves constructions of existing gender orders; women's autonomy continues to be violated through both quite subtle and overt discourse and practice.

  10. "Teaching Is a Lot More than Just Showing up to Class and Grading Assignments": Preparing Middle-Level Teachers for Longevity in the Profession

    Science.gov (United States)

    Van Overschelde, James P.; Saunders, Jane M.; Ash, Gwynne Ellen

    2017-01-01

    The university's teacher preparation program has implemented and continually refined a professional development school program, with extended university-school relationships in its middle-level certification program. This program offers dialogue, targeted learning activities, and intensive field-based experiences to help ease preservice teachers…

  11. Vicarious birth experiences and childbirth fear: does it matter how young canadian women learn about birth?

    Science.gov (United States)

    Stoll, Kathrin; Hall, Wendy

    2013-01-01

    In our secondary analysis of a cross-sectional survey, we explored predictors of childbirth fear for young women (n = 2,676). Young women whose attitudes toward pregnancy and birth were shaped by the media were 1.5 times more likely to report childbirth fear. Three factors that were associated with reduced fear of birth were women's confidence in reproductive knowledge, witnessing a birth, and learning about pregnancy and birth through friends. Offering age-appropriate birth education during primary and secondary education, as an alternative to mass-mediated information about birth, can be evaluated as an approach to reduce young women's childbirth fear.

  12. Steps Toward Innovative Childbirth Education: Selected Strategies From the Blueprint for Action

    Science.gov (United States)

    Jolivet, R. Rima; Corry, Maureen P.

    2010-01-01

    To mark the 50th anniversary of Lamaze International, Childbirth Connection celebrates landmark accomplishments in education for childbearing women and families, and takes stock of the changing educational needs and preferences of current childbearing families in looking toward the future. Childbirth Connection's multi-year, multi-stakeholder Transforming Maternity Care initiative resulted in two landmark reports: 2020 Vision for a High-Quality, High-Value Maternity Care System and Blueprint for Action: Steps Toward a High-Quality, High-Value Maternity Care System. Selected recommendations of greatest relevance to the field of childbirth education are discussed, and the new Transforming Maternity Care Partnership is introduced. PMID:21629389

  13. Cómo realizar una clase modelo de una asignatura o disciplina How to prepare a Model Class of a Subject

    Directory of Open Access Journals (Sweden)

    Eddy Llobany González Ungo

    2007-09-01

    Full Text Available Existen ciertas relaciones entre las clases, que son la forma organizativa de carácter especial del proceso docente de tipo académico, y el eslabón, como momentos del proceso en el lapso determinado por el tema o unidad de estudio. Las clases son un espacio para el desarrollo de la habilidad, en que sus objetivos se adecuarán a las condiciones específicas del grupo y hasta de cada estudiante, los eslabones son momentos sistémicos para el logro de una habilidad, de un objetivo mayor, que puede ser el tema, de ahí que un eslabón puede incluir varias clases, y viceversa, una clase puede incluir varios eslabones. Cada eslabón de este proceso cumple una tarea determinada. En cada una de ellas, los estudiantes asimilan el material estudiado y avanzan en el estudio de lo nuevo. La interacción de estos elementos constituye la dialéctica real del proceso docente que determina la actividad creadora y la orientación ideológica del estudiante. De esta forma amplía y profundiza los conocimientos sobre la asignatura estudiada. Se plantea que el pensamiento creador es aquel que no está sujeto a patrones preestablecidos. La propia capacidad de utilizar los mecanismos del pensamiento hasta llegar a niveles superiores de generalización es un rasgo característico de la personalidad creadora.There are some relationships between the classes which represent the special organization character of the academic teaching process and the link, as interval of time determined by the theme or unity of study. The classes represent a space for the development of the skill, whose objectives will be adapted to the specific conditions of the group and every student, the links are systemic moments for attaining a skill, as well as a greater objective which may be the theme so that is why a link may include many classes and vice versa, a class may include various links. Every link in the process has a particular role. The interaction of these elements represent the

  14. Participant experiences of mindfulness-based childbirth education: a qualitative study

    Directory of Open Access Journals (Sweden)

    Fisher Colleen

    2012-11-01

    Full Text Available Abstract Background Childbirth is an important transitional life event, but one in which many women are dissatisfied stemming in part from a sense that labour is something that happens to them rather than with them. Promoting maternal satisfaction with childbirth means equipping women with communication and decision making skills that will enhance their ability to feel involved in their labour. Additionally, traditional antenatal education does not necessarily prepare expectant mothers and their birth support partner adequately for birth. Mindfulness-based interventions appear to hold promise in addressing these issues. Mindfulness-based Child Birth Education (MBCE was a pilot intervention combining skills-based antenatal education and Mindfulness Based Stress Reduction. Participant experiences of MBCE, both of expectant mothers and their birth support partners are the focus of this article. Methods A generic qualitative approach was utilised for this study. Pregnant women between 18 and 28 weeks gestation, over 18 years of age, nulliparous with singleton pregnancies and not taking medication for a diagnosed mental illness or taking illicit drugs were eligible to undertake the MBCE program which was run in a metropolitan city in Australia. Focus groups with 12 mothers and seven birth support partners were undertaken approximately four months after the completion of MBCE. Audio recordings of the groups were transcribed verbatim and analysed thematically using the method of constant comparison by all four authors independently and consensus on analysis and interpretation arrived at through team meetings. Results A sense of both ‘empowerment’ and ‘community’ were the essences of the experiences of MBCE both for mothers and their birth support partner and permeated the themes of ‘awakening my existing potential’ and ‘being in a community of like-minded parents’. Participants suggested that mindfulness techniques learned during MBCE

  15. Perceptions of barriers to paternal presence and contribution during childbirth: an exploratory study from Syria.

    Science.gov (United States)

    Abushaikha, Lubna; Massah, Rana

    2013-03-01

    The barriers that face fathers during childbirth are an understudied phenomenon. The objective of our study was to explore Syrian parents' perceptions of barriers to paternal presence and contribution during childbirth. A descriptive phenomenological qualitative approach based on Colaizzi's method was used with a purposive sample of 23 mothers and 14 fathers recruited from a major public maternity hospital in Syria. In our study, four themes on barriers to paternal presence and contribution during childbirth were found: 1) sociocultural influences and rigidity; 2) being unprepared; 3) unsupportive policies and attitudes; and 4) unfavorable reactions and circumstances. Common and current sociocultural norms in Syria do not encourage fathers to be present or contribute during childbirth. Therefore, establishing culturally sensitive supportive policies and practices is a vital step toward overcoming these barriers. © 2013, Copyright the Authors Journal compilation © 2013, Wiley Periodicals, Inc.

  16. Prevalent urinary incontinence as a correlate of pregnancy, vaginal childbirth and obstetric techniques

    DEFF Research Database (Denmark)

    Foldspang, Anders; Mommsen, Søren; Djurhuus, Jens Christian

    1999-01-01

    OBJECTIVES: This study examined the association between pregnancy, vaginal childbirth and obstetric techniques, and the prevalence of urinary incontinence among adult women aged 20 to 59 years. METHODS: A cross-sectional survey enrolled a random sample of 6240 women aged 20 to 59 years who were...... mailed a self-administered questionnaire focusing on urinary incontinence and other health variables. More than 75% of the women responded. The present analysis includes 4345 women who were not pregnant and did not experience a vaginal childbirth during 1994. RESULTS: Multivariate prevalence odds ratios...... showed increases in relation to urinary incontinence during pregnancy, urinary incontinence immediately after a vaginal childbirth, and age of 30 years or more at the second vaginal childbirth. No multivariate associations were found for forceps delivery or vacuum extraction delivery, episiotomy...

  17. The Effect of Work-family Balance Policy on Childbirth and Women's Work

    OpenAIRE

    Mizuochi, Masaaki

    2012-01-01

    This study examines the effect of Japan's 2005 work-family legislation?the Act on Advancement of Measures to Support Raising Next-Generation Children? on childbirth and women's job continuity. This Act requires firms to support their employees in bearing and rearing children. In particular, it helps working women to continue their careers, thereby reducing the opportunity cost of having children and boosting childbirth. Although the Act requires large firms to support their employees in this ...

  18. The impact of negative childbirth experience on future reproductive decisions: A quantitative systematic review.

    Science.gov (United States)

    Shorey, Shefaly; Yang, Yen Yen; Ang, Emily

    2018-06-01

    The aim of this study was to systematically retrieve, critique and synthesize available evidence regarding the association between negative childbirth experiences and future reproductive decisions. A child's birth is often a joyous event; however, there is a proportion of women who undergo negative childbirth experiences that have long-term implications on their reproductive decisions. A systematic review of quantitative studies was undertaken using Joanna Briggs Institute's methods. A search was carried out in CINAHL Plus with Full Text, Embase, PsycINFO, PubMed, Scopus and Web of Science from January 1996 - July 2016. Studies that fulfilled the inclusion criteria were assessed by two independent reviewers using the Joanna Briggs Institute's Critical Appraisal Tools. Data were extracted under subheadings adapted from the institute's data extraction forms. Twelve studies, which examined either one or more influences of negative childbirth experiences, were identified. The included studies were either cohort or cross-sectional designs. Five studies observed positive associations between prior negative childbirth experiences and decisions to not have another child, three studies found positive associations between negative childbirth experiences and decisions to delay a subsequent birth and six studies concluded positive associations between negative childbirth experiences and maternal requests for caesarean section in subsequent pregnancies. To receive a holistic understanding on negative childbirth experiences, a suitable definition and validated measuring tools should be used to understand this phenomenon. Future studies or reviews should include a qualitative component and/or the exploration of specific factors such as cultural and regional differences that influence childbirth experiences. © 2018 John Wiley & Sons Ltd.

  19. Post-Traumatic Stress Disorder (PTSD) Following Childbirth: Prevalence and Contributing Factors

    OpenAIRE

    Shaban, Zainab; Dolatian, Mahrokh; Shams, Jamal; Alavi-Majd, Hamid; Mahmoodi, Zohreh; Sajjadi, Homeira

    2013-01-01

    Background Childbirth might be a traumatic event for some women. Objectives This study was conducted with the objective of investigating the prevalence of Post-Traumatic Stress Disorder (PTSD) following childbirth. Patients and Methods The study was designed using a descriptive correlation scheme. The participants were selected from the women referred to the healthcare centers affiliated with Zahedan University of Medical Sciences, Zahedan, Iran. Personal interviews were conducted with 600 wo...

  20. Preventing traumatic childbirth experiences: 2192 women?s perceptions and views

    OpenAIRE

    Hollander, M. H.; van Hastenberg, E.; van Dillen, J.; van Pampus, M. G.; de Miranda, E.; Stramrood, C. A. I.

    2017-01-01

    The purpose of this study is to explore and quantify perceptions and experiences of women with a traumatic childbirth experience in order to identify areas for prevention and to help midwives and obstetricians improve woman-centered care. A retrospective survey was conducted online among 2192 women with a self-reported traumatic childbirth experience. Women were recruited in March 2016 through social media, including specific parent support groups. They filled out a 35-item questionnaire of w...

  1. Cutting Classes

    Science.gov (United States)

    Hacker, Andrew

    1976-01-01

    Provides critical reviews of three books, "The Political Economy of Social Class", "Ethnicity: Theory and Experience," and "Ethnicity in the United States," focusing on the political economy of social class and ethnicity. (Author/AM)

  2. A longitudinal study of women's memories of their childbirth experiences at five years postpartum.

    Science.gov (United States)

    Takehara, Kenji; Noguchi, Makiko; Shimane, Takuya; Misago, Chizuru

    2014-07-05

    Few studies have investigated whether women can accurately recall their birthing experiences after a long period. We investigated the consistency of women's memories of their childbirth experiences between those at a few days postpartum and 5 years later. This prospective cohort study comprised 1,168 women who delivered at a maternity hospital and four maternity homes in Japan between May 2002 and August 2003. Data were collected using structured interviews and transcriptions from medical records. The childbirth experience was assessed using the Childbirth Experience Scale (CBE-Scale) at a few days postpartum and 5 years later. We obtained 584 (50.0%) valid responses from women who completed the survey at a few days postpartum and 5 years later. Significant differences were observed in 16 out of 18 items on the CBE-Scale when responses were compared at both time points. Women who answered "yes" to any item on the CBE-Scale at the baseline survey tended to demonstrate a more precise recollection for that item 5 years after childbirth than those who answered "no" for the corresponding item. We conclude that women remember their childbirth experience clearly at 5 years after the childbirth.

  3. A longitudinal study of women’s memories of their childbirth experiences at five years postpartum

    Science.gov (United States)

    2014-01-01

    Background Few studies have investigated whether women can accurately recall their birthing experiences after a long period. We investigated the consistency of women’s memories of their childbirth experiences between those at a few days postpartum and 5 years later. Methods This prospective cohort study comprised 1,168 women who delivered at a maternity hospital and four maternity homes in Japan between May 2002 and August 2003. Data were collected using structured interviews and transcriptions from medical records. The childbirth experience was assessed using the Childbirth Experience Scale (CBE-Scale) at a few days postpartum and 5 years later. Results We obtained 584 (50.0%) valid responses from women who completed the survey at a few days postpartum and 5 years later. Significant differences were observed in 16 out of 18 items on the CBE-Scale when responses were compared at both time points. Women who answered "yes" to any item on the CBE-Scale at the baseline survey tended to demonstrate a more precise recollection for that item 5 years after childbirth than those who answered "no" for the corresponding item. Conclusions We conclude that women remember their childbirth experience clearly at 5 years after the childbirth. PMID:24996683

  4. The effect of delaying childbirth on primary cesarean section rates.

    Science.gov (United States)

    Smith, Gordon C S; Cordeaux, Yolande; White, Ian R; Pasupathy, Dharmintra; Missfelder-Lobos, Hannah; Pell, Jill P; Charnock-Jones, D Stephen; Fleming, Michael

    2008-07-01

    The relationship between population trends in delaying childbirth and rising rates of primary cesarean delivery is unclear. The aims of the present study were (1) to characterize the association between maternal age and the outcome of labor, (2) to determine the proportion of the increase in primary cesarean rates that could be attributed to changes in maternal age distribution, and (3) to determine whether the contractility of uterine smooth muscle (myometrium) varied with maternal age. We utilized nationally collected data from Scotland, from 1980 to 2005, and modeled the risk of emergency cesarean section among women delivering a liveborn infant in a cephalic presentation at term. We also studied isolated myometrial strips obtained from 62 women attending for planned cesarean delivery in Cambridge, England, from 2005 to 2007. Among 583,843 eligible nulliparous women, there was a linear increase in the log odds of cesarean delivery with advancing maternal age from 16 y upwards, and this increase was unaffected by adjustment for a range of maternal characteristics (adjusted odds ratio for a 5-y increase 1.49, 95% confidence interval [CI] 1.48-1.51). Increasing maternal age was also associated with a longer duration of labor (0.49 h longer for a 5-y increase in age, 95% CI 0.46-0.51) and an increased risk of operative vaginal birth (adjusted odds ratio for a 5-y increase 1.49, 95% CI 1.48-1.50). Over the period from 1980 to 2005, the cesarean delivery rate among nulliparous women more than doubled and the proportion of women aged 30-34 y increased 3-fold, the proportion aged 35-39 y increased 7-fold, and the proportion aged > or =40 y increased 10-fold. Modeling indicated that if the age distribution had stayed the same over the period of study, 38% of the additional cesarean deliveries would have been avoided. Similar associations were observed in multiparous women. When studied in vitro, increasing maternal age was associated with reduced spontaneous activity and

  5. The effect of delaying childbirth on primary cesarean section rates.

    Directory of Open Access Journals (Sweden)

    Gordon C S Smith

    2008-07-01

    Full Text Available The relationship between population trends in delaying childbirth and rising rates of primary cesarean delivery is unclear. The aims of the present study were (1 to characterize the association between maternal age and the outcome of labor, (2 to determine the proportion of the increase in primary cesarean rates that could be attributed to changes in maternal age distribution, and (3 to determine whether the contractility of uterine smooth muscle (myometrium varied with maternal age.We utilized nationally collected data from Scotland, from 1980 to 2005, and modeled the risk of emergency cesarean section among women delivering a liveborn infant in a cephalic presentation at term. We also studied isolated myometrial strips obtained from 62 women attending for planned cesarean delivery in Cambridge, England, from 2005 to 2007. Among 583,843 eligible nulliparous women, there was a linear increase in the log odds of cesarean delivery with advancing maternal age from 16 y upwards, and this increase was unaffected by adjustment for a range of maternal characteristics (adjusted odds ratio for a 5-y increase 1.49, 95% confidence interval [CI] 1.48-1.51. Increasing maternal age was also associated with a longer duration of labor (0.49 h longer for a 5-y increase in age, 95% CI 0.46-0.51 and an increased risk of operative vaginal birth (adjusted odds ratio for a 5-y increase 1.49, 95% CI 1.48-1.50. Over the period from 1980 to 2005, the cesarean delivery rate among nulliparous women more than doubled and the proportion of women aged 30-34 y increased 3-fold, the proportion aged 35-39 y increased 7-fold, and the proportion aged > or =40 y increased 10-fold. Modeling indicated that if the age distribution had stayed the same over the period of study, 38% of the additional cesarean deliveries would have been avoided. Similar associations were observed in multiparous women. When studied in vitro, increasing maternal age was associated with reduced spontaneous

  6. Emotions in labour: Italian obstetricians' experiences of presence during childbirth.

    Science.gov (United States)

    Morano, S; Migliorini, L; Rania, N; Piano, L; Tassara, T; Nicoletti, J; Lundgren, I

    2018-02-01

    The present study represents a qualitative research aimed to explore the obstetricians' psychological experiences of birth. During labour the role of obstetricians assumes a fundamental importance in hospitalised childbirth. However, literature analysis has shown that the psychological side of birth has been investigated only considering the woman's and midwife's points of view. The obstetricians' psychological experiences have not been considered enough and only a few studies at a quantitative level have been performed. Seven focus groups for a total of 72 obstetricians were conducted in hospital contexts in Italy. The qualitative methodology of grounded theory was adopted. The results were divided into three different core themes: obstetricians' approaches to delivery, critical aspects about relationships in the delivery room, and obstetricians' feelings and emotions in the delivery room. Each theme was subdivided into different subthemes. The results highlight different ways obstetricians approach their profession, the complex and multifaceted relationship with the woman and the extraordinary variety of feelings and emotions, which enrich, but also may complicate, life in the delivery room. Further studies could provide more details to help researchers to develop new and more effective strategies to support obstetricians' training and work.

  7. Comparison of childbirth care models in public hospitals, Brazil.

    Science.gov (United States)

    Vogt, Sibylle Emilie; Silva, Kátia Silveira da; Dias, Marcos Augusto Bastos

    2014-04-01

    To compare collaborative and traditional childbirth care models. Cross-sectional study with 655 primiparous women in four public health system hospitals in Belo Horizonte, MG, Southeastern Brazil, in 2011 (333 women for the collaborative model and 322 for the traditional model, including those with induced or premature labor). Data were collected using interviews and medical records. The Chi-square test was used to compare the outcomes and multivariate logistic regression to determine the association between the model and the interventions used. Paid work and schooling showed significant differences in distribution between the models. Oxytocin (50.2% collaborative model and 65.5% traditional model; p relief (85.0% collaborative model and 78.9% traditional model; p = 0.042). The association between the collaborative model and the reduction in the use of oxytocin, artificial rupture of membranes and episiotomy remained after adjustment for confounding. The care model was not associated with complications in newborns or mothers neither with the use of spinal or epidural analgesia. The results suggest that collaborative model may reduce interventions performed in labor care with similar perinatal outcomes.

  8. [Hospital length-of-stay after childbirth in France].

    Science.gov (United States)

    Coulm, B; Blondel, B

    2013-02-01

    To study hospital length-of-stay (LOS) after childbirth and its determinants and to describe home care offered after discharge. We studied 10,302 women with vaginal delivery from the 2010 French National Perinatal Survey. Maternal, newborn, maternity unit characteristics and the region of birth were considered. Simple and polytomial regression analyses were used to study determinants of postpartum LOS. Maternity units that offered routinely home visits by midwives after discharge were described. Around 29,0% of women had a LOS ≤ 3 days, with significant variations between regions. LOS ≤ 3 days was more common among multiparas and women who bottle-fed their newborn. In the Greater Parisian Region, LOS ≤ 3 days ranged from 16,6% in private units women who had a LOS ≤ 3 days, only 19,7% were in a unit, which offered home visits routinely. LOS varies mainly according to the place of delivery. The trends towards short LOS are likely to continue due to economic pressures and home care services should be developed to ensure continuity of care for all mothers after discharge. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  9. The Impact of Premature Childbirth on Parental Bonding

    Directory of Open Access Journals (Sweden)

    Hannah N. Hoffenkamp

    2012-07-01

    Full Text Available The development of an affectionate parent-infant bond is essential for a newborn infant's survival and development. However, from evolutionary theory it can be derived that parental bonding is not an automatic process, but dependent on infants' cues to reproductive potential and parents' access to resources. The purpose of the present study was to examine the process of bonding in a sample of Dutch mothers (n = 200 and fathers (n = 193 of full-term (n = 69, moderately premature (n = 68, and very premature infants (n = 63. During the first month postpartum parents completed the Pictorial Representation of Attachment Measure (PRAM and Postpartum Bonding Questionnaire (PBQ. Longitudinal analyses revealed that mothers' PRAM scores decreased after moderately preterm delivery, whereas decreases in PRAM scores occurred in both parents after very preterm delivery. As lower PRAM scores represent stronger feelings of parent-infant connectedness, our findings suggest a higher degree of bonding after premature childbirth. Results of the PBQ analysis were in line with PRAM outcomes, as parents of preterm infants reported less bonding problems compared to parents of full-terms. These findings support the hypothesis that in affluent countries with adequate resources, bonding in parents of preterm infants on average may be higher than in parents of full-term infants.

  10. Evaluation of microleakage occurred in class V restoration prepared with Er:YAG laser and also with high speed, restored using composite; Avaliacao da microinfiltracao em cavidades classe V preparada com laser de Er:YAG ou alta rotacao, jateadas ou nao com bicarbonato de sodio e restauradas com resina composta

    Energy Technology Data Exchange (ETDEWEB)

    Junqueira, Angelo Maercio Finochio

    2002-07-01

    The microleakage is one of the great problems found in restoring dentistry. In spite of adhesive system evolution, several materials have been studied intending to minimize or to eliminate the microleakage occurred between the tooth and restorative material. The objective of this in vitro study was to evaluate and compare the marginal microleakage in class V cavities prepared by Er:YAG laser or high speed and restored with composite resin. One of the groups received the sodium bicarbonate jet while the other group have not received. Twenty teeth third extracted molars were sectioned in the sense medial-distal being obtained forty samples that were divided in four groups: Group I (G1): prepared with Er:YAG laser (2940 nm), E= 350 mJ/p, F=2 Hz, fluency of 112,5 J/cm{sup 2}. Preparing occlusion margin slice with 250 mJ/p, F=2 Hz, fluency of 80,3 J/cm{sup 2}. The prepared total area was irradiated with E=80 mJ/p, F=2 Hz and fluency of 25,75 J/cm{sup 2}. Every prepared area was finally submitted to sodium bicarbonate jet. Group 2 (G2): it was employed the same parameters used on group 1, except the sodium carbonate jet application. Group 3 (G3): the cavities' prepare were executed with high speed rotation using diamond cylindrical point. The slice confection has been made with the same point with 45 degrees inclined, utilizing also the sodium carbonate jet in all prepared area. Group 4 (G4): it was executed similarly prepared to group 3, without the sodium bicarbonate jet. In all the groups the cavities were washed with water spray and drought with air jet. Dentin and enamel surfaces have been conditioned with phosphoric acid at 35%. All the samples of all groups were restored using the single bond system adhesive and composite resin Z250, kept at 37 deg C in stove during 24 hours, thermally stressed, immersed in silver nitrate solution at 50% for 24 hours while kept in darkness. The specimens were soaked in photo developing solution and exposed to fluorescent light for

  11. Evaluation of microleakage occurred in class V restoration prepared with Er:YAG laser and also with high speed, restored using composite; Avaliacao da microinfiltracao em cavidades classe V preparada com laser de Er:YAG ou alta rotacao, jateadas ou nao com bicarbonato de sodio e restauradas com resina composta

    Energy Technology Data Exchange (ETDEWEB)

    Junqueira, Angelo Maercio Finochio

    2002-07-01

    The microleakage is one of the great problems found in restoring dentistry. In spite of adhesive system evolution, several materials have been studied intending to minimize or to eliminate the microleakage occurred between the tooth and restorative material. The objective of this in vitro study was to evaluate and compare the marginal microleakage in class V cavities prepared by Er:YAG laser or high speed and restored with composite resin. One of the groups received the sodium bicarbonate jet while the other group have not received. Twenty teeth third extracted molars were sectioned in the sense medial-distal being obtained forty samples that were divided in four groups: Group I (G1): prepared with Er:YAG laser (2940 nm), E= 350 mJ/p, F=2 Hz, fluency of 112,5 J/cm{sup 2}. Preparing occlusion margin slice with 250 mJ/p, F=2 Hz, fluency of 80,3 J/cm{sup 2}. The prepared total area was irradiated with E=80 mJ/p, F=2 Hz and fluency of 25,75 J/cm{sup 2}. Every prepared area was finally submitted to sodium bicarbonate jet. Group 2 (G2): it was employed the same parameters used on group 1, except the sodium carbonate jet application. Group 3 (G3): the cavities' prepare were executed with high speed rotation using diamond cylindrical point. The slice confection has been made with the same point with 45 degrees inclined, utilizing also the sodium carbonate jet in all prepared area. Group 4 (G4): it was executed similarly prepared to group 3, without the sodium bicarbonate jet. In all the groups the cavities were washed with water spray and drought with air jet. Dentin and enamel surfaces have been conditioned with phosphoric acid at 35%. All the samples of all groups were restored using the single bond system adhesive and composite resin Z250, kept at 37 deg C in stove during 24 hours, thermally stressed, immersed in silver nitrate solution at 50% for 24 hours while kept in darkness. The specimens were soaked in photo developing solution and exposed to fluorescent

  12. The Relationship of Labor Pain, Medication Usage, and Length of Labor with Childbirth Preparation in Primigravidas.

    Science.gov (United States)

    1992-01-01

    that the placenta was not a barrier between the mother and the infant. Dr. Virginia Apgar , a world renown authority on birth defects, described the...out. My placenta did not extract so she had to manually get it. Everyone was really nice and supportive but until you have a baby you really don’t

  13. The paradox of vaginal examination practice during normal childbirth: Palestinian women's feelings, opinions, knowledge and experiences.

    Science.gov (United States)

    Hassan, Sahar J; Sundby, Johanne; Husseini, Abdullatif; Bjertness, Espen

    2012-08-28

    Vaginal examination (VE), is a frequent procedure during childbirth. It is the most accepted ways to assess progress during childbirth, but its repetition at short intervals has no value. Over years, VE continued to be plagued by a nature that implies negative feelings and experiences of women. The aim of this exploratory qualitative study was to explore women's feelings, opinions, knowledge and experiences of vaginal examinations (VE) during normal childbirth. We interviewed 176 postpartum women using semi-structured questionnaire in a Palestinian public hospital in the oPt. Descriptive statistics were conducted; frequency counts and percentages for the quantitative questions. The association between the frequency of VE and age, parity, years of education, locale and the time of delivery was tested by Chi-squared and Fisher's Exact test. The open-ended qualitative questions were read line-by-line for the content and coded. The assigned codes for all responses were entered to the SPSS statistical software version 18. As compared with WHO recommendations, VE was conducted too frequently, and by too many providers during childbirth. The proportion of women who received a 'too high' frequency of VEs during childbirth was significantly larger in primipara as compared to multipara women (P = .037). 82% of women reported pain or severe pain and 68% reported discomfort during VE. Some women reported insensitive approaches of providers, insufficient means of privacy and no respect of dignity or humanity during the exam. Palestinian women are undergoing unnecessary and frequent VEs during childbirth, conducted by several different providers and suffer pain and discomfort un-necessarily. Adhering to best evidence, VE during childbirth should be conducted only when necessary, and if possible, by the same provider. This will decrease the laboring women's unnecessary suffering from pain and discomfort. Providers should advocate for women's right to information, respect

  14. A hermeneutic phenomenological analysis of midwives' ways of knowing during childbirth.

    Science.gov (United States)

    Hunter, Lauren P

    2008-12-01

    to explore the ways of knowing used by the midwife while attending women during childbirth through textual analysis of poems written by American midwives. a hermeneutic phenomenology and human science research method inspired by van Manen was used. Midwifery ways of knowing during childbirth were thematically derived from 10 poems written by midwives about attending childbirth or the experience of being a midwife. Textual analysis included examination of the poems as a whole, via verse and metaphor, and via individual lines of prose. 10 American midwives wrote the poems used in this study. The poems were discovered through online searches of many databases using the key words 'poetry, poems, midwifery and childbirth' and through a national call for poetry by the researcher over a period of 4 years (1996-2000), undertaken in order to publish an anthology of poetry written by midwives. three authoritative ways of knowing that guided the care given by the midwife to women during childbirth were discovered. They were self-knowledge from the belief system of the individual midwife, grounded knowledge from the midwife's personal lived experience with childbirth, and informed knowledge from objective and scholarly sources. midwives must continue to develop their own body of knowledge in order to move the profession forward. Multiple ways of knowing including the use of experiential/contextual and intuitive knowledge is legitimate and humane, if provision of care is holistic. Care of women during childbirth can be enhanced with the use of multiple knowers and multiple ways of knowing. This study captured a unique and fresh interpretation of the lived experience of midwifery knowledge. Midwifery educational programmes should offer opportunities for students to explore the artistry as well as the science of midwifery practice.

  15. Factors influencing first-time fathers' involvement in their wives' pregnancy and childbirth: A correlational study.

    Science.gov (United States)

    Xue, Weilin Lynn; He, Hong-Gu; Chua, Ying Jie; Wang, Wenru; Shorey, Shefaly

    2018-03-20

    To examine factors influencing first-time fathers' involvement in their wives' pregnancy and childbirth in Singapore. A cross-sectional descriptive correlational study was conducted in a public tertiary hospital in Singapore. A total of 182 first-time fathers whose wives were hospitalized at four obstetric wards were recruited from November 2015 to January 2016. Data were collected by three newly developed and validated instruments, namely Father's Involvement in Pregnancy and Childbirth, Father's Informational and Sources of Support, and Father's Attitude Towards Involvement in Pregnancy and Childbirth, as well as the 16-item Couple Satisfaction Index and Family of Origin Questionnaire. The participants were generally involved in their wives' pregnancy and childbirth, with 35.2% being highly involved. There was no significant difference in fathers' levels of involvement between or among any sociodemographic subgroups. Significant Spearman's correlations were found between fathers' levels of involvement and levels of informational support as well as fathers' attitudes towards involvement. However, the logistic regression showed the level of informational support was the only significant factor that influenced first-time fathers' high levels of involvement in their wives' pregnancy and childbirth. The study revealed the importance of providing sufficient informational support to first-time fathers so that they can be highly involved in their wife's pregnancy and childbirth. Future studies can develop technology-based intervention programmes to improve fathers' involvement in their wife's pregnancy and childbirth. Healthcare professionals should examine and improve the existing informational support for first-time fathers and ensure its relevance and convenient access. Copyright © 2018 Elsevier Ltd. All rights reserved.

  16. [Effectiveness of an early discharge program after normal childbirth].

    Science.gov (United States)

    Teulón González, M; Martínez Pillado, M; Cuadrado Martín, M M; Rivero Martín, M J; Cerezuela Requena, J F

    To implement a program of early hospital discharge after an uncomplicated birth, in order to improve the effectiveness, as well as ensuring clinical safety and patient acceptability. Descriptive study of the effectiveness of an early discharge program after uncomplicated delivery between February 2012 and September 2013. The populations are post-partum women and newborns admitted to the University Hospital of Fuenlabrada, with a duration of less than 24h after uncomplicated delivery that met the defined inclusion criteria. Satisfaction was assessed using a Likert scale. The effectiveness of the program was monitored by safety indicators, productivity, adaptation, and continuity of care. A total of 20% of cases capable of early discharge from Fuenlabrada University Hospital completed the program. Almost all (94%) were normal deliveries. The 188 cases included were from 911 patients with uncomplicated childbirth, accounting for 6.5% of the 2,857 total births. The mean stay of patients included showed a decrease of 50% (2.4 to 1.2 days). All patients received continuity of care after hospital discharge. The review consultation was reprogrammed for 4.8% of cases, with 2% of patients re-admitted within 96h. with no serious problems. Four newborns (2%) required attention in the emergency department (mother or newborn) before 96h. The assessment of patient satisfaction achieved a score of 4.5 out of 5. The program achieved a decrease in the average stay by 50%, favouring the autonomy of midwives. This acceptance level is in line with similar interventions. The deployment of the program may be useful for other changes in care processes. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. What matters to women during childbirth: A systematic qualitative review.

    Directory of Open Access Journals (Sweden)

    Soo Downe

    Full Text Available Design and provision of good quality maternity care should incorporate what matters to childbearing women. This qualitative systematic review was undertaken to inform WHO intrapartum guidelines.Using a pre-determined search strategy, we searched Medline, CINAHL, PsycINFO, AMED, EMBASE, LILACS, AJOL, and reference lists of eligible studies published 1996-August 2016 (updated to January 2018, reporting qualitative data on womens' childbirth beliefs, expectations, and values. Studies including specific interventions or health conditions were excluded. PRISMA guidelines were followed.Authors' findings were extracted, logged on a study-specific data form, and synthesised using meta-ethnographic techniques. Confidence in the quality, coherence, relevance and adequacy of data underpinning the resulting themes was assessed using GRADE-CERQual. A line of argument synthesis was developed.35 studies (19 countries were included in the primary search, and 2 in the update. Confidence in most results was moderate to high. What mattered to most women was a positive experience that fulfilled or exceeded their prior personal and socio-cultural beliefs and expectations. This included giving birth to a healthy baby in a clinically and psychologically safe environment with practical and emotional support from birth companions, and competent, reassuring, kind clinical staff. Most wanted a physiological labour and birth, while acknowledging that birth can be unpredictable and frightening, and that they may need to 'go with the flow'. If intervention was needed or wanted, women wanted to retain a sense of personal achievement and control through active decision-making. These values and expectations were mediated through womens' embodied (physical and psychosocial experience of pregnancy and birth; local familial and sociocultural norms; and encounters with local maternity services and staff.Most healthy childbearing women want a positive birth experience. Safety and

  18. Maternal Confidence for Physiologic Childbirth: A Concept Analysis.

    Science.gov (United States)

    Neerland, Carrie E

    2018-06-06

    Confidence is a term often used in research literature and consumer media in relation to birth, but maternal confidence has not been clearly defined, especially as it relates to physiologic labor and birth. The aim of this concept analysis was to define maternal confidence in the context of physiologic labor and childbirth. Rodgers' evolutionary method was used to identify attributes, antecedents, and consequences of maternal confidence for physiologic birth. Databases searched included Ovid MEDLINE, CINAHL, PsycINFO, and Sociological Abstracts from the years 1995 to 2015. A total of 505 articles were retrieved, using the search terms pregnancy, obstetric care, prenatal care, and self-efficacy and the keyword confidence. Articles were identified for in-depth review and inclusion based on whether the term confidence was used or assessed in relationship to labor and/or birth. In addition, a hand search of the reference lists of the selected articles was performed. Twenty-four articles were reviewed in this concept analysis. We define maternal confidence for physiologic birth as a woman's belief that physiologic birth can be achieved, based on her view of birth as a normal process and her belief in her body's innate ability to birth, which is supported by social support, knowledge, and information founded on a trusted relationship with a maternity care provider in an environment where the woman feels safe. This concept analysis advances the concept of maternal confidence for physiologic birth and provides new insight into how women's confidence for physiologic birth might be enhanced during the prenatal period. Further investigation of confidence for physiologic birth across different cultures is needed to identify cultural differences in constructions of the concept. © 2018 by the American College of Nurse-Midwives.

  19. Satisfaction of women urologists with maternity leave and childbirth timing.

    Science.gov (United States)

    Lerner, Lori B; Baltrushes, Robin J; Stolzmann, Kelly L; Garshick, Eric

    2010-01-01

    Women physicians must consider many conflicting issues when timing childbirth. We characterized maternity leave, breast-feeding practices and satisfaction associated with pregnancy timing in women urologists. A 114-item anonymous survey including questions on maternity leave duration for firstborn children, workplace policies, attitudes and satisfaction was mailed to all 365 American board certified women urologists in May and July 2007. Logistic regression was used to identify factors associated with greater satisfaction. A total of 243 women urologists (69%) responded, of whom 158 had at least 1 biological child. Average maternal age at first birth was 32.6 years. Of the children 10%, 32% and 52% were born before, during and after residency, respectively. Only 42% of women reported the existence of a formal maternity leave policy. Of the women 70% took 8 weeks or less of leave. Those with 9 weeks or greater were 3.8 times more likely to report satisfaction (p = 0.001). Although women in practice were 2.0 times more likely to take 9 weeks or greater compared to those in training or earlier (p = 0.046), only 30% in practice took this much time. Dissatisfaction with leave was not related to birth timing (residency vs practice) or maternal age at delivery but to work/residency related issues in 69% of respondents, financial concerns in 13% and personal/other in 18%. For breast-feeding 67% of respondents were satisfied with the duration and 22% were not. Dissatisfaction was secondary to work factors. Satisfaction with leave was related to the amount of maternity leave with women with 9 weeks or greater more likely to report satisfaction. Women in practice were more likely to take 9 weeks or greater but most did not due to strong stressors related to work, partners/peers or finances. Work factors were cited for dissatisfaction with breast-feeding.

  20. Unemployment and psychological distress one year after childbirth in France.

    Science.gov (United States)

    Saurel-Cubizolles, M J; Romito, P; Ancel, P Y; Lelong, N

    2000-03-01

    To analyse the relation between unemployment and the psychological distress of mothers one year after childbirth. Multicentric survey concerning births occurring between September 1993 and July 1994. In France: two maternity units in the Parisian area and one in Champagne-Ardennes, in the east of France, comprising both urban and rural areas. Primipara and secondipara women were interviewed three times: at birth by a face to face interview, five months and 12 months after the birth, by postal questionnaires, with a 83% response rate for the two postal questionnaires. The analysis includes 632 women who answered all three stages of the survey. Psychological distress was mainly assessed one year after birth by the 12-item General Health Questionnaire. After adjustment for unwanted pregnancy, marital conflicts, marital status, hospitalisation of the baby during the last year, lack of confiding relationship, depressive or anxious troubles before pregnancy, age, educational level and parity, unemployed women had an excess of psychological distress compared with employed women (OR = 1.87; 95% CI = 1.12, 3.13). The ratios for housewives were very close to those of employed women. Among the unemployed women, 60% had recently been without a job, since a few months before or after the birth. An excess of psychological distress among unemployed compared with employed women was observed in all social groups defined by the current or last occupation, but with various extents. Psychological distress was specially linked to the employment status in the group of women with the more qualified occupations. Even after a birth, when women are very much involved in their maternal role, those seeking a job have worse mental health than those in a stable situation, either employed or housewives. In France, the unemployment rate among young women is high. It is specially important that social regulations protecting employment during and after pregnancy are adequately applied. Employers

  1. Korean immigrant women's lived experience of childbirth in the United States.

    Science.gov (United States)

    Seo, Jin Young; Kim, Wooksoo; Dickerson, Suzanne S

    2014-01-01

    To understand Korean immigrant women's common experiences and practices of utilizing health care services in the United States during childbirth. A qualitative interpretive phenomenological research design. Recruitment was conducted through advertisement on the MissyUSA.com website, which is the largest online community for married Korean women who live in North America. A purposive sample of 15 Korean immigrant women who experienced childbirth in the United States within the past 5 years was recruited. Data were collected using semistructured telephone interviews and were analyzed using the Heideggerian hermeneutical methodology. During childbirth in the United States, participants faced multifaceted barriers in unfamiliar sociocultural contexts yet maintained their own cultural heritages. They navigated the unfamiliar health care system and developed their own strategies to overcome barriers to health care access. Korean immigrant women actively sought health information on the Internet and through social networking during childbirth. Korean immigrant women selectively accepted new cultural beliefs with some modifications from their own cultural contexts and developed their own distinct birth cultures. Understanding a particular culture and respecting women's traditions, beliefs, and practices about their childbirth could help nurses to provide culturally sensitive care. © 2014 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  2. Emotional Distress Following Childbirth: An Intervention to Buffer Depressive and PTSD Symptoms.

    Science.gov (United States)

    Di Blasio, Paola; Miragoli, Sarah; Camisasca, Elena; Di Vita, Angela Maria; Pizzo, Rosalia; Pipitone, Laura

    2015-05-01

    Childbirth for some women is a negative experience associated with depressive and post-traumatic symptoms. The preventive actions focusing on helping mothers to cope with negative emotions experienced after childbirth are strongly recommended. It is also recommended both to intervene early and on all women to avoid the risk that these symptoms can worsen in the months after childbirth. The intervention described in the current study is focalized on the elaboration of post-partum negative thoughts and emotion through a writing task, with the purpose to help new mothers to reflect, understand, evaluate and, thus, reformulate the stressful situation with new beliefs and emotions. 176 women aged from 19 to 43 years (M = 31.55, SD = 4.58) were assessed for depression and PTSD in the prenatal phase (T1). In about 96 hours after childbirth they were randomly assigned to either "Making Sense condition" (MS: in which they wrote about the thoughts and emotions connected with delivery and childbirth) or "Control-Neutral condition" (NC: in which they wrote about the daily events in behavioural terms) and then reassessed for depression and PTSD (T2). A follow up was conducted 3 months later (T3) to verify depression and posttraumatic symptoms. The results showed that depressive symptoms decreased both at 96 hours and at 3 months as a result of making-sense task. Regarding the posttraumatic symptoms the positive effect emerged at three months and not at 96 hours after birth.

  3. Emotional Distress Following Childbirth: An Intervention to Buffer Depressive and PTSD Symptoms

    Directory of Open Access Journals (Sweden)

    Paola Di Blasio

    2015-05-01

    Full Text Available Childbirth for some women is a negative experience associated with depressive and post-traumatic symptoms. The preventive actions focusing on helping mothers to cope with negative emotions experienced after childbirth are strongly recommended. It is also recommended both to intervene early and on all women to avoid the risk that these symptoms can worsen in the months after childbirth. The intervention described in the current study is focalized on the elaboration of post-partum negative thoughts and emotion through a writing task, with the purpose to help new mothers to reflect, understand, evaluate and, thus, reformulate the stressful situation with new beliefs and emotions. 176 women aged from 19 to 43 years (M = 31.55, SD = 4.58 were assessed for depression and PTSD in the prenatal phase (T1. In about 96 hours after childbirth they were randomly assigned to either “Making Sense condition” (MS: in which they wrote about the thoughts and emotions connected with delivery and childbirth or “Control-Neutral condition” (NC: in which they wrote about the daily events in behavioural terms and then reassessed for depression and PTSD (T2. A follow up was conducted 3 months later (T3 to verify depression and posttraumatic symptoms. The results showed that depressive symptoms decreased both at 96 hours and at 3 months as a result of making-sense task. Regarding the posttraumatic symptoms the positive effect emerged at three months and not at 96 hours after birth.

  4. Swedish fathers' experiences of childbirth in relation to maternal birth position: a mixed method study.

    Science.gov (United States)

    Johansson, Margareta; Thies-Lagergren, Li

    2015-12-01

    Fathers often want to be involved in labour and birth. To investigate how maternal birth position during second stage of labour may influence fathers' experience of childbirth. Mixed method study with 221 Swedish fathers completing an on-line questionnaire. Descriptive statistics and qualitative content analysis were used. In total 174 (78.7%) had a positive overall birth experience. The theme An emotional life-changing event influenced by the birth process and the structure of obstetrical care was revealed and included the categories; Midwives ability to be professional, The birth process' impact, and Being prepared to participate. The most frequently utilised birth position during a spontaneous vaginal birth was birth seat (n=83; 45.1%), and the fathers in this group were more likely to assess the birth position as very positive (n=40; 54.8%) compared to other upright and horizontal birth positions. Fathers with a partner having an upright birth position were more likely to have had a positive birth experience (p=0.048), to have felt comfortable (p=0.003) and powerful (p=0.019) compared to women adopting a horizontal birth position during a spontaneous vaginal birth. When the women had an upright birth position the fathers deemed the second stage of labour to have been more rapid (mean VAS 7.01 vs. 4.53) compared to women in a horizontal birth position. An upright birth position enhances fathers' experience of having been positively and actively engaged in the birth process. Midwives can enhance fathers' feelings of involvement and participation by attentiveness through interaction and communicating skills. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  5. Reproductive history and involvement in pregnancy and childbirth of fathers of babies born to teenage mothers in Stockholm, Sweden.

    Science.gov (United States)

    Ekeus, Cecilia; Christensson, Kyllike

    2003-06-01

    to describe and compare sexual and reproductive history as well as reactions to the pregnancy and attendance in antenatal care, family classes and childbirth of fathers of babies born to teenage mothers and fathers of babies born to average aged mothers. a descriptive comparative study using a structured questionnaire for data collection. eleven postnatal wards at the five obstetric and gynaecological departments in the Stockholm area. 132 fathers of babies born to primiparous teenage mothers (Group A) and the same number of fathers of babies born to primiparous women aged between 25-29 years (Group B) who were present in the postnatal wards. 43 of Group A compared to 17% of the Group B fathers had their first intercourse before 15 years of age. This early sexual debut was related to other health hazard, such as use of illicit drugs and cigarette smoking. The majority of the pregnancies in Group A were unplanned but most fathers reacted positively to the pregnancy and participated in the antenatal care. In contrast, only half of these fathers attended family classes. fathers of babies born to teenage mothers differed from fathers of babies to older mothers regarding reproductive background as well as involvement during pregnancy. The findings of this study challenge midwives to organise clinical practice in order to meet the specific needs of this group.

  6. Psychosocial health and well-being among obstetricians and midwives involved in traumatic childbirth

    DEFF Research Database (Denmark)

    Schrøder, Katja; Larsen, Pia Veldt; Jørgensen, Jan Stener

    2016-01-01

    Objective this study investigates the self-reported psychosocial health and well-being of obstetricians and midwives in Denmark during the most recent four weeks as well as their recall of their health and well-being immediately following their exposure to a traumatic childbirth. Material...... and methods a 2012 national survey of all Danish obstetricians and midwives (n=2098). The response rate was 59% of which 85% (n=1027) stated that they had been involved in a traumatic childbirth. The psychosocial health and well-being of the participants was investigated using six scales from the Copenhagen...... significantly higher scores than obstetricians, to a minor extent during the most recent four weeks and to a greater extent immediately following a traumatic childbirth scale, indicating higher levels of self-reported psychosocial health problems. Sub-group analyses showed that this difference might be gender...

  7. Factors associated with health facility childbirth in districts of Kenya, Tanzania and Zambia

    DEFF Research Database (Denmark)

    Phiri, Selia Ng'anjo; Kiserud, Torvid; Kvåle, Gunnar

    2014-01-01

    of delivery. Socioeconomic position was measured by employing a construct of educational attainment and wealth index. All analyses were stratified by district and urban-rural residence. RESULTS: There were substantial inter-district differences in proportion of health facility childbirth. Facility childbirth......BACKGROUND: Maternal mortality continues to be a heavy burden in low and middle income countries where half of all deliveries take place in homes without skilled attendance. The study aimed to investigate the underlying and proximate determinants of health facility childbirth in rural and urban...... areas of three districts in Kenya, Tanzania and Zambia. METHODS: A population-based survey was conducted in 2007 as part of the 'REsponse to ACcountable priority setting for Trust in health systems' (REACT) project. Stratified random cluster sampling was used and the data included information on place...

  8. Influence of obstetrical events on satisfaction and anxiety during childbirth: a prospective longitudinal study.

    Science.gov (United States)

    Floris, Lucia; Irion, Olivier; Courvoisier, Delphine

    2017-09-01

    The aim of this study was to investigate the feelings of anxiety and satisfaction among 79 primiparas who had uncomplicated pregnancies, at the time of hospital admission and after birth, considering the mode of delivery, analgesia, and pain levels. Questionnaires were completed at admission to the hospital and two months after delivery, using the State-Trait Anxiety Inventory (STAI) state scale and the Labour Agentry Scale. The mean (SD) STAI state score was higher at admission (36.7 (10.7)) than 4 months after childbirth (32.1 (9.7)) (paired Student's t-test, t = 2.93; df = 78; p = .004). However, the postnatal anxiety was not associated with the mode of delivery, epidural or pain. Regarding the satisfaction with the expectations of control during childbirth, the mean (SD) score was higher before childbirth (166.0 (21.8)) than after (157.5 (33.5)) (paired Student's t-test, t = -2.28; df = 77; p = .03). The satisfaction with the childbirth experience was significantly associated with the expectations of childbirth and the mode of delivery, but not with analgesia or pain. The postnatal anxiety was associated with physical health, pain and the Edinburgh Postnatal Depression Scale score during the postpartum period. It is important to consider the temporality of perinatal anxiety in order to understand its causes. Our results indicate that the experience of childbirth was predicted in this sample by the antenatal expectations and delivery outcomes.

  9. Disrespect and abuse of women during childbirth in Nigeria: A systematic review.

    Directory of Open Access Journals (Sweden)

    Foluso Ishola

    Full Text Available Promoting respectful care at childbirth is important to improve quality of care and encourage women to utilize skilled delivery services. However, there has been a relative lack of public health research on this topic in Nigeria. A systematic review was conducted to synthesize current evidence on disrespect and abuse of women during childbirth in Nigeria in order to understand its nature and extent, contributing factors and consequences, and propose solutions.Five electronic databases were searched for relevant published studies, and five data sources for additional grey literature. A qualitative synthesis was conducted using the Bowser and Hill landscape analytical framework on disrespect and abuse of women during childbirth.Fourteen studies were included in this review. Of these studies, eleven were cross sectional studies, one was a qualitative study and two used a mixed method approach. The type of abuse most frequently reported was non-dignified care in form of negative, poor and unfriendly provider attitude and the least frequent were physical abuse and detention in facilities. These behaviors were influenced by low socioeconomic status, lack of education and empowerment of women, poor provider training and supervision, weak health systems, lack of accountability and legal redress mechanisms. Overall, disrespectful and abusive behavior undermined the utilization of health facilities for delivery and created psychological distance between women and health providers.This systematic review documented a broad range of disrespectful and abusive behavior experienced by women during childbirth in Nigeria, their contributing factors and consequences. The nature of the factors influencing disrespectful and abusive behavior suggests that educating women on their rights, strengthening health systems to respond to specific needs of women at childbirth, improving providers training to encompass interpersonal aspects of care, and implementing and

  10. Disrespect and abuse during childbirth in Tanzania: are women living with HIV more vulnerable?

    Science.gov (United States)

    Sando, David; Kendall, Tamil; Lyatuu, Goodluck; Ratcliffe, Hannah; McDonald, Kathleen; Mwanyika-Sando, Mary; Emil, Faida; Chalamilla, Guerino; Langer, Ana

    2014-12-01

    HIV-related stigma and discrimination and disrespect and abuse during childbirth are barriers to use of essential maternal and HIV health services. Greater understanding of the relationship between HIV status and disrespect and abuse during childbirth is required to design interventions to promote women's rights and to increase uptake of and retention in health services; however, few comparative studies of women living with HIV (WLWH) and HIV-negative women exist. Mixed methods included interviews with postpartum women (n = 2000), direct observation during childbirth (n = 208), structured questionnaires (n = 50), and in-depth interviews (n = 18) with health care providers. Bivariate and multivariate regressions analyzed associations between HIV status and disrespect and abuse, whereas questionnaires and in-depth interviews provided insight into how provider attitudes and workplace culture influence practice. Of the WLWH and HIV-negative women, 12.2% and 15.0% reported experiencing disrespect and abuse during childbirth (P = 0.37), respectively. In adjusted analyses, no significant differences between WLWH and HIV-negative women's experiences of different types of disrespect and abuse were identified, with the exception of WLWH having greater odds of reporting non-consented care (P = 0.03). None of the WLWH reported violations of HIV confidentiality or attributed disrespect and abuse to their HIV status. Provider interviews indicated that training and supervision focused on prevention of vertical HIV transmission had contributed to changing the institutional culture and reducing HIV-related violations. In general, WLWH were not more likely to report disrespect and abuse during childbirth than HIV-negative women. However, the high overall prevalence of disrespect and abuse measured indicates a serious problem. Similar institutional priority as has been given to training and supervision to reduce HIV-related discrimination during childbirth should be focused on

  11. Disrespect and abuse of women during childbirth in Nigeria: A systematic review.

    Science.gov (United States)

    Ishola, Foluso; Owolabi, Onikepe; Filippi, Veronique

    2017-01-01

    Promoting respectful care at childbirth is important to improve quality of care and encourage women to utilize skilled delivery services. However, there has been a relative lack of public health research on this topic in Nigeria. A systematic review was conducted to synthesize current evidence on disrespect and abuse of women during childbirth in Nigeria in order to understand its nature and extent, contributing factors and consequences, and propose solutions. Five electronic databases were searched for relevant published studies, and five data sources for additional grey literature. A qualitative synthesis was conducted using the Bowser and Hill landscape analytical framework on disrespect and abuse of women during childbirth. Fourteen studies were included in this review. Of these studies, eleven were cross sectional studies, one was a qualitative study and two used a mixed method approach. The type of abuse most frequently reported was non-dignified care in form of negative, poor and unfriendly provider attitude and the least frequent were physical abuse and detention in facilities. These behaviors were influenced by low socioeconomic status, lack of education and empowerment of women, poor provider training and supervision, weak health systems, lack of accountability and legal redress mechanisms. Overall, disrespectful and abusive behavior undermined the utilization of health facilities for delivery and created psychological distance between women and health providers. This systematic review documented a broad range of disrespectful and abusive behavior experienced by women during childbirth in Nigeria, their contributing factors and consequences. The nature of the factors influencing disrespectful and abusive behavior suggests that educating women on their rights, strengthening health systems to respond to specific needs of women at childbirth, improving providers training to encompass interpersonal aspects of care, and implementing and enforcing policies on

  12. Contraception, pregnancy, childbirth--when things go wrong.

    Science.gov (United States)

    Samuels, A

    1986-01-01

    This discussion of contraception, pregnancy, and childbirth covers the following: accepting and discharging patients; legal duty of care; contract law; consent; records; time limit; criminal law; sanctions; children under 16; contraception; failed sterilization, vasectomy, and abortion; abortions; pregnancy; delivery; postnatal care; birth at home; and unqualified persons. The relationship of the doctor to the private patient is governed by the law of contract and in a particular case may impose a greater duty on the doctor than that imposed by tort. The doctor must obtain the consent of the patient and must adhere to the proper standards of competent professional practice, either the generally accepted practice or, if there are 2 or more alternative procedures, one which can be professional supported. Where sterilization (tubal occlusion) is proposed, advice and counseling should be offered. On the birth of a child, drugs may not be administered without the mother's consent. The records of the National Health Service patient appear to belong to the Secretary of State for Social Services and the records of the private patient to the patient. The patient may sue within 3 years from the date of the alleged negligence or the discovery of the negligence. The doctor is most unlikely to be prosecuted for a criminal offense but failure to attend the patient, or gross carelessness, could possibly lead to a manslaughter charge. The Family Practitioner Committee may give a warning, a reprimand, and may stop the payment of fees. The doctor may give contraceptive advice and treatment to an adolescent female under age 16, but the doctor must first conform to 5 guidelines, known as the Fraser Guidelines. These guidelines are listed. The doctor must be aware of the possible risks and side effects of the various contraceptive methods and must evaluate each method and each patient accordingly. A doctor may be liable under the law of contract for a failed sterilization, vasectomy

  13. Word classes

    DEFF Research Database (Denmark)

    Rijkhoff, Jan

    2007-01-01

    in grammatical descriptions of some 50 languages, which together constitute a representative sample of the world’s languages (Hengeveld et al. 2004: 529). It appears that there are both quantitative and qualitative differences between word class systems of individual languages. Whereas some languages employ...... a parts-of-speech system that includes the categories Verb, Noun, Adjective and Adverb, other languages may use only a subset of these four lexical categories. Furthermore, quite a few languages have a major word class whose members cannot be classified in terms of the categories Verb – Noun – Adjective...... – Adverb, because they have properties that are strongly associated with at least two of these four traditional word classes (e.g. Adjective and Adverb). Finally, this article discusses some of the ways in which word class distinctions interact with other grammatical domains, such as syntax and morphology....

  14. Assessment of social psychological determinants of satisfaction with childbirth in a cross-national perspective.

    Science.gov (United States)

    Christiaens, Wendy; Bracke, Piet

    2007-10-26

    The fulfilment of expectations, labour pain, personal control and self-efficacy determine the postpartum evaluation of birth. However, researchers have seldom considered the multiple determinants in one analysis. To explore to what extent the results can be generalised between countries, we analyse data of Belgian and Dutch women. Although Belgium and the Netherlands share the same language, geography and political system and have a common history, their health care systems diverge. The Belgian maternity care system corresponds to the ideal type of the medical model, whereas the Dutch system approaches the midwifery model. In this paper we examine multiple determinants, the fulfilment of expectations, labour pain, personal control and self-efficacy, for their association with satisfaction with childbirth in a cross-national perspective. Two questionnaires were filled out by 605 women, one at 30 weeks of pregnancy and one within the first 2 weeks after childbirth either at home or in a hospital. Of these, 560 questionnaires were usable for analysis. Women were invited to participate in the study by independent midwives and obstetricians during antenatal visits in 2004-2005. Satisfaction with childbirth was measured by the Mackey Satisfaction with Childbirth Rating Scale, which takes into account the multidimensional nature of the concept. Labour pain was rated retrospectively using Visual Analogue Scales. Personal control was assessed with the Wijma Delivery Expectancy/Experience Questionnaire and Pearlin and Schooler's mastery scale. A hierarchical linear analysis was performed. Satisfaction with childbirth benefited most consistently from the fulfilment of expectations. In addition, the experience of personal control buffered the lowering impact of labour pain. Women with high self-efficacy showed more satisfaction with self-, midwife- and physician-related aspects of the birth experience. Our findings focus the attention toward personal control, self-efficacy and

  15. Fear of childbirth and risk for birth complications in nulliparous women in the Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Laursen, M; Johansen, C; Hedegaard, M

    2009-01-01

    nulliparous women in spontaneous labour with a single fetus in cephalic presentation at term following an uncomplicated pregnancy. METHODS: Data were collected during 1997-2003 from computer-assisted telephone interviews twice in pregnancy linked with national health registers. MAIN OUTCOME MEASURES: Risk...... for emergency caesarean section of women who feared childbirth; risk for dystocia/protracted labour or fetal distress of women who feared childbirth. RESULTS: Fear of childbirth in early (16 weeks, 6 +/- 29 days) and late (31 weeks, 4 +/- 21 days) pregnancy was associated with emergency caesarean section: OR, 1.......23 (1.05-1.47) and 1.32 (1.13-1.55), respectively. When fear of childbirth was expressed at both interviews, the OR was 1.43 (1.13-1.80). Women who feared childbirth had an increased risk for dystocia or protracted labour (OR, 1.33; 1.15-1.54), but not for fetal distress (OR, 0.94; 0...

  16. Class size versus class composition

    DEFF Research Database (Denmark)

    Jones, Sam

    Raising schooling quality in low-income countries is a pressing challenge. Substantial research has considered the impact of cutting class sizes on skills acquisition. Considerably less attention has been given to the extent to which peer effects, which refer to class composition, also may affect...... bias from omitted variables, the preferred IV results indicate considerable negative effects due to larger class sizes and larger numbers of overage-for-grade peers. The latter, driven by the highly prevalent practices of grade repetition and academic redshirting, should be considered an important...

  17. Associations between perceptions of care and women's childbirth experience: a population-based cross-sectional study in Rwanda.

    Science.gov (United States)

    Mukamurigo, Judith U; Berg, Marie; Ntaganira, Joseph; Nyirazinyoye, Laetitia; Dencker, Anna

    2017-06-09

    In recent years Rwanda has achieved remarkable improvement in quality of maternity care services but there is evidence of deficiencies in care quality in terms of disrespectful care. Women's overall childbirth experience is an important outcome of childbirth and a factor in assessing quality of care. The aim of this study was to investigate how women's overall childbirth experience in Rwanda was related to their perceptions of childbirth care. A cross-sectional household study of women who had given birth 1-13 months earlier (n = 921) was performed in the Northern Province and in the capital city. Data was collected via structured interviews following a questionnaire. Significant variables measuring perceptions of care were included in a stepwise forward selection logistic regression model with overall childbirth experience as a dichotomised target variable to find independent predictors of a good childbirth experience. The majority of women (77.5%) reported a good overall childbirth experience. In a logistic regression model five factors of perceived care were significant independent predictors of a good experience: confidence in staff (Adjusted OR 1.73, 95% CI 1.20-2.49), receiving enough information (AOR 1.44, 95% CI 1.03-2.00), being treated with respect (AOR 1.69, 95% CI 1.18-2.43), getting support from staff (AOR 1.75, 95% CI 1.20-2.56), and having the baby skin-to-skin after birth (AOR 2.21, 95% CI 1.52-3.19). To further improve childbirth care in Rwanda and care for women according to their preferences, it is important to make sure that the childbirth care includes the following quality aspects in national and clinical guidelines: build confidence, provide good information, treat women and families with respect, provide good professional support during childbirth and put the newborn baby skin-to-skin with its mother early after birth.

  18. Preparation and configurational analysis of the stereoisomers of β,γ-bidentate Rh(H2O)4ATP and α,β,γ-tridentate Rh(H2O)3ATP. A new class of enzyme active site probes

    International Nuclear Information System (INIS)

    Lu, Z.; Shorter, A.L.; Lin, I.; Dunaway-Mariano, D.

    1988-01-01

    Exchange-inert Co(III) and Cr(III) complexes of polyphosphates have proved to be useful probes of the structural and biochemical properties of naturally occurring Mg II (polyphosphate) complexes. However, applications of these complexes are not without limitations. The Cr III (polyphosphate) probes or their enzymatic products cannot be used in NMR methods because of the paramagnetic nature of the Cr(III) metal. The redox properties of the metal in the Co III (polyphosphate) complexes require that they also be coordinated to a nitrogen-containing ligand. This requirement is not always convenient. This work reported herein was undertaken to create a new class of exchange-inert metal polyphosphate complexes that contain a metal that is both diamagnetic and redox stable. The preparation, properties, and configurational analysis of the stereoisomers of β, γ-bidentate Rh(H 2 O) 4 ATP (ATP = adenosine 5'-triphosphate) and α,β,γ-tridentate Rh(H 2 O) 3 ATP are described. 12 refs., 5 figs

  19. Social Classes

    DEFF Research Database (Denmark)

    Aktor, Mikael

    2018-01-01

    . Although this social structure was ideal in nature and not equally confirmed in other genres of ancient and medieval literature, it has nevertheless had an immense impact on Indian society. The chapter presents an overview of the system with its three privileged classes, the Brahmins, the Kṣatriyas......The notions of class (varṇa) and caste (jāti) run through the dharmaśāstra literature (i.e. Hindu Law Books) on all levels. They regulate marriage, economic transactions, work, punishment, penance, entitlement to rituals, identity markers like the sacred thread, and social interaction in general...

  20. Preventing post-traumatic stress disorder following childbirth and traumatic birth experiences: a systematic review.

    Science.gov (United States)

    de Graaff, Lisanne F; Honig, Adriaan; van Pampus, Mariëlle G; Stramrood, Claire A I

    2018-06-01

    Between 9 and 44% of women experience giving birth as traumatic, and 3% of women develop a post-traumatic stress disorder following childbirth. Knowledge on risk factors is abundant, but studies on treatment are limited. This study aimed to present an overview of means to prevent traumatic birth experiences and childbirth-related post-traumatic stress disorder. Major databases [Cochrane; Embase; PsycINFO; PubMed (Medline)] were searched using combinations of the key words and their synonyms. After screening titles and abstracts and reading 135 full-text articles, 13 studies were included. All evaluated secondary prevention, and none primary prevention. Interventions included debriefing, structured psychological interventions, expressive writing interventions, encouraging skin-to-skin contact with healthy newborns immediately postpartum and holding or seeing the newborn after stillbirth. The large heterogeneity of study characteristics precluded pooling of data. The writing interventions to express feelings appeared to be effective in prevention. A psychological intervention including elements of exposure and psycho-education seemed to lead to fewer post-traumatic stress disorder symptoms in women who delivered via emergency cesarean section. No research has been done on primary prevention of traumatic childbirth. Research on secondary prevention of traumatic childbirth and post-traumatic stress disorder following delivery provides insufficient evidence that the described interventions are effective in unselected groups of women. In certain subgroups, results are inhomogeneous. © 2018 Nordic Federation of Societies of Obstetrics and Gynecology.

  1. "Relinquish the reins": persuasion and consensus in the discourse of pregnancy and childbirth advice literature.

    Science.gov (United States)

    Rodgers, Ornaith

    2015-03-01

    Popular pregnancy and childbirth advice books constitute an important source of information for pregnant women. These texts shape women's perceptions of pregnancy, childbirth and the medical care they will receive during this time. This article reports on a study of the enactment of power relations between pregnant women and their medical caregivers in the discourse of pregnancy and childbirth advice literature and its implications for practice. The study focuses on the discursive positioning of women in relation to medical personnel through a critical discourse analysis of two popular advice books, one in English and one in French. The article suggests that through the use of a number of key discursive strategies, pregnant women are constructed as under the control of the medical institution in these texts. However, this control is not achieved by an overt oppressive discourse, instead it is achieved through persuasion and consensus by generating the consent of pregnant women to comply with medical norms. The medical institution is represented in these texts as a dominant force while women are constructed as powerless recipients of medical care. Medical professionals should firstly consider whether the power relations represented in these texts correspond to those enacted in clinics and delivery rooms. Secondly, caregivers should be cautious about recommending popular pregnancy and childbirth advice books to women as the relationship between pregnant women and their caregivers may be undermined by the negative power asymmetry enacted in these texts. Copyright © 2014 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  2. First childbirth experience of international marriage migrant women in South Korea.

    Science.gov (United States)

    Chu, Min Sun; Park, Minna; Kim, Jung A

    2017-08-01

    Since the mid-1990s, a large number of foreign women have migrated from developing countries to South Korea by means of international marriages. These nulliparous foreign women may experience more difficulties in pregnancy and childbirth than native Koreans. This study aimed to describe the meaning of the first childbirth experiences of international marriage migrant women marrying Korean men in South Korea. This is a descriptive phenomenological study that included 10 participants using the purposive and snowball sampling in one multicultural support center in Seoul, South Korea. Colaizzi's data analysis method was used to inductively determine themes and formulate meanings. The meanings of first childbirth were categorized into four themes-'coming to a crisis,' 'depending on others,' 'searching for solutions,' and 'strengthening family unity.' Inadequate antenatal care is associated with obstacles such as language barriers, social isolation, lack of knowledge, different midwifery practice and dependent lifestyle. Meanwhile, their children were a source of energy for the women to fulfill their emotional needs and improve family relationships. Childbirth is a life-changing event for these women, in which they face challenges as well as opportunities to develop new coping skills and a new role identity in their family. It is important for healthcare providers and policy makers to identify obstacles and unmet needs to improve maternity care in light of the distinctive challenges of immigrant living in multicultural families. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  3. Working around Childbirth: Comparative and Empirical Perspectives on Parental Leave Policy.

    Science.gov (United States)

    Garrett, Patricia; And Others

    1990-01-01

    Cites research that supports a U.S. parental leave policy that includes job protection and wage replacement during childbirth. Issues dealt with in the literature include current U.S. child welfare legislation, international parental leave legislation, job continuity, reduced stress on the child welfare system, and prejudice against young mothers.…

  4. Nonsuturing or Skin Adhesives versus Suturing of the Perineal Skin After Childbirth: A Systematic Review

    NARCIS (Netherlands)

    Seijmonsbergen-Schermers, A.E.; Sahami, S.; Lucas, C.; de Jonge, A.

    2015-01-01

    Background: Suturing of perineal trauma after childbirth can cause problems such as pain, discomfort because of tight sutures, the need for suture removal, and dyspareunia. It is unclear whether leaving the perineal skin unsutured or using skin adhesives might prevent these problems. Methods:

  5. Nonsuturing or Skin Adhesives versus Suturing of the Perineal Skin After Childbirth: A Systematic Review

    NARCIS (Netherlands)

    Seijmonsbergen-Schermers, Anna E.; Sahami, Saloomeh; Lucas, Cees; Jonge, Ank de

    2015-01-01

    Suturing of perineal trauma after childbirth can cause problems such as pain, discomfort because of tight sutures, the need for suture removal, and dyspareunia. It is unclear whether leaving the perineal skin unsutured or using skin adhesives might prevent these problems. CENTRAL, MEDLINE, EMBASE,

  6. Childbirth attendance strategies and their impact on maternal mortality and morbidity in low-income settings

    DEFF Research Database (Denmark)

    Pyone, Thidar; Sorensen, Bjarke Lund; Tellier, Siri

    2012-01-01

    Objective. To review quantitative evidence of the effect on maternal health of different childbirth attendance strategies in low-income settings. Design. Systematic review. Methods. Studies using quantitative methods, referring to the period 1987-2011, written in English and reporting the impact ...

  7. Private View, Public Birth: Making Feminist Sense of the New Visual Culture of Childbirth

    Directory of Open Access Journals (Sweden)

    Imogen Tyler

    2013-07-01

    Full Text Available In the last three decades, there has been a dramatic increase in media representations of childbirth across a range of platforms: cinema, reality television and television drama, online video-sharing platforms, pornographic film, and in fine art practice. As yet, however, there is little feminist scholarship on the implications of this new and varied visual culture of childbirth and its relationship to earlier feminist debates about the cultural taboo against the representation of birth. This paper focuses on two contemporary sites: the growing phenomenon of 'childbirth reality TV' and the birthrites collection, a unique art collection in the UK dedicated to the subject of childbirth. We explore the meanings and implications of this new visual culture of birth, and the ways its reception is challenging earlier feminist conceptualisations of motherhood and the birthing body. In particular, we argue that these new popular and artistic representations of birth trouble accounts of the birthing body as abject, and what could be described as the 'abject aesthetics' that has dominated the visual representation of birth. In place of abjection, we conclude by arguing for a more thoroughly social and political account of the place of birth in contemporary culture, based on forms of 'natal thinking', which we suggest that the birthrites collection proposes.

  8. Doulas' Perceptions on Single Mothers' Risk and Protective Factors, and Aspirations Relative to Child-Birth

    Science.gov (United States)

    Arat, Gizem

    2013-01-01

    This study the author aims to explore the perceptions of doulas on single mothers' risk and protective factors, and aspirations relative to child-birth in the postpartum care. The current study was conducted by semi-structured questions, case file reviews, field notes, and twelve home visits via utilizing Grounded Theory. These mothers receive…

  9. NEUROENDOCRINE FUNCTIONS OF PUERPERAE WITH POSTPARTUM DEPRESSION AGGRAVATED BY STRESSFUL CHILDBIRTH-RELATED EVENTS.

    Science.gov (United States)

    Song, W; Yu, S

    2015-01-01

    In the period of gestation, delivery and post-delivery, fear and tension produced in puerperae are likely to evolve into depression as they worry too much about delivery pain. In recent years, it has been noted that stressful events during this period aggravate postpartum depression. To discuss the effect of these childbirth-related stressful events on neuroendocrine functions of patients with postpartum depression, 300 full-term puerperae who had been admitted to the Beijing Obstetrics and Gynecology Hospital, Capital Medical University between October, 2011 and October, 2013 and who had suffered from stressful childbirth-related events were enrolled as a study group. This group was divided into six subgroups, i.e., A, B, C, D, E and F, based on the number of stressful events they had suffered which were labeled by numbers 1 to 6. Additionally, 100 puerperae from the same hospital who had not suffered from childbirth-related stressful events were taken as controls. Relevant clinical indexes, including serum adrenocorticotropic hormone (ACTH), plasma 5-hydroxytryptamine (5-HT), noradrenaline ELISA (NE), dopamine (DA) and cortisol level were measured and compared. It was found that incidence probability of postpartum depression was significantly different between the study group (13.67%, 41/300) and the control group (7%, 7/100). Moreover, the incidence probability of postpartum depression of puerperae suffering from no less than 4 childbirth-related stressful events was higher than those suffering from no more than 3, and the difference was statistically significant (Pdepression.

  10. Prevalence and associated factors of fear of childbirth in six European countries

    DEFF Research Database (Denmark)

    Lukasse, Mirjam; Schei, Berit; Ryding, Elsa Lena

    2014-01-01

    for prevalence of severe fear of childbirth, varying from 4.5% in Belgium to 15.6% in Estonia for primiparous women and from 7.6% in Iceland to 15.2% in Sweden for multiparous women. After adjusting for age, education and gestational age, only primiparous women from Belgium had significantly less fear...

  11. Psychoprophylaxis during labor: associations with labor-related outcomes and experience of childbirth.

    Science.gov (United States)

    Bergström, Malin; Kieler, Helle; Waldenström, Ulla

    2010-06-01

    To study whether use of psychoprophylaxis during labor affects course of labor and experience of childbirth in nulliparous women. Cohort study. Women were recruited from 15 antenatal clinics in Sweden between October 2005 and January 2007. A total of 857 nulliparous women with a planned vaginal delivery. Using data from a randomized controlled trial of antenatal education where the allocated groups were merged, we compared course of labor and experience of childbirth between women who used psychoprophylaxis during labor and those who did not. Data were collected by questionnaires in mid-pregnancy and three months after birth, and from the Swedish Medical Birth Register. Logistic regression was used to assess associations. Mode of delivery, augmentation of labor, length of labor, Apgar score, pain relief and experience of childbirth as measured by the Wijma Delivery Experience Questionnaire. Use of psychoprophylaxis during labor was associated with a lower risk of emergency cesarean section (adjusted odds ratio (OR) 0.57; 95% confidence interval (CI) 0.37-0.88), but an increased risk of augmentation of labor (adjusted OR 1.68; 95% CI 1.23-2.28). No statistical differences were found in length of labor (adjusted OR 1.32; 95% CI 0.95-1.83), Apgar score Psychoprophylaxis may reduce the rate of emergency cesarean section but may not affect the experience of childbirth.

  12. Birthing Classes

    Science.gov (United States)

    ... management options. Breastfeeding basics. Caring for baby at home. Birthing classes are not just for new parents, though. ... midwife. Postpartum care. Caring for your baby at home, including baby first aid. Lamaze One of the most popular birthing techniques in the U.S., Lamaze has been around ...

  13. Fears related to pregnancy and childbirth among primigravidae who requested caesarean versus vaginal delivery in Iran.

    Science.gov (United States)

    Matinnia, Nasrin; Faisal, Ibrahim; Hanafiah Juni, Muhamad; Herjar, Abdul Rahman; Moeini, Babak; Osman, Zubaidah Jamil

    2015-05-01

    Pregnancy- and childbirth-related fears are common psychological concerns and the primary reasons for requesting caesarean section (CS). We aimed to examine the content of maternal fear and the associated demographic factors in a sample of Iranian primigravidae. A randomly selected sample of primigravidae (n = 342) was recruited in four health care centres in Iran. Data were collected using a 30-item questionnaire. Principal components factor analysis was applied to identify the main factors of pregnancy- and childbirth-related fears. All primigravidae reported some degree of fear, 48.2 % presented severe fear, and 62.6 % requested a CS because of childbirth-related fear. Most of the employed primigravidae with higher education level, higher family income, and unplanned pregnancy requested CS. The items constructed to measure maternal fear were subjected to exploratory factor analysis. Six categories were identified, including 'process of labour and childbirth', 'life and well-being of the baby', 'competence and behaviour of maternity ward personnel', 'own capabilities and reactions', 'becoming a parent and family life after delivery' and 'general fear in pregnancy' that cumulatively explained 55.3 % of the variance. The most common factor was 'life and well-being of the baby'. Severe fear was found in 70.6 % of those who chose CS, while 10.9 % of those who chose vaginal delivery reported severe fear. The between-group differences for mean scores and levels of fear were statistically significant. Pregnancy- and childbirth-related fears were frequently experienced by all low-risk primigravidae. Better strategies to address women's psychological needs during pregnancy are necessary.

  14. Maternal morbidity in the first year after childbirth in Mombasa Kenya; a needs assessment

    Directory of Open Access Journals (Sweden)

    Luchters Stanley MF

    2009-11-01

    Full Text Available Abstract Background In sub-Saharan Africa, few services specifically address the needs of women in the first year after childbirth. By assessing the health status of women in this period, key interventions to improve maternal health could be identified. There is an underutilised opportunity to include these interventions within the package of services provided for woman-child pairs attending child-health clinics. Methods This needs assessment entailed a cross-sectional survey with 500 women attending a child-health clinic at the provincial hospital in Mombasa, Kenya. A structured questionnaire, clinical examination, and collection of blood, urine, cervical swabs and Pap smear were done. Women's health care needs were compared between the early (four weeks to two months after childbirth, middle (two to six months and late periods (six to twelve months since childbirth. Results More than one third of women had an unmet need for contraception (39%, 187/475. Compared with other time intervals, women in the late period had more general health symptoms such as abdominal pain, fever and depression, but fewer urinary or breast problems. Over 50% of women in each period had anaemia (Hb Trichomonas vaginalis and 11% (54/496 HIV infection. Conclusion Throughout the first year after childbirth, women had high levels of morbidity. Interface with health workers at child health clinics should be used for treatment of anaemia, screening and treatment of reproductive tract infections, and provision of family planning counselling and contraception. Providing these services during visits to child health clinics, which have high coverage both early and late in the year after childbirth, could make an important contribution towards improving women's health.

  15. Does a referral from home to hospital affect satisfaction with childbirth? A cross-national comparison

    Directory of Open Access Journals (Sweden)

    Gouwy Anneleen

    2007-07-01

    Full Text Available Abstract Background The Belgian and Dutch societies present many similarities but differ with regard to the organisation of maternity care. The Dutch way of giving birth is well known for its high percentage of home births and its low medical intervention rate. In contrast, home births in Belgium are uncommon and the medical model is taken for granted. Dutch and Belgian maternity care systems are compared with regard to the influence of being referred to specialist care during pregnancy or intrapartum while planning for a home birth. We expect that a referral will result in lower satisfaction with childbirth, especially in Belgium. Methods Two questionnaires were filled out by 605 women, one at 30 weeks of pregnancy and one within the first two weeks after childbirth, either at home or in a hospital. Of these, 563 questionnaires were usable for analysis. Women were invited to participate in the study by independent midwives and obstetricians during antenatal visits in 2004–2005. Satisfaction with childbirth was measured by the Mackey Satisfaction with Childbirth Rating Scale, which takes into account the multidimensional nature of the concept. Results Belgian women are more satisfied than Dutch women and home births are more satisfying than hospital births. Women who are referred to the hospital while planning for a home birth are less satisfied than women who planned to give birth in hospital and did. A referral has a greater negative impact on satisfaction for Dutch women. Conclusion There is no reason to believe Dutch women receive hospital care of lesser quality than Belgian women in case of a referral. Belgian and Dutch attach different meaning to being referred, resulting in a different evaluation of childbirth. In the Dutch maternity care system home births lead to higher satisfaction, but once a referral to the hospital is necessary satisfaction drops and ends up lower than satisfaction with hospital births that were planned in advance

  16. PTSD following childbirth: a prospective study of incidence and risk factors in Canadian women.

    Science.gov (United States)

    Verreault, Nancy; Da Costa, Deborah; Marchand, André; Ireland, Kierla; Banack, Hailey; Dritsa, Maria; Khalifé, Samir

    2012-10-01

    The goals of the present study were to estimate the incidence and course of full and partial Post-Traumatic Stress Disorder (PTSD) following childbirth and to prospectively identify factors associated with the development of PTSD symptoms at 1month following childbirth. The sample comprised 308 women, with assessments at four time points: 25-40weeks gestation, 4-6weeks postpartum, 3 and 6months postpartum. Current and prior PTSD were assessed by the Structured Clinical Interview for DSM-IV (SCID-I) and the Modified PTSD Symptom Scale Self-Report (MPSS-SR). Incidence rates of PTSD varied according to time of measurement and instrument used, with higher rates of full and partial PTSD using the MPSS-SR at 1month postpartum (7.6% and 16.6%, respectively). Multivariate logistic regression showed that higher anxiety sensitivity (OR=1.75; 95% CI=1.19‒2.57, p=.005), history of sexual trauma (OR=2.81; 95% CI=1.07‒7.37, p=.036), a more negative childbirth experience than expected (OR=0.96; 95% CI=0.94‒0.98, p=.001), and less available social support at 1month postpartum (OR=0.40; 95% CI=0.17‒0.96, p=.041) independently predicted full or partial PTSD at 1month following childbirth. Our results indicate that a history of sexual trauma and anxiety sensitivity can increase the probability of developing PTSD after childbirth. The findings highlight the importance of screening and providing more tailored services for women at high risk. Crown Copyright © 2012. Published by Elsevier Inc. All rights reserved.

  17. Prevalence and risk factors of childbirth-related post-traumatic stress symptoms.

    Science.gov (United States)

    Modarres, Maryam; Afrasiabi, Sedigheh; Rahnama, Parvin; Montazeri, Ali

    2012-09-03

    There is evidence that traumatic birth experiences are associated with psychological impairments. This study aimed to estimate the prevalence of childbirth-related post-traumatic stress symptoms and its obstetric and perinatal risk factors among a sample of Iranian women. This was a cross-sectional study carried out in Bushehr, Iran during a 3-months period from July to September 2009. Data were collected from all women attending eleven healthcare centers for postnatal care 6 to 8 weeks after childbirth. Those who had a traumatic delivery were identified and entered into the study. In order to assess childbirth-related post-traumatic stress, the Post-traumatic Symptom Scale-Interview (PSS-I) was administered. Data on demographic, obstetric and perinatal characteristics also were collected. Multivariate logistic regression was performed to examine the association between childbirth-related post-traumatic stress and demographic and obstetric and perinatal variables. In all, 400 women were initially evaluated. Of these, 218 women (54.5%) had a traumatic delivery and overall, 80 women (20%) were found to be suffering from post-partum post-traumatic stress disorder (PTSD). Multiple logistic regression analysis revealed that post-partum PTSD was associated with educational level, gestational age at delivery, number of prenatal care visits, pregnancy complications, pregnancy intervals, labor duration, and mode of delivery. The findings indicated that the prevalence of traumatic birth experiences and post-partum PTSD were relatively high among Iranian women. The findings also indicated that obstetric and perinatal variables were independently the most significant contributing factors to women's post-partum PTSD. It seems that a better perinatal care and supportive childbirth might help to reduce the burden of post-partum PTSD among this population.

  18. Risk factors in pregnancy for post-traumatic stress and depression after childbirth.

    Science.gov (United States)

    Söderquist, J; Wijma, B; Thorbert, G; Wijma, K

    2009-04-01

    The objective of this study was to find risk factors in pregnancy for post-traumatic stress and depression 1 month after childbirth. Furthermore, the relation between post-traumatic stress and depression was explored. A prospective longitudinal study. Pregnant women in Linköping and Kalmar, Sweden. A total of 1224 women were assessed in pregnancy, week 12-20 and 32, as well as 1 month postpartum. Post-traumatic stress and depression after delivery were assessed 1 month postpartum. Potential risk factors were assessed in early and late pregnancy. Variables measured during pregnancy were trait anxiety, depression, fear of childbirth, childbirth-related traumatic stress, stress coping capacity, social support, parity, educational level, age, gestation week, parity, educational level, civil status, previous psychological/psychiatric counselling, and previous experience of any traumatic events. Delivery mode was assessed from the medical records. Prevalence of post-traumatic stress (criteria A, B, C, D, E, and F according to DSM-IV) and depression (Beck's depression inventory). One month postpartum, 12 (1.3%) women had post-traumatic stress (met symptom criteria B, C, and D for post-traumatic stress disorder according to Diagnostic and statistical manual of mental disorders, 4th edition [DSM-IV]). The most important risk factors in pregnancy were depression in early pregnancy (OR=16.3), severe fear of childbirth (OR=6.2), and 'pre'-traumatic stress (in view of the forthcoming delivery) in late pregnancy (OR=12.5). The prevalence of depression was 5.6%. Post-traumatic stress and depression were positively related 1 month postpartum and were predicted by mainly the same factors. Risk factors for post-traumatic stress and depression after childbirth can be assessed in early pregnancy. Post-traumatic stress and depression also seem to share the same underlying vulnerability factors.

  19. Testing a cognitive model to predict posttraumatic stress disorder following childbirth.

    Science.gov (United States)

    King, Lydia; McKenzie-McHarg, Kirstie; Horsch, Antje

    2017-01-14

    One third of women describes their childbirth as traumatic and between 0.8 and 6.9% goes on to develop posttraumatic stress disorder (PTSD). The cognitive model of PTSD has been shown to be applicable to a range of trauma samples. However, childbirth is qualitatively different to other trauma types and special consideration needs to be taken when applying it to this population. Previous studies have investigated some cognitive variables in isolation but no study has so far looked at all the key processes described in the cognitive model. This study therefore aimed to investigate whether theoretically-derived variables of the cognitive model explain unique variance in postnatal PTSD symptoms when key demographic, obstetric and clinical risk factors are controlled for. One-hundred and fifty-seven women who were between 1 and 12 months post-partum (M = 6.5 months) completed validated questionnaires assessing PTSD and depressive symptoms, childbirth experience, postnatal social support, trauma memory, peritraumatic processing, negative appraisals, dysfunctional cognitive and behavioural strategies and obstetric as well as demographic risk factors in an online survey. A PTSD screening questionnaire suggested that 5.7% of the sample might fulfil diagnostic criteria for PTSD. Overall, risk factors alone predicted 43% of variance in PTSD symptoms and cognitive behavioural factors alone predicted 72.7%. A final model including both risk factors and cognitive behavioural factors explained 73.7% of the variance in PTSD symptoms, 37.1% of which was unique variance predicted by cognitive factors. All variables derived from Ehlers and Clark's cognitive model significantly explained variance in PTSD symptoms following childbirth, even when clinical, demographic and obstetric were controlled for. Our findings suggest that the CBT model is applicable and useful as a way of understanding and informing the treatment of PTSD following childbirth.

  20. The meaning of a poor childbirth experience - A qualitative phenomenological study with women in Rwanda.

    Science.gov (United States)

    Mukamurigo, Judith; Dencker, Anna; Ntaganira, Joseph; Berg, Marie

    2017-01-01

    Being pregnant and giving birth is a pivotal life event and one that a woman ordinarily remembers for most of her life. A negative childbirth experience can affect a woman's health well beyond the episode of the labour and birth itself. This study explored the meaning of a poor childbirth experience, as expressed by women who had given birth in Rwanda. In a cross-sectional household study conducted in Northern Province and in Kigali City, the capital of Rwanda, a structured questionnaire was answered by women who had given birth one to 13 months earlier. One question, answered by 898 women, asked them to rate their overall experience of childbirth from 0 (very bad) to 10 (very good). Of these, 28 women (3.1%) who had rated their childbirth experience as bad (≤ 4) were contacted for individual interviews. Seventeen of these women agreed to participate in individual in-depth interviews. The texts were analysed with a reflective lifeworld approach. The essential meaning of a "poor" childbirth experience was that the women had been exposed to disrespectful care, constituted by neglect, verbal or physical abuse, insufficient information, and denial of their husband as a companion. The actions of carers included abandonment, humiliation, shaming and insult, creating feelings of insecurity, fear and distrust in the women. Two of the women did not report any experience of poor care; their low rating was related to having suffered from medical complications. It is challenging that the main finding is that women are exposed to disrespectful care. In an effort to provide an equitable and high quality maternal health care system in Rwanda, there is a need to focus on activities to implement respectful, evidence-based care for all. One such activity is to develop and provide education programmes for midwives and nurses about professional behaviour when caring for and working with women during labour and birth.

  1. The meaning of a poor childbirth experience - A qualitative phenomenological study with women in Rwanda.

    Directory of Open Access Journals (Sweden)

    Judith Mukamurigo

    Full Text Available Being pregnant and giving birth is a pivotal life event and one that a woman ordinarily remembers for most of her life. A negative childbirth experience can affect a woman's health well beyond the episode of the labour and birth itself. This study explored the meaning of a poor childbirth experience, as expressed by women who had given birth in Rwanda.In a cross-sectional household study conducted in Northern Province and in Kigali City, the capital of Rwanda, a structured questionnaire was answered by women who had given birth one to 13 months earlier. One question, answered by 898 women, asked them to rate their overall experience of childbirth from 0 (very bad to 10 (very good. Of these, 28 women (3.1% who had rated their childbirth experience as bad (≤ 4 were contacted for individual interviews. Seventeen of these women agreed to participate in individual in-depth interviews. The texts were analysed with a reflective lifeworld approach.The essential meaning of a "poor" childbirth experience was that the women had been exposed to disrespectful care, constituted by neglect, verbal or physical abuse, insufficient information, and denial of their husband as a companion. The actions of carers included abandonment, humiliation, shaming and insult, creating feelings of insecurity, fear and distrust in the women. Two of the women did not report any experience of poor care; their low rating was related to having suffered from medical complications.It is challenging that the main finding is that women are exposed to disrespectful care. In an effort to provide an equitable and high quality maternal health care system in Rwanda, there is a need to focus on activities to implement respectful, evidence-based care for all. One such activity is to develop and provide education programmes for midwives and nurses about professional behaviour when caring for and working with women during labour and birth.

  2. The effects of a childbirth psychoeducation program on learned resourcefulness, maternal role competence and perinatal depression: a quasi-experiment.

    Science.gov (United States)

    Ngai, Fei-Wan; Chan, Sally Wai-Chi; Ip, Wan-Yim

    2009-10-01

    Learned resourcefulness plays a significant role in facilitating maternal coping during the transition to motherhood. Given the growing evidence of perinatal depression and the frequent feeling of incompetence in the maternal role, the implementation of an effective intervention to promote maternal role competence and emotional well-being is essential. To determine the impact of a childbirth psychoeducation program based on the concept of learned resourcefulness on maternal role competence and depressive symptoms in Chinese childbearing women. A pretest-posttest, control group quasi-experimental design with repeated measures was used. The study was conducted in two regional public hospitals in Hong Kong that provide routine childbirth education programs with similar content and structure. One hospital was being randomly selected as the experimental hospital. A convenience sample of 184 Chinese pregnant women attending the childbirth education was recruited between October 2005 and April 2007. Inclusion criteria were primiparous with singleton and uneventful pregnancy, at gestation between 12 and 35 weeks, and did not have a past or familial psychiatric illness. The intervention was a childbirth psychoeducation program that was incorporated into the routine childbirth education in the experimental hospital. The experimental group (n=92) received the childbirth psychoeducation program and the routine childbirth education. The comparison group (n=92) received the routine childbirth education alone in the comparison hospital. Outcomes were measured by the Self-Control Schedule, Parenting Sense of Competence Scale-Efficacy subscale and Edinburgh Postnatal Depression Scale at baseline, immediately post-intervention, at 6 weeks and 6 months postpartum. Analysis was by intention to treat. Women receiving the childbirth psychoeducation program had significant improvement in learned resourcefulness at 6 weeks postpartum (p=0.004) and an overall reduction in depressive

  3. Coding Class

    DEFF Research Database (Denmark)

    Ejsing-Duun, Stine; Hansbøl, Mikala

    Denne rapport rummer evaluering og dokumentation af Coding Class projektet1. Coding Class projektet blev igangsat i skoleåret 2016/2017 af IT-Branchen i samarbejde med en række medlemsvirksomheder, Københavns kommune, Vejle Kommune, Styrelsen for IT- og Læring (STIL) og den frivillige forening...... Coding Pirates2. Rapporten er forfattet af Docent i digitale læringsressourcer og forskningskoordinator for forsknings- og udviklingsmiljøet Digitalisering i Skolen (DiS), Mikala Hansbøl, fra Institut for Skole og Læring ved Professionshøjskolen Metropol; og Lektor i læringsteknologi, interaktionsdesign......, design tænkning og design-pædagogik, Stine Ejsing-Duun fra Forskningslab: It og Læringsdesign (ILD-LAB) ved Institut for kommunikation og psykologi, Aalborg Universitet i København. Vi har fulgt og gennemført evaluering og dokumentation af Coding Class projektet i perioden november 2016 til maj 2017...

  4. [Husband's presence at childbirth in light of obstetric psychoprophylaxis].

    Science.gov (United States)

    Sioma-Markowska, Urszula; Sipiński, Adam; Majerczyk, Iwona; Selwet, Monika; Kuna, Anna; Machura, Mariola

    2004-01-01

    Contemporary obstetric psychoprophylaxis gives prospective parents wide opportunities to prepare to the pregnancy period and delivery. It is educationally-minded and points the importance to modify the life style, introduces exercises accompanied by the relative during the pregnancy and delivery. The survey portrays husband's--child father's role in obstetric psychoprophylaxis. The importance to continue the psychoprophylaxis in the delivery room was spotted in the survey, too. The continuation might be reached by close relative's presence.

  5. Who Delivers without Water? A Multi Country Analysis of Water and Sanitation in the Childbirth Environment.

    Directory of Open Access Journals (Sweden)

    Giorgia Gon

    Full Text Available Hygiene during childbirth is essential to the health of mothers and newborns, irrespective of where birth takes place. This paper investigates the status of water and sanitation in both the home and facility childbirth environments, and for whom and where this is a more significant problem.We used three datasets: a global dataset, with information on the home environment from 58 countries, and two datasets for each of four countries in Eastern Africa: a healthcare facility dataset, and a dataset that incorporated information on facilities and the home environment to create a comprehensive description of birth environments in those countries. We constructed indices of improved water, and improved water and sanitation combined (WATSAN, for the home and healthcare facilities. The Joint Monitoring Program was used to construct indices for household; we tailored them to the facility context-household and facility indices include different components. We described what proportion of women delivered in an environment with improved WATSAN. For those women who delivered at home, we calculated what proportion had improved WATSAN by socio-economic status, education and rural-urban status.Among women delivering at home (58 countries, coverage of improved WATSAN by region varied from 9% to 53%. Fewer than 15% of women who delivered at home in Sub-Saharan Africa, had access to water and sanitation infrastructure (range 0.1% to 37%. This was worse among the poorest, the less educated and those living in rural areas. In Eastern Africa, where we looked at both the home and facility childbirth environment, a third of women delivered in an environment with improved water in Uganda and Rwanda; whereas, 18% of women in Kenya and 7% in Tanzania delivered with improved water and sanitation. Across the four countries, less than half of the facility deliveries had improved water, or improved water and sanitation in the childbirth environment.Access to water and

  6. The transition of childbirth practices among tribal women in Gujarat, India - a grounded theory approach

    Science.gov (United States)

    2013-01-01

    Background Under the National Rural Health Mission, the current emphasis is on achieving universal institutional births through incentive schemes as part of reforms related to childbirth in India. There has been rapid progress in achieving this goal. To understand the choices made as well as practices and perceptions related to childbirth amongst tribal women in Gujarat and how these have been influenced by modernity in general and modernity brought in through maternal health policies. Method A model depicting the transition in childbirth practices amongst tribal women was constructed using the grounded theory approach with; 8 focus groups of women, 5 in depth interviews with traditional birth attendants, women, and service providers and field notes on informal discussions and observations. Results A transition in childbirth practices across generations was noted, i.e. a shift from home births attended by Traditional Birth Attendants (TBAs) to hospital births. The women and their families both adapted to and shaped this transition through a constant ’trade-off between desirable and essential’- the desirable being a traditional homebirth in secure surroundings and the essential being the survival of mother and baby by going to hospital. This transition was shaped by complex multiple factors: 1) Overall economic growth and access to modern medical care influencing women’s choices, 2) External context in terms of the international maternal health discourses and national policies, especially incentive schemes for promoting institutional deliveries, 3) Socialisation into medical childbirth practices, through exposure to many years of free outreach services for maternal and child health, 4) Loss of self reliance in the community as a consequence of role redefinition and deskilling of the TBAs and 5) Cultural belief that intervention is necessary during childbirth aiding easy acceptance of medical interventions. Conclusion In resource poor settings where choices are

  7. Disrespect and abuse of women during the process of childbirth in the 2015 Pelotas birth cohort.

    Science.gov (United States)

    Mesenburg, Marilia Arndt; Victora, Cesar Gomes; Jacob Serruya, Suzzane; Ponce de León, Rodolfo; Damaso, Andrea Homsi; Domingues, Marlos Rodrigues; da Silveira, Mariangela Freitas

    2018-03-27

    The disrespect and abuse of women during the process of childbirth is an emergent and global problem and only few studies have investigated this worrying issue. The objective of the present study was to describe the prevalence of disrespect and abuse of women during childbirth in Pelotas City, Brazil, and to investigate the factors involved. This was a cross-sectional population-based study of women delivering members of the 2015 Pelotas birth cohort. Information relating to disrespect and abuse during childbirth was obtained by household interview 3 months after delivery. The information related to verbal and physical abuse, denial of care and invasive and/or inappropriate procedures. Poisson regression was used to evaluate the factors associated with one or more, and two or more, types of disrespectful treatment or abuse. A total of 4275 women took part in a perinatal study. During the three-month follow-up, we interviewed 4087 biological mothers with regards to disrespect and abuse. Approximately 10% of women reported having experienced verbal abuse, 6% denial of care, 6% undesirable or inappropriate procedures and 5% physical abuse. At least one type of disrespect or abuse was reported by 18.3% of mothers (95% confidence interval [CI]: 17.2-19.5); and at least two types by 5.1% (95% CI: 4.4-5.8). Women relying on the public health sector, and those whose childbirths were via cesarean section with previous labor, had the highest risk, with approximately a three- and two-fold increase in risk, respectively. Our study showed that the occurrence of disrespect and abuse during childbirth was high and mostly associated with payment by the public sector and labor before delivery. The efforts made by civil society, governments and international organizations are not sufficient to restrain institutional violence against women during childbirth. To eradicate this problem, it is essential to 1) implement policies and actions specific for this type of violence and 2

  8. Working Together in Class

    Directory of Open Access Journals (Sweden)

    Pateşan Marioara

    2017-12-01

    Full Text Available The scores obtained by the military students are very important as a lot of opportunities depend on them: the choice of the branch, selection for different in and off-campus activities, the appointment to the workplace and so on. A qualifier, regardless of its form of effective expression, can make a difference in a given context of issuing a value judgment, in relation to the student's performance assessment. In our research we tried to find out what motives students, what determines them to get actively involved in the tasks they are given and the ways we can improve their participation in classes and assignments. In order to have an educated generation we need to have not only well prepared teachers but ones that are open-minded, flexible and in pace with the methodological novelties that can improve the teaching learning process in class. Along the years we have noticed that in classes where students constituted a cohesive group with an increasing degree of interaction between members, the results were better than in a group that did not appreciate team-work. In this article we want to highlight the fact that a teacher can bring to class the appropriate methods and procedures can contribute decisively to the strengthening of the group cohesion and high scores.

  9. Childbirth care: the oral history of women who gave birth from the 1940s to 1980s

    OpenAIRE

    Leister,Nathalie; Riesco,Maria Luiza Gonzalez

    2013-01-01

    This study's objective was to gain a greater understanding of the changes that took place in the childbirth care model from the experience of women who gave birth in the State of Sao Paulo, Brazil from the 1940s to the 1980s. This is a descriptive study conducted with 20 women using the Thematic Oral History method. Data were collected through unstructured interviews. The theme extracted from the interviews was "The experience of childbirth". The results indicate a time and generational demar...

  10. ATTENTION OF CHILDBIRTH, RURAL-URBAN MIGRATION AND PUBLIC POLITICS OF REPRODUCTIVE HEALTH IN INDIGENOUS POPULATION OF CHIAPAS

    Directory of Open Access Journals (Sweden)

    Austreberta Nazar Beutelspacher, Benito Salvatierra Izaba y Emma Zapata Martelo

    2007-12-01

    Full Text Available In this paper it’s analyze the tendencies of childbirth attention of urban indigenous women excluded in Chiapas, from rural settlement in Los Altos de Chiapas. It’s an exploratory essay which contributes to clear up the relation that establishes immigrant indigenous population with institutional health services for childbirth attention and modifications in traditional medicine. Are discussed the scopes of these changes in the operation of the institutional program of reproductive health and the risk of mother death.

  11. The Effect of Debriefing and Brief Cognitive-Behavioral Therapy on Postpartum Depression in Traumatic Childbirth: A Randomized Clinical Trial

    OpenAIRE

    Sedigheh Abdollahpour; Afsaneh Keramat; Seyyed Abbas Mousavi; Ahmad Khosravi; zahra motaghi

    2018-01-01

    Background & aim: Childbirth is a stressful event in women’s lives, and if a mother perceives it as an unpleasant event, it can influence her postpartum mental health. Depression is a common mental disorder, which can has serious consequences depending on its severity. Therefore, this study aimed to investigate the effect of debriefing and brief cognitive-behavioral therapy on postpartum depression in traumatic childbirth. Methods: This clinical trial was performed on 179 mothers who experien...

  12. Women’s employment patterns after childbirth and the perceived access to and use of flexitime and teleworking

    OpenAIRE

    Chung, Heejung; van der Horst, Mariska

    2017-01-01

    This article sets out to investigate how flexitime and teleworking can help women maintain their careers after childbirth. Despite the increased number of women in the labour market in the UK, many significantly reduce their working hours or leave the labour market altogether after childbirth. Based on border and boundary management theories, we expect flexitime and teleworking can help mothers stay employed and maintain their working hours. We explore the UK case, where the right to request ...

  13. "A midwife at every confinement": Midwifery and Medicalized Childbirth in Ontario and Britain, 1920-1950.

    Science.gov (United States)

    Cross, Gwenith Siobhan

    2014-01-01

    This paper compares midwifery in Ontario and Britain in the first half of the 20th century. British midwives improved maternal and infant health and welfare by making childbirth a cooperative, medically managed event in conjunction with physicians. British midwives thus participated in, and contributed to, developments in obstetrics. In contrast, Ontario physicians worked to exclude midwives from participation in the modernization of birth management, relying on a narrower concept of "medicalization" defined as physician dominance. This study challenges the medical profession's assumptions that the exclusion of midwifery in Ontario was necessary to the medicalization of childbirth. The British alternative, where midwives were seen as partners rather than obstacles, illustrates that medicalization in the interest of infant and maternal safety could be integrated with the work of midwives.

  14. CT and MR findings of neurological disorders associated with pregnancy and childbirth

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jee Young; Ahn, Kook Jin; Kim, Young Joo; Kim, Bum Soo; Hahn, Seong Tae [College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2008-08-15

    The onset of pregnancy may predispose women to a variety of neurological diseases due to changes in their hemodynamics, hormonal effects, and complications associated with childbirth. The spectrum of neurological disorders associated with pregnancy and childbirth include hypertensive intracerebral hemorrhaging, posterior reversible encephalopathy syndrome (PRES) (secondary to eclampsia), Wernicke encephalopathy, cerebral venous sinus thrombosis, Sheehan's syndrome, hypoxic ischemic encephalopathy (secondary to pulmonary amniotic fluid embolism), multifocal infarctions, and extra-potine myelinolysis. The recognition of the various imaging findings of these diseases, along with the clinical presentations should aid in their early diagnosis and prompt treatment. The purpose of this pictorial assay is to describe the characteristic CT and MR findings of these diseases with a literature review to explain the mechanisms and clinical symptoms.

  15. Fear of childbirth and emergency caesarean section in low-risk nulliparous women

    DEFF Research Database (Denmark)

    Jespersen, Cecilie; Hegaard, Hanne Kristine; Schroll, Anne-Mette

    2014-01-01

    OBJECTIVE: To assess the association between fear of childbirth (FOC) and emergency caesarean section. DESIGN: A prospective cohort study of low-risk nulliparous women at term. SETTING: Nine obstetric departments in Denmark, May 2004-July 2005. POPULATION: A total of 2598 nulliparous women...... in spontaneous labor with a single fetus in cephalic presentation at term. METHODS: Self-reported FOC was assessed at 37 weeks of gestation by the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) version A and at admission to the labor ward by the Delivery Fear Scale (DFS). Mode of delivery...... was recorded by the attending staff. Logistic regression analyses were used to estimate unadjusted and adjusted odds ratios (OR). MAIN OUTCOME MEASURES: Risk of emergency caesarean section in women who feared childbirth. RESULTS: FOC (W-DEQ sum score ≥ 85 and DFS sum score ≥ 70) was not associated...

  16. Obstetric violence: A Latin American legal response to mistreatment during childbirth.

    Science.gov (United States)

    Williams, Caitlin R; Jerez, Celeste; Klein, Karen; Correa, Malena; Belizán, José M; Cormick, Gabriela

    2018-05-04

    Over the last several years, a new legal construct has emerged in Latin America that encompasses elements of quality of obstetric care and mistreatment of women during childbirth - both issues of global maternal health import. Termed "obstetric violence," this legal construct refers to disrespectful and abusive treatment that women may experience from health care providers during pregnancy, childbirth, and the postpartum period, as well as other elements of poor quality care, such as failure to adhere to evidence-based best practices. This new legal term emerged out of concerted efforts by women's groups and networks, feminists, professional organizations, international and regional bodies, and public health agents and researchers to improve the quality of care that women receive across the region. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  17. CT and MR findings of neurological disorders associated with pregnancy and childbirth

    International Nuclear Information System (INIS)

    Kim, Jee Young; Ahn, Kook Jin; Kim, Young Joo; Kim, Bum Soo; Hahn, Seong Tae

    2008-01-01

    The onset of pregnancy may predispose women to a variety of neurological diseases due to changes in their hemodynamics, hormonal effects, and complications associated with childbirth. The spectrum of neurological disorders associated with pregnancy and childbirth include hypertensive intracerebral hemorrhaging, posterior reversible encephalopathy syndrome (PRES) (secondary to eclampsia), Wernicke encephalopathy, cerebral venous sinus thrombosis, Sheehan's syndrome, hypoxic ischemic encephalopathy (secondary to pulmonary amniotic fluid embolism), multifocal infarctions, and extra-potine myelinolysis. The recognition of the various imaging findings of these diseases, along with the clinical presentations should aid in their early diagnosis and prompt treatment. The purpose of this pictorial assay is to describe the characteristic CT and MR findings of these diseases with a literature review to explain the mechanisms and clinical symptoms

  18. Retailing research: increasing the role of evidence in clinical services for childbirth.

    Science.gov (United States)

    Lomas, J

    1993-01-01

    A current review of the structures and assumptions of research transfer for clinical care reveals some progress from "passive diffusion" to "active dissemination" models, but little or no progress has been made toward targeting local influences on practitioner behavior for "coordinated implementation" of clinically relevant research into childbirth (or other) medical practices. The implementation of scientifically valid research syntheses, such as Effective Care in Pregnancy and Childbirth (ECPC), is therefore constrained by a poorly developed marketplace for retailing research information to practitioners. A survey in Canada of the four most significant potential retailing groups demonstrated that whereas clinical and community groups were adopting the necessary knowledge and attitudes, public policy makers and administrators trailed well behind them. To increase the probability of thorough retailing of ECPC, a three-phase plan could be instituted that would identify product champions within potential retailing groups, develop implementation activities for each retailing group, and convene annual conferences.

  19. Do pregnant women know about danger signs of pregnancy and childbirth? – A study of the level of knowledge and its associated factors from a tertiary care hospital in Southern India

    Directory of Open Access Journals (Sweden)

    R Nithya

    2017-01-01

    Full Text Available Background: Awareness about danger signs during pregnancy is essential for a woman to seek prompt care. This can avert long-term morbidity and mortality. This study was aimed to find the level of knowledge and its related factors about danger signs of pregnancy and childbirth among pregnant women attending a tertiary care hospital in southern India. Patients and Methods: We conducted a cross-sectional survey of pregnant women attending a tertiary care hospital in South India. Systematic random sampling of every 10th woman exiting the antenatal clinic was done. Results: We studied 382 pregnant women. Of them, 188 (49.2% [95% confidence interval (CI: 44%–54%], 104 (27.2% [95% CI: 23%–32%], and 81 (21.2% [95% CI: 17%–26%] women had sufficient knowledge about danger signs during pregnancy, labor, and childbirth, respectively. On multivariable analysis, lack of exposure to formal awareness raising health counseling classes was the only factor found to be significantly associated with a lack of knowledge about danger signs of pregnancy (adjusted prevalence ratio, 95% CI: 1.8 [1.2–2.7] and after childbirth (1.4 [1.1–1.7]. Lower education level was significantly associated with a lack of knowledge about danger signs of labor (1.2 [1.1–1.4]. Conclusion: We found that lack of exposure to formal awareness raising health counseling classes is a modifiable risk factor to improve knowledge about danger signs. We recommend structured mandatory health awareness sessions addressing the danger signs of pregnancy and child health to all pregnant women.

  20. Prolonged sexual abstinence after childbirth: gendered norms and perceived family health risks. Focus group discussions in a Tanzanian suburb.

    Science.gov (United States)

    Mbekenga, Columba K; Pembe, Andrea B; Darj, Elisabeth; Christensson, Kyllike; Olsson, Pia

    2013-01-15

    Prolonged sexual abstinence after childbirth is a socio-cultural practice with health implications, and is described in several African countries, including Tanzania. This study explored discourses on prolonged postpartum sexual abstinence in relation to family health after childbirth in low-income suburbs of Dar es Salaam, Tanzania. Data for the discourse analysis were collected through focus group discussions with first-time mothers and fathers and their support people in Ilala, Dar es Salaam, Tanzania. In this setting, prolonged sexual abstinence intended at promoting child health was the dominant discourse in the period after childbirth. Sexual relations after childbirth involved the control of sexuality for ensuring family health and avoiding the social implications of non-adherence to sexual abstinence norms. Both abstinence and control were emphasised more with regard to women than to men. Although the traditional discourse on prolonged sexual abstinence for protecting child health was reproduced in Ilala, some modern aspects such as the use of condoms and other contraceptives prevailed in the discussion. Discourses on sexuality after childbirth are instrumental in reproducing gender-power inequalities, with women being subjected to more restrictions and control than men are. Thus, interventions that create openness in discussing sexual relations and health-related matters after childbirth and mitigate gendered norms suppressing women and perpetuating harmful behaviours are needed. The involvement of males in the interventions would benefit men, women, and children through improving the gender relations that promote family health.

  1. Smoking in the home after childbirth: prevalence, determinants and the relationship to smoking in pregnancy

    OpenAIRE

    Orton, Sophie

    2016-01-01

    Childhood secondhand smoke (SHS) exposure causes substantial ill health and mortality, and poses a significant economic and social burden. This thesis aimed to explore the prevalence and determinants of smoking in the home after childbirth, and to understand the experience and attitudes of mothers who stop smoking during pregnancy but relapse soon after delivery.\\ud \\ud \\ud In study one, the factors associated with child SHS exposure in the home were systematically reviewed. Parental smoking,...

  2. Prediction of posttraumatic stress disorder symptomatology after childbirth - A Croatian longitudinal study.

    Science.gov (United States)

    Srkalović Imširagić, Azijada; Begić, Dražen; Šimičević, Livija; Bajić, Žarko

    2017-02-01

    Following childbirth, a vast number of women experience some degree of mood swings, while some experience symptoms of postpartum posttraumatic stress disorder. Using a biopsychosocial model, the primary aim of this study was to identify predictors of posttraumatic stress disorder and its symptomatology following childbirth. This observational, longitudinal study included 372 postpartum women. In order to explore biopsychosocial predictors, participants completed several questionnaires 3-5 days after childbirth: the Impact of Events Scale Revised, the Big Five Inventory, The Edinburgh Postnatal Depression Scale, breastfeeding practice and social and demographic factors. Six to nine weeks after childbirth, participants re-completed the questionnaires regarding psychiatric symptomatology and breastfeeding practice. Using a multivariate level of analysis, the predictors that increased the likelihood of postpartum posttraumatic stress disorder symptomatology at the first study phase were: emergency caesarean section (odds ratio 2.48; confidence interval 1.13-5.43) and neuroticism personality trait (odds ratio 1.12; confidence interval 1.05-1.20). The predictor that increased the likelihood of posttraumatic stress disorder symptomatology at the second study phase was the baseline Impact of Events Scale Revised score (odds ratio 12.55; confidence interval 4.06-38.81). Predictors that decreased the likelihood of symptomatology at the second study phase were life in a nuclear family (odds ratio 0.27; confidence interval 0.09-0.77) and life in a city (odds ratio 0.29; confidence interval 0.09-0.94). Biopsychosocial theory is applicable to postpartum psychiatric disorders. In addition to screening for depression amongst postpartum women, there is a need to include other postpartum psychiatric symptomatology screenings in routine practice. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  3. Facilitators and barriers in the humanization of childbirth practice in Japan

    Directory of Open Access Journals (Sweden)

    Goulet Lise

    2010-05-01

    Full Text Available Abstract Background Humanizing birth means considering women's values, beliefs, and feelings and respecting their dignity and autonomy during the birthing process. Reducing over-medicalized childbirths, empowering women and the use of evidence-based maternity practice are strategies that promote humanized birth. Nevertheless, the territory of birth and its socio-cultural values and beliefs concerning child bearing can deeply affect birthing practices. The present study aims to explore the Japanese child birthing experience in different birth settings where the humanization of childbirth has been indentified among the priority goals of the institutions concerned, and also to explore the obstacles and facilitators encountered in the practice of humanized birth in those centres. Methods A qualitative field research design was used in this study. Forty four individuals and nine institutions were recruited. Data was collected through observation, field notes, focus groups, informal and semi-structured interviews. A qualitative content analysis was performed. Results All the settings had implemented strategies aimed at reducing caesarean sections, and keeping childbirth as natural as possible. The barriers and facilitators encountered in the practice of humanized birth were categorized into four main groups: rules and strategies, physical structure, contingency factors, and individual factors. The most important barriers identified in humanized birth care were the institutional rules and strategies that restricted the presence of a birth companion. The main facilitators were women's own cultural values and beliefs in a natural birth, and institutional strategies designed to prevent unnecessary medical interventions. Conclusions The Japanese birthing institutions which have identified as part of their mission to instate humanized birth have, as a whole, been successful in improving care. However, barriers remain to achieving the ultimate goal

  4. A longitudinal study of women’s memories of their childbirth experiences at five years postpartum

    OpenAIRE

    Takehara, Kenji; Noguchi, Makiko; Shimane, Takuya; Misago, Chizuru

    2014-01-01

    Background Few studies have investigated whether women can accurately recall their birthing experiences after a long period. We investigated the consistency of women’s memories of their childbirth experiences between those at a few days postpartum and 5 years later. Methods This prospective cohort study comprised 1,168 women who delivered at a maternity hospital and four maternity homes in Japan between May 2002 and August 2003. Data were collected using structured interviews and transcriptio...

  5. Distance, accessibility and costs. Decision-making during childbirth in rural Sierra Leone: A qualitative study.

    Directory of Open Access Journals (Sweden)

    Laura Treacy

    Full Text Available Sierra Leone has one of the highest maternal mortality ratios in the world. Efforts to reduce maternal mortality have included initiatives to encourage more women to deliver at health facilities. Despite the introduction of the free health care initiative for pregnant women, many women still continue to deliver at home, with few having access to a skilled birth attendant. In addition, inequalities between rural and urban areas in accessing and utilising health facilities persist. Further insight into how and why women make decisions around childbirth will help guide future plans and initiatives in improving maternal health in Sierra Leone. The objective of this study was to explore the perceptions and decision-making processes of women and their communities during childbirth in rural Sierra Leone.Data were collected through seven focus group discussions and 22 in-depth interviews with recently pregnant women and their community members in two rural villages. Data were analysed using systematic text condensation. Findings revealed that decision-making processes during childbirth are dynamic, intricate and need to be understood within the broader social context that they take place. Factors such as distance and lack of transport, perceived negative behaviour of hospital staff, direct and indirect financial obstacles, as well as the position of women in society all interact and influence how and what decisions are made.Pregnant women face multiple interacting vulnerabilities that influence their healthcare-seeking decisions during pregnancy and childbirth. Future initiatives to improve access and utilisation of safe healthcare services for pregnant women need to be based on adequate knowledge of structural constraints and health inequities that affect women in rural Sierra Leone.

  6. Birth preference in women undergoing treatment for childbirth fear: A randomised controlled trial.

    Science.gov (United States)

    Larsson, Birgitta; Karlström, Annika; Rubertsson, Christine; Ternström, Elin; Ekdahl, Johanna; Segebladh, Birgitta; Hildingsson, Ingegerd

    2017-12-01

    Childbirth fear is the most common underlying reason for requesting a caesarean section without medical reason. The aim of this randomised controlled study was to investigate birth preferences in women undergoing treatment for childbirth fear, and to investigate birth experience and satisfaction with the allocated treatment. Pregnant women classified with childbirth fear (≥60 on the Fear Of Birth Scale) (n=258) were recruited at one university hospital and two regional hospitals over one year. The participants were randomised (1:1) to intervention (Internet-based Cognitive Behaviour Therapy (ICBT)) (n=127) or standard care (face-to-face counselling) (n=131). Data were collected by questionnaires in pregnancy week 20-25 (baseline), week 36 and two months after birth. Caesarean section preference decreased from 34% to 12% in the ICBT group and from 24% to 20% in the counselling group. Two months after birth, the preference for caesarean increased to 20% in the ICBT group and to 29% in the counselling group, and there was no statistically significant change over time. Women in the ICBT group were less satisfied with the treatment (OR 4.5). The treatment had no impact on or worsened their childbirth fear (OR 5.5). There were no differences between the groups regarding birth experience. Women's birth preferences fluctuated over the course of pregnancy and after birth regardless of treatment method. Women felt their fear was reduced and were more satisfied with face-to-face counselling compared to ICBT. A higher percentage were lost to follow-up in ICBT group suggesting a need for further research. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  7. Determinants of use of health facility for childbirth in rural Hadiya zone, Southern Ethiopia.

    Science.gov (United States)

    Asseffa, Netsanet Abera; Bukola, Fawole; Ayodele, Arowojolu

    2016-11-16

    Maternal mortality remains a major global public health concern despite many international efforts. Facility-based childbirth increases access to appropriate skilled attendance and emergency obstetric care services as the vast majority of obstetric complications occur during delivery. The purpose of the study was to determine the proportion of facility delivery and assess factors influencing utilization of health facility for childbirth. A cross-sectional study was conducted in two rural districts of Hadiya zone, southern Ethiopia. Participants who delivered within three years of the survey were selected by stratified random sampling. Trained interviewers administered a pre-tested semi-structured questionnaire. We employed bivariate analysis and logistic regression to identify determinants of facility-based delivery. Data from 751 participants showed that 26.9% of deliveries were attended in health facilities. In bivariate analysis, maternal age, education, husband's level of education, possession of radio, antenatal care, place of recent ANC attended, planned pregnancy, wealth quintile, parity, birth preparedness and complication readiness, being a model family and distance from the nearest health facility were associated with facility delivery. On multiple logistic regression, age, educational status, antenatal care, distance from the nearest health facility, wealth quintile, being a model family, planned pregnancy and place of recent ANC attended were the determinants of facility-based childbirth. Efforts to improve institutional deliveries in the region must strengthen initiatives that promote female education, opportunities for wealth creation, female empowerment and increased uptake of family planning among others. Service related barriers and cultural influences on the use of health facility for childbirth require further evaluation.

  8. Childbirth and Diagnosis Related Groups (DRGs): patient classification and hospital reimbursement in 11 European countries.

    Science.gov (United States)

    Bellanger, Martine M; Quentin, Wilm; Tan, Siok Swan

    2013-05-01

    The study compares how Diagnosis-Related Group (DRG) based hospital payment systems in eleven European countries (Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Spain, and Sweden) deal with women giving birth in hospitals. It aims to assist gynaecologists and national authorities in optimizing their DRG systems. National or regional databases were used to identify childbirth cases. DRG grouping algorithms and indicators of resource consumption were compared for those DRGs which account for at least 1% of all childbirth cases in the respective database. Five standardized case vignettes were defined and quasi prices (i.e. administrative prices or tariffs) of hospital deliveries according to national DRG-based hospital payment systems were ascertained. European DRG systems classify childbirth cases according to different sets of variables (between one and eight variables) into diverging numbers of DRGs (between three and eight DRGs). The most complex DRG is valued 3.5 times more resource intensive than an index case in Ireland but only 1.1 times more resource intensive than an index case in The Netherlands. Comparisons of quasi prices for the vignettes show that hypothetical payments for the most complex case amount to only € 479 in Poland but to € 5532 in Ireland. Differences in the classification of hospital childbirth cases into DRGs raise concerns whether European systems rely on the most appropriate classification variables. Physicians, hospitals and national DRG authorities should consider how other countries' DRG systems classify cases to optimize their system and to ensure fair and appropriate reimbursement. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  9. Qualitative study of pregnancy and childbirth experiences in Somalian women resident in Sweden.

    Science.gov (United States)

    Essén, B; Johnsdotter, S; Hovelius, B; Gudmundsson, S; Sjöberg, N O; Friedman, J; Ostergren, P O

    2000-12-01

    To explore the attitudes, strategies and habits of Somalian immigrant women related to pregnancy and childbirth, in order to gain an understanding as to how cultural factors might affect perinatal outcome. Interpreter assisted qualitative in depth interviews around topics such as attitudes and strategies regarding childbirth. Fifteen women from the Somalian community in a city in Sweden, between the ages of 20 and 55 years with delivery experience in Somalia and Sweden. The interviews describe how the women themselves perceived their experiences of childbirth in the migrant situation. Many voluntarily decreased food intake in order to have a smaller fetus, an easier delivery and to avoid caesarean section. The participants considered a safe delivery to be the same as a normal vaginal delivery They reduced food intake in order to diminish the growth of the fetus, thereby avoiding caesarean section and mortality. The practice of food intake reduction, while rational for the participants when in Somalia, was found less rational in Sweden and may lead to suboptimal obstetric surveillance. Somalian women have childbirth strategies that differ from those of Swedish women. These strategies should be seen as 'survival behaviours' related to their background in an environment with high maternal mortality. The hypothesis generated is that there is a relationship between the strategies during pregnancy and adverse perinatal outcome among Somalian immigrants. Considering the strong association of the habits to safe birth, it seems doubtful whether the women will change their habits as long as health care providers are unaware of their motives. We suggest a more culturally sensitive perinatal surveillance.

  10. Examining the Association of Antidepressant Prescriptions With First Abortion and First Childbirth

    DEFF Research Database (Denmark)

    Steinberg, Julia R; Laursen, Thomas M; Adler, Nancy E

    2018-01-01

    : IRR, 1.12; 95% CI, 1.05-1.18). The fully adjusted IRRs that compared women who gave birth with women who did not give birth were lower in the year before childbirth (IRR, 0.47; 95% CI, 0.43-0.50) compared with the year after childbirth (IRR, 0.93; 95% CI, 0.88-0.98) (P ... with women who did not have an abortion were not statistically different in the year before the abortion (IRR, 1.46; 95% CI, 1.38-1.54) and the year after the abortion (IRR, 1.54; 95% CI, 1.45-1.62) (P = .10) and decreased as time from the abortion increased (1-5 years: IRR, 1.24; 95% CI, 1.19-1.29; >5 years...... from the childbirth increased (1-5 years: IRR, 1.52; 95% CI, 1.47-1.56; >5 years: IRR, 1.99; 95% CI, 1.91-2.09). Across all women in the sample, the strongest risk factors associated with antidepressant use in the fully adjusted model were having a previous psychiatric contact (IRR, 3.70; 95% CI, 3...

  11. Women's employment patterns after childbirth and the perceived access to and use of flexitime and teleworking.

    Science.gov (United States)

    Chung, Heejung; van der Horst, Mariska

    2018-01-01

    This article sets out to investigate how flexitime and teleworking can help women maintain their careers after childbirth. Despite the increased number of women in the labour market in the UK, many significantly reduce their working hours or leave the labour market altogether after childbirth. Based on border and boundary management theories, we expect flexitime and teleworking can help mothers stay employed and maintain their working hours. We explore the UK case, where the right to request flexible working has been expanded quickly as a way to address work-life balance issues. The dataset used is Understanding Society (2009-2014), a large household panel survey with data on flexible work. We find some suggestive evidence that flexible working can help women stay in employment after the birth of their first child. More evidence is found that mothers using flexitime and with access to teleworking are less likely to reduce their working hours after childbirth. This contributes to our understanding of flexible working not only as a tool for work-life balance, but also as a tool to enhance and maintain individuals' work capacities in periods of increased family demands. This has major implications for supporting mothers' careers and enhancing gender equality in the labour market.

  12. Good practices in normal childbirth: reliability analysis of an instrument by Cronbach's Alpha.

    Science.gov (United States)

    Gottems, Leila Bernarda Donato; Carvalho, Elisabete Mesquita Peres De; Guilhem, Dirce; Pires, Maria Raquel Gomes Maia

    2018-01-01

    to analyze the internal consistency of the evaluation instrument of the adherence to the good practices of childbirth and birth care in the professionals, through Cronbach's Alpha Coefficient for each of the dimensions and for the total instrument. this is a descriptive and cross-sectional study performed in obstetric centers of eleven public hospitals in the Federal District, with a questionnaire applied to 261 professionals who worked in the delivery care. The study was attended by 261 professionals, 42.5% (111) nurses and 57.5% (150) physicians. The reliability evaluation of the instrument by the Cronbach Alfa resulted in 0.53, 0.78 and 0.76 for dimensions 1, 2 and 3, after debugging that resulted in the exclusion of 11 items. the instrument obtained Cronbach's alpha of 0.80. There is a need for improvement in the items of dimension 1 that refer to attitudes, knowledge, and practices of the organization of the network of care to gestation, childbirth, and birth. However, it can be applied in the way it is used to evaluate practices based on scientific evidence of childbirth care.

  13. Patterns of attention and experiences of post-traumatic stress symptoms following childbirth: an experimental study.

    Science.gov (United States)

    Dale-Hewitt, Vanessa; Slade, Pauline; Wright, Ingram; Cree, Michelle; Tully, Chris

    2012-08-01

    Childbirth for some women can be experienced as a traumatic event whereby it is appraised as threatening to life and associated with feelings of fear, helplessness or horror. These women may develop symptoms consistent with post-traumatic stress disorder or its sub-clinical symptoms (post-traumatic stress, PTS). Cognitive processes such as attentional biases have been identified in individuals with PTS exposed to other traumatic events. This study used an experimental design (the modified Stroop task) to investigate the relationship between attentional biases and PTS symptoms in 50 women who experienced their labour and delivery as stressful and responded with fear, helplessness and horror. Attentional biases away from childbirth words were significantly associated with both symptoms of post-traumatic stress and more negative experiences of childbirth. A negative experience was also associated with more severe symptoms of PTS. Positive experiences were unassociated with attentional biases or symptoms. Post-traumatic stress responses, in this population, may be associated with avoidance, and through influencing cognitive processing, acting as a maintaining factor of distress.

  14. The Impact of Childbirth on Sexual Functioning in Women With Episiotomy

    Directory of Open Access Journals (Sweden)

    Isabel Leal

    2013-11-01

    Full Text Available Objective: To compare the pregnancy period with the postpartum period, and infer if the presence of episiotomy interferes with the experience of female sexuality after childbirth. Method: This is an exploratory and descriptive, quantitative study. A non-probability, convenience sample of 108 women in the first stage (during pregnancy, and of 93 women in the second stage (after birth, was gathered in the Obstetrics and Gynaecology Service of a Portuguese hospital. The Female Sexual Function Index and a socio-demographic/clinical questionnaire were used for data collection. Results: Women that had an episiotomy/episiorrhaphy presented higher mean levels of sexual satisfaction after birth, lower mean levels of sexual desire, sexual arousal, and vaginal lubrication after delivery. Regarding the orgasm, they presented higher mean levels in the postpartum period. Statistical significant differences were found regarding the pain levels, as women with episiotomy presented a significantly higher intensity of pain during sexual intercourse after childbirth than during the pregnancy. Conclusion: The overall sexual function after childbirth did not present significant differences when compared to the pregnancy period. However, there was an exception regarding the pain, which was significantly higher in the postpartum period.

  15. Transfer from home to hospital: what is its effect on the experience of childbirth?

    Science.gov (United States)

    Wiegers, T A; van der Zee, J; Keirse, M J

    1998-03-01

    In the Netherlands women with low-risk pregnancies are free to choose where to give birth, at home or in hospital, attended by an independent midwife or general practitioner. On average one of five women who remains in the care of a midwife at the onset of labor will be referred to an obstetrician during or shortly after childbirth. If women had planned to give birth at home, they would then have to be transferred to the hospital. Postal questionnaires were sent to 2301 pregnant women before and after birth to measure the experience of childbirth, appropriateness of the chosen place of birth, satisfaction with the birth, midwife's care, and first days postpartum of women planning to give birth at home or in hospital. The response rate for both questionnaires was 89.3 percent. Of 745 nulliparous women and 895 multiparous women, 39.3 and 10.3 percent, respectively, experienced referral to an obstetrician during labor. Of these women, the ones who wanted to give birth at home but were transferred to hospital because of the referral were as positive about the birth, early puerperium, and attendance of the midwife as the women who wanted to give birth in hospital. Our research showed, contrary to expectations, that an unplanned transfer from a planned home birth to hospital has little influence on the experience of childbirth.

  16. Economic crisis and women's labor force return after childbirth: Evidence from South Korea

    Directory of Open Access Journals (Sweden)

    Li Ma

    2014-08-01

    Full Text Available Background: Most research on women's labor force return after childbirth concentrates on industrialized countries in the West; the link between economic swings and mothers' work-return behavior is rarely addressed. This study closes these gaps by focusing on South Korea, a developed society in East Asia that has in recent decades witnessed increases in female labor force participation and dramatic economic ups and downs. This is the first relevant study on South Korea. Objective: This study examines how women's labor force return after childbirth (with and without career interruption and their career prospects upon work return varied before, during, and after the Asian financial crisis in South Korea. Methods: Logistic and hazard regression models were applied to the Korea Labor and Income Panel Study (KLIPS waves 1-10. Results: The study reveals an increase in women's immediate work return after childbirth without career interruption since the 1980s. The Asian financial crisis boosted this immediate return pattern. The implementation of job-protected maternity leave further contributed to this pattern. Women who underwent career interruption at first birth were also more likely to re-enter the labor market during and after the crisis than before. Downward occupational moves were especially common during the period of financial crisis. Conclusions: The results suggest that the Asian financial crisis triggered a noticeable change in women's post-birth work-return behavior. The economic volatility pushed mothers to hold onto their role in the labor force more strongly than before.

  17. Features of pregnancy and childbirth in women with congenital malformations of the fetus development

    Directory of Open Access Journals (Sweden)

    S. R. Halych

    2015-03-01

    Odessa National Medical University   Key words: pregnancy, childbirth, women, congenital malformations, fetus development.   Abstract   There is a very high percentage (39.8% of  childbirth at the age of 30 years old and more. Pregnant patients with CMF are subjects to complications, including predominating placental dysfunction (46.7%, which manifested itself in the form of fetus’s development retardation (26.3%, hypamnion (13.5% or a combination of fetus’s development retardation and hypamnion (6.9 %. Early preeclampsia (40%, threatened miscarriage (35%, hydramnios (19.03%, preeclampsia (25%, wrong position of the fetus and placenta (20% are among other complications of pregnancy course. Parturient women who had fetal birth defects developed complications of childbirth, including a violation of the child’s state (fetal distress - 31%, and abnormal contractions (anomalies of labor activity - 18%; premature rupture of the amniotic membranes - 18%. The high frequency of operative delivery by cesarean section (47% needs further careful analysis of the indications.

  18. 'Drawing aside the curtain': natural childbirth on screen in 1950s Britain.

    Science.gov (United States)

    Al-Gailani, Salim

    2017-09-01

    This article recovers the importance of film, and its relations to other media, in communicating the philosophies and methods of 'natural childbirth' in the post-war period. It focuses on an educational film made in South Africa around 1950 by controversial British physician Grantly Dick-Read, who had achieved international fame with bestselling books arguing that relaxation and education, not drugs, were the keys to freeing women from pain in childbirth. But he soon came to regard the 'vivid' medium of film as a more effective means of disseminating the 'truth of [his] mission' to audiences who might never have read his books. I reconstruct the history of a film that played a vital role in teaching Dick-Read's method to both the medical profession and the first generation of Western women to express their dissatisfaction with highly drugged, hospitalized maternity care. The article explains why advocates of natural childbirth such as Dick-Read became convinced of the value of film as a tool for recruiting supporters and discrediting rivals. Along the way, it offers insight into the British medical film industry and the challenges associated with producing, distributing and screening a depiction of birth considered unusually graphic for the time.

  19. Understanding childbirth practices as an organizational cultural phenomenon: a conceptual framework.

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    Behruzi, Roxana; Hatem, Marie; Goulet, Lise; Fraser, William; Misago, Chizuru

    2013-11-11

    Understanding the main values and beliefs that might promote humanized birth practices in the specialized hospitals requires articulating the theoretical knowledge of the social and cultural characteristics of the childbirth field and the relations between these and the institution. This paper aims to provide a conceptual framework allowing examination of childbirth practices through the lens of an organizational culture theory. A literature review performed to extrapolate the social and cultural factors contribute to birth practices and the factors likely overlap and mutually reinforce one another, instead of complying with the organizational culture of the birth place. The proposed conceptual framework in this paper examined childbirth patterns as an organizational cultural phenomenon in a highly specialized hospital, in Montreal, Canada. Allaire and Firsirotu's organizational culture theory served as a guide in the development of the framework. We discussed the application of our conceptual model in understanding the influences of organizational culture components in the humanization of birth practices in the highly specialized hospitals and explained how these components configure both the birth practice and women's choice in highly specialized hospitals. The proposed framework can be used as a tool for understanding the barriers and facilitating factors encountered birth practices in specialized hospitals.

  20. Class Cuisine: Food in the Foreign Language Class.

    Science.gov (United States)

    Rauschenberg, Gretchen S.

    1984-01-01

    Food can both interest students in a foreign culture and motivate them to broaden their interests. Cooking with students can take many forms. The students can cook in class if adequate preparations are made and permission is granted. Students can contribute toward the purchase of food for snacks and meals, and the cost can be kept to the price of…

  1. [Fear of childbirth among nulliparous women: Relations with pain during delivery, post-traumatic stress symptoms, and postpartum depressive symptoms].

    Science.gov (United States)

    Gosselin, P; Chabot, K; Béland, M; Goulet-Gervais, L; Morin, A J S

    2016-04-01

    Fear of childbirth is common in women who are pregnant with their first child and is associated with important consequences such as abortions and miscarriages. Twenty percent of nulliparous women seem to exhibit a mild or moderate fear, while 6% present an excessive and irrational fear known as tocophobia. Tocophobia is suggested to be associated with many negative consequences such as postpartum depression (PPD) and Post-traumatic stress (PTS). However, there is little empirical evidence to support these relationships. Recently, Fairbrother and Woody (2007) did not observe a link between the fear of childbirth and symptoms of PPD and PTS in nulliparous women. Some results, near the significance level, could be explained by a lack of statistical power. The present study focused on the link between the fear of childbirth and the process of delivery, the perception of pain, PPD and PTS. More specifically, it aimed to test three hypotheses: (i) fear of childbirth will be linked to the process of delivery, especially regarding the perception of pain, the use of anaesthesia and the use of Caesarean section; (ii) a high level of fear of childbirth will be associated with more negative postpartum consequences (namely PPD/PTS symptoms); (iii) the process of delivery and pain will also be related to post-delivery symptoms. Mediation effects were tested. Data from a longitudinal study were used to meet the hypotheses. A total of 176 nulliparous pregnant women responded to questionnaires at two time measurements (during pregnancy and at 5weeks postpartum). Fear of childbirth is related to the perception of pain at birth among women delivering vaginally, in the absence of anaesthesia. It is also linked to symptoms of PPD and PTS, regardless of whether or not anaesthesia was used. Fear of childbirth also appears to be strongly associated to symptoms of PTS in women who have experienced an unplanned caesarean section. Thus, symptoms of postpartum PTS could play a mediating role

  2. Weight six years after childbirth: a follow-up of obese women in a weight-gain restriction programmme.

    Science.gov (United States)

    Claesson, Ing-Marie; Josefsson, Ann; Sydsjö, Gunilla

    2014-05-01

    to compare weight development in an intervention group and a control group, six years after participation in a gestational weight-gain restriction programme. follow-up of a prospective intervention study. antenatal care clinics. a total of 129 women (88.4%) from the original intervention group and 166 women (88.8%) from the original control group. the women answered a study specific questionnaire, covering socio-demographic data and health- and weight status. after adjusting for socio-demographic factors, the mean weight was lower (4.1kg) among the women in the intervention group, compared to the controls (p=0.028). Furthermore, the mean weight change, e.g. the weight at the six year assessment compared with the weight at the start of the intervention at the first antenatal care visit, was greater in the intervention group than in the control group. The women in the intervention group had a larger mean weight change (-5.2kg), e.g. weighed less than the women in the control group (-1.9kg) (p=0.046). Mean weight change expressed in 5kg classes also showed a significant difference between the two groups (p=0.030). the results indicate that attending a gestational weight-gain-restriction programme can have a positive effect on weight up to six years after the intervention. a restrictive gestational weight gain can result in a positive weight development during the first years after childbirth. It might provide both short- and long term medical health benefits for the mother as well as the child. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. The paradox of vaginal examination practice during normal childbirth: Palestinian women’s feelings, opinions, knowledge and experiences

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    Hassan Sahar J

    2012-08-01

    Full Text Available Abstract Background Vaginal examination (VE, is a frequent procedure during childbirth. It is the most accepted ways to assess progress during childbirth, but its repetition at short intervals has no value. Over years, VE continued to be plagued by a nature that implies negative feelings and experiences of women. The aim of this exploratory qualitative study was to explore women’s feelings, opinions, knowledge and experiences of vaginal examinations (VE during normal childbirth. Methods We interviewed 176 postpartum women using semi-structured questionnaire in a Palestinian public hospital in the oPt. Descriptive statistics were conducted; frequency counts and percentages for the quantitative questions. The association between the frequency of VE and age, parity, years of education, locale and the time of delivery was tested by Chi-squared and Fisher’s Exact test. The open-ended qualitative questions were read line-by-line for the content and coded. The assigned codes for all responses were entered to the SPSS statistical software version 18. Results As compared with WHO recommendations, VE was conducted too frequently, and by too many providers during childbirth. The proportion of women who received a ‘too high’ frequency of VEs during childbirth was significantly larger in primipara as compared to multipara women (P = .037. 82% of women reported pain or severe pain and 68% reported discomfort during VE. Some women reported insensitive approaches of providers, insufficient means of privacy and no respect of dignity or humanity during the exam. Conclusions Palestinian women are undergoing unnecessary and frequent VEs during childbirth, conducted by several different providers and suffer pain and discomfort un-necessarily. Practice implications Adhering to best evidence, VE during childbirth should be conducted only when necessary, and if possible, by the same provider. This will decrease the laboring women’s unnecessary suffering

  4. Assessing Factors that affect Childbirth Choices of People living positively with HIV/AIDS in Abia State of Nigeria.

    Science.gov (United States)

    Enwereji, Ezinne E; Enwereji, Kelechi O

    2010-04-01

    Poor interpersonal relationships with women especially those living positively with HIV/AIDS can make them take risks that would expose their new born and others to infection during childbirth. The factors that influence childbirth choices of people living positively with HIV/AIDS (PLWHA) deserve attention. Sometimes, women, especially PLWHA, for several reasons, resort to the use of other health care services instead of the general hospitals equipped for ante-natal care (ANC). This study aims to identify factors and conditions that determine childbirth choices of PLWHA in the Abia State of Nigeria. A cross-sectional descriptive study was carried out using a total sample of 96 PLWHA who attend meetings with the network of PLWHA and also a purposive convenience sample of 45 health workers. Data collection instruments were questionnaire, focus group discussions and interview guides. Data was analyzed both qualitatively and quantitatively using simple percentages. There was a low patronage for hospital services. A total of 79 (82%) PLWHA did not use hospital services due to the lack of confidentiality. In total, 61 (64%) PLWHA had their childbirth with Traditional Birth Attendants (TBAs) at home. Embarrassment, rejection, interpersonal conflicts with health workers, non-confidentiality, cultural stigma and stigmatization were among the factors that encouraged childbirth choices. On the whole, 82 (85%) of the PLWHA discontinued ANC services because of stigmatization. Poor interpersonal relationships between health workers and PLWHA facilitated PLWHA childbirth choices more than other factors. PLWHA and health workers termed management of belligerent tendencies against each other as their greatest concern. Therefore, concerted effort is needed to improve health workers/PLWHA relationship in hospitals. This would minimize factors and/or conditions that encourage HIV infection. Exposing PLWHA to factors that influence childbirth at home demonstrates high risks of mother

  5. Assessing Factors that affect Childbirth Choices of People living positively with HIV/AIDS in Abia State of Nigeria

    Directory of Open Access Journals (Sweden)

    Ezinne E. Enwereji

    2010-04-01

    Full Text Available Objectives: Poor interpersonal relationships with women especially those living positively with HIV/AIDS can make them take risks that would expose their new born and others to infection during childbirth. The factors that influence childbirth choices of people living positively with HIV/AIDS (PLWHA deserve attention. Sometimes, women, especially PLWHA, for several reasons, resort to the use of other health care services instead of the general hospitals equipped for ante-natal care (ANC. This study aims to identify factors and conditions that determine childbirth choices of PLWHA in the Abia State of Nigeria.Methods:A cross-sectional descriptive study was carried out using a total sample of 96 PLWHA who attend meetings with the network of PLWHA and also a purposive convenience sample of 45 health workers. Data collection instruments were questionnaire, focus group discussions and interview guides. Data was analyzed both qualitatively and quantitatively using simple percentages.Results: There was a low patronage for hospital services. A total of 79 (82% PLWHA did not use hospital services due to the lack of confidentiality. In total, 61 (64% PLWHA had their childbirth with Traditional Birth Attendants (TBAs at home. Embarrassment, rejection, interpersonal conflicts with health workers, non-confidentiality, cultural stigma and stigmatization were among the factors that encouraged childbirth choices. On the whole, 82 (85% of the PLWHA discontinued ANC services because of stigmatization.Conclusion: Poor interpersonal relationships between health workers and PLWHA facilitated PLWHA childbirth choices more than other factors. PLWHA and health workers termed management of belligerent tendencies against each other as their greatest concern. Therefore, concerted effort is needed to improve health workers/PLWHA relationship in hospitals. This would minimize factors and/or conditions that encourage HIV infection. Exposing PLWHA to factors that influence

  6. Debriefing interventions for the prevention of psychological trauma in women following childbirth.

    Science.gov (United States)

    Bastos, Maria Helena; Furuta, Marie; Small, Rhonda; McKenzie-McHarg, Kirstie; Bick, Debra

    2015-04-10

    Childbirth is a complex life event that can be associated with both positive and negative psychological responses. When giving birth is experienced as particularly traumatic this can have a negative impact on a woman's postnatal emotional well-being. There has been an increasing focus on women's psychological trauma symptoms following childbirth, including the relatively rare phenomenon of post-traumatic stress disorder (PTSD), and the benefit of debriefing interventions to prevent this. In this review we examined the evidence for debriefing as a preventative intervention for psychological trauma following childbirth. To assess the effects of debriefing interventions compared with standard postnatal care for the prevention of psychological trauma in women following childbirth. The trials registers of the Cochrane Depression, Anxiety and Neurosis Group (CCDANCTR-References and CCDANCTR-Studies) and the Cochrane Pregnancy and Childbirth Group were searched up to 4 March 2015. These registers include relevant randomised controlled trials from the following bibliographic databases: the Cochrane Library (all years to date), MEDLINE (1950 to date), EMBASE (1974 to date), and PsycINFO (1967 to date). Additional searches were conducted in CENTRAL, MEDLINE, EMBASE, PsycINFO, and Maternity and Infant Care. The reference lists of all included studies were checked for additional published reports and citations of unpublished research. Experts in the field were contacted. We included randomised controlled trials (RCTs) and quasi-randomised trials comparing postnatal debriefing interventions with standard postnatal care for the prevention of psychological trauma of women following childbirth. The intervention consisted of at least one debriefing intervention session, which had the purpose of allowing women to describe their experience and to normalise their emotional reaction to that experience. Three authors independently assessed trial quality and extracted data. Meta

  7. Yemeni women's perceptions of own authority during childbirth: what does it have to do with achieving the Millennium Development Goals?

    Science.gov (United States)

    Kempe, Annica; Theorell, Töres; Noor-Aldin Alwazer, Fatoom; Christensson, Kyllike; Johansson, Annika

    2013-10-01

    women's underutilisation of professional care during childbirth in many low-income countries is a serious concern in terms of achievement of maternal Millennium Development Goal 5. to explore women's perceived own authority within the modern and traditional spheres of childbirth in a high maternal mortality setting on the Arab peninsula. Yemen is a signatory to the Millennium Development Goals and one of 10 countries chosen for the United Nations Millennium Project. In Yemen, home birth has remained the norm for several decades in spite of high maternal mortality and morbidity rates. a multistage (stratified-purposive-random) sampling process was used. Two hundred and twenty women with childbirth experience in urban/rural Yemen were selected at random for interview. Answers to the question 'Did you feel that you were the authority during childbirth?' were analysed using qualitative content analysis. the governorates of Aden, Lahej, Hadramout, Taiz and Hodeidah. three main themes emerged from the analysis: (i) 'Being at the centre', including two categories 'being able to follow through on own wants' and its opposite 'to be under the authority of others'; (ii) 'A sense of belonging' with the categories 'belonging and support among women in the community' and 'the denial of support, the experience of separation' and (iii) 'Husband's role in childbirth' including one category 'opportunity to show authority over the husband'. Authority was experienced primarily among women within the traditional childbirth sector although a general complaint among women delivered by trained medical staff was the loss of own authority. these findings show that women's authority during childbirth is decreasing in the context of Safe Motherhood and the expansion of modern delivery care. This is likely to be an important reason why women underutilise professional care. Acquisition of knowledge from the traditional childbirth sector regarding how women exercise authority to facilitate

  8. Women's attitudes towards the medicalization of childbirth and their associations with planned and actual modes of birth.

    Science.gov (United States)

    Benyamini, Yael; Molcho, Maya Lila; Dan, Uzi; Gozlan, Miri; Preis, Heidi

    2017-10-01

    Rates of medical interventions in childbirth have greatly increased in the Western world. Women's attitudes affect their birth choices. To assess women's attitudes towards the medicalization of childbirth and their associations with women's background as well as their fear of birth and planned and unplanned modes of birth. This longitudinal observational study included 836 parous woman recruited at women's health centres and natural birth communities in Israel. All women filled in questionnaires about attitudes towards the medicalization of childbirth, fear of birth, and planned birth choices. Women at birth. Attitudes towards medicalization were more positive among younger and less educated women, those who emigrated from the former Soviet Union, and those with a more complicated obstetric background. Baseline attitudes did not differ by parity yet became less positive throughout pregnancy only for primiparae. More positive attitudes were related to greater fear of birth. The attitudes were significantly associated with planned birth choices and predicted emergency caesareans and instrumental births. Women form attitudes towards the medicalization of childbirth which may still be open to change during the first pregnancy. More favourable attitudes are related to more medical modes of birth, planned and unplanned. Understanding women's views of childbirth medicalization may be key to understanding their choices and how they affect labour and birth. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  9. MATERNAL ACCOUNTS OF THEIR BREASTFEEDING INTENT AND EARLY CHALLENGES AFTER CESAREAN CHILDBIRTH

    Science.gov (United States)

    Tully, Kristin P.; Ball, Helen L.

    2013-01-01

    Background Breastfeeding outcomes are often worse after cesarean section compared to vaginal childbirth. Objectives This study characterizes mothers’ breastfeeding intentions and their infant feeding experiences after cesarean childbirth. Methods Data are from 115 mothers on a postnatal unit in Northeast England during February 2006 to March 2009. Interviews were conducted an average of 1.5 days (range 1–6 days) after the women underwent unscheduled or scheduled cesarean. Results Thematic analysis of the data suggested breastfeeding was mostly considered the “right thing to do,” preferable, natural, and “supposedly healthier,” but tiring and painful. Advantages of supplementation involved more satiated infants, feeding ease, and longer sleep bouts. The need for “thinking about yourself” was part of cesarean recovery. Infrequent feeding was concerning but also enabled maternal rest. Other breastfeeding obstacles were maternal mobility limitations, positioning difficulties, and frustration at the need for assistance. Participants were confused about nocturnal infant wakings, leading many to determine that they had insufficient milk. Mothers were surprised that sub-clinically poor infant condition was common following cesarean section. Some breastfeeding difficulty stemmed from “mucus” expulsion that had to occur before the infants could be “interested” in feeding. Women who cited motivations for breastfeeding that included benefit to themselves were more likely to exclusively breastfeed on the postnatal unit after their cesareans than those who reported infant-only motivations. Conclusions For the majority of mothers, breastfeeding after a cesarean is affected by interrelated and compounding difficulties. Provision of more relational breastfeeding information may enable families to better anticipate early feeding experiences after cesarean section childbirth. PMID:24252711

  10. Decision-making in Swiss home-like childbirth: A grounded theory study.

    Science.gov (United States)

    Meyer, Yvonne; Frank, Franziska; Schläppy Muntwyler, Franziska; Fleming, Valerie; Pehlke-Milde, Jessica

    2017-12-01

    Decision-making in midwifery, including a claim for shared decision-making between midwives and women, is of major significance for the health of mother and child. Midwives have little information about how to share decision-making responsibilities with women, especially when complications arise during birth. To increase understanding of decision-making in complex home-like birth settings by exploring midwives' and women's perspectives and to develop a dynamic model integrating participatory processes for making shared decisions. The study, based on grounded theory methodology, analysed 20 interviews of midwives and 20 women who had experienced complications in home-like births. The central phenomenon that arose from the data was "defining/redefining decision as a joint commitment to healthy childbirth". The sub-indicators that make up this phenomenon were safety, responsibility, mutual and personal commitments. These sub-indicators were also identified to influence temporal conditions of decision-making and to apply different strategies for shared decision-making. Women adopted strategies such as delegating a decision, making the midwife's decision her own, challenging a decision or taking a decision driven by the dynamics of childbirth. Midwives employed strategies such as remaining indecisive, approving a woman's decision, making an informed decision or taking the necessary decision. To respond to recommendations for shared responsibility for care, midwives need to strengthen their shared decision-making skills. The visual model of decision-making in childbirth derived from the data provides a framework for transferring clinical reasoning into practice. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  11. Factors associated with contraceptive use and initiation of coital activity after childbirth

    Directory of Open Access Journals (Sweden)

    John E Ekabua

    2010-08-01

    Full Text Available John E Ekabua1, Kufre J Ekabua2, Patience Odusolu1, Chritopher U Iklaki1, Thomas U Agan1, Aniekan J Etokidem21Department of Obstetrics and Gynecology, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria; 2Department of Community Medicine, University of Calabar Teaching Hospital, Calabar, Cross River State, NigeriaAbstract: The aim of the study is to identify the factors influencing contraceptive use and initiation of sexual intercourse after childbirth. This was a cross-sectional descriptive survey involving 256 consecutive women, who delivered between April and October, 2007, presenting at the Immunization Clinic, University of Calabar Teaching Hospital, Nigeria in April, 2008. Data was obtained using an interviewer-administered structured questionnaire. Women who had antenatal and postnatal counseling were significantly more likely to use contraceptives than those who did not have counseling (odds ratio (OR 0.29; 95% confidence interval (CI 0.14–0.59; P = 0.0002 and OR 0.18; 95% CI 0.08–0.38; P = 0.0000002 respectively. Other variables significantly associated with contraceptive use included education (P = 0.0470 and reproductive goal (P = 0.0303. Linear regression analysis showed direct relationship between caesarean section and episiotomy as modes of delivery, and initiation of coitus (r2 = 0.439 and 0.45 respectively. Concerning residence after childbirth, staying at home and with in-laws showed direct relationship with initiation of coitus (r2 = 0.208 and 10.750 respectively. The number of women abstaining from intercourse showed a decreasing trend with increasing months after childbirth. Initiation of coitus was significantly associated with resumption of menstruation (P < 0.0001 and non-contraceptive use (P = 0.0089. In conclusion, this study shows the need for use of postpartum contraception before fecund women become susceptible to pregnancy.Keywords: postpartum contraception, factors affecting use

  12. The aetiology of post-traumatic stress following childbirth: a meta-analysis and theoretical framework.

    Science.gov (United States)

    Ayers, S; Bond, R; Bertullies, S; Wijma, K

    2016-04-01

    There is evidence that 3.17% of women report post-traumatic stress disorder (PTSD) after childbirth. This meta-analysis synthesizes research on vulnerability and risk factors for birth-related PTSD and refines a diathesis-stress model of its aetiology. Systematic searches were carried out on PsycINFO, PubMed, Scopus and Web of Science using PTSD terms crossed with childbirth terms. Studies were included if they reported primary research that examined factors associated with birth-related PTSD measured at least 1 month after birth. In all, 50 studies (n = 21 429) from 15 countries fulfilled inclusion criteria. Pre-birth vulnerability factors most strongly associated with PTSD were depression in pregnancy (r = 0.51), fear of childbirth (r = 0.41), poor health or complications in pregnancy (r = 0.38), and a history of PTSD (r = 0.39) and counselling for pregnancy or birth (r = 0.32). Risk factors in birth most strongly associated with PTSD were negative subjective birth experiences (r = 0.59), having an operative birth (assisted vaginal or caesarean, r = 0.48), lack of support (r = -0.38) and dissociation (r = 0.32). After birth, PTSD was associated with poor coping and stress (r = 0.30), and was highly co-morbid with depression (r = 0.60). Moderator analyses showed that the effect of poor health or complications in pregnancy was more apparent in high-risk samples. The results of this meta-analysis are used to update a diathesis-stress model of the aetiology of postpartum PTSD and can be used to inform screening, prevention and intervention in maternity care.

  13. The ambiguity of disabled women's experiences of pregnancy, childbirth and motherhood: a phenomenological understanding.

    Science.gov (United States)

    Walsh-Gallagher, Dympna; Sinclair, Marlene; Mc Conkey, Roy

    2012-04-01

    there is limited knowledge about the pregnancy, childbirth and motherhood experiences of women living with a disability. Traditionally, such women have been viewed unsympathetically by society and professionals have challenged their fitness for motherhood. The situation is compounded by a lack of robust evidence regarding the life experience of pregnant women with a disability and their perspective on childbirth. seventeen pregnant women from the island of Ireland who had a physical, sensory and/or intellectual disability were interviewed at home, pre and post birth, using a qualitative approach derived from descriptive phenomenology. Interpretative phenomenological analysis (IPA), was chosen for data analysis. the women in this study welcomed pregnancy as affirming their identity and worth as women and as mothers. They encountered mixed reactions from partners and families, while professionals tended to view them as liabilities, regarding most as 'high risk'. These reactions intensified mothers' fears. They felt their ability to make choices and maintain control over their childbirth experiences was removed as the usual services were geared to provide for 'normal', able bodied women and were not adapted to their individual needs. Moreover, a proportion were offered a termination and, although all refused, they subsequently went on to indicate feeling pressurised to place their newborn babies into social services care. pregnant women with disabilities, in particular those labelled 'high risk', should expect equal ease of access to appropriate maternity care and consultation as that enjoyed by their mainstream, 'low risk' or 'normal' counterparts. Maternity services should foster these vulnerable women's independence and autonomy as far as practicable and uphold their identity and worth as women and as mothers. Three strategies are proposed for doing this. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. A Virtual Class Calculus

    DEFF Research Database (Denmark)

    Ernst, Erik; Ostermann, Klaus; Cook, William Randall

    2006-01-01

    Virtual classes are class-valued attributes of objects. Like virtual methods, virtual classes are defined in an object's class and may be redefined within subclasses. They resemble inner classes, which are also defined within a class, but virtual classes are accessed through object instances...... model for virtual classes has been a long-standing open question. This paper presents a virtual class calculus, vc, that captures the essence of virtual classes in these full-fledged programming languages. The key contributions of the paper are a formalization of the dynamic and static semantics of vc...

  15. Physical and sexual lifetime violence: prevalence and influence on fear of childbirth before, during and after delivery

    DEFF Research Database (Denmark)

    Schroll, Anne-Mette; Tabor, Ann; Kjaergaard, Hanne

    2011-01-01

    To estimate the prevalence of self-reported lifetime violence and to assess whether women exposed to any physical violence or sexual violence (SEV) had a higher risk of having fear of childbirth (FOC) before, during or after delivery compared with women without such history.......To estimate the prevalence of self-reported lifetime violence and to assess whether women exposed to any physical violence or sexual violence (SEV) had a higher risk of having fear of childbirth (FOC) before, during or after delivery compared with women without such history....

  16. Increased self-efficacy for vegetable preparation following an online, skill-based intervention and in-class tasting experience as a part of a general education college nutrition course.

    Science.gov (United States)

    Brown, Katie N; Wengreen, Heidi J; Vitale, Tamara S; Anderson, Janet B

    2011-01-01

    Assess the effectiveness of the integration of vegetable demonstration videos and tasting experiences into a college nutrition course to influence students' readiness to change vegetable intake, self-efficacy for vegetable preparation, and usual vegetable intake. Quasiexperimental, preintervention-postintervention comparisons. College nutrition course. Of the 376 students enrolled in the course, 186 completed the online assessments (145 female, 41 male; mean age, 20 years). Participants viewed online vegetable preparation videos and participated in vegetable tasting experiences that featured four target vegetables, one vegetable each month for 4 months. Preintervention and postintervention online surveys determined usual vegetable intake, readiness to change vegetable consumption, and self-efficacy of vegetable preparation. Chi-square distribution and paired sample t-tests were used to examine differences preintervention and postintervention. Stage of readiness to change vegetable intake shifted from contemplation toward preparation (p Online vegetable demonstration videos may be an effective and cost-efficient intervention for increasing self-efficacy of vegetable preparation and readiness to increase vegetable consumption among college students. More research is needed to determine long-term effects on vegetable consumption.

  17. The Influence of Acculturation on Traumatic Stress Following Childbirth Among Hispanic Adolescents.

    Science.gov (United States)

    Anderson, Cheryl; Strickland, Sarah

    2017-09-01

    Many studies have explored the role of acculturation on health outcomes; however, no studies to date have examined relationships between acculturation and the traumatic stress of childbirth among Hispanic adolescents. A convenience sample of 66 Hispanic adolescents 13 to 19 years of age completed the Acculturation Rating Scale for Mexican Americans-II (ARSMA-II), a demographic sheet, birth appraisal scale, and the Impact of Event Scale within 72 hours of birth. Significant associations were found between the ARSMA-II subscales and acculturation proxy variables, excluding language; however, only the Mexican Orientation Subscale and generation proxy variable influenced the birth experience. The study findings showed that Hispanic adolescents reporting a more traumatic childbirth identified closer with the Mexican culture and reported fewer family generations residing in the United States. As an overlooked area of research, our findings support the need for additional research related to the traumatic stress of birth among Hispanic adolescents. Using multiple acculturation measurements, including the ARSMA-II, with larger, more diverse samples of adolescents, equally balanced between all categories of acculturation and placement within the five-tier generation matrix, can provide some insightful information and directed health care.

  18. Gender equality and childbirth in a health facility: Nigeria and MDG5.

    Science.gov (United States)

    Singh, Kavita; Bloom, Shelah; Haney, Erica; Olorunsaiye, Comfort; Brodish, Paul

    2012-09-01

    This paper examined how addressing gender equality can lead to reductions in maternal mortality in Nigeria through an increased use of facility delivery. Because the majority of maternal complications cannot be predicted and often arise suddenly during labor, delivery and the immediate postpartum period, childbirth in a health facility is key to reducing maternal mortality. This paper used data from the 2008 Nigeria Demographic and Health Survey (DHS) to examine associations of gender measures on the utilization of facility delivery after controlling for socio-demographic factors. Four gender equality measures were studied: household decision-making, financial decision-making, attitudes towards wife beating, and attitudes regarding a wife's ability to refuse sex. Results found older, more educated, wealthier, urban, and working women were more likely to have a facility delivery than their counterparts. In addition ethnicity was a significant variable indicating the importance of cultural and regional diversity. Notably, after controlling for the socioeconomic variables, two of the gender equality variables were significant: household decision-making and attitudes regarding a wife's ability to refuse sex. In resource-poor settings such as Nigeria, women with more decision-making autonomy are likely better able to advocate for and access a health facility for childbirth. Thus programs and policies that focus on gender in addition to focusing on education and poverty have the potential to reduce maternal mortality even further.

  19. Perceived Social Support and Maternal Competence in Primipara Women during Pregnancy and After Childbirth.

    Science.gov (United States)

    Esmaelzadeh Saeieh, Sara; Rahimzadeh, Mitra; Yazdkhasti, Mansooreh; Torkashvand, Shoukofeh

    2017-10-01

    Developing maternal competence in first time mothers has a significant impact on neonate's growth psychosocial development and neonates growth and psychological development. Social support can be an important element for becoming a new mother. We aimed to investigate how social support and maternal competence change during pregnancy and 4 months after it and examine the relationships among social support and maternal competence. This longitudinal study was conducted on 100 first time mothers attending health centers in Alborz city, Alborz Province, between February 2015 and January 2016. Data were collected through perceived social support questionnaire that consisted of 12 questions and Parenting Sense of Competence Scale consisting of 17 items scored based on Likert's scale. The collected data were analyzed by SPSS software, version 16. Repeated-measure test and Pearson's correlation coefficient were used. Psocial support did not show any significant reduction (P=0.286). A direct relationship was found between social support and maternal competent six weeks after childbirth (r=0.19, P=0.049), and also social support and maternal competence sixteen weeks after childbirth (r=0.23, P=0.01). Considering the reduction of maternal competency during the study, social support by healthcare providers may be helpful for the mothers' transition to motherhood, and midwives must design specific interventions to promote the sense of maternal competence and perceived social support in first time mothers.

  20. The Relationship between Happiness and Fear of Childbirth in Nulliparous Women

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    Farnaz Sadat Seyed Ahmadi Nejad

    2017-10-01

    Full Text Available Background & aim: Happiness is a mental or emotional state of well-being. Happy individuals tend to interpret and process feeling in a positive way. Accordingly, the response to the pain may alter due to the effects of subjective elements on the pain perception. This study aimed to evaluate the relationship between the level of contentment and fear of childbirth (FOC in nulliparous women referring to the healthcare centers of Mashhad, Iran. Methods: This cross-sectional study was conducted on 370 nulliparous women who were selected through multistage sampling method from urban healthcare centers in Mashhad, Iran, 2014. Data collected using demographic and obstetric questionnaire, Oxford Happiness Questionnaire, and Childbirth Attitude Questionnaire (CAQ (an instrument for measuring the FOC. Data analyzed using Kolmogorov-Smirnov, one-way analysis of variance (ANOVA, independent samples t-test, regression, Kruskal-Wallis, Chi-square, Tukey honest significant difference (HSD, Mann-Whitney U, and Spearman and Pearson correlation coefficient tests with SPSS software version 11.5. Results: The mean levels of happiness and FOC were 123.97±18.82 and 45.80±7.57, respectively. There was a significant correlation between happiness and FOC (P

  1. Law and the medicalization of maternity, paternity, and childbirth in Cuba

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    García-Jordá D

    2012-05-01

    Full Text Available The childbirth is a transcendental moment in personal and family life. During this event, some aspects are revised related with femininity and masculinity. Objective: from this perspective, was carried out this research with the purpose of understand how the maternity representation, the medical system that attend childbirth and the laws influence in the conception and practice of maternity and paternity during the pregnant, labour, and puerperium. Methodology: some qualitative techniques were used, as interviews and open observation to women and their partners (spouses or common laws who were attended in three hospitals of Havana. Results: the results show as the traditional gender roles are reinforced by the laws, institutional regulations and the medical practice in hospitals. This traditional view has been that women take on most child care responsibilities and men are relegated of this. Parallel with this, a new form of masculinity emerges as a result of the increasing of participation of men in the event and in household activities and the externalization of feelings when they know their children. Conclusion: New gender policies are needed in order to deconstruct the patriarchal culture and develop egalitarian and democratic relationships in Cuban society

  2. Needs of fathers during labour and childbirth: A cross-sectional study.

    Science.gov (United States)

    Eggermont, Katrijn; Beeckman, Dimitri; Van Hecke, Ann; Delbaere, Ilse; Verhaeghe, Sofie

    2017-08-01

    Fathers play an important role in the childbearing process, but are sometimes sidelined by midwives. The objectives were: identify fathers' needs during the labor and childbirth process; determine if their needs were met by midwives; and identify variables influencing these needs. The questionnaire was designed based on a systematic literature search and validated by a multistage consensus method. Data were collected during a cross-sectional study in two maternity wards in Belgium, where a medical-led model is used. Fathers present during natural childbirth were recruited via consecutive sampling. Based on multivariate analyses, fathers with a higher education level and multiparous fathers needed less information about the process of birth compared to less educated fathers (pfathers (pfathers, a tour of the delivery room was less important than for primiparous fathers (p=0.005; OR=0.14; 95% CI=0.03-0.54). Married fathers needed less information on how to support their partners physically (pfathers. Information needs are more important to fathers compared to needs focusing on the birth experience or their involvement. Socio-demographic variables like educational level, parity, and marital status were associated with fathers' needs. Midwives need to be aware of fathers' needs during the birth process and to fulfill these needs appropriately. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  3. Women's experiences of recovery from childbirth: focus on pelvis problems that extend beyond the puerperium.

    Science.gov (United States)

    O'Reilly, Rebecca; Peters, Kath; Beale, Barbara; Jackson, Debra

    2009-07-01

    This study aimed to build understandings of women's recovery experiences in the presence of continued pelvic problems extending beyond the puerperium to provide nurses and other health care professionals with information to enhance current practice. Trauma to the pelvic floor during childbirth is a relatively common occurrence and can include damage to structures and nerves. A significant number of women will experience ongoing physical pelvic problems resulting from childbirth that extend past the puerperium; however, little is known about the experiential aspects of recovery for these women. A qualitative, phenomenological study. Narrative data were collected during conversational interviews with 10 mothers who had sustained pelvic injury during the birth process that persisted past the puerperium. Recruitment was via media releases and brochures distributed through childcare facilities. The data was analysed using Van Manen's thematic analysis. The themes that arose from the analysis were: 'fearing intimacy', 'managing an unpredictable body', 'being resigned' and 'feeling devalued and dismissed'. Pelvic injuries that extend beyond the postpartum period are distressing for women. They negatively affect women's views of themselves and have an impact on various aspects of life including intimate relationships and social activities. Currently, postpartum care may have a focus on baby rather than mother and this focus may impede women making full disclosures of ongoing health needs arising from their delivery. Findings of this study suggest that women may have specific needs that extend beyond the puerperium, indicating a need for continued holistic assessments and extending practice to identify and support women experiencing persistent pelvic postpartum complications.

  4. Validation of the Malay Version of the Inventory of Functional Status after Childbirth Questionnaire

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    Norhayati Mohd Noor

    2015-01-01

    Full Text Available Objective. This study was designed to examine the psychometric properties of Malay version of the Inventory of Functional Status after Childbirth (IFSAC. Design. A cross-sectional study. Materials and Methods. A total of 108 postpartum mothers attending Obstetrics and Gynaecology Clinic, in a tertiary teaching hospital in Malaysia, were involved. Construct validity and internal consistency were performed after the translation, content validity, and face validity process. The data were analyzed using Analysis of Moment Structure version 18 and Statistical Packages for the Social Sciences version 20. Results. The final model consists of four constructs, namely, infant care, personal care, household activities, and social and community activities, with 18 items demonstrating acceptable factor loadings, domain to domain correlation, and best fit (Chi-squared/degree of freedom = 1.678; Tucker-Lewis index = 0.923; comparative fit index = 0.936; and root mean square error of approximation = 0.080. Composite reliability and average variance extracted of the domains ranged from 0.659 to 0.921 and from 0.499 to 0.628, respectively. Conclusion. The study suggested that the four-factor model with 18 items of the Malay version of IFSAC was acceptable to be used to measure functional status after childbirth because it is valid, reliable, and simple.

  5. Validation of the Malay version of the Inventory of Functional Status after Childbirth questionnaire.

    Science.gov (United States)

    Noor, Norhayati Mohd; Aziz, Aniza Abd; Mostapa, Mohd Rosmizaki; Awang, Zainudin

    2015-01-01

    This study was designed to examine the psychometric properties of Malay version of the Inventory of Functional Status after Childbirth (IFSAC). A cross-sectional study. A total of 108 postpartum mothers attending Obstetrics and Gynaecology Clinic, in a tertiary teaching hospital in Malaysia, were involved. Construct validity and internal consistency were performed after the translation, content validity, and face validity process. The data were analyzed using Analysis of Moment Structure version 18 and Statistical Packages for the Social Sciences version 20. The final model consists of four constructs, namely, infant care, personal care, household activities, and social and community activities, with 18 items demonstrating acceptable factor loadings, domain to domain correlation, and best fit (Chi-squared/degree of freedom = 1.678; Tucker-Lewis index = 0.923; comparative fit index = 0.936; and root mean square error of approximation = 0.080). Composite reliability and average variance extracted of the domains ranged from 0.659 to 0.921 and from 0.499 to 0.628, respectively. The study suggested that the four-factor model with 18 items of the Malay version of IFSAC was acceptable to be used to measure functional status after childbirth because it is valid, reliable, and simple.

  6. Efficacy of an educational manual for childbirth companions: pilot study of a randomized clinical trial

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    Liana Mara Rocha Teles

    2018-05-01

    Full Text Available ABSTRACT Objective: to evaluate the effectiveness of an educational manual in the instrumentalization of companions to provide support to the parturients and check its influence on the satisfaction of companions and women during vaginal delivery. Method: pilot study of a randomized controlled clinical trial with 65 companions and puerperal women (intervention = 21 and control = 44. The previous knowledge of the companions was evaluated at baseline. The Evaluation Form for Companions in the Delivery Room was used to measure the actions provided and the satisfaction with the experience, and the Questionnaire for Evaluation of the Experience and Satisfaction of Puerperal Women with Labor and Delivery was used to evaluate the satisfaction of women with childbirth. The Student’s t-test or Wilcoxon, chi-square or Fisher’s exact test, risk ratios and 95% confidence intervals were used. Results: the companions in the intervention group performed a greater number of support actions (7.2 vs 4.6, p: 0.001 and had higher satisfaction scores (72.4 vs 64.2; p = 0.00. Puerperal women in the intervention group had higher satisfaction with childbirth (119.6 vs 107.9; p: 0.000. Conclusion: the manual was effective for the instrumentalization of companions, contributed to support actions to the parturients and had repercussions on the satisfaction of companions and women with the birthing process. RBR-776d9s

  7. Systematic Review of Hydrotherapy Research: Does a Warm Bath in Labor Promote Normal Physiologic Childbirth?

    Science.gov (United States)

    Shaw-Battista, Jenna

    Health sciences research was systematically reviewed to assess randomized controlled trials of standard care versus immersion hydrotherapy in labor before conventional childbirth. Seven studies of 2615 women were included. Six trials examined hydrotherapy in midwifery care and found an effect of pain relief; of these, 2 examined analgesia and found reduced use among women who bathed in labor. One study each found that hydrotherapy reduced maternal anxiety and fetal malpresentation, increased maternal satisfaction with movement and privacy, and resulted in cervical dilation progress equivalent to standard labor augmentation practices. Studies examined more than 30 fetal and neonatal outcomes, and no benefit or harm of hydrotherapy was identified. Two trials had anomalous findings of increased newborn resuscitation or nursery admission after hydrotherapy, which were not supported by additional results in the same or other studies. Review findings demonstrate that intrapartum immersion hydrotherapy is a helpful and benign practice. Hydrotherapy facilitates physiologic childbirth and may increase satisfaction with care. Maternity care providers are recommended to include hydrotherapy among routine labor pain management options and consider immersion to promote progress of normal or protracted labor, particularly among women with preferences to avoid obstetric medications and procedures.

  8. Depressive symptoms and symptoms of post-traumatic stress disorder in women after childbirth.

    Science.gov (United States)

    Zaers, Stefanie; Waschke, Melanie; Ehlert, Ulrike

    2008-03-01

    This study examined the course of psychological problems in women from late pregnancy to six months postpartum, the rates of psychiatric, especially depressive and post-traumatic stress symptoms and possible related antecedent variables. During late pregnancy, one to three days postpartum, six weeks and six months postpartum, 47 of the 60 participating women completed a battery of questionnaires including the General Health Questionnaire, the State-Trait Anxiety Inventory, the Edinburgh Postnatal Depression Scale, and the PTSD Symptom Scale. In general, most women recovered from psychiatric and somatic problems over the period of investigation. However, depressive and post-traumatic stress symptoms in particular were not found to decline significantly. Six weeks postpartum, 22% of the women had depressive symptoms, with this figure remaining at 21.3% six months postpartum. In addition, 6% of the women studied reported clinically significant PTSD symptoms at six weeks postpartum with 14.9% reporting such symptoms at six months postpartum. The most important predictor for depressive and post-traumatic stress symptoms was the block variable "anxiety in late pregnancy". Other predictors were the variables "psychiatric symptoms in late pregnancy", "critical life events" and the "experience of delivery". The results of our study show a high prevalence rate of psychiatric symptoms in women after childbirth and suggest, besides the experience of the delivery itself, a vulnerability or predisposing history that makes the development of psychiatric symptoms after childbirth more probable.

  9. Prácticas para estimular el parto normal Practices to stimulate normal childbirth

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    Flora Maria Barbosa da Silva

    2011-09-01

    Full Text Available Este artículo lleva a una reflexión sobre las prácticas del estímulo al parto normal, con la fundamentación teórica de cada una de ellas. Las prácticas incluidas en este estudio fueron el ayuno, enemas, spray y baños de inmersión, caminatas, movimientos pélvicos y masaje. En un contexto de revalorización del parto normal, ofrecer a la mujer durante el parto opciones de comodidad basadas en evidencias puede ser una forma de preservar el curso fisiológico del parto.This article leads to a reflection about the practices of encouraging normal childbirth, with the theoretical foundation for each one of them. The practices included in this study were fasting, enema, shower and immersion baths, walking, pelvic movements and massage. In a context of revaluation of normal birth, providing evidence-based comfort options for women during childbirth can be a way to preserve the physiological course of labour.

  10. Natural Childbirth

    Science.gov (United States)

    ... through the pain is up to you. Different women find that different methods work best for them. Many can control the pain ... timetable when you're giving birth. For some women, the baby comes in a few hours; for many others it may take all day ( ...

  11. Parenting classes: focus on discipline.

    Science.gov (United States)

    Campbell, J M

    1992-01-01

    Nurses in community settings have an opportunity to provide instruction related to health and life-style needs. An important consideration is the parental role. A particularly controversial and opinion-laden aspect of parenting is disciplining children. Discipline provides children with the security of clearly enforced rules to help them learn self-control and social standards. Parenting classes are worthwhile for people who have little formal or informal preparation. A survey of middle-class elementary school district parents' and childrens' attitudes toward discipline was conducted to develop meaningful parenting classes. Parents' feelings about being a mother or father were surprisingly negative. A parent educational program was developed to cover child growth and development and disciplinary practices. Parent evaluations led to continuation and an expansion of this program to other schools within the area.

  12. ‘I’ve Changed My Mind’, Mindfulness-Based Childbirth and Parenting (MBCP) for pregnant women with a high level of fear of childbirth and their partners : study protocol of the quasi-experimental controlled trial

    NARCIS (Netherlands)

    Veringa, I.K.; de Bruin, E.I.; Bardacke, N.; Duncan, L.G.; van Steensel, F.J.A.; Dirksen, C.D.; Bögels, S.M.

    2016-01-01

    Background Approximately 25 % of pregnant women suffer from a high level of Fear of Childbirth (FoC), as assessed by the Wijma Delivery Expectancy Questionnaire (W-DEQ-A, score ≥66). FoC negatively affects pregnant women’s mental health and adaptation to the perinatal period. Mindfulness-Based

  13. RxClass

    Data.gov (United States)

    U.S. Department of Health & Human Services — The RxClass Browser is a web application for exploring and navigating through the class hierarchies to find the RxNorm drug members associated with each class....

  14. Women’s pelvic floor muscle strength and urinary and anal incontinence after childbirth: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Priscila Tavares Zizzi

    Full Text Available Abstract OBJECTIVE To analyse pelvic floor muscle strength (PFMS and urinary and anal incontinence (UI and AI in the postpartum period. METHOD Cross-sectional study carried out with women in their first seven months after child birth. Data were collected through interviews, perineometry (Peritron™, and the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF. RESULTS 128 women participated in the study. The PFMS mean was 33.1 (SD=16.0 cmH2O and the prevalence of UI and AI was 7.8% and 5.5%, respectively. In the multiple analyses, the variables associated with PFMS were type of birth and cohabitation with a partner. Newborn’s weight, previous pregnancy, UI during pregnancy, and sexual activity showed an association with UI after child birth. Only AI prior to pregnancy was associated with AI after childbirth. CONCLUSION Vaginal birth predisposes to the reduction of PFMS, and caesarean section had a protective effect to its reduction. The occurrence of UI during pregnancy is a predictor of UI after childbirth, and women with previous pregnancies and newborns with higher weights are more likely to have UI after childbirth.AI prior to pregnancy is the only risk factor for its occurrence after childbirth. Associations between PFMS and cohabitation with a partner, and between UI and sexual activity do not make possible to conclude that these variables are directly associated.

  15. The impact of IVF/ICSI on parental well-being and anxiety 1 year after childbirth

    NARCIS (Netherlands)

    Jongbloed-Pereboom, M.; Middelburg, K. J.; Heineman, M. J.; Bos, A. F.; Haadsma, M. L.; Hadders-Algra, M.

    More couples are delaying childbirth resulting in an increase of age-related subfertility in women. Subfertility and assisted reproductive technology (ART) treatments may affect couples psychological well-being. The aim of the present study was to investigate whether factors related to IVF/ICSI

  16. Women’s employment patterns after childbirth and the perceived access to and use of flexitime and teleworking

    NARCIS (Netherlands)

    Chung, Heejung; van der Horst, Mariska

    2018-01-01

    Despite the increased number of women in the labour market in the UK, many significantly reduce their working hours or leave the labour market altogether after childbirth; typically with serious consequences for their careers. Based on border and boundary management theories, this study examines

  17. The effect of counseling on anxiety after traumatic childbirth in nulliparous women; a single blind randomized clinical trial

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    Mahnaz Azizi

    2010-09-01

    Full Text Available Background: Traumatic birthing mothers may expose more susceptible to experiences posttraumatic mental disorder such as anxiety. This study aimed to determine the effect of midwifery counseling intervention on the anxiety level after traumatic childbirth of primiparous women.Methods: In a randomized control trial 180 woman who had experienced traumatic childbirth based on DSM-IV criteria have been selected. The subjects were randomly divided into an intervention (n=90 and control (n=90 groups. The intervention group received midwifery counseling during two sessions and control group just received routin health care after childbirth. Both groups were followed up with partial – blind technique and compared 4-6 weeks and 3 months post partum. The data were analyzed using descriptive statistics by SPSS software. Results: Demographic characteristics, pregnancy complications and social support level were the same in both groups. In addition, there was no significant difference between two groups according to stress, depression and anxiety level before intervention (P>0.05. There was significant difference between two groups in anxiety level after 4-6 weeks and 3 months followup (P<0.001.Conclusion: Findings of this research shows that performing midwifery-counseling program may have significant effect on decreasing of anxiety level after traumatic childbirth.

  18. She will give birth immediately. Pregnancy and childbirth in medieval Hebrew medical texts produced in the Mediterranean West.

    Science.gov (United States)

    Navas, Carmen Caballero

    2014-01-01

    This essay approaches the medieval Hebrew literature on women's healthcare, with the aim of analysing notions and ideas regarding fertility, pregnancy and childbirth, as conveyed in the texts that form the corpus. Firstly, the work discusses the approach of written texts to pregnancy and childbirth as key elements in the explanation of women's health and the functioning of the female body. In this regard it also explores the role of this approach in the creation of meanings for both the female body and sexual difference. Secondly, it examines female management of pregnancy and childbirth as recorded in Hebrew medical literature. It pays attention to both the attitudes expressed by the authors, translators and copyists regarding female practice, as well as to instances and remedies derived from "local" traditions--that is, from women's experience--in the management of pregnancy and childbirth, also recorded in the texts. Finally, the paper explores how medical theories alien to, or in opposition to, Judaism were adopted or not and, at times, adapted to Jewish notions with the aim of eliminating tensions from the text, on the one hand, and providing Jewish practitioners with adequate training to retain their Christian clientele, on the other.

  19. Conduct Disorder Symptoms and Subsequent Pregnancy, Child-Birth and Abortion: A Population-Based Longitudinal Study of Adolescents

    Science.gov (United States)

    Pedersen, Willy; Mastekaasa, Arne

    2011-01-01

    Research on teenage pregnancy and abortion has primarily focused on socio-economic disadvantage. However, a few studies suggest that risk of unwanted pregnancy is related to conduct disorder symptoms. We examined the relationship between level of conduct disorder symptoms at age 15 and subsequent pregnancy, child-birth and abortion. A…

  20. Do Mothers Stay on the Job? What Employers Can Do To Increase Retention after Childbirth. Research-in-Brief.

    Science.gov (United States)

    Glass, Jennifer

    According to a recent study of how women manage maternity in the workplace, more than 70% of pregnant employees were still employed at the same job 6 months after childbirth (compared to 80% of young women who had not been pregnant). A study of 324 randomly selected employed women in the Midwest yielded similar results. Six months after giving…

  1. Health and Turnover of Working Mothers after Childbirth via the Work-Family Interface: An Analysis across Time

    Science.gov (United States)

    Carlson, Dawn S.; Grzywacz, Joseph G.; Ferguson, Merideth; Hunter, Emily M.; Clinch, C. Randall; Arcury, Thomas A.

    2011-01-01

    This study examined organizational levers that impact work-family experiences, participant health, and subsequent turnover. Using a sample of 179 women returning to full-time work 4 months after childbirth, we examined the associations of 3 job resources (job security, skill discretion, and schedule control) with work-to-family enrichment and the…

  2. Physical and sexual lifetime violence: prevalence and influence on fear of childbirth before, during and after delivery

    DEFF Research Database (Denmark)

    Schroll, Anne-Mette; Tabor, Ann; Kjaergaard, Hanne

    2011-01-01

    To estimate the prevalence of self-reported lifetime violence and to assess whether women exposed to any physical violence or sexual violence (SEV) had a higher risk of having fear of childbirth (FOC) before, during or after delivery compared with women without such history....

  3. Regulating cinematic stories about reproduction: pregnancy, childbirth, abortion and movie censorship in the US, 1930-1958.

    Science.gov (United States)

    Kirby, David A

    2017-09-01

    In the mid-twentieth century film studios sent their screenplays to Hollywood's official censorship body, the Production Code Administration (PCA), and to the Catholic Church's Legion of Decency for approval and recommendations for revision. This article examines the negotiations between filmmakers and censorship groups in order to show the stories that censors did, and did not, want told about pregnancy, childbirth and abortion, as well as how studios fought to tell their own stories about human reproduction. I find that censors considered pregnancy to be a state of grace and a holy obligation that was restricted to married women. For censors, human reproduction was not only a private matter, it was also an unpleasant biological process whose entertainment value was questionable. They worried that realistic portrayals of pregnancy and childbirth would scare young women away from pursuing motherhood. In addition, I demonstrate how filmmakers overcame censors' strict prohibitions against abortion by utilizing ambiguity in their storytelling. Ultimately, I argue that censors believed that pregnancy and childbirth should be celebrated but not seen. But if pregnancy and childbirth were required then censors preferred mythic versions of motherhood instead of what they believed to be the sacred but horrific biological reality of human reproduction.

  4. Post-traumatic stress symptoms, parenting stress and mother-child relationships following childbirth and at 2 years postpartum.

    Science.gov (United States)

    McDonald, Sarah; Slade, Pauline; Spiby, Helen; Iles, Jane

    2011-09-01

    This study examined the prevalence of childbirth-related post-traumatic stress (PTS) symptoms at 2 years postpartum and the relationship between such symptoms and both self-reported parenting stress and perceptions of the mother-child relationship. 81 women completed measures of childbirth-related PTS symptoms at 6 weeks and 3 months postpartum; these results were used in an exploration of their predictive links with mother-child relationship and parenting measures at 2 years. 17.3% of respondents reported some PTS symptoms at a clinically significant level at 2 years postpartum. However, these symptoms were only weakly linked to parenting stress and were not related to mothers' perceptions of their children. However earlier PTS symptoms within 3 months of childbirth did show limited associations with parenting stress at 2 years but no association with child relationship outcomes once current depression was taken into account. Implications for clinical practice and the concept of childbirth-related post-traumatic stress disorder are discussed.

  5. The Effect of Debriefing and Brief Cognitive-Behavioral Therapy on Postpartum Depression in Traumatic Childbirth: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Sedigheh Abdollahpour

    2018-01-01

    Full Text Available Background & aim: Childbirth is a stressful event in women’s lives, and if a mother perceives it as an unpleasant event, it can influence her postpartum mental health. Depression is a common mental disorder, which can has serious consequences depending on its severity. Therefore, this study aimed to investigate the effect of debriefing and brief cognitive-behavioral therapy on postpartum depression in traumatic childbirth. Methods: This clinical trial was performed on 179 mothers who experienced a traumatic childbirth and were admitted in postnatal ward of Nohom Dey Hospital in Torbat-e Heydarieh, North East of Iran in 2016. The subjects were randomly allocated into three groups, including two intervention groups of debriefing and brief cognitive-behavioral counseling and a control group. The intervention groups received appropriate counseling for 40-60 minutes in the first 48 postpartum hours and the control group received the routine postpartum care. Edinburgh Postnatal Depression Scale was used to evaluate postpartum depression 4-6 weeks and also three months after the intervention. Post-traumatic stress symptoms in were compared in three groups using t-test, chi-square test, and repeated measures analysis of variance. Results: No significant differences were observed between the mean depression scores of the two intervention groups and that of the control group 4-6 weeks after childbirth. However, three months after delivery, the mean depression scores of the two intervention groups was lower than the control group (P

  6. Blame and guilt - a mixed methods study of obstetricians' and midwives' experiences and existential considerations after involvement in traumatic childbirth.

    Science.gov (United States)

    Schrøder, Katja; Jørgensen, Jan S; Lamont, Ronald F; Hvidt, Niels C

    2016-07-01

    When complications arise in the delivery room, midwives and obstetricians operate at the interface of life and death, and in rare cases the infant or the mother suffers severe and possibly fatal injuries related to the birth. This descriptive study investigated the numbers and proportions of obstetricians and midwives involved in such traumatic childbirth and explored their experiences with guilt, blame, shame and existential concerns. A mixed methods study comprising a national survey of Danish obstetricians and midwives and a qualitative interview study with selected survey participants. The response rate was 59% (1237/2098), of which 85% stated that they had been involved in a traumatic childbirth. We formed five categories during the comparative mixed methods analysis: the patient, clinical peers, official complaints, guilt, and existential considerations. Although blame from patients, peers or official authorities was feared (and sometimes experienced), the inner struggles with guilt and existential considerations were dominant. Feelings of guilt were reported by 36-49%, and 50% agreed that the traumatic childbirth had made them think more about the meaning of life. Sixty-five percent felt that they had become a better midwife or doctor due to the traumatic incident. The results of this large, exploratory study suggest that obstetricians and midwives struggle with issues of blame, guilt and existential concerns in the aftermath of a traumatic childbirth. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

  7. Developing a Questionnaire for Iranian Women's Attitude on Medical Ethics in Vaginal Childbirth.

    Science.gov (United States)

    Mirzaee Rabor, Firoozeh; Taghipour, Ali; Mirzaee, Moghaddameh; Mirzaii Najmabadi, Khadigeh; Fazilat Pour, Masoud; Fattahi Masoum, Seyed Hosein

    2015-12-01

    Vaginal delivery is one of the challenging issues in medical ethics. It is important to use an appropriate instrument to assess medical ethics attitudes in normal delivery, but the lack of tool for this purpose is clear. The aim of this study was to develop and validate a questionnaire for the assessment of women's attitude on medical ethics application in normal vaginal delivery. This methodological study was carried out in Iran in 2013 - 2014. Medical ethics attitude in vaginal delivery questionnaire (MEAVDQ) was developed using the findings of a qualitative data obtained from a grounded theory research conducted on 20 women who had vaginal childbirth, in the first phase. Then, the validation criteria of this tool were tested by content and face validity in the second phase. Exploratory factor analysis was used for construct validity and reliability was also tested by Cronbach's alpha coefficient in the third phase of this study. SPSS version 13 was used in this study. The sample size for construct validity was 250 females who had normal vaginal childbirth. In the first phase of this study (tool development), by the use of four obtained categories and nine subcategories from grounded theory and literature review, three parts (98-items) of this tool were obtained (A, B and J). Part A explained the first principle of medical ethics, part B pointed to the second and third principles of medical ethics, and part J explained the fourth principle of medical ethics. After evaluating and confirming its face and content validity, 75 items remained in the questionnaire. In construct validity, by the employment of exploratory factor analysis, in parts A, B and J, 3, 7 and 3 factors were formed, respectively; and 62.8%, 64% and 51% of the total variances were explained by the obtained factors in parts A, B and J, respectively. The names of these factors in the three parts were achieved by consideration of the loading factor and medical ethics principles. The subscales of

  8. Individual or group antenatal education for childbirth or parenthood, or both.

    Science.gov (United States)

    Gagnon, A J; Sandall, J

    2007-07-18

    Structured antenatal education programs for childbirth or parenthood, or both, are commonly recommended for pregnant women and their partners by healthcare professionals in many parts of the world. Such programs are usually offered to groups but may be offered to individuals. To assess the effects of this education on knowledge acquisition, anxiety, sense of control, pain, labour and birth support, breastfeeding, infant-care abilities, and psychological and social adjustment. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (April 2006), CINAHL (1982 to April 2006), ERIC (1984 to April 2006), EMBASE (1980 to April 2006) and PsycINFO (1988 to April 2006). We handsearched the Journal of Psychosomatic Research from 1956 to April 2006 and reviewed the reference lists of retrieved studies. Randomized controlled trials of any structured educational program provided during pregnancy by an educator to either parent that included information related to pregnancy, birth or parenthood. The educational interventions could have been provided on an individual or group basis. Educational interventions directed exclusively to either increasing breastfeeding success, knowledge of and coping skills concerning postpartum depression, improving maternal psycho-social health including anxiety, depression and self-esteem or reducing smoking were excluded. Both authors assessed trial quality and extracted data from published reports. Nine trials, involving 2284 women, were included. Thirty-seven studies were excluded. Educational interventions were the focus of eight of the studies (combined n = 1009). Details of the randomization procedure, allocation concealment, and/or participant accrual or loss for these trials were not reported. No consistent results were found. Sample sizes were very small to moderate, ranging from 10 to 318. No data were reported concerning anxiety, breastfeeding success, or general social support. Knowledge acquisition, sense of control

  9. Access to childbirth care by adolescents and young people in the Northeastern region of Brazil

    Directory of Open Access Journals (Sweden)

    Érida Zoé Lustosa Furtado

    2016-01-01

    Full Text Available ABSTRACT OBJECTIVE To identify the factors that interfere with the access of adolescents and young people to childbirth care for in the Northeast region of Brazil. METHODS Cross-sectional study with 3,014 adolescents and young people admitted to the selected maternity wards to give birth in the Northeast region of Brazil. The sample design was probabilistic, in two stages: the first corresponded to the health establishments and the second to women who had recently given birth and their babies. The data was collected by means of interviews and consulting the hospital records, from pre-tested electronic form. Descriptive statistics were used for the univariate analysis, Pearson’s Chi-square test for the bivariate analysis and multiple logistic regressions for the multivariate analysis. Sociodemographic variables, obstetrical history, and birth care were analyzed. RESULTS Half of the adolescents and young people interviewed had not been given guidance on the location that they should go to when in labor, and among those who had, 23.5% did not give birth in the indicated health service. Furthermore, one third (33.3% had to travel in search of assisted birth, and the majority (66.7% of the postpartum women came to maternity by their own means. In the bivariate analysis, the variables marital status, paid work, health insurance, number of previous pregnancies, parity, city location, and type of health establishment showed a significant association (p < 0.20 with inadequate access to childbirth care. The multivariate analysis showed that married adolescents and young people (p < 0.015, with no health insurance (p < 0.002 and from the countryside (p < 0.001 were more likely to have inadequate access to childbirth care. CONCLUSIONS Adolescents and young women, married, without health insurance, and from the countryside are more likely to have inadequate access to birth care. The articulation between outpatient care and birth care can improve this

  10. Antenatal psychosomatic programming to reduce postpartum depression risk and improve childbirth outcomes: a randomized controlled trial in Spain and France.

    Science.gov (United States)

    Ortiz Collado, Maria Assumpta; Saez, Marc; Favrod, Jérôme; Hatem, Marie

    2014-01-15

    Postpartum depression (PPD) and poor childbirth outcomes are associated with poverty; these variables should be addressed by an adapted approach. The aim of this research was to evaluate the impact of an antenatal programme based on a novel psychosomatic approach to pregnancy and delivery, regarding the risk of PPD and childbirth outcomes in disadvantaged women. A multi-centre, randomized, controlled trial comparing a novel to standard antenatal programme. Primary outcome was depressive symptoms (using EPDS) and secondary outcome was preterm childbirth (fewer 37 weeks). The sample comprised 184 couples in which the women were identified to be at PPD risk by validated interview. The study was conducted in three public hospitals with comparable standards of perinatal care. Women were randomly distributed in to an experimental group (EG) or a control group (CG), and evaluated twice: during pregnancy (T1) and four weeks post-partum (T2). At T2, the variables were compared using the chi square test. Data analysis was based on intention to treat. The novel programme used the Tourné psychosomatic approach focusing on body awareness sensations, construction of an individualized childbirth model, and attachment. The 10 group antenatal sessions each lasted two hours, with one telephone conversation between sessions. In the control group, the participants choose the standard model of antenatal education, i.e., 8 to 10 two-hour sessions focused on childbirth by obstetrical prophylaxis. A difference of 11.2% was noted in postpartum percentages of PPD risk (EPDS ≥ 12): 34.3% (24) in EG and 45.5% (27) in CG (p = 0.26). The number of depressive symptoms among EG women decreased at T2 (intragroup p = 0.01). Premature childbirth was four times less in EG women: three (4.4%) compared to 13 (22.4%) among CG women (p = 0.003). Birth weight was higher in EG women (p = 0.01). The decrease of depressive symptoms in women was not conclusive. However, because birth weight was higher and

  11. Returning to Work after Childbirth in Europe: Well-Being, Work-Life Balance, and the Interplay of Supervisor Support

    Directory of Open Access Journals (Sweden)

    Ana M. Lucia-Casademunt

    2018-02-01

    Full Text Available Parents returning to work after the arrival of a new son or daughter is an important question for understanding the trajectory of people's lives and professional careers amid current debates about gender equality and work-life balance (WLB. Interestingly, current research concludes that general WLB practices at the workplace may be necessary in the specific case of women returning to work after childbirth because of the particular maternal and infant factors involved. However, WLB practices as a flexible arrangement may work against women because they may be viewed as a lack of organizational commitment. Therefore, research on this topic could benefit from considering supervisor support as a complement of such practices, but previous research has analyzed WLB and supervisor support separately and scarcely. To fill this gap in the literature, we use two sub-samples of 664 female employees and 749 male employees with children under the age of one from 27 European countries participating in the 6th European Working Conditions Survey (EWCS-2015 to study the impact of perceived WLB on European women's perceived well-being after childbirth, in contrast with previous literature. We also analyze the impact of perceived supervisor support (SS and its interaction with perceived WLB on women's well-being after childbirth, and explore differences with men after childbirth, a collective underexplored by the literature. We find significant gender differences on the relative impact of WLB, SS, and their interaction on perceived job well-being. Our results have important implications for human resource practices in organizations. In particular, they suggest that gendered WLB practices should be encouraged, and stress the relevance of the human factor over human resource practices in addressing the difficulties that women returning to work face after childbirth.

  12. Returning to Work after Childbirth in Europe: Well-Being, Work-Life Balance, and the Interplay of Supervisor Support

    Science.gov (United States)

    Lucia-Casademunt, Ana M.; García-Cabrera, Antonia M.; Padilla-Angulo, Laura; Cuéllar-Molina, Deybbi

    2018-01-01

    Parents returning to work after the arrival of a new son or daughter is an important question for understanding the trajectory of people's lives and professional careers amid current debates about gender equality and work-life balance (WLB). Interestingly, current research concludes that general WLB practices at the workplace may be necessary in the specific case of women returning to work after childbirth because of the particular maternal and infant factors involved. However, WLB practices as a flexible arrangement may work against women because they may be viewed as a lack of organizational commitment. Therefore, research on this topic could benefit from considering supervisor support as a complement of such practices, but previous research has analyzed WLB and supervisor support separately and scarcely. To fill this gap in the literature, we use two sub-samples of 664 female employees and 749 male employees with children under the age of one from 27 European countries participating in the 6th European Working Conditions Survey (EWCS-2015) to study the impact of perceived WLB on European women's perceived well-being after childbirth, in contrast with previous literature. We also analyze the impact of perceived supervisor support (SS) and its interaction with perceived WLB on women's well-being after childbirth, and explore differences with men after childbirth, a collective underexplored by the literature. We find significant gender differences on the relative impact of WLB, SS, and their interaction on perceived job well-being. Our results have important implications for human resource practices in organizations. In particular, they suggest that gendered WLB practices should be encouraged, and stress the relevance of the human factor over human resource practices in addressing the difficulties that women returning to work face after childbirth. PMID:29467695

  13. Returning to Work after Childbirth in Europe: Well-Being, Work-Life Balance, and the Interplay of Supervisor Support.

    Science.gov (United States)

    Lucia-Casademunt, Ana M; García-Cabrera, Antonia M; Padilla-Angulo, Laura; Cuéllar-Molina, Deybbi

    2018-01-01

    Parents returning to work after the arrival of a new son or daughter is an important question for understanding the trajectory of people's lives and professional careers amid current debates about gender equality and work-life balance (WLB). Interestingly, current research concludes that general WLB practices at the workplace may be necessary in the specific case of women returning to work after childbirth because of the particular maternal and infant factors involved. However, WLB practices as a flexible arrangement may work against women because they may be viewed as a lack of organizational commitment. Therefore, research on this topic could benefit from considering supervisor support as a complement of such practices, but previous research has analyzed WLB and supervisor support separately and scarcely. To fill this gap in the literature, we use two sub-samples of 664 female employees and 749 male employees with children under the age of one from 27 European countries participating in the 6th European Working Conditions Survey (EWCS-2015) to study the impact of perceived WLB on European women's perceived well-being after childbirth, in contrast with previous literature. We also analyze the impact of perceived supervisor support (SS) and its interaction with perceived WLB on women's well-being after childbirth, and explore differences with men after childbirth, a collective underexplored by the literature. We find significant gender differences on the relative impact of WLB, SS, and their interaction on perceived job well-being. Our results have important implications for human resource practices in organizations. In particular, they suggest that gendered WLB practices should be encouraged, and stress the relevance of the human factor over human resource practices in addressing the difficulties that women returning to work face after childbirth.

  14. Dirty and 40 days in the wilderness: Eliciting childbirth and postnatal cultural practices and beliefs in Nepal.

    Science.gov (United States)

    Sharma, Sheetal; van Teijlingen, Edwin; Hundley, Vanora; Angell, Catherine; Simkhada, Padam

    2016-07-05

    Pregnancy and childbirth are socio-cultural events that carry varying meanings across different societies and cultures. These are often translated into social expectations of what a particular society expects women to do (or not to do) during pregnancy, birth and/or the postnatal period. This paper reports a study exploring beliefs around childbirth in Nepal, a low-income country with a largely Hindu population. The paper then sets these findings in the context of the wider global literature around issues such as periods where women are viewed as polluted (or dirty even) after childbirth. A qualitative study comprising five in-depth face-to-face interviews and 14 focus group discussions with mainly women, but also men and health service providers. The qualitative findings in Nepal were compared and contrasted with the literature on practices and cultural beliefs related to the pregnancy and childbirth period across the globe and at different times in history. The themes that emerged from the analysis included: (a) cord cutting & placenta rituals; (b) rest & seclusion; (c) purification, naming & weaning ceremonies and (d) nutrition and breastfeeding. Physiological changes in mother and baby may underpin the various beliefs, ritual and practices in the postnatal period. These practices often mean women do not access postnatal health services. The cultural practices, taboos and beliefs during pregnancy and around childbirth found in Nepal largely resonate with those reported across the globe. This paper stresses that local people's beliefs and practices offer both opportunities and barriers to health service providers. Maternity care providers need to be aware of local values, beliefs and traditions to anticipate and meet the needs of women, gain their trust and work with them.

  15. Recent childbirth is an adverse prognostic factor in breast cancer and melanoma, but not in Hodgkin lymphoma.

    Science.gov (United States)

    Møller, Henrik; Purushotham, Arnie; Linklater, Karen M; Garmo, Hans; Holmberg, Lars; Lambe, Mats; Yallop, Deborah; Devereux, Stephen

    2013-11-01

    The relationship between gestation, childbirth and cancer prognosis is unknown for most cancers (e.g. Hodgkin lymphoma), whereas a body of evidence exists for melanoma and breast cancer. The national cancer registration and hospital discharge data for women in England (1998-2007) were linked, and the records for Hodgkin lymphoma, melanoma and breast cancer were indexed as to whether women had delivered a child in separate time periods prior to their cancer diagnosis. Survival analyses were conducted in order to characterise prognosis in relation to childbirth, with statistical adjustment for age and (where possible) stage. For melanoma and breast cancer, survival was strongly reduced in women who gave birth in the year prior to cancer diagnosis. The age-adjusted hazard ratios (HR) with 95% confidence intervals (CI) were 2.06 (1.42-3.01) for melanoma and 1.84 (1.64-2.06) for breast cancer. The associations were only slightly attenuated by further adjustment for tumour stage. For breast cancer, the excess death rate in women with a recent childbirth peaked at 2 years and remained elevated for 6 to 8 years. Previous childbirth had no overall effect on the outcome of Hodgkin lymphoma. Melanoma and breast cancer prognosis are adversely affected by recent gestation and childbirth in a way that is not due to stage of the cancer, but rather to inherent biological properties of the tumours. Possible biological mechanisms include immunosuppression (melanoma), the hormonal milieu in gestation and a tumour promoting microenvironment post-partum (breast cancer). Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. Proximate Context of HIV-Related Stigma and Women's Use of Skilled Childbirth Services in Uganda.

    Science.gov (United States)

    Ng, Courtney K; Tsai, Alexander C

    2017-01-01

    HIV-related stigma compromises both HIV prevention and treatment and has recently been described as a barrier to utilization of skilled childbirth services in sub-Saharan Africa. This study uses the 2011 Uganda Demographic Health Survey to estimate the associations between HIV-related stigma, measured both at the individual and community level, and use of facility delivery among women. Consistent with theoretical predictions, higher levels of stigma are associated with reduced likelihood of facility delivery. The negative relationship between stigma and facility delivery is especially pronounced when stigma is measured at the community level, highlighting the importance of understanding the proximate context of HIV-related stigma and its potential effects on behavior. Reducing the stigma of HIV will be critical to achieving the twin goals of reducing overall maternal mortality and preventing mother-to-child HIV transmission.

  17. The effect of psychosocial factors on the level of cholyglycine before childbirth

    International Nuclear Information System (INIS)

    Zhang Hongmei; Fan Jie; Yu Jie; Wu Aiqin

    2005-01-01

    To observe the effect of psychosocial factors on the level of cholyglycine(CG) before childbirth, 69 gravidas were investigated by using the Gravida General Situation Questionnaire, the A Strait Behavior Questionnaire, and Symptom Checklist-90(SCL-90) in the term of pregnancy till giving birth. The data were subjected to statistical analysis. The result showed that: (1) The level of CG was significantly higher in the group with A-behavior than that in the group with B-or M-Behavior(P<0.05); (2) The incidence of post partum complication in the high CG group (8%) was significantly higher than that in the low CG group (P<0.01); (3)The gestational period, the relation with parents of gravidas husband and SCL-90 panic score were main influencing factors on the level of CG . Besides physiological factors' effecting on CG, psychosocial factors should also be paid attention to. (authors)

  18. Diet or exercise, or both, for weight reduction in women after childbirth.

    Science.gov (United States)

    Amorim Adegboye, Amanda R; Linne, Yvonne M

    2013-07-23

    Weight retention after pregnancy may contribute to obesity. It is known that diet and exercise are recommended components of any weight loss programme in the general population. However, strategies to achieve healthy body weight among postpartum women have not been adequately evaluated. The objectives of this review were to evaluate the effect of diet, exercise or both for weight reduction in women after childbirth, and to assess the impact of these interventions on maternal body composition, cardiorespiratory fitness, breastfeeding performance and other child and maternal outcomes. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 January 2012) and LILACS (31 January 2012). We scanned secondary references and contacted experts in the field. We updated the search of the Cochrane Pregnancy and Childbirth Group's Trials Register on 30 April 2013 and added the results to the awaiting classification section of the review. All published and unpublished randomised controlled trials (RCTs) and quasi-randomised trials of diet or exercise or both, among women during the postpartum period. Both review authors independently assessed trial quality and extracted data. Results are presented using risk ratio (RR) for categorical data and mean difference (MD) for continuous data. Data were analysed with a fixed-effect model. A random-effects model was used in the presence of heterogeneity. Fourteen trials were included, but only 12 trials involving 910 women contributed data to outcome analysis. Women who exercised did not lose significantly more weight than women in the usual care group (two trials; n = 53; MD -0.10 kg; 95% confidence interval (CI) -1.90 to 1.71). Women who took part in a diet (one trial; n = 45; MD -1.70 kg; 95% CI -2.08 to -1.32), or diet plus exercise programme (seven trials; n = 573; MD -1.93 kg; 95% CI -2.96 to -0.89; random-effects, T² = 1.09, I² = 71%), lost significantly more weight than women in the usual care group. There

  19. [Development of an Instrument to Assess the Quality of Childbirth Care from the Mother's Perspective].

    Science.gov (United States)

    Jeong, Geum Hee; Kim, Hyun Kyoung; Kim, Young Hee; Kim, Sun Hee; Lee, Sun Hee; Kim, Kyung Won

    2018-02-01

    This study aimed to develop an instrument to assess the quality of childbirth care from the perspective of a mother after delivery. The instrument was developed from a literature review, interviews, and item validation. Thirty-eight items were compiled for the instrument. The data for validity and reliability testing were collected using a questionnaire survey conducted on 270 women who had undergone normal vaginal delivery in Korea and analyzed with descriptive statistics, exploratory factor analysis, and reliability coefficients. The exploratory factor analysis reduced the number of items in the instrument to 28 items that were factored into four subscales: family-centered care, personal care, emotional empowerment, and information provision. With respect to convergence validation, there was positive correlation between this instrument and birth satisfaction scale (r=.34, pinstrument could be used as a measure of the quality of nursing care for women who have a normal vaginal delivery. © 2018 Korean Society of Nursing Science.

  20. Workplace Accommodations for Pregnant Employees: Associations With Women's Access to Health Insurance Coverage After Childbirth.

    Science.gov (United States)

    Jou, Judy; Kozhimannil, Katy B; Blewett, Lynn A; McGovern, Patricia M; Abraham, Jean M

    2016-06-01

    This study evaluates the associations between workplace accommodations for pregnancy, including paid and unpaid maternity leave, and changes in women's health insurance coverage postpartum. Secondary analysis using Listening to Mothers III, a national survey of women ages 18 to 45 years who gave birth in U.S. hospitals during 2011 to 2012 (N = 700). Compared with women without access to paid maternity leave, women with access to paid leave were 0.4 times as likely to lose private health insurance coverage, 0.3 times as likely to lose public health coverage, and 0.3 times as likely to become uninsured after giving birth. Workplace accommodations for pregnant employees are associated with health insurance coverage via work continuity postpartum. Expanding protections for employees during pregnancy and after childbirth may help reduce employee turnover, loss of health insurance coverage, and discontinuity of care.

  1. Family leave after childbirth and the mental health of new mothers.

    Science.gov (United States)

    Chatterji, Pinka; Markowitz, Sara

    2012-06-01

    Recent studies indicate that short maternity leave, and, more generally, full-time maternal employment during the first year of life, detract from children's health, cognitive development, and behavioral outcomes. Much less is known, however, about how early parental employment affects the mental and physical health of the mothers themselves. The purpose of this paper is to examine the association between short family leave length (less than 12 weeks of total leave after childbirth, less than 8 weeks of paid leave) and mental and physical health outcomes among new mothers. Data come from the Early Childhood Longitudinal Study--Birth Cohort (ECLS-B), a nationally representative sample of 14,000 children born in 2001 and followed until kindergarten entry. We focus on a sample of ECLS-B mothers from the first wave of the survey who had worked during pregnancy and who had returned to work by the time of the first follow-up interview, which was conducted about 9 months after childbirth. When examining the effects of paternal leave, we further restrict this sample to mothers who were married at the time of the first follow-up interview. The maternal health outcomes of interest are measures of depression and overall health status. We use standard OLS and ordered probit models, as well as two-stage least squares and two-stage residual inclusion methods which address the potential endogeneity of family leave with respect to maternal health. Our findings from the OLS and ordered probit models indicate that, for mothers who worked prior to childbirth and who return to work in the first year, having less than 12 weeks of maternal leave and having less than 8 weeks of paid maternal leave are both associated with increases in depressive symptoms, and having less than 8 weeks of paid leave is associated with a reduction in overall health status. Findings from models that address the potential endogeneity of maternal leave generally support these results, and suggest that longer

  2. SELECTED PROFESSIONAL ACTIVATION INSTRUMENTS OF WOMEN DURING PREGNANCY AND CHILDBIRTH IN POLAND

    Directory of Open Access Journals (Sweden)

    Anna Galik

    2015-03-01

    Full Text Available This article describes selected professional activation instruments of women during their pregnancy and after birth in Poland. An author indicates the main macroeconomic aggregates in the context of women's fertility and analysed available data in order to show the scale of the problem and identify a statistic picture of a woman who enters into motherhood. The article presents the situation of women, employed on the basis of the Labour Code, before and after childbirth in the context of current rights and privileges. The last part of the paper shows different forms of childcare services, their availability and limitations. The purpose of this article is to present the individual behaviour of economically active female as pregnant women, and after birth who make choices based on the available tools, selecting the most beneficial for their households. In conclusion the author identify new solutions that are beneficial for the individual, household, and the whole economy.

  3. Psychological and psychosomatic disorders during pregnancy and childbirth: a review of contemporary international researches

    Directory of Open Access Journals (Sweden)

    Lantsburg M.E.,

    2016-06-01

    Full Text Available In recent decades, the increasing worldwide problems in the reproductive sphere of people, the problem of preserving reproductive health of the population has become very topical, it requires joint medical and psychological efforts. This article presents a review of more than 70 modern English-language scientific publications devoted to the study of psychological and psychosomatic peculiarities of men, women and couples with reproductive disorders and psychological predictors and consequences of these problems. The best known and the least explored psychological aspects of reproductive disorders are highlighted, the results of research are described, also R. Linder’s psychotherapeutic method of preventing premature births is outlined. The article has two parts: the first part presents the research of psychosomatic aspects of male and female reproductive diseases, including infertility; the second one is devoted to psychological and psychosomatic disorders of women during pregnancy and childbirth.

  4. Pregnancy and childbirth: What changes in the lifestyle of women who become mothers?

    Directory of Open Access Journals (Sweden)

    Emília de Carvalho Coutinho

    2014-12-01

    Full Text Available Pregnancy is a period influenced by the interaction of several factors, therefore this study aimed to identify changes in lifestyles due to pregnancy and childbirth in Portuguese and immigrant women in Portugal. This is a qualitative study, using the semi-structured interview, with eighty-two Portuguese and immigrant women. Content analysis was used, with verbatim classification supported by Nvivo 10. It was authorized by an Ethics Commission. Results revealed that the primary changes in lifestyles due to pregnancy were in eating habits (nutrition, daily activity, exposure to danger, sleep and rest patterns, social and family relationships, going out, self-care, work, clothing and footwear, travel, health monitoring and sexual activity and substances consumption. The main change after the birth, manifested by these women, was that their lives began to revolve around their baby.

  5. Validation of the Spanish version of Mackey childbirth satisfaction rating scale.

    Science.gov (United States)

    Caballero, Pablo; Delgado-García, Beatriz E; Orts-Cortes, Isabel; Moncho, Joaquin; Pereyra-Zamora, Pamela; Nolasco, Andreu

    2016-04-16

    The "Mackey Childbirth Satisfaction Rating Scale" (MCSRS) is a complete non-validated scale which includes the most important factors associated with maternal satisfaction. Our primary purpose was to describe the internal structure of the scale and validate the reliability and validity of concept of its Spanish version MCSRS-E. The MCSRS was translated into Spanish, back-translated and adapted to the Spanish population. It was then administered following a pilot test with women who met the study participant requirements. The scale structure was obtained by performing an exploratory factorial analysis using a sample of 304 women. The structures obtained were tested by conducting a confirmatory factorial analysis using a sample of 159 women. To test the validity of concept, the structure factors were correlated with expectations prior to childbirth experiences. McDonald's omegas were calculated for each model to establish the reliability of each factor. The study was carried out at four University Hospitals; Alicante, Elche, Torrevieja and Vinalopo Salud of Elche. The inclusion criteria were women aged 18-45 years old who had just delivered a singleton live baby at 38-42 weeks through vaginal delivery. Women who had difficulty speaking and understanding Spanish were excluded. The process generated 5 different possible internal structures in a nested model more consistent with the theory than other internal structures of the MCSRS applied hitherto. All of them had good levels of validation and reliability. This nested model to explain internal structure of MCSRS-E can accommodate different clinical practice scenarios better than the other structures applied to date, and it is a flexible tool which can be used to identify the aspects that should be changed to improve maternal satisfaction and hence maternal health.

  6. Disrespect and abuse during childbirth in fourteen hospitals in nine cities of Peru.

    Science.gov (United States)

    Montesinos-Segura, Reneé; Urrunaga-Pastor, Diego; Mendoza-Chuctaya, Giuston; Taype-Rondan, Alvaro; Helguero-Santin, Luis M; Martinez-Ninanqui, Franklin W; Centeno, Dercy L; Jiménez-Meza, Yanina; Taminche-Canayo, Ruth C; Paucar-Tito, Liz; Villamonte-Calanche, Wilfredo

    2018-02-01

    To assess the prevalence of disrespect and abuse during childbirth and its associated factors in Peru. In an observational cross-sectional study, women were surveyed within 48 hours of live delivery at 14 hospitals located in nine Peruvian cities between April and July 2016. The survey was based on seven categories of disrespect and abuse proposed by Bowser and Hill. To evaluate factors associated with each category, prevalence ratios (PRs) and 95% confidence intervals (CIs) were calculated using adjusted Poisson models with robust variances. Among 1528 participants, 1488 (97.4%) had experienced at least one category of disrespect and abuse. Frequency of abandonment of care was increased with cesarean delivery (PR 1.27, 95% CI 1.03-1.57) but decreased in the jungle region (PR 0.27, 0.14-0.53). Discrimination was associated with the jungle region (PR 5.67, 2.32-13.88). Physical abuse was less frequent with cesarean than vaginal delivery (PR 0.23, 0.11-0.49). The prevalences of abandonment of care (PR 0.42, 0.29-0.60), non-consented care (PR 0.70, 0.57-0.85), discrimination (PR 0.40, 0.19-0.85), and non-confidential care (PR 0.71, 0.55-0.93) were decreased among women who had been referred. Nearly all participants reported having experienced at least one category of disrespect and abuse during childbirth care, which was associated with type of delivery, being referred, and geographic region. © 2017 International Federation of Gynecology and Obstetrics.

  7. Non-invasive nursing technologies for pain relief during childbirth--the Brazilian nurse midwives' view.

    Science.gov (United States)

    Vargens, Octavio M C; Silva, Alexandra C V; Progianti, Jane M

    2013-11-01

    to describe the non-invasive care technologies most frequently used by nurse midwives to relieve childbirth pain, and provide a synthesis of studies published by Brazilian nurse midwives on the use of such technologies. a systematic literature review focusing on the non-invasive pain relief strategies used by nurse midwives in Brazil. Surveys of three databases (BDENF, CINAHL and MEDLINE) were conducted between 2002 and 2012. The inclusion criteria were: (1) full-text article available; (2) published between 2002 and 2012; (3) written by Brazilian nurse midwives, and (4) fitting the descriptors: childbirth pain; non-invasive technologies; labour; and pain relief. For purposes of analysis, the technologies mentioned were classified into four main categories of support as they relate to environment, position, tactile stimulation, and energy level. we located 21 scientific articles that met the inclusion criteria and addressed the non-invasive technologies that nurse midwives use to provide pain relief during labour. The technologies most used was: stimulation of breathing and relaxation; use of massage with essential oils; encouraging freedom to move, to walk and the free choice for vertical positioning; use of showers and baths; use of birth ball. Brazilian nurse midwives have made efforts to focus care during delivery on the parturient. By studying and publishing about the non-invasive care technologies they have strengthened de-medicalised knowledge, based on scientific evidence and good outcomes in pain relief during labour. the study presented ideas towards improved theoretical foundations and strategies for establishing practice consonant with humanised care. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. Perceived Social Support and Maternal Competence in Primipara Women during Pregnancy and After Childbirth

    Directory of Open Access Journals (Sweden)

    Sara Esmaelzadeh Saeieh

    2017-10-01

    Full Text Available Background: Developing maternal competence in first time mothers has a significant impact on neonate’s growth psychosocial development and neonates growth and psychological development. Social support can be an important element for becoming a new mother. We aimed to investigate how social support and maternal competence change during pregnancy and 4 months after it and examine the relationships among social support and maternal competence. Methods: This longitudinal study was conducted on 100 first time mothers attending health centers in Alborz city, Alborz Province, between February 2015 and January 2016. Data were collected through perceived social support questionnaire that consisted of 12 questions and Parenting Sense of Competence Scale consisting of 17 items scored based on Likert’s scale. The collected data were analyzed by SPSS software, version 16. Repeated-measure test and Pearson’s correlation coefficient were used. P<0.05 was considered significant. Results: Maternal competence significantly reduced during the study (P=0.008, while perceived social support did not show any significant reduction (P=0.286. A direct relationship was found between social support and maternal competent six weeks after childbirth (r=0.19, P=0.049, and also social support and maternal competence sixteen weeks after childbirth (r=0.23, P=0.01. Conclusion: Considering the reduction of maternal competency during the study, social support by healthcare providers may be helpful for the mothers’ transition to motherhood, and midwives must design specific interventions to promote the sense of maternal competence and perceived social support in first time mothers.

  9. Pregnancy and childbirth after repair of obstetric fistula in sub-Saharan Africa: Scoping Review.

    Science.gov (United States)

    Delamou, Alexandre; Utz, Bettina; Delvaux, Therese; Beavogui, Abdoul Habib; Shahabuddin, Asm; Koivogui, Akoi; Levêque, Alain; Zhang, Wei-Hong; De Brouwere, Vincent

    2016-11-01

    To synthesise the evidence on pregnancy and childbirth after repair of obstetric fistula in sub-Saharan Africa and to identify the existing knowledge gaps. A scoping review of studies reporting on pregnancy and childbirth in women who underwent repair for obstetric fistula in sub-Saharan Africa was conducted. We searched relevant articles published between 1 January 1970 and 31 March 2016, without methodological or language restrictions, in electronic databases, general Internet sources and grey literature. A total of 16 studies were included in the narrative synthesis. The findings indicate that many women in sub-Saharan Africa still desire to become pregnant after the repair of their obstetric fistula. The overall proportion of pregnancies after repair estimated in 11 studies was 17.4% (ranging from 2.5% to 40%). Among the 459 deliveries for which the mode of delivery was reported, 208 women (45.3%) delivered by elective caesarean section (CS), 176 women (38.4%) by emergency CS and 75 women (16.3%) by vaginal delivery. Recurrence of fistula was a common maternal complication in included studies while abortions/miscarriage, stillbirths and neonatal deaths were frequent foetal consequences. Vaginal delivery and emergency C-section were associated with increased risk of stillbirth, recurrence of the fistula or even maternal death. Women who get pregnant after repair of obstetric fistula carry a high risk for pregnancy complications. However, the current evidence does not provide precise estimates of the incidence of pregnancy and pregnancy outcomes post-repair. Therefore, studies clearly assessing these outcomes with the appropriate study designs are needed. © 2016 John Wiley & Sons Ltd.

  10. Returning to work one year after childbirth: data from the mother-child cohort EDEN.

    Science.gov (United States)

    Wallace, Maeve; Saurel-Cubizolles, Marie-Josèphe

    2013-10-01

    The amount of time women spend out of work postpartum has implications for both health and economic trajectories which may result in long-term social inequities or exacerbate those already existing. The purpose of this investigation was to describe the characteristics of women who return to work within the first year postpartum and to identify specific occupational and health factors associated with returning to work among women who worked during pregnancy. The EDEN cohort is comprised of pregnant women recruited in two French university hospitals before 24 weeks gestation with a singleton pregnancy. Questionnaires were administered at 4, 8, and 12 months after birth. Multivariate logistic regression was used to model the odds of returning to work within 1 year of childbirth with inclusion of sociodemographic, health, and occupational variables that were significantly related to returning to work at the level of p worked during pregnancy in our sample had resumed work before their infant's first birthday. After adjustment, occupational level, full-time work, standing position, job reward, desire to change job, education, and father's occupational level remained significantly associated with returning to work. Women's perception of their work as rewarding was the strongest predictor of resuming employment (OR comparing high reward to low reward: 2.48, 95 % CI: 1.60-3.83 for women with parity 0 or 1). Experiencing an adverse birth outcome had no relation to returning to work within 1 year postpartum. Across all indicator variables, women of higher socioeconomic status or with greater resources had greater odds of returning to work compared to those of lower status. This suggests that the crucial period of employment transition around the time of childbirth may intensify preexisting social inequalities.

  11. Travel Time to Hospital for Childbirth: Comparing Calculated Versus Reported Travel Times in France.

    Science.gov (United States)

    Pilkington, Hugo; Prunet, Caroline; Blondel, Béatrice; Charreire, Hélène; Combier, Evelyne; Le Vaillant, Marc; Amat-Roze, Jeanne-Marie; Zeitlin, Jennifer

    2018-01-01

    Objectives Timely access to health care is critical in obstetrics. Yet obtaining reliable estimates of travel times to hospital for childbirth poses methodological challenges. We compared two measures of travel time, self-reported and calculated, to assess concordance and to identify determinants of long travel time to hospital for childbirth. Methods Data came from the 2010 French National Perinatal Survey, a national representative sample of births (N = 14 681). We compared both travel time measures by maternal, maternity unit and geographic characteristics in rural, peri-urban and urban areas. Logistic regression models were used to study factors associated with reported and calculated times ≥30 min. Cohen's kappa coefficients were also calculated to estimate the agreement between reported and calculated times according to women's characteristics. Results In urban areas, the proportion of women with travel times ≥30 min was higher when reported rather than calculated times were used (11.0 vs. 3.6%). Longer reported times were associated with non-French nationality [adjusted odds ratio (aOR) 1.3 (95% CI 1.0-1.7)] and inadequate prenatal care [aOR 1.5 (95% CI 1.2-2.0)], but not for calculated times. Concordance between the two measures was higher in peri-urban and rural areas (52.4 vs. 52.3% for rural areas). Delivery in a specialised level 2 or 3 maternity unit was a principal determinant of long reported and measured times in peri-urban and rural areas. Conclusions for Practice The level of agreement between reported and calculated times varies according to geographic context. Poor measurement of travel time in urban areas may mask problems in accessibility.

  12. An evaluation of mindfulness-based childbirth and parenting courses for pregnant women and prospective fathers/partners within the UK NHS (MBCP-4-NHS).

    Science.gov (United States)

    Warriner, Sian; Crane, Catherine; Dymond, Maret; Krusche, Adele

    2018-05-26

    An evaluation of mindfulness-based childbirth and parenting courses for pregnant women and prospective fathers/partners within the UK NHS (MBCP-4-NHS). To explore the usefulness within the National Health Service (NHS) of a brief (four week, ten hour) course based upon the Mindfulness Based Childbirth and Parenting (MBCP) programme (Duncan and Bardacke, 2010) described here as MBCP-4-NHS. The National Maternity Review (2016) and report of The Independent Mental Health Taskforce to the NHS (2016a, 2016b) in England highlight the need for significant investment into perinatal mental health services, with the Government pledging funding to improve such services through a range of measures. Whilst the field of mindfulness during the perinatal period is in need of well controlled trials and studies exploring the mechanisms of action (Hall et al., 2016) the limited research to date supports the potential for mindfulness based interventions in pregnancy and the need for further scientific study in this area (Dhillon et al., 2017; Shi and Macbeth, 2017). Particularly because it may broaden women's repertoire of coping strategies with the potential to improve the developmental trajectory of both parents and infants (Dunn et al., 2012; Duncan and Bardacke, 2010; Vieten and Astin, 2008). However, most of the studies to date have involved lengthy courses of around 8-9 weeks (24 h) duration, which may not be feasible or economical within a UK NHS setting and therefore, would be unlikely to be adopted as routine practice. An initial pilot study to discover if MBCP-4-NHS is acceptable and feasible within NHS maternity services, comparing maternal and paternal pre and post intervention self-report measures of mental health to begin to explore the effectiveness of this intervention. NHS antenatal education classes held in children's centres for expectant parents across Oxfordshire. All expectant parents receiving Oxfordshire maternity services between October 2014 and January 2015

  13. Class 1 Areas

    Data.gov (United States)

    U.S. Environmental Protection Agency — A "Class 1" area is a geographic area recognized by the EPA as being of the highest environmental quality and requiring maximum protection. Class I areas are areas...

  14. PRCR Classes and Activities

    Data.gov (United States)

    Town of Cary, North Carolina — This data is specific to Parks and Recreation classes, workshops, and activities within the course catalog. It contains an entry for upcoming classes.*This data set...

  15. Women?s status and experiences of mistreatment during childbirth in Uttar Pradesh: a mixed methods study using cultural health capital theory

    OpenAIRE

    Sudhinaraset, May; Treleaven, Emily; Melo, Jason; Singh, Kanksha; Diamond-Smith, Nadia

    2016-01-01

    Background Mistreatment of women in healthcare settings during childbirth has been gaining attention globally. Mistreatment during childbirth directly and indirectly affects health outcomes, patient satisfaction, and the likelihood of delivering in a facility currently or in the future. It is important that we study patients? reports of mistreatment and abuse to develop a deeper understanding of how it is perpetrated, its consequences, and to identify potential points of intervention. Patient...

  16. The BetterBirth Program: Pursuing Effective Adoption and Sustained Use of the WHO Safe Childbirth Checklist Through Coaching-Based Implementation in Uttar Pradesh, India

    OpenAIRE

    Kara, Nabihah; Firestone, Rebecca; Kalita, Tapan; Gawande, Atul A; Kumar, Vishwajeet; Kodkany, Bhala; Saurastri, Rajiv; Pratap Singh, Vinay; Maji, Pinki; Karlage, Ami; Hirschhorn, Lisa R; Semrau, Katherine EA

    2017-01-01

    Shifting childbirth into facilities has not improved health outcomes for mothers and newborns as significantly as hoped. Improving the quality and safety of care provided during facility-based childbirth requires helping providers to adhere to essential birth practices?evidence-based behaviors that reduce harm to and save lives of mothers and newborns. To achieve this goal, we developed the BetterBirth Program, which we tested in a matched-pair, cluster-randomized controlled trial in Uttar Pr...

  17. Class Notes for "Class-Y-News."

    Science.gov (United States)

    Stuart, Judy L.

    1991-01-01

    A self-contained class of students with mild to moderate disabilities published a monthly newsletter which was distributed to students' families. Students became involved in writing, typing, drawing, folding, basic editing, and disseminating. (JDD)

  18. Classed identities in adolescence

    OpenAIRE

    Jay, Sarah

    2015-01-01

    peer-reviewed The central argument of this thesis is that social class remains a persistent system of inequality in education, health, life chances and opportunities. Therefore class matters. But why is it that so little attention has been paid to class in the psychological literature? Three papers are presented here which draw together theoretical advances in psychological understandings of group processes and sociological understandings of the complexity of class. As western labour marke...

  19. Understanding the increase in the number of childbirth-related leave beneficiaries in Serbia

    Directory of Open Access Journals (Sweden)

    Stanić Katarina

    2017-01-01

    Full Text Available Over the past number of years, the public expenditures for childbirth-related leave benefits have more than doubled – in 2015 amounted to 0.7% GDP in relation to 0.3% GDP in 2002. This increase can mainly be attributed to the increased number of beneficiaries that grew consistently from 24 thousand in 2002 up to 40 thousand in 2015, despite the fact that the annual number of live births has been almost continually decreasing and the registered employment has dropped by almost 20 per cent in the observed period. One of the clear reasons explaining part of this increase is the extension of 3+ order of birth leaves in 2006, from one to two years, which can explain the increase of around 3.5 thousand of beneficiaries. Another reason is high number of beneficiaries using special child-care leave meant for parents with children with disabilities, but which, in reality, is very often used simply as the extension of parental leave. The average number of special child-care leave beneficiaries in the second half of 2015 amounted to 2.8 thousand. When these two effects are taken into account, we still notice significant increase of beneficiaries of around 10 thousand in the observed period. Fictitious employment during the pregnancy can explain this increase to some extent. Available data unambiguously show that a number of women formally employing during the second and third trimester of pregnancy has increased from 800 in 2002 to almost 3.5 thousand monthly average in the second half of 2015. There are two flaws of the childbirth-related leave programme in Serbia, which together lead to the constant increase of the number of beneficiaries. First is the lack of flexibility of the programme, both in terms of eligibility for acquiring the right as well as in terms of flexibility in use. Maternity/parental leave benefit may acquire only those in „standard employment” i.e. employed under employment contract (and entrepreneurs while other type of

  20. An economic evaluation alongside a randomised controlled trial on psycho-education counselling intervention offered by midwives to address women's fear of childbirth in Australia.

    Science.gov (United States)

    Turkstra, Erika; Mihala, Gabor; Scuffham, Paul A; Creedy, Debra K; Gamble, Jenny; Toohill, Jocelyn; Fenwick, Jennifer

    2017-03-01

    The rate of caesarean section continues to increase, and there is evidence that childbirth fear is a contributing factor. Insufficient evidence is available on the impact of reducing childbirth fear on health-related quality of life and health service use. We undertook an economic evaluation of a psycho-education counselling intervention offered by midwives to address women's fear of childbirth in Australia. Pregnant women (n = 339) with high childbirth fear were randomised to a midwife-led psycho-education intervention for childbirth fear or to usual care. This paper presents the economic evaluation of the intervention based on health-related quality of life and health service use from recruitment to six weeks postpartum (n = 184). The changes in health-related quality of life after birth (EQ-5D-3L: 0.016 vs. 0.010, p = 0.833, for usual care and intervention) and total health care use cost (AUS$10,110 vs. AUS$9980, p = 0.819) were similar between groups. The intervention did not increase costs; however, in a post hoc analysis, the interventions might be cost-effective for those women with very high childbirth fear. This brief psycho-education intervention by midwives did not improve the health-related quality of life of women, and had no impact on overall cost. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. Audit of Childbirth Emergency Referrals by Trained Traditional Birth Attendants in Enugu, Southeast, Nigeria.

    Science.gov (United States)

    Okafor, I I; Arinze-Onyia, S U; Ohayi, Sar; Onyekpa, J I; Ugwu, E O

    2015-01-01

    The essence of training traditional birth attendants (TBAs) is to attend to women in uncomplicated labor and to refer them immediately to hospitals when complications develop. The aim was to audit childbirth emergency referrals by trained TBAs to a specialist hospital in Enugu, Nigeria. A retrospective study of 205 childbirth emergencies referred to Semino Hospital and Maternity (SHM), Enugu by trained TBAs from August 1, 2011 to January 31, 2014. Data analysis was descriptive and inferential at 95% confidence level. Most of the patients (185/205, 90.2%) were married and (100/205, 48.8%) had earlier booked for antenatal care in formal health facilities. There were obstetric danger signs or previous bad obstetric histories (pregnancies with unfavorable outcome) in 110 (110/205, 53.7%) women on admission at SHM. One hundred and fifteen (115/205, 56.1%) women walked into the hospital by themselves while 50 (50/205, 24.39%) could not walk. The fetal heart sounds were normal in 94 (94/205, 45.6%), abnormal in 65 (65/205, 31.8%) and absent in 42 (42/205, 20.4%) of the women on admission. Five healthy babies were delivered by the TBAs before referring their mothers. Delays of more than 12 h had occurred in 155 (155/205, 76.6%) of the women before referrals. Prolonged labor (100/205, 48.8%), obstructed labor (40/205, 19.5%), attempted vaginal birth after previous cesarean delivery (40/205, 19.5%) and malpresentation (30/205, 14.6%) were the common indications for referrals. The maternal mortality and perinatal mortality ratios were 610/100,000 live births and 228/1000 total births respectively. Delays at TBA centers are common before referral and most patients are referred in poor clinical state. Further training and re-training of the TBAs with more emphasis on recognition of obstetric danger signs and bad obstetric histories may help in screening high-risk patients for prompt referral to hospitals before complications develop.

  2. Prenatal exposure to maternal bereavement and childbirths in the offspring: a population-based cohort study.

    Science.gov (United States)

    Plana-Ripoll, Oleguer; Olsen, Jørn; Andersen, Per Kragh; Gómez, Guadalupe; Cnattingius, Sven; Li, Jiong

    2014-01-01

    The decline in birth rates is a concern in public health. Fertility is partly determined before birth by the intrauterine environment and prenatal exposure to maternal stress could, through hormonal disturbance, play a role. There has been such evidence from animal studies but not from humans. We aimed to examine the association between prenatal stress due to maternal bereavement following the death of a relative and childbirths in the offspring. This population-based cohort study included all subjects born in Denmark after 1968 and in Sweden after 1973 and follow-up started at the age of 12 years. Subjects were categorized as exposed if their mothers lost a close relative during pregnancy or the year before and unexposed otherwise. The main outcomes were age at first child and age-specific mean numbers of childbirths. Data was analyzed using Cox Proportional Hazards models stratified by gender and adjusted for several covariates. Subanalyses were performed considering the type of relative deceased and timing of bereavement. A total of 4,121,596 subjects were followed-up until up to 41 years of age. Of these subjects, 93,635 (2.3%) were exposed and 981,989 (23.8%) had at least one child during follow-up time. Compared to unexposed, the hazard ratio (HR) [95% confidence interval] of having at least one child for exposed males and females were 0.98 [0.96-1.01] and 1.01 [0.98-1.03], respectively. We found a slightly reduced probability of having children in females born to mothers who lost a parent with HR = 0.97 [0.94-0.99] and increased probability in females born to mothers who lost another child (HR = 1.09 [1.04-1.14]), the spouse (HR = 1.29 [1.12-1.48]) or a sibling (HR = 1.13 [1.01-1.27]). Our results suggested no overall association between prenatal exposure to maternal stress and having a child in early adulthood but a longer time of follow-up is necessary in order to reach a firmer conclusion.

  3. Prenatal exposure to maternal bereavement and childbirths in the offspring: a population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Oleguer Plana-Ripoll

    Full Text Available The decline in birth rates is a concern in public health. Fertility is partly determined before birth by the intrauterine environment and prenatal exposure to maternal stress could, through hormonal disturbance, play a role. There has been such evidence from animal studies but not from humans. We aimed to examine the association between prenatal stress due to maternal bereavement following the death of a relative and childbirths in the offspring.This population-based cohort study included all subjects born in Denmark after 1968 and in Sweden after 1973 and follow-up started at the age of 12 years. Subjects were categorized as exposed if their mothers lost a close relative during pregnancy or the year before and unexposed otherwise. The main outcomes were age at first child and age-specific mean numbers of childbirths. Data was analyzed using Cox Proportional Hazards models stratified by gender and adjusted for several covariates. Subanalyses were performed considering the type of relative deceased and timing of bereavement.A total of 4,121,596 subjects were followed-up until up to 41 years of age. Of these subjects, 93,635 (2.3% were exposed and 981,989 (23.8% had at least one child during follow-up time. Compared to unexposed, the hazard ratio (HR [95% confidence interval] of having at least one child for exposed males and females were 0.98 [0.96-1.01] and 1.01 [0.98-1.03], respectively. We found a slightly reduced probability of having children in females born to mothers who lost a parent with HR = 0.97 [0.94-0.99] and increased probability in females born to mothers who lost another child (HR = 1.09 [1.04-1.14], the spouse (HR = 1.29 [1.12-1.48] or a sibling (HR = 1.13 [1.01-1.27].Our results suggested no overall association between prenatal exposure to maternal stress and having a child in early adulthood but a longer time of follow-up is necessary in order to reach a firmer conclusion.

  4. POSTPARTUM BONDING DIFFICULTIES AND ADULT ATTACHMENT STYLES: THE MEDIATING ROLE OF POSTPARTUM DEPRESSION AND CHILDBIRTH-RELATED PTSD.

    Science.gov (United States)

    S Hairston, Ilana; E Handelzalts, Jonathan; Assis, Chen; Kovo, Michal

    2018-03-01

    Despite decades of research demonstrating the role of adult attachment styles and early mother-infant bonding in parenting behaviors and maternal mental health, these constructs have seldom been studied together. The present study aimed to investigate the relationship between attachment styles and specific bonding difficulties of mothers. In addition, as postpartum depression and childbirth-related posttraumatic stress symptoms have been associated with both constructs, we explored their possible mediation effect. One hundred fourteen mothers, 4 to 12 weeks' postpartum, completed a demographic questionnaire, the Adult Attachment Style Questionnaire (M. Mikulincer, V. Florian, & A. Tolmacz, 1990), the Postpartum Bonding Questionnaire (L.F. Brockington, C. Fraser, & D. Wilson, 2006), the Modified Perinatal Posttraumatic Stress Disorder Questionnaire (J.L. Callahan, S.E. Borja, & M.T. Hynan, 2006), and the Edinburgh Postnatal Depression Scale (J.L. Cox, G. Chapman, D. Murray, & P. Jones, 1996), using an online survey system. As predicted, insecure attachment styles were associated with bonding difficulties wherein anxious/ambivalent attachment was associated with greater infant-focused anxiety, mediated by postpartum depression but not childbirth-related PTSD symptoms. In contrast, greater avoidant attachment style was associated with greater rejection and anger, mediated by childbirth-related posttraumatic stress disorder (PTSD), but not depression symptoms. The current study confirmed the association of different attachment styles with bonding as well as the mediating roles of childbirth-related PTSD and postpartum depression symptoms. Future psychological interventions may utilize such evidence to target interventions for bonding disorders in accordance with individual differences. © 2018 Michigan Association for Infant Mental Health.

  5. Criteria to facilitate the implementation of woman-centred care in childbirth units of Limpopo Province, South Africa (Part 2

    Directory of Open Access Journals (Sweden)

    Maria S. Maputle

    2013-05-01

    Full Text Available Background: Facilitation of mutual participation, respectful and egalitarian relationship between the mother and the midwife during childbirth is a critical aspect. This article delineated the criteria that would facilitate the implementation of woman-centred care in childbirth units of the Limpopo Province in South Africa, following a concept analysis described in Part 1. Empirical referents or indicators were used to measure the concept woman-centred care and to validate its existence in reality. These empirical referents were referred to as measurable properties that further verified the concept. Objective: The objective of this article was to formulate criteria that would facilitate implementation of woman-centred care in childbirth units of Limpopo Province in South Africa. Method: Criteria to facilitate the implementation of woman-centred care were formulated by the gathering of information about the topic under review and the use of resources to define the key elements of the criteria which were integrated into the Batho Pele principles. The criteria were then validated by selecting with a vested interest in the successful development and implementation of the criteria. Results: Criteria were formulated to facilitate the implementation of woman-centred care that was integrated within the framework of Batho Pele principles. Conclusion: These formulated criteria for woman-centred care will be used as an institutional self-evaluation tool to enhance implementation of the Batho Pele principles in childbirth units. These criteria will give direction and provide guidelines for the performance of midwifery staff and will also help supervisors to guide staff to improve performance.

  6. Criteria to facilitate the implementation of woman-centred care in childbirth units of Limpopo Province, South Africa (Part 2

    Directory of Open Access Journals (Sweden)

    Maria S. Maputle

    2013-05-01

    Full Text Available Background: Facilitation of mutual participation, respectful and egalitarian relationship between the mother and the midwife during childbirth is a critical aspect. This article delineated the criteria that would facilitate the implementation of woman-centred care in childbirth units of the Limpopo Province in South Africa, following a concept analysis described in Part 1. Empirical referents or indicators were used to measure the concept woman-centred care and to validate its existence in reality. These empirical referents were referred to as measurable properties that further verified the concept. Objective: The objective of this article was to formulate criteria that would facilitate implementation of woman-centred care in childbirth units of Limpopo Province in South Africa.Method: Criteria to facilitate the implementation of woman-centred care were formulated by the gathering of information about the topic under review and the use of resources to define the key elements of the criteria which were integrated into the Batho Pele principles. The criteria were then validated by selecting with a vested interest in the successful development and implementation of the criteria. Results: Criteria were formulated to facilitate the implementation of woman-centred care that was integrated within the framework of Batho Pele principles. Conclusion: These formulated criteria for woman-centred care will be used as an institutional self-evaluation tool to enhance implementation of the Batho Pele principles in childbirth units. These criteria will give direction and provide guidelines for the performance of midwifery staff and will also help supervisors to guide staff to improve performance.

  7. Returning to Work after Childbirth in Europe: Well-Being, Work-Life Balance, and the Interplay of Supervisor Support

    OpenAIRE

    Ana M. Lucia-Casademunt; Antonia M. García-Cabrera; Laura Padilla-Angulo; Deybbi Cuéllar-Molina

    2018-01-01

    Parents returning to work after the arrival of a new son or daughter is an important question for understanding the trajectory of people's lives and professional careers amid current debates about gender equality and work-life balance (WLB). Interestingly, current research concludes that general WLB practices at the workplace may be necessary in the specific case of women returning to work after childbirth because of the particular maternal and infant factors involved. However, WLB practices ...

  8. Father for the first time - development and validation of a questionnaire to assess fathers’ experiences of first childbirth (FTFQ

    Directory of Open Access Journals (Sweden)

    Premberg Åsa

    2012-05-01

    Full Text Available Abstract Background A father’s experience of the birth of his first child is important not only for his birth-giving partner but also for the father himself, his relationship with the mother and the newborn. No validated questionnaire assessing first-time fathers' experiences during childbirth is currently available. Hence, the aim of this study was to develop and validate an instrument to assess first-time fathers’ experiences of childbirth. Method Domains and items were initially derived from interviews with first-time fathers, and supplemented by a literature search and a focus group interview with midwives. The comprehensibility, comprehension and relevance of the items were evaluated by four paternity research experts and a preliminary questionnaire was pilot tested in eight first-time fathers. A revised questionnaire was completed by 200 first-time fathers (response rate = 81% Exploratory factor analysis using principal component analysis with varimax rotation was performed and multitrait scaling analysis was used to test scaling assumptions. External validity was assessed by means of known-groups analysis. Results Factor analysis yielded four factors comprising 22 items and accounting 48% of the variance. The domains found were Worry, Information, Emotional support and Acceptance. Multitrait analysis confirmed the convergent and discriminant validity of the domains; however, Cronbach’s alpha did not meet conventional reliability standards in two domains. The questionnaire was sensitive to differences between groups of fathers hypothesized to differ on important socio demographic or clinical variables. Conclusions The questionnaire adequately measures important dimensions of first-time fathers’ childbirth experience and may be used to assess aspects of fathers’ experiences during childbirth. To obtain the FTFQ and permission for its use, please contact the corresponding author.

  9. A prospective longitudinal study of the prevalence of post-traumatic stress disorder resulting from childbirth events.

    Science.gov (United States)

    Alcorn, K L; O'Donovan, A; Patrick, J C; Creedy, D; Devilly, G J

    2010-11-01

    Childbirth has been linked to postpartum impairment. However, controversy exists regarding the onset and prevalence of post-traumatic stress disorder (PTSD) after childbirth, with seminal studies being limited by methodological issues. This longitudinal prospective study examined the prevalence of PTSD following childbirth in a large sample while controlling for pre-existing PTSD and affective symptomatology. Pregnant women in their third trimester were recruited over a 12-month period and interviewed to identify PTSD and anxiety and depressive symptoms during the last trimester of pregnancy, 4-6 weeks postpartum, 12 weeks postpartum and 24 weeks postpartum. Of the 1067 women approached, 933 were recruited into the study. In total, 866 (93%) were retained to 4-6 weeks, 826 (89%) were retained to 12 weeks and 776 (83%) were retained to 24 weeks. Results indicated that, uncontrolled, 3.6% of women met PTSD criteria at 4-6 weeks postpartum, 6.3% at 12 weeks postpartum and 5.8% at 24 weeks postpartum. When controlling for PTSD and partial PTSD due to previous traumatic events as well as clinically significant anxiety and depression during pregnancy, PTSD rates were less at 1.2% at 4-6 weeks, 3.1% at 12 weeks and 3.1% at 24 weeks postpartum. This is the first study to demonstrate the occurrence of full criteria PTSD resulting from childbirth after controlling for pre-existing PTSD and partial PTSD and clinically significant depression and anxiety in pregnancy. The findings indicate that PTSD can result from a traumatic birth experience, though this is not the normative response.

  10. Fear of childbirth and obstetrical events as predictors of postnatal symptoms of depression and post-traumatic stress disorder.

    Science.gov (United States)

    Fairbrother, Nichole; Woody, Sheila R

    2007-12-01

    This prospective study examined psychological and obstetrical predictors of enduring postpartum symptoms of depression and post-traumatic stress disorder. Contrary to prediction, prenatal fear of childbirth did not significantly predict symptoms of depression or post-traumatic stress disorder at one month postpartum, but anxiety sensitivity was an unexpected predictor that merits further investigation. Several obstetrical and neonatal variables significantly predicted symptoms of post-traumatic disorder, but not depression.

  11. Women’s employment patterns after childbirth and the perceived access to and use of flexitime and teleworking

    Science.gov (United States)

    Chung, Heejung; van der Horst, Mariska

    2017-01-01

    This article sets out to investigate how flexitime and teleworking can help women maintain their careers after childbirth. Despite the increased number of women in the labour market in the UK, many significantly reduce their working hours or leave the labour market altogether after childbirth. Based on border and boundary management theories, we expect flexitime and teleworking can help mothers stay employed and maintain their working hours. We explore the UK case, where the right to request flexible working has been expanded quickly as a way to address work–life balance issues. The dataset used is Understanding Society (2009–2014), a large household panel survey with data on flexible work. We find some suggestive evidence that flexible working can help women stay in employment after the birth of their first child. More evidence is found that mothers using flexitime and with access to teleworking are less likely to reduce their working hours after childbirth. This contributes to our understanding of flexible working not only as a tool for work–life balance, but also as a tool to enhance and maintain individuals’ work capacities in periods of increased family demands. This has major implications for supporting mothers’ careers and enhancing gender equality in the labour market. PMID:29276304

  12. Cost of hospitalization for childbirth in India: how equitable it is in the post-NRHM era?

    Science.gov (United States)

    Tripathy, Jaya Prasad; Shewade, Hemant D; Mishra, Sanskruti; Kumar, A M V; Harries, A D

    2017-08-15

    Information on out-of-pocket (OOP) expenditure during childbirth in public and private health facilities in India is needed to make rational decisions for improving affordability to maternal care services. We undertook this study to evaluate the OOP expenditure due to hospitalization from childbirth and its impact on households. This is a secondary data analysis of a nationwide household survey by the National Sample Survey Organization in 2014. The survey reported health service utilization and health care related expenditure by income quintiles and type of health facility. The recall period for hospitalization expenditure was 365 days. OOP expenditure amounting to more than 10% of annual consumption expenditure was termed as catastrophic. Median expenditure per episode of hospitalisation due to childbirth was US$54. The expenditure incurred was about six times higher among the richest quintile compared to the poorest quintile. Median private sector OOP hospitalization expenditure was nearly nine times higher than in the public sector. Hospitalization in a private sector facility leads to a significantly higher prevalence of catastrophic expenditure than hospitalization in a public sector (60% vs. 7%). Indirect cost (43%) constituted the largest share in the total expenditure in public sector hospitalizations. Urban residence, poor wealth quintile, residing in eastern and southern regions of India and delivery in private hospital were significantly associated with catastrophic expenditure. We strongly recommend cash transfer schemes with effective pro-poor targeting to reduce the impact of catastrophic expenditure. Strengthening of public health facilities is required along with private sector regulation.

  13. Non-pharmacological interventions during childbirth for pain relief, anxiety, and neuroendocrine stress parameters: A randomized controlled trial.

    Science.gov (United States)

    Henrique, Angelita José; Gabrielloni, Maria Cristina; Rodney, Patricia; Barbieri, Márcia

    2018-03-07

    This study aimed to investigate the effect of warm shower hydrotherapy and perineal exercises with a ball on pain, anxiety, and neuroendocrine stress parameters during childbirth. This randomized controlled trial was conducted with 128 women during childbirth, admitted for hospital birth in São Paulo, Brazil, from June 2013 to February 2014. The participants were randomly assigned into one of the following intervention groups: received warm shower hydrotherapy (GA); performed perineal exercises with a ball (GB); and combined intervention group, which received warm shower hydrotherapy and perineal exercises with a ball (GC) (n = 39). Pre-and post-intervention parameters were evaluated using visual analogue scales for pain and anxiety, and salivary samples were collected for the stress hormones analysis. Pain, anxiety, and epinephrine release decreased in the group performing perineal exercises with a ball (GB). β-endorphin levels increased in this group (GB) after the intervention and showed significant difference in capacity to cause this effect (P = .007). However, no significant differences were observed in cortisol, epinephrine, and norepinephrine levels. Warm showers and perineal exercises could be considered as adjunct therapy for women suffering from pain, anxiety, and stress during childbirth. Clinical Trial Registry RBR-84xprt. © 2018 John Wiley & Sons Australia, Ltd.

  14. Childhood sexual abuse, intimate partner violence during pregnancy, and posttraumatic stress symptoms following childbirth: a path analysis.

    Science.gov (United States)

    Oliveira, Aline Gaudard E Silva de; Reichenheim, Michael Eduardo; Moraes, Claudia Leite; Howard, Louise Michele; Lobato, Gustavo

    2017-04-01

    The aim of the study was to explore the pathways by which childhood sexual abuse (CSA), psychological and physical intimate partner violence (IPV) during pregnancy, and other covariates relate to each other and to posttraumatic stress disorder (PTSD) symptoms in the postpartum period. The sample comprised 456 women who gave birth at a maternity service for high-risk pregnancies in Rio de Janeiro, Brazil, interviewed at 6-8 weeks after birth. A path analysis was carried out to explore the postulated pathways between exposures and outcome. Trauma History Questionnaire, Conflict Tactics Scales and Posttraumatic Stress Disorder Checklist were used to assess information about exposures of main interest and outcome. The link between CSA and PTSD symptoms was mediated by history of trauma, psychiatric history, psychological IPV, and fear of childbirth during pregnancy. Physical IPV was directly associated with postnatal PTSD symptoms, whereas psychological IPV connection seemed to be partially mediated by physical abuse and fear of childbirth during pregnancy. The role of CSA, IPV, and other psychosocial characteristics on the occurrence of PTSD symptoms following childbirth as well as the intricate network of these events should be acknowledged in clinic and intervention approaches.

  15. Work-family balance after childbirth: the association between employer-offered leave characteristics and maternity leave duration.

    Science.gov (United States)

    Guendelman, Sylvia; Goodman, Julia; Kharrazi, Martin; Lahiff, Maureen

    2014-01-01

    Early return to work after childbirth has been increasing among working mothers in the US. We assessed the relationship between access to employer-offered maternity leave (EOML) (both paid and unpaid) and uptake and duration of maternity leave following childbirth in a socio-economically diverse sample of full-time working women. We focus on California, a state that has long provided more generous maternity leave benefits than those offered by federal maternity leave policies through the State Disability Insurance program. The sample included 691 mothers who gave birth in Southern California in 2002-2003. Using weighted logistic regression, we examined the EOML-maternity leave duration relationship, controlling for whether the leave was paid, as well as other occupational, personality and health-related covariates. Compared with mothers who were offered more than 12 weeks of maternity leave, mothers with leave had six times higher odds of an early return. These relationships were similar after controlling for whether the leave was paid and after controlling for other occupational and health characteristics. Access to and duration of employer-offered maternity leave significantly determine timing of return to work following childbirth, potentially affecting work-family balance. Policy makers should recognize the pivotal role of employers in offering job security during and after maternity leave and consider widening the eligibility criteria of the Family and Medical Leave Act.

  16. The Role of Intra-personal and Inter-personal Factors in Fear of Childbirth: A Preliminary Study.

    Science.gov (United States)

    Hamama-Raz, Yaira; Sommerfeld, Eliane; Ken-Dror, Daniel; Lacher, Rina; Ben-Ezra, Menachem

    2017-06-01

    Childbirth is a major life event, but for some women, the fear of childbirth goes beyond trepidation towards full-blown anxiety and panic, known as fear of childbirth (FOC) or tokophobia. In the present study the authors investigated and compared the intrapersonal and interpersonal factors that might be associated with FOC among women who previously gave birth (parous) and women who did not. A cross sectional survey was conducted among 529 women (parous women (n = 365) and women who had never given birth (n = 173). All participants completed self-report measures using an online survey system. The questionnaires assessed intrapersonal factors including attitudes toward pregnancy and birth, body image, self-esteem and life satisfaction as well as interpersonal factors namely relationship satisfaction. Multiple regression analyses revealed that among parous women age and attitudes toward pregnancy and birth, especially those that relate to body image and delivery were significantly associated with FOC. Among women who had never given birth, only attitudes toward pregnancy and birth, especially those that relate to body image, importance of pregnancy and delivery, and preference of caesarean section (CS), were significantly associated with FOC. In both groups, satisfaction with spousal relationship was not found to be associated with FOC. The results indicate that regarding FOC, intra-personal factors are more dominant than inter-personal factors. When assessing this medico-psychological fear, cognitive aspects should also be addressed.

  17. A historical review of the concept of labor support in technocratic, humanistic and holistic paradigms of childbirth.

    Science.gov (United States)

    Najafi, Tahereh Fathi; Roudsari, Robab Latifnejad; Ebrahimipour, Hossein

    2017-10-01

    In the past century, maternal support during childbirth has been changed according to the different approaches suggested by various health care paradigms. The aim of this review was to argue the maternity supportive care paradigms of the past century and to closely analyze each paradigm. This is a historical review, in which published articles were retrieved from databases including Scopus, Science Direct, PubMed and Google Scholar. Sage Journals and Springer's publications were also searched due to the high citation rate of their articles. The keywords entered were "Labor support", "Normal delivery", "Birth attendance", "Supportive approaches", "Health care paradigms", and "Midwifery models of care". They were entered alone or in combinations using "AND". Also, Persian articles were searched in local databases including Irandoc, SID, IranMedex, and Magiran using the above-mentioned keywords in Persian. Sixty articles met inclusion criteria. The review revealed four main themes including the definitions of continuous labor support, the technocratic paradigm, the humanistic paradigm and the naturalistic paradigm as models of labor support. According to the evidence, labor support has changed from technocratic to humanistic and holistic approaches, which in turn, caused some changes in midwifery models of care used by midwives in the practice. Labor support based on the holistic approaches and the naturalistic paradigms could bring about remarkable outcomes, the most important being satisfied with the birth experience, increased mother's self-confidence, enhanced mother's ability in childbirth and better completion of the childbirth process.

  18. Loosely coupled class families

    DEFF Research Database (Denmark)

    Ernst, Erik

    2001-01-01

    are expressed using virtual classes seem to be very tightly coupled internally. While clients have achieved the freedom to dynamically use one or the other family, it seems that any given family contains a xed set of classes and we will need to create an entire family of its own just in order to replace one...... of the members with another class. This paper shows how to express class families in such a manner that the classes in these families can be used in many dierent combinations, still enabling family polymorphism and ensuring type safety....

  19. Influence of psychological factors on pregnancy, childbirth and puerperium. A longitudinal study

    Directory of Open Access Journals (Sweden)

    Dolores Marín Morales

    2008-11-01

    Full Text Available The aim of the present study is to analyze different psychological factors (personality, psychiatric symptoms, pregnancy worries, beliefs about delivery, locus of control, coping styles and its relation to clinical symptomatology and the presence of complications during pregnancy, quality of life indicators, perception and coping with labour pain, type of delivery, neonatal well-being indicators, delivery satisfaction, maternal bond development and care of the baby and presence of post-partum depression.To achieve this we will develop a prospective correlational longitudinal study. The sample will be composed by pregnant women from the area 9 from the Madrid Community that voluntarily accept the inclusion in this research.Structured questionnaires will be used to evaluate all the psychological variables in the following moments in time:- during the first and third trimester the following variables will be assessed: personality, psychiatric symptoms, pregnancy worries, delivery beliefs, locus of control, coping styles, first trimester physical sintomatology, quality of life indicators,- during the inmediate post-partum: pain during labour and after delivery, childbirth satisfaction,- during the puerperium: post-partum depression and anxiety, post-traumatic stress disorder, child bond, neonatal care, personality, psychiatric symptomatology.From the clinical record the following data will be obtained: sociodemographic variables, and parameters related to pregnancy evolution, delivery and puerperium that are relevant to the research.

  20. The Psychoprophylactic Method of Painless Childbirth in Socialist Czechoslovakia: from State Propaganda to Activism of Enthusiasts.

    Science.gov (United States)

    Hrešanová, Ema

    2016-10-01

    This paper explores the history of the 'psychoprophylactic method of painless childbirth' in socialist Czechoslovakia, in particular, in the Czech and Moravian regions of the country, showing that it substantially differs from the course that the method took in other countries. This non-pharmacological method of pain relief originated in the USSR and became well known as the Lamaze method in western English-speaking countries. Use of the method in Czechoslovakia, however, followed a very different path from both the West, where its use was refined mainly outside the biomedical frame, and the USSR, where it ceased to be pursued as a scientific method in the 1950s after Stalin's death. The method was imported to Czechoslovakia in the early 1950s and it was politically promoted as Soviet science's gift to women. In the 1960s the method became widespread in practice but research on it diminished and, in the 1970s, its use declined too. However, in the 1980s, in the last decade of the Communist regime, the method resurfaced in the pages of Czechoslovak medical journals and underwent an exciting renaissance, having been reintroduced by a few enthusiastic individuals, most of them women. This article explores the background to the renewed interest in the method while providing insight into the wider social and political context that shaped socialist maternity and birth care in different periods.

  1. The best laid plans? Women's choices, expectations and experiences in childbirth.

    Science.gov (United States)

    Malacrida, Claudia; Boulton, Tiffany

    2014-01-01

    The past decades have seen a drastic increase in the medicalization of childbirth, evidenced by increasing Caesarean section rates in many Western countries. In a rare moment of congruence, alternative health-care providers, feminist advocates for women's health and, most recently, mainstream medical service providers have all expressed serious concerns about the rise in Caesarean section rates and women's roles in medicalization. These concerns stem from divergent philosophical positions as well as differing assumptions about the causes for increasing medicalization. Drawing on this debate, and using a feminist and governmentality framing of the problem, we interviewed 22 women who have recently had children about their birthing choices, their expectations and their birth experiences. The women's narratives revealed a disjuncture between their expectations of choosing, planning and achieving as natural a birth as possible, and their lived experiences of births that did not typically go to plan. They also reveal the disciplining qualities of both natural and medical discourses about birth and choice. Furthermore, their narratives counter assumptions that women, as ideal patient consumers, are driving medicalization.

  2. Childbirth in a rural highlands community in Papua New Guinea: a descriptive study.

    Science.gov (United States)

    Vallely, Lisa M; Homiehombo, Primrose; Kelly-Hanku, Angela; Vallely, Andrew; Homer, Caroline S E; Whittaker, Andrea

    2015-03-01

    to explore men's and women's experiences, beliefs and practices surrounding childbirth in a rural highlands community in Papua New Guinea. a qualitative study comprising focus group discussions, key informant and in depth interviews. the study was undertaken in a rural community in Eastern Highlands Province, Papua New Guinea. 51 women and 26 men participated in 11 focus group discussions. Key informant and in depth interviews were undertaken with 21 women and five men. both women and men recognised the importance of health facility births, linking village births with maternal and newborn deaths. Despite this, many women chose to give birth in the community in circumstances influenced by cultural and customary beliefs and practices. Women giving birth in the community frequently gave birth in an isolated location. Traditional beliefs surrounding reasons for difficult births, including spiritual beliefs were reported along with the use of traditional methods used to help prolonged and difficult births. while the importance of health facility births is recognised in this rural community many women continue to give birth in the village. Identifying and understanding local customs, beliefs and practices, particularly those that may be harmful to women and their newborn infants, is critical to the development of locally-appropriate community-based strategies for improving maternal and infant health in rural communities in PNG and other resource-limited, high burden settings. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Barriers to utilization of childbirth services of a rural birthing center in Nepal: A qualitative study

    Science.gov (United States)

    Shrestha, Khadka Narayan; Homer, Caroline S. E.

    2017-01-01

    Background Maternal mortality and morbidity are public health problems in Nepal. In rural communities, many women give birth at home without the support of a skilled birth attendant, despite the existence of rural birthing centers. The aim of this study was to explore the barriers and provide pragmatic recommendations for better service delivery and use of rural birthing centers. Methods We conducted 26 in-depth interviews with service users and providers, and three focus group discussions with community key informants in a rural community of Rukum district. We used the Adithya Cattamanchi logic model as a guiding framework for data analysis. Results Irregular and poor quality services, inadequate human and capital resources, and poor governance were health system challenges which prevented service delivery. Contextual barriers including difficult geography, poor birth preparedness practices, harmful culture practices and traditions and low level of trust were also found to contribute to underutilization of the birthing center. Conclusion The rural birthing center was not providing quality services when women were in need, which meant women did not use the available services properly because of systematic and contextual barriers. Approaches such as awareness-raising activities, local resource mobilization, ensuring access to skilled providers and equipment and other long-term infrastructure development works could improve the quality and utilization of childbirth services in the rural birthing center. This has resonance for other centers in Nepal and similar countries. PMID:28493987

  4. [Cooperation and conflict in childbirth care: representations and practices of nurses and obstetricians].

    Science.gov (United States)

    Angulo-Tuesta, Antonia; Giffin, Karen; Gama, Andréa de Sousa; d'Orsi, Eleonora; Barbosa, Gisele Peixoto

    2003-01-01

    In Brazil, where birthing generally occurs in hospitals and under the care of obstetricians, the incorporation of nurses is a strategy that has been used recently in an attempt to improve obstetric care. This study, conducted in two maternity hospitals in Rio de Janeiro, focuses on representations of obstetricians and nurses regarding teamwork and analyzes how the dimensions of power, cooperation/conflict, and technical autonomy are permeated by dualistic conceptions which influence the quality of health care for women during childbirth. On the one hand, the results show a consensus regarding the advantages of professional cooperation in the improvement of health care, assuming the existence of a clear definition of professional roles. At the same time, conflicts regarding therapeutic conduct during the birth process reflect the professionals' perceptions of autonomy and the influence of professional hierarchies, in which obstetric care is seen to depend on the "objective observation" of the women giving birth. The degree of conflict is differentiated according to the institutional context and related to dualistic conceptions such as objective/subjective, rational/emotional, and male/female.

  5. Women's use of private and government health facilities for childbirth in Nairobi's informal settlements.

    Science.gov (United States)

    Bazant, Eva S; Koenig, Michael A; Fotso, Jean-Christophe; Mills, Samuel

    2009-03-01

    The private sector's role in increasing the use of maternal health care for the poor in developing countries has received increasing attention, yet few data exist for urban slums. Using household-survey data from 1,926 mothers in two informal settlements in Nairobi, Kenya, collected in 2006, we describe and examine the factors associated with women's use of private and government health facilities for childbirth. More women gave birth at private facilities located in the settlements than at government facilities, and one-third of the women gave birth at home or with the assistance of a traditional birth attendant. In multivariate models, women's education, ethnic group, and household wealth were associated with institutional deliveries, especially in government hospitals. Residents in the more disadvantaged settlement were more likely than those in the better-off settlement to give birth in private facilities. In urban areas, maternal health services in both the government and private sectors should be strengthened, and efforts made to reach out to women who give birth at home.

  6. Women's perceptions of their right to choose the place of childbirth: an integrative review.

    Science.gov (United States)

    Hadjigeorgiou, Eleni; Kouta, Christiana; Papastavrou, Evridiki; Papadopoulos, Irena; Mårtensson, Lena B

    2012-06-01

    to provide a critical synthesis of published research concerning women's experiences in choosing where to give birth. an integrative literature review was conducted using three databases (MEDLINE, CINAHL and Ovid) for 1997-2009. Inclusion criteria were: (1) publication in the English language; (2) research article; (3) focus on women's perceptions for their birthplace choices; and (4) data collected during pregnancy, at birth and post partum. twenty-one research-based papers met the inclusion criteria, and these used a range of approaches and methods. Four themes were derived from the data: choice of birthplace and medicalisation of childbirth; the midwifery model of care and the rhetoric of birthplace choices; perceptions of safety shaped women's preferences; and choice is related to women's autonomy. there is considerable evidence that women worldwide wish to be able to exercise their rights and make informed choices about where to give birth. The medical model remains a strong and powerful influence on women's decisions in many countries. The midwifery model offers birthplace choices to women, while policies and culture in some countries affect midwifery practise. Perceptions of safety shaped women's preferences, and women's autonomy facilitated birthplace choices. these findings can be seen as a challenge for health professionals and policy makers to improve perinatal care based on women's needs. Local research is advisable due to cultural and health system differences. Copyright © 2011 Elsevier Ltd. All rights reserved.

  7. Barriers to utilization of childbirth services of a rural birthing center in Nepal: A qualitative study.

    Directory of Open Access Journals (Sweden)

    Resham Bahadur Khatri

    Full Text Available Maternal mortality and morbidity are public health problems in Nepal. In rural communities, many women give birth at home without the support of a skilled birth attendant, despite the existence of rural birthing centers. The aim of this study was to explore the barriers and provide pragmatic recommendations for better service delivery and use of rural birthing centers.We conducted 26 in-depth interviews with service users and providers, and three focus group discussions with community key informants in a rural community of Rukum district. We used the Adithya Cattamanchi logic model as a guiding framework for data analysis.Irregular and poor quality services, inadequate human and capital resources, and poor governance were health system challenges which prevented service delivery. Contextual barriers including difficult geography, poor birth preparedness practices, harmful culture practices and traditions and low level of trust were also found to contribute to underutilization of the birthing center.The rural birthing center was not providing quality services when women were in need, which meant women did not use the available services properly because of systematic and contextual barriers. Approaches such as awareness-raising activities, local resource mobilization, ensuring access to skilled providers and equipment and other long-term infrastructure development works could improve the quality and utilization of childbirth services in the rural birthing center. This has resonance for other centers in Nepal and similar countries.

  8. Barriers to utilization of childbirth services of a rural birthing center in Nepal: A qualitative study.

    Science.gov (United States)

    Khatri, Resham Bahadur; Dangi, Tara Prasad; Gautam, Rupesh; Shrestha, Khadka Narayan; Homer, Caroline S E

    2017-01-01

    Maternal mortality and morbidity are public health problems in Nepal. In rural communities, many women give birth at home without the support of a skilled birth attendant, despite the existence of rural birthing centers. The aim of this study was to explore the barriers and provide pragmatic recommendations for better service delivery and use of rural birthing centers. We conducted 26 in-depth interviews with service users and providers, and three focus group discussions with community key informants in a rural community of Rukum district. We used the Adithya Cattamanchi logic model as a guiding framework for data analysis. Irregular and poor quality services, inadequate human and capital resources, and poor governance were health system challenges which prevented service delivery. Contextual barriers including difficult geography, poor birth preparedness practices, harmful culture practices and traditions and low level of trust were also found to contribute to underutilization of the birthing center. The rural birthing center was not providing quality services when women were in need, which meant women did not use the available services properly because of systematic and contextual barriers. Approaches such as awareness-raising activities, local resource mobilization, ensuring access to skilled providers and equipment and other long-term infrastructure development works could improve the quality and utilization of childbirth services in the rural birthing center. This has resonance for other centers in Nepal and similar countries.

  9. Maternal role development: the impact of maternal distress and social support following childbirth.

    Science.gov (United States)

    Emmanuel, Elizabeth N; Creedy, Debra K; St John, Winsome; Brown, Claire

    2011-04-01

    to explore the relationship between maternal role development (MRD), maternal distress (MD) and social support following childbirth. prospective longitudinal survey. three public hospital maternity units in Brisbane, Australia. 630 pregnant women were invited to participate in the study, with a 77% (n=473) completion rate. to measure MRD, the Prenatal Maternal Expectation Scale was used at 36 weeks of pregnancy, and the revised What Being the Parent of a New Baby is Like (with subscales of evaluation, centrality and life change) was used at six and 12 weeks post partum. At all three data collection points, the Edinburgh Postnatal Depression Scale was used to measure MD, and the Maternal Social Support Scale was used to measure social support. at 36 weeks of gestation, optimal scaling for MRD produced a parsimonious model with MD providing 39% of predictive power. At six weeks post partum, similar models predicting MRD were found (evaluation: r(2)=0.14, MD providing 64% of predictive power; centrality: r(2)=0.07, MD providing 11% of predictive power; life change: r(2)=0.26, MD providing 59% of predictive power). At 12 weeks post partum, MD was a predictor for evaluation (r(2)=0.11) and life change (r(2)=0.26, 54% of predictive power). there is a statistically significant but moderate correlation between MRD and MD. The transition to motherhood can be stressful, but may be facilitated by appropriate acknowledgement and support with an emphasis on MRD. Copyright © 2009 Elsevier Ltd. All rights reserved.

  10. Guilt without fault: A qualitative study into the ethics of forgiveness after traumatic childbirth.

    Science.gov (United States)

    Schrøder, Katja; la Cour, Karen; Jørgensen, Jan Stener; Lamont, Ronald F; Hvidt, Niels Christian

    2017-03-01

    When a life is lost or severely impaired during childbirth, the midwife and obstetrician involved may experience feelings of guilt in the aftermath. Through three empirical cases, the paper examines the sense of guilt in the context of the current patient safety culture in healthcare where a blame-free approach is promoted in the aftermath of adverse events. The purpose is to illustrate how healthcare professionals may experience guilt without being at fault after adverse events, and Gamlund's theory on forgiveness without blame is used as the theoretical framework for this analysis. Philosophical insight has proven to be a useful resource in dealing with psychological issues of guilt and Gamlund's view on error and forgiveness elucidates an interesting dilemma in the field of traumatic events and medical harm in healthcare, where healthcare professionals experience that well-intended actions may cause injury, harm or even death to their patients. Failing to recognise and acknowledge guilt or guilty feelings may preclude self-forgiveness, which could have a negative impact on the recovery of midwives and obstetricians after adverse events. Developing and improving support systems for healthcare professionals is a multi-factorial task, and the authors suggest that the narrow focus on medico-legal and patient safety perspectives is complemented with moral philosophical perspectives to promote non-judgemental recognition and acknowledgement of guilt and of the fallible nature of medicine. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Effect of childbirth on the course of Crohn's disease; results from a retrospective cohort study in the Netherlands

    Directory of Open Access Journals (Sweden)

    Albers Lisette

    2011-01-01

    Full Text Available Abstract Background Pregnant women with Crohn's disease needs proper counselling about the effect of pregnancy and childbirth on their disease. However, Literature about the effect of childbirth on Crohn's disease is limited. This study examined the effect of childbirth on the course of Crohn's disease and especially perianal Crohn's disease. Methods This is a retrospective cohort study which was performed in a tertiary level referral hospital in the Netherlands. From the IBD database, female patients aged 18-80 years in 2004 were selected. Data analysis took place in the years 2005 and 2006. Eventually, 114 women with at least one pregnancy after the diagnosis of Crohn's disease were eligible for the study. Differences between groups were analyzed using Wilcoxon Mann Whitney tests and Chi-square analysis with 2 × 2 or 2 × 3 contingency tables. Two-tailed values were used and p values Results 21/114 women (18% had active luminal disease prior to pregnancy, with significantly more pregnancy related complications compared to women with inactive luminal disease (Odds ratio 2.8; 95% CI 1.0 - 7.4. Caesarean section rate was relatively high (37/114, 32%, especially in patients with perianal disease prior to pregnancy compared to women without perianal disease (Odds ratio 4.6; 95% CI 1.8 - 11.4. Disease progression after childbirth was more frequent in patients with active luminal disease prior to pregnancy compared to inactive luminal disease (Odds ratio 9.7; 95% CI 2.1 - 44.3. Progression of perianal disease seems less frequent after vaginal delivery compared with caesarean section, in both women with prior perianal disease (18% vs. 31%, NS and without prior perianal disease (5% vs 14%, NS. There were no more fistula-related complications after childbirth in women with an episiotomy or second degree tear. Conclusion A relatively high rate of caesarean sections was observed in women with Crohn's disease, especially in women with perianal disease

  12. Personnel Preparation.

    Science.gov (United States)

    Fair, George, Ed.; Stodden, Robert, Ed.

    1981-01-01

    Three articles comprise a section on personnel preparation in vocational education. Articles deal with two inservice programs in career/vocational education for the handicapped and a project to train paraprofessionals to assist special educators in vocational education. (CL)

  13. Comprehending text in literature class

    Directory of Open Access Journals (Sweden)

    Purić Daliborka S.

    2016-01-01

    Full Text Available The paper discusses the problem of understanding a text and the contribution of methodological apparatus in the reader book to comprehension of a text being read in junior classes of elementary school. By using the technique of content analysis from methodological apparatuses in eight reader books for the fourth grade of elementary school, approved for usage in 2014/2015 academic year, and surveying 350 teachers in 33 elementary schools and 11 administrative districts in the Republic of Serbia we examined: (a to what extent the Serbian language text book contents enable junior students to understand a literary text; (b to what extent teachers accept the suggestions offered in the textbook for preparing literature teaching. The results show that a large number of suggestions relate to reading comprehension, but some of categories of understanding are unevenly distributed in the methodological apparatus. On the other hand, the majority of teachers use the methodological apparatus given in a textbook for preparing classes, not only the textbook he or she selected for teaching but also other textbooks for the same grade.

  14. Solution preparation

    International Nuclear Information System (INIS)

    Seitz, M.G.

    1982-01-01

    Reviewed in this statement are methods of preparing solutions to be used in laboratory experiments to examine technical issues related to the safe disposal of nuclear waste from power generation. Each approach currently used to prepare solutions has advantages and any one approach may be preferred over the others in particular situations, depending upon the goals of the experimental program. These advantages are highlighted herein for three approaches to solution preparation that are currently used most in studies of nuclear waste disposal. Discussion of the disadvantages of each approach is presented to help a user select a preparation method for his particular studies. Also presented in this statement are general observations regarding solution preparation. These observations are used as examples of the types of concerns that need to be addressed regarding solution preparation. As shown by these examples, prior to experimentation or chemical analyses, laboratory techniques based on scientific knowledge of solutions can be applied to solutions, often resulting in great improvement in the usefulness of results

  15. Class, Culture and Politics

    DEFF Research Database (Denmark)

    Harrits, Gitte Sommer

    2013-01-01

    Even though contemporary discussions of class have moved forward towards recognizing a multidimensional concept of class, empirical analyses tend to focus on cultural practices in a rather narrow sense, that is, as practices of cultural consumption or practices of education. As a result......, discussions within political sociology have not yet utilized the merits of a multidimensional conception of class. In light of this, the article suggests a comprehensive Bourdieusian framework for class analysis, integrating culture as both a structural phenomenon co-constitutive of class and as symbolic...... practice. Further, the article explores this theoretical framework in a multiple correspondence analysis of a Danish survey, demonstrating how class and political practices are indeed homologous. However, the analysis also points at several elements of field autonomy, and the concluding discussion...

  16. Class network routing

    Science.gov (United States)

    Bhanot, Gyan [Princeton, NJ; Blumrich, Matthias A [Ridgefield, CT; Chen, Dong [Croton On Hudson, NY; Coteus, Paul W [Yorktown Heights, NY; Gara, Alan G [Mount Kisco, NY; Giampapa, Mark E [Irvington, NY; Heidelberger, Philip [Cortlandt Manor, NY; Steinmacher-Burow, Burkhard D [Mount Kisco, NY; Takken, Todd E [Mount Kisco, NY; Vranas, Pavlos M [Bedford Hills, NY

    2009-09-08

    Class network routing is implemented in a network such as a computer network comprising a plurality of parallel compute processors at nodes thereof. Class network routing allows a compute processor to broadcast a message to a range (one or more) of other compute processors in the computer network, such as processors in a column or a row. Normally this type of operation requires a separate message to be sent to each processor. With class network routing pursuant to the invention, a single message is sufficient, which generally reduces the total number of messages in the network as well as the latency to do a broadcast. Class network routing is also applied to dense matrix inversion algorithms on distributed memory parallel supercomputers with hardware class function (multicast) capability. This is achieved by exploiting the fact that the communication patterns of dense matrix inversion can be served by hardware class functions, which results in faster execution times.

  17. Culture and social class.

    Science.gov (United States)

    Miyamoto, Yuri

    2017-12-01

    A large body of research in Western cultures has demonstrated the psychological and health effects of social class. This review outlines a cultural psychological approach to social stratification by comparing psychological and health manifestations of social class across Western and East Asian cultures. These comparisons suggest that cultural meaning systems shape how people make meaning and respond to material/structural conditions associated with social class, thereby leading to culturally divergent manifestations of social class. Specifically, unlike their counterparts in Western cultures, individuals of high social class in East Asian cultures tend to show high conformity and other-orientated psychological attributes. In addition, cultures differ in how social class impacts health (i.e. on which bases, through which pathways, and to what extent). Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Semantic Analysis of Virtual Classes and Nested Classes

    DEFF Research Database (Denmark)

    Madsen, Ole Lehrmann

    1999-01-01

    Virtual classes and nested classes are distinguishing features of BETA. Nested classes originated from Simula, but until recently they have not been part of main stream object- oriented languages. C++ has a restricted form of nested classes and they were included in Java 1.1. Virtual classes...... classes and parameterized classes have been made. Although virtual classes and nested classes have been used in BETA for more than a decade, their implementation has not been published. The purpose of this paper is to contribute to the understanding of virtual classes and nested classes by presenting...

  19. Class in disguise

    DEFF Research Database (Denmark)

    Faber, Stine Thidemann; Prieur, Annick

    This paper asks how class can have importance in one of the worlds’ most equal societies: Denmark. The answer is that class here appears in disguised forms. The field under study is a city, Aalborg, in the midst of transition from a stronghold of industrialism to a post industrial economy. The pa....... The paper also raises questions about how sociological discourses may contribute to the veiling of class....

  20. Microleakage of different provisionalization techniques for class I inlays

    Directory of Open Access Journals (Sweden)

    Selim Erkut

    2013-03-01

    Conclusion: The microleakage in class I inlay cavities could be reduced by the application of dentin-bonding agents after cavity preparation followed by the placement of light-polymerized provisional restorative materials.

  1. Comparative study analysing women's childbirth satisfaction and obstetric outcomes across two different models of maternity care

    Science.gov (United States)

    Conesa Ferrer, Ma Belén; Canteras Jordana, Manuel; Ballesteros Meseguer, Carmen; Carrillo García, César; Martínez Roche, M Emilia

    2016-01-01

    Objectives To describe the differences in obstetrical results and women's childbirth satisfaction across 2 different models of maternity care (biomedical model and humanised birth). Setting 2 university hospitals in south-eastern Spain from April to October 2013. Design A correlational descriptive study. Participants A convenience sample of 406 women participated in the study, 204 of the biomedical model and 202 of the humanised model. Results The differences in obstetrical results were (biomedical model/humanised model): onset of labour (spontaneous 66/137, augmentation 70/1, p=0.0005), pain relief (epidural 172/132, no pain relief 9/40, p=0.0005), mode of delivery (normal vaginal 140/165, instrumental 48/23, p=0.004), length of labour (0–4 hours 69/93, >4 hours 133/108, p=0.011), condition of perineum (intact perineum or tear 94/178, episiotomy 100/24, p=0.0005). The total questionnaire score (100) gave a mean (M) of 78.33 and SD of 8.46 in the biomedical model of care and an M of 82.01 and SD of 7.97 in the humanised model of care (p=0.0005). In the analysis of the results per items, statistical differences were found in 8 of the 9 subscales. The highest scores were reached in the humanised model of maternity care. Conclusions The humanised model of maternity care offers better obstetrical outcomes and women's satisfaction scores during the labour, birth and immediate postnatal period than does the biomedical model. PMID:27566632

  2. Treatment of nulliparous women with severe fear of childbirth via the Internet: a feasibility study.

    Science.gov (United States)

    Nieminen, Katri; Andersson, Gerhard; Wijma, Barbro; Ryding, Elsa-Lena; Wijma, Klaas

    2016-01-01

    The aim of the present study was to test the feasibility of Internet interventions among nulliparous women suffering from severe fear of childbirth (FOC) by means of an Internet-delivered therapist-supported self-help program based on cognitive behavioral therapy (ICBT). Prospective, longitudinal cohort study. A feasibility study of an ICBT program for the treatment of severe FOC in pregnant women. Twenty-eight Swedish-speaking nulliparous women with severe FOC recruited via a project home page from January 2012 to December 2013. The main components of the ICBT program for the treatment of severe FOC comprised psycho-education, breathing retraining, cognitive restructuring, imaginary exposure, in vivo exposure and relapse prevention. The study participants were anonymously self-recruited over the Internet, interviewed by telephone and then enrolled. All participants were offered 8 weeks of treatment via the Internet. Participants reported their homework weekly, submitted measurements of their fear and received feedback from a therapist via a secure online contact management system. Level of FOC measured with the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ A) during screening at enrollment and weekly during the treatment (W-DEQ version A), and after the delivery (W-DEQ version B). A statistically significant (p pre to post-therapy, with a large effect size (Cohen's d = 0.95)]. The results of this feasibility study suggest that ICBT has potential in the treatment of severe FOC during pregnancy in motivated nulliparous women. The results need to be confirmed by randomized controlled studies.

  3. Critical care nurses' experiences of nursing mothers in an ICU after complicated childbirth.

    Science.gov (United States)

    Engström, Asa; Lindberg, Inger

    2013-09-01

    Providing nursing care for a critically ill obstetric patient or a patient who has just become a mother after a complicated birth can be a challenging experience for critical care nurses (CCNs). These patients have special needs because of the significant alterations in their physiology and anatomy together with the need to consider such specifics as breastfeeding and mother-child bonding. The aim with this study was to describe CCNs' experience of nursing the new mother and her family after a complicated childbirth. The design of the study was qualitative. Data collection was carried out through focus group discussions with 13 CCNs in three focus groups during spring 2012. The data were subjected to qualitative content analysis. The analysis resulted in the formulation of four categories: the mother and her vital functions are prioritized; not being responsible for the child and the father; an environment unsuited to the new family and collaboration with staff in neonatal and maternity delivery wards. When nursing a mother after a complicated birth the CCNs give her and her vital signs high priority. The fathers of the children or partners of the mothers are expected to take on the responsibility of caring for the newborn child and of being the link with the neonatal ward. It is suggested that education about the needs of new families for nursing care would improve the situation and have clinical implications. Whether the intensive care unit is always the best place in which to provide care for mothers and new families is debatable. © 2013 British Association of Critical Care Nurses.

  4. Assessment of pain associated with childbirth: Women's perspectives, preferences and solutions.

    Science.gov (United States)

    Jones, Lester E; Whitburn, Laura Y; Davey, Mary-Ann; Small, Rhonda

    2015-07-01

    to develop an understanding of women's experiences of pain associated with childbirth and the assessment of labour pain. This exploratory study, informed by modern pain science, sought to explore women's retrospective reports of their pain experience during labour and to ascertain what pain assessment strategies might be acceptable in maternity care or future research. a qualitative study was performed using phenomenology as the theoretical framework. Data were collected from semistructured telephone interviews. Thematic analysis of transcripts was performed. Melbourne, Australia. 19 women - both primiparous and multiparous - who gave birth in a large maternity hospital, either in a midwife-led birth centre or with standard hospital birth suite care were interviewed in the month following labour and birth. two themes were identified in post-birth interviews that related to pain assessment. The first theme is the acceptability of pain assessment and reflects the interview structure, drawing on responses from a set question that asked what pain assessment strategies would be acceptable. The second theme emerged from women's comments about measurement accuracy, including the limitations of using a scale with a static upper limit and the changing nature of labour pain. a woman-centred approach demands pain assessment that matches each woman's preference for mode and timing and captures the multiple dimensions of pain. Women describe the need for an expanding scale to accommodate the progressive modifications of their conception of what is extreme pain. whenever a series of pain ratings is required, researchers and health professionals need to find ways to adjust for the fluctuations in pain scale interpretation. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Prevalência e preditores de sintomatologia depressiva após o parto Prevalence and predictors of depressive symptoms after childbirth

    Directory of Open Access Journals (Sweden)

    Raquel Costa

    2007-01-01

    Full Text Available CONTEXTO: A depressão pós-parto é uma patologia que ocorre nas primeiras semanas após o parto com conseqüências negativas não só para a mãe, como também para o bebê e para a família. OBJETIVO: Examinar a prevalência de depressão após o parto, bem como as circunstâncias suscetíveis de predizer a sintomatologia depressiva 1 semana e 3 meses após o parto. MÉTODOS: 197 grávidas preencheram o Questionário de Antecipação do Parto (QAP (Costa et al., 2005a no segundo trimestre de gestação. Na primeira semana após o parto, responderam ao Questionário de Experiência e Satisfação com o Parto (QESP (Costa et al., 2005b e à Edinburgh Postnatal Depression Scale (EPDS (Augusto et al., 1996, esta última aplicada novamente no terceiro mês do puerpério. RESULTADOS: Uma percentagem significativa de mulheres encontra-se clinicamente deprimida (EPDS 13 na primeira semana e 3 meses após o parto (12,4% e 13,7%, respectivamente. Das que têm EPDS > 13 na primeira semana, 25% estão ainda deprimidas 3 meses após o parto. Circunstâncias relativas à saúde física, à experiência emocional de parto e ao primeiro contato com o bebê predizem a sintomatologia depressiva na primeira semana do puerpério. A sintomatologia depressiva na primeira semana após o parto e a experiência emocional negativa de parto predizem a sintomatologia depressiva 3 meses após o parto. CONCLUSÕES: Constata-se a importância da experiência emocional de parto e do primeiro contato com o bebê, enfatizando a necessidade de atender às necessidades psicológicas da mulher.BACKGROUND: Postnatal depression is a pathology occurring in the first weeks after childbirth with negative consequence not only for mothers, but also for theirs babies and families. OBJECTIVE: To examine the prevalence of postnatal depression and factors that might predict depressive symptoms one week and three months after childbirth. METHODS: 197 pregnant women filled out the

  6. Glass ionomer-silver cermet Class II tunnel-restorations for primary molars.

    Science.gov (United States)

    Croll, T P

    1988-01-01

    Tunnel preparations preserve the anatomical marginal ridge and minimize the loss of healthy tooth structure adjacent to the carious lesion. When the practitioner has developed proficiency in restoring class II carious lesions with tunnel restorations, less treatment time is required than with traditional class II preparations. The technique for restoring a primary first molar with a class II carious lesion, using a tunnel preparation and Ketac-Silver restorative material is described.

  7. Teaching Social Class

    Science.gov (United States)

    Tablante, Courtney B.; Fiske, Susan T.

    2015-01-01

    Discussing socioeconomic status in college classes can be challenging. Both teachers and students feel uncomfortable, yet social class matters more than ever. This is especially true, given increased income inequality in the United States and indications that higher education does not reduce this inequality as much as many people hope. Resources…

  8. Generalized Fourier transforms classes

    DEFF Research Database (Denmark)

    Berntsen, Svend; Møller, Steen

    2002-01-01

    The Fourier class of integral transforms with kernels $B(\\omega r)$ has by definition inverse transforms with kernel $B(-\\omega r)$. The space of such transforms is explicitly constructed. A slightly more general class of generalized Fourier transforms are introduced. From the general theory...

  9. Cutting Class Harms Grades

    Science.gov (United States)

    Taylor, Lewis A., III

    2012-01-01

    An accessible business school population of undergraduate students was investigated in three independent, but related studies to determine effects on grades due to cutting class and failing to take advantage of optional reviews and study quizzes. It was hypothesized that cutting classes harms exam scores, attending preexam reviews helps exam…

  10. 'I've Changed My Mind', Mindfulness-Based Childbirth and Parenting (MBCP) for pregnant women with a high level of fear of childbirth and their partners: study protocol of the quasi-experimental controlled trial.

    Science.gov (United States)

    Veringa, Irena K; de Bruin, Esther I; Bardacke, Nancy; Duncan, Larissa G; van Steensel, Francisca J A; Dirksen, Carmen D; Bögels, Susan M

    2016-11-07

    Approximately 25 % of pregnant women suffer from a high level of Fear of Childbirth (FoC), as assessed by the Wijma Delivery Expectancy Questionnaire (W-DEQ-A, score ≥66). FoC negatively affects pregnant women's mental health and adaptation to the perinatal period. Mindfulness-Based Childbirth and Parenting (MBCP) seems to be potentially effective in decreasing pregnancy-related anxiety and stress. We propose a theoretical model of Avoidance and Participation in Pregnancy, Birth and the Postpartum Period in order to explore FoC and to evaluate the underlying mechanisms of change of MBCP. The 'I've Changed My Mind' study is a quasi-experimental controlled trial among 128 pregnant women (week 16-26) with a high level of FoC, and their partners. Women will be allocated to MBCP (intervention group) or to Fear of Childbirth Consultation (FoCC; comparison group). Primary outcomes are FoC, labour pain, and willingness to accept obstetrical interventions. Secondary outcomes are anxiety, depression, general stress, parental stress, quality of life, sleep quality, fatigue, satisfaction with childbirth, birth outcome, breastfeeding self-efficacy and cost-effectiveness. The total study duration for women is six months with four assessment waves: pre- and post-intervention, following the birth and closing the maternity leave period. Given the high prevalence and severe negative impact of FoC this study can be of major importance if statistically and clinically meaningful benefits are found. Among the strengths of this study are the clinical-based experimental design, the extensive cognitive-emotional and behavioural measurements in pregnant women and their partners during the entire perinatal period, and the representativeness of study sample as well as generalizability of the study's results. The complex and innovative measurements of FoC in this study are an important strength in clinical research on FoC not only in pregnant women but also in their partners. Dutch Trial

  11. Classes of modules

    CERN Document Server

    Dauns, John

    2006-01-01

    Because traditional ring theory places restrictive hypotheses on all submodules of a module, its results apply only to small classes of already well understood examples. Often, modules with infinite Goldie dimension have finite-type dimension, making them amenable to use with type dimension, but not Goldie dimension. By working with natural classes and type submodules (TS), Classes of Modules develops the foundations and tools for the next generation of ring and module theory. It shows how to achieve positive results by placing restrictive hypotheses on a small subset of the complement submodules, Furthermore, it explains the existence of various direct sum decompositions merely as special cases of type direct sum decompositions. Carefully developing the foundations of the subject, the authors begin by providing background on the terminology and introducing the different module classes. The modules classes consist of torsion, torsion-free, s[M], natural, and prenatural. They expand the discussion by exploring...

  12. Gaining hope and self-confidence-An interview study of women's experience of treatment by art therapy for severe fear of childbirth.

    Science.gov (United States)

    Wahlbeck, Helén; Kvist, Linda J; Landgren, Kajsa

    2017-10-31

    Fear of childbirth is a serious problem that can have negative effects on both women and babies and to date treatment options are limited. The aim of this study was to elucidate the experience of undergoing art therapy in women with severe fear of childbirth. Nineteen women residing in Sweden, who had undergone art therapy for severe fear of childbirth, were interviewed during 2011-2013 about their experiences of the treatment. All women had received both support from a specialist team of midwives and treatment by an art therapist who was also a midwife. The women were interviewed three months after giving birth. The transcribed interviews were analysed with a phenomenological hermeneutical method. A main theme and three themes emerged from the analysis. The main theme was Gaining hope and self confidence. The three themes were; Carrying heavy baggage, Creating images as a catalyst for healing and Gaining new insights and abilities. Through the use of images and colours the women gained access to difficult emotions and the act of painting helped them visualize these emotions and acted as a catalyst for the healing process. Art therapy was well accepted by the women. Through sharing their burden of fear by creating visible images, they gained hope and self-confidence in the face of their impending childbirth. The results may contribute to knowledge about the feasibility of treating fear of childbirth by art therapy. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. Sample preparation

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    Sample preparation prior to HPLC analysis is certainly one of the most important steps to consider in trace or ultratrace analysis. For many years scientists have tried to simplify the sample preparation process. It is rarely possible to inject a neat liquid sample or a sample where preparation may not be any more complex than dissolution of the sample in a given solvent. The last process alone can remove insoluble materials, which is especially helpful with the samples in complex matrices if other interactions do not affect extraction. Here, it is very likely a large number of components will not dissolve and are, therefore, eliminated by a simple filtration process. In most cases, the process of sample preparation is not as simple as dissolution of the component interest. At times, enrichment is necessary, that is, the component of interest is present in very large volume or mass of material. It needs to be concentrated in some manner so a small volume of the concentrated or enriched sample can be injected into HPLC. 88 refs

  14. Preparing for the SAT: A Review

    Science.gov (United States)

    Appelrouth, Jed I.; Zabrucky, Karen M.

    2017-01-01

    In 2016, more than 1.6 million students took the Scholastic Aptitude Test (SAT), a standardized college admissions test (College Board 2016a). Researchers have estimated that 33 percent of students who take the SAT participate in some mode of formal test preparation, such as private tutoring or classes, to prepare for the exam (Buchmann, Condron…

  15. Women's status and experiences of mistreatment during childbirth in Uttar Pradesh: a mixed methods study using cultural health capital theory.

    Science.gov (United States)

    Sudhinaraset, May; Treleaven, Emily; Melo, Jason; Singh, Kanksha; Diamond-Smith, Nadia

    2016-10-28

    Mistreatment of women in healthcare settings during childbirth has been gaining attention globally. Mistreatment during childbirth directly and indirectly affects health outcomes, patient satisfaction, and the likelihood of delivering in a facility currently or in the future. It is important that we study patients' reports of mistreatment and abuse to develop a deeper understanding of how it is perpetrated, its consequences, and to identify potential points of intervention. Patients' perception of the quality of care is dependent, not only on the content of care, but importantly, on women's expectations of care. This study uses rich, mixed-methods data to explore women's characteristics and experiences of mistreatment during childbirth among slum-resident women in Uttar Pradesh, India. To understand the ways in which women's social and cultural factors influence their expectations of care and consequently their perceptions of respectful care, we adopt a Cultural Health Capital (CHC) framework. The quantitative sample includes 392 women, and the qualitative sample includes 26 women. Quantitative results suggest high levels of mistreatment (over 57 % of women reported any form of mistreatment). Qualitative findings suggest that lack of cultural health capital disadvantages patients in their patient-provider relationships, and that women use resources to improve care they receive. Participants articulated how providers set expectations and norms regarding behaviors in facilities; patients with lower social standing may not always understand standard practices and are likely to suffer poor health outcomes as a result. Of importance, however, patients also blame themselves for their own lack of knowledge. Lack of cultural health capital disadvantages women during delivery care in India. Providers set expectations and norms around behaviors during delivery, while women are often misinformed and may have low expectations of care.

  16. Through the client's eyes: using narratives to explore experiences of care transfers during pregnancy, childbirth, and the neonatal period.

    Science.gov (United States)

    van Stenus, Cherelle M V; Gotink, Mark; Boere-Boonekamp, Magda M; Sools, Anneke; Need, Ariana

    2017-06-12

    The client experience is an important outcome in the evaluation and development of perinatal healthcare. But because clients meet different professionals, measuring such experiences poses a challenge. This is especially the case in the Netherlands, where pregnant women are often transferred between professionals due to the nation's approach to risk selection. This paper explores questions around how clients experience transfers of care during pregnancy, childbirth, and the neonatal period, as well as how these experiences compare to the established quality of care aspects the Dutch Patient Federation developed. Narratives from 17 Dutch women who had given birth about their experiences with transfers were collected in the Netherlands. The narratives, for which informed consent was obtained, were collected on paper and online. Storyline analysis was used to identify story types. Story types portray patterns that indicate how clients experience transfers between healthcare providers. A comparative analysis was performed to identify differences and similarities between existing quality criteria and those clients mentioned. Four story types were identified: 1) Disconnected transfers of care lead to uncertainties; 2) Seamless transfers of care due to proper collaboration lead to positive experiences; 3) Transfers of care lead to disruption of patient-provider connectedness; 4) Transfer of care is initiated by the client to make pregnancy and childbirth dreams come true. Most of the quality aspects derived from these story types were identified as being similar or complementary to the Dutch Patient Federation list. A 'new' aspect identified in the clients' stories was the influencing role of prior experiences with transfers of care on current expectations, fears, and wishes. Transfers of care affect clients greatly and influence their experiences. Good communication, seamless transfers, and maintaining autonomy contribute to more positive experiences. The stories also

  17. Cross-cultural development and psychometric evaluation of a measure to assess fear of childbirth prior to pregnancy.

    Science.gov (United States)

    Stoll, Kathrin; Hauck, Yvonne; Downe, Soo; Edmonds, Joyce; Gross, Mechthild M; Malott, Anne; McNiven, Patricia; Swift, Emma; Thomson, Gillian; Hall, Wendy A

    2016-06-01

    Assessment of childbirth fear, in advance of pregnancy, and early identification of modifiable factors contributing to fear can inform public health initiatives and/or school-based educational programming for the next generation of maternity care consumers. We developed and evaluated a short fear of birth scale that incorporates the most common dimensions of fear reported by men and women prior to pregnancy, fear of: labour pain, being out of control and unable to cope with labour and birth, complications, and irreversible physical damage. University students in six countries (Australia, Canada, England, Germany, Iceland, and the United States, n = 2240) participated in an online survey to assess their fears and attitudes about birth. We report internal consistency reliability, corrected-item-to-total correlations, factor loadings and convergent and discriminant validity of the new scale. The Childbirth Fear - Prior to Pregnancy (CFPP) scale showed high internal consistency across samples (α > 0.86). All corrected-item-to total correlations exceeded 0.45, supporting the uni-dimensionality of the scale. Construct validity of the CFPP was supported by a high correlation between the new scale and a two-item visual analogue scale that measures fear of birth (r > 0.6 across samples). Weak correlations of the CFPP with scores on measures that assess related psychological states (anxiety, depression and stress) support the discriminant validity of the scale. The CFPP is a short, reliable and valid measure of childbirth fear among young women and men in six countries who plan to have children. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. Variations in childbirth interventions in high-income countries: protocol for a multinational cross-sectional study.

    Science.gov (United States)

    Seijmonsbergen-Schermers, Anna; van den Akker, Thomas; Beeckman, Katrien; Bogaerts, Annick; Barros, Monalisa; Janssen, Patricia; Binfa, Lorena; Rydahl, Eva; Frith, Lucy; Gross, Mechthild M; Hálfdánsdóttir, Berglind; Daly, Deirdre; Calleja-Agius, Jean; Gillen, Patricia; Vika Nilsen, Anne Britt; Declercq, Eugene; de Jonge, Ank

    2018-01-10

    There are growing concerns about the increase in rates of commonly used childbirth interventions. When indicated, childbirth interventions are crucial for preventing maternal and perinatal morbidity and mortality, but their routine use in healthy women and children leads to avoidable maternal and neonatal harm. Establishing ideal rates of interventions can be challenging. This study aims to describe the range of variations in the use of commonly used childbirth interventions in high-income countries around the world, and in outcomes in nulliparous and multiparous women. This multinational cross-sectional study will use data from births in 2013 with national population data or representative samples of the population of pregnant women in high-income countries. Data from women who gave birth to a single child from 37 weeks gestation onwards will be included and the results will be presented for nulliparous and multiparous women separately. Anonymised individual level data will be analysed. Primary outcomes are rates of commonly used childbirth interventions, including induction and/or augmentation of labour, intrapartum antibiotics, epidural and pharmacological pain relief, episiotomy in vaginal births, instrument-assisted birth (vacuum or forceps), caesarean section and use of oxytocin postpartum. Secondary outcomes are maternal and perinatal mortality, Apgar score below 7 at 5 min, postpartum haemorrhage and obstetric anal sphincter injury. Univariable and multivariable logistic regression analyses will be conducted to investigate variations among countries, adjusted for maternal age, body mass index, gestational weight gain, ethnic background, socioeconomic status and infant birth weight. The overall mean rates will be considered as a reference category, weighted for the size of the study population per country. The Medical Ethics Review Committee of VU University Medical Center Amsterdam confirmed that an official approval of this study was not required

  19. Fathers' experience of childbirth when non-progressive labour occurs and augmentation is established. A qualitative study

    DEFF Research Database (Denmark)

    Hasman, Kirsten; Kjaergaard, Hanne; Esbensen, Bente Appel

    2014-01-01

    as uncontrollable processes and (3) Relief about the decision of augmentation. The fathers had a rational approach and felt powerless when the process of labour was uncontrollable. They felt they were not able to help their partners in pain when non-progressive labour occurred. They experienced relief when......OBJECTIVE: Augmentation with oxytocin during labour has increased in Western obstetrics over the last few decades. The aim of this study was to describe how fathers experienced childbirth when non-progressive labour occurred and augmentation was established. METHOD: A qualitative descriptive design...... after experiencing the non-progressive labour, need directions from the midwives to carry out appropriate and usefull tasks....

  20. The safety and quality of childbirth in the context of health systems: mapping maternal health provision in Lebanon

    Science.gov (United States)

    DeJong, Jocelyn; Akik, Chaza; El Kak, Faysal; Osman, Hibah; El-Jardali, Fadi

    2010-01-01

    Objective to provide basic information on the distribution (public/private and geographically) and the nature of maternity health provision in Lebanon, including relevant health outcome data at the hospital level in order to compare key features of provision with maternal/neonatal health outcomes. Design a self-completion questionnaire was sent to private hospitals by the Syndicate of Private Hospitals in collaboration with the study team and to all public hospitals in Lebanon with a functioning maternity ward by the study team in cooperation with the Ministry of Public Health. Setting childbirth in an institutional setting by a trained attendant is almost universal in Lebanon and the predominant model of care is obstetrician-led rather than midwife-led. Yet due to a 15-year-old civil war and a highly privatised health sector, Lebanon lacks systematic or publically available data on the organisation, distribution and quality of maternal health services. An accreditation system for private hospitals was recently initiated to regulate the quality of hospital care in Lebanon. Participants in total, 58 (out of 125 eligible) hospitals responded to the survey (46% total response rate). Only hospital-level aggregate data were collected. Measurements the survey addressed the volume of services, mode of payment for deliveries, number of health providers, number of labour and childbirth units, availability of neonatal intensive care units, fetal monitors and infusion rate regulation pumps for oxytocin, as well as health outcome data related to childbirth care and stillbirths for the year 2008. Findings the study provides the first data on maternal health provision from a survey of all eligible hospitals in Lebanon. More than three-quarters of deliveries occur in private hospitals, but the Ministry of Public Health is the single most important source of payment for childbirth. The reported hospital caesarean section rate is high at 40.8%. Essential equipment for safe maternal

  1. Intimate partner violence and its association with maternal depressive symptoms 6–8 months after childbirth in rural Bangladesh

    Directory of Open Access Journals (Sweden)

    Zarina N. Kabir

    2014-09-01

    Full Text Available Background: The prevalence of intimate partner violence (IPV, a gross violation of human rights, ranges widely across the world with higher prevalence reported in low- and middle-income countries. Evidence related mainly to physical health shows that IPV has both direct and indirect impacts on women's health. Little is known about the impact of IPV on the mental health of women, particularly after childbirth. Objective: To describe the prevalence of IPV experienced by women 6–8 months after childbirth in rural Bangladesh and the factors associated with physical IPV. The study also aims to investigate the association between IPV and maternal depressive symptoms after childbirth. Design: The study used cross-sectional data at 6–8 months postpartum. The sample included 660 mothers of newborn children. IPV was assessed by physical, emotional, and sexual violence. The Edinburgh Postnatal Depression Scale assessed maternal depressive symptoms. Results: Prevalence of physical IPV was 52%, sexual 65%, and emotional 84%. The husband's education (OR: 0.41, CI: 0.23–0.73, a poor relationship with the husband (OR: 2.64, CI: 1.07–6.54, and emotional violence by spouse (OR: 1.58, CI: 1.35–1.83 were significantly associated with physical IPV experienced by women. The perception of a fussy and difficult child (OR: 1.05, CI: 1.02–1.08, a poor relationship with the husband (OR: 4.95, CI: 2.55–9.62, and the experience of physical IPV (OR: 2.83, CI: 1.72–4.64 were found to be significant predictors of maternal depressive symptoms among women 6–8 months after childbirth. Neither forced sex nor emotional violence by an intimate partner was found to be significantly associated with maternal depressive symptoms 6–8 months postpartum. Conclusions: It is important to screen for both IPV and depressive symptoms during pregnancy and postpartum. Since IPV and spousal relationships are the most important predictors of maternal depressive symptoms in this

  2. The operations of the free maternal care policy and out of pocket payments during childbirth in rural Northern Ghana.

    Science.gov (United States)

    Dalinjong, Philip Ayizem; Wang, Alex Y; Homer, Caroline S E

    2017-11-22

    To promote skilled attendance at births and reduce maternal deaths, the government of Ghana introduced the free maternal care policy under the National Health Insurance Scheme (NHIS) in 2008. The objective is to eliminate financial barriers associated with the use of services. But studies elsewhere showed that out of pocket (OOP) payments still exist in the midst of fee exemptions. The aim of this study was to estimate OOP payments and the financial impact on women during childbirth in one rural and poor area of Northern Ghana; the Kassena-Nankana municipality. Costs were taken from the perspective of women. Quantitative and qualitative data collection techniques were used in a convergent parallel mixed methods study. The study used structured questionnaire (n = 353) and focus group discussions (FGDs =7) to collect data from women who gave birth in health facilities. Quantitative data from the questionnaire were analysed, using descriptive statistics. Qualitative data from the FGDs were recorded, transcribed and analysed to determine common themes. The overall mean OOP payments during childbirth was GH¢33.50 (US$17), constituting 5.6% of the average monthly household income. Over one-third (36%, n = 145) of women incurred OOP payments which exceeded 10% of average monthly household income (potentially catastrophic). Sixty-nine percent (n = 245) of the women perceived that the NHIS did not cover all expenses incurred during childbirth; which was confirmed in the FGDs. Both survey and FGDs demonstrated that women made OOP payments for drugs and other supplies. The FGDs showed women bought disinfectants, soaps, rubber pads and clothing for newborns as well. Seventy-five percent (n = 264) of the women used savings, but 19% had to sell assets to finance the payments; this was supported in the FGDs. The NHIS policy has not eliminated financial barriers associated with childbirth which impacts the welfare of some women. Women continued to make OOP

  3. Social Class Dialogues and the Fostering of Class Consciousness

    Science.gov (United States)

    Madden, Meredith

    2015-01-01

    How do critical pedagogies promote undergraduate students' awareness of social class, social class identity, and social class inequalities in education? How do undergraduate students experience class consciousness-raising in the intergroup dialogue classroom? This qualitative study explores undergraduate students' class consciousness-raising in an…

  4. The impact of childbirth-related post-traumatic stress on a couple's relationship: a systematic review and meta-synthesis.

    Science.gov (United States)

    Delicate, A; Ayers, S; Easter, A; McMullen, S

    2018-02-01

    This review aimed to identify the impact of childbirth-related post-traumatic stress disorder (PTSD) or symptoms (PTSS) on a couple's relationship. Childbirth can be psychologically traumatic and can lead to PTSD. There is emerging evidence that experiencing a traumatic birth can affect the quality of the couple's relationship. This is an important issue because poor-quality relationships can impact on the well-being of partners, their parenting and the welfare of the infant. A systematic search was conducted of Amed, CENTRAL, Cinahl, Embase, Maternity and Infant Care, Medline, MITCognet, POPLINE, PsycARTICLES, PsycBITE, PsycINFO, Pubmed and Science Direct. Additionally, grey literature, citation and reference searches were conducted. Papers were eligible for inclusion if they reported qualitative data about parents who had experienced childbirth and measures of PTSD or PTSS and the relationship were taken. Analysis was conducted using meta-ethnography. Seven studies were included in the meta-synthesis. Results showed that childbirth-related PTSD or PTSS can have a perceived impact on the couple's relationship and five themes were identified: negative emotions; lack of understanding and support; loss of intimacy; strain on the relationship; and strengthened relationships. A model of proposed interaction between these themes is presented. The impact of childbirth-related PTSD or PTSS on the couple's relationships is complex. As the quality of the couple relationship is important to family well-being, it is important that healthcare professionals are aware of the impact of experiencing psychologically traumatic childbirth as impetus for prevention and support.

  5. Self reported fear of childbirth and its association with women's birth experience and mode of delivery: a longitudinal population-based study.

    Science.gov (United States)

    Nilsson, Christina; Lundgren, Ingela; Karlström, Annika; Hildingsson, Ingegerd

    2012-09-01

    To explore fear of childbirth (FOC) during pregnancy and one year after birth and its association to birth experience and mode of delivery. A longitudinal population-based study. Pregnant women who were listed for a routine ultrasound at three hospitals in the middle-north part of Sweden. Differences between women who reported FOC and who did not were calculated using risk ratios with a 95% confidence interval. In order to explain which factors were most strongly associated to suffer from FOC during pregnancy and one year after childbirth, multivariate logistic regression analyses were used. FOC during pregnancy in multiparous women was associated with a previous negative birth experience (RR 5.1, CI 2.5-10.4) and a previous emergency caesarean section (RR 2.5, CI 1.2-5.4). Associated factors for FOC one year after childbirth were: a negative birth experience (RR 10.3, CI 5.1-20.7), fear of childbirth during pregnancy (RR 7.1, CI 4.4-11.7), emergency caesarean section (RR 2.4, CI 1.2-4.5) and primiparity (RR 1.9, CI 1.2-3.1). FOC was associated with negative birth experiences. Women still perceived the birth experience as negative a year after the event. Women's perception of the overall birth experience as negative seems to be more important for explaining subsequent FOC than mode of delivery. Maternity care should focus on women's experiences of childbirth. Staff at antenatal clinics should ask multiparous women about their previous experience of childbirth. So that FOC is minimized, research on factors that create a positive birth experience for women is required. Copyright © 2011 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  6. Reliability tests and validation tests of the client satisfaction questionnaire (CSQ-8) as an index of satisfaction with childbirth-related care among Filipino women.

    Science.gov (United States)

    Matsubara, Chieko; Green, Joseph; Astorga, Linda Teresa; Daya, Edgardo L; Jervoso, Honorato C; Gonzaga, Edgardo M; Jimba, Masamine

    2013-12-17

    Satisfaction is an important indicator of the quality of care during childbirth. Previous research found that a good environment at a health facility can increase the number of deliveries at that facility. In contrast, an unsatisfying childbirth experience could cause postpartum mental disorder. Therefore it is important to measure mothers' satisfaction with their childbirth experiences. We tested whether the eight-item Client Satisfaction Questionnaire (CSQ-8) provided useful information about satisfaction with childbirth-related care. The government of the Philippines promotes childbirth at health facilities, so we tested the CSQ-8 in the Philippine cities of Ormoc and Palo. This was a cross-sectional study. We targeted multigravid mothers whose last baby had been delivered at a hospital (without complications) and whose 2nd-to-last baby had been delivered at a hospital or at home (without complications). We developed versions of the CSQ-8 in Cebuano and Waray, which are two of the six major Filipino languages. Reliability tests and validation tests were done with data from 100 Cebuano-speaking mothers and 106 Waray-speaking mothers. Both the Cebuano and Waray versions of the CSQ-8 had high coefficients of internal-consistency reliability (greater than 0.80). Both versions were also unidimensional, which is generally consistent with the English CSQ-8 in a mental-health setting. As hypothesized, the scores for data regarding the second-to-last delivery were higher for mothers who had both their second-to-last and their last delivery in a hospital, than for mothers who had their second-to-last delivery at home and their last delivery in a hospital (Cebuano: p one language. These versions of the CSQ-8 can now be used to assess mothers' satisfaction, so that mothers' opinions can be taken into account in efforts to improve childbirth-related services, which could increase the proportion of deliveries in medical facilities and thus reduce maternal mortality.

  7. Optimizing UML Class Diagrams

    Directory of Open Access Journals (Sweden)

    Sergievskiy Maxim

    2018-01-01

    Full Text Available Most of object-oriented development technologies rely on the use of the universal modeling language UML; class diagrams play a very important role in the design process play, used to build a software system model. Modern CASE tools, which are the basic tools for object-oriented development, can’t be used to optimize UML diagrams. In this manuscript we will explain how, based on the use of design patterns and anti-patterns, class diagrams could be verified and optimized. Certain transformations can be carried out automatically; in other cases, potential inefficiencies will be indicated and recommendations given. This study also discusses additional CASE tools for validating and optimizing of UML class diagrams. For this purpose, a plugin has been developed that analyzes an XMI file containing a description of class diagrams.

  8. Classes of Heart Failure

    Science.gov (United States)

    ... Introduction Types of Heart Failure Classes of Heart Failure Heart Failure in Children Advanced Heart Failure • Causes and ... and Advanced HF • Tools and Resources • Personal Stories Heart Failure Questions to Ask Your Doctor Use these questions ...

  9. Late to Class: Social Class and Schooling in the New Economy

    Science.gov (United States)

    Van Galen, Jane

    2007-01-01

    This essay outlines several ways in which educators might better prepare young people of all backgrounds to understand, enter, and eventually act upon the changing economic landscape. The contributors to this article, which presents perspectives on social class and education in the United States, suggest that one might learn some lessons from the…

  10. Adopting a healthy lifestyle when pregnant and obese - an interview study three years after childbirth.

    Science.gov (United States)

    Dencker, Anna; Premberg, Åsa; Olander, Ellinor K; McCourt, Christine; Haby, Karin; Dencker, Sofie; Glantz, Anna; Berg, Marie

    2016-07-30

    monitoring to maintain healthy eating and regular physical activity habits after childbirth involving also the partner and family.

  11. Holding the baby: early mother-infant contact after childbirth and outcomes.

    Science.gov (United States)

    Redshaw, Maggie; Hennegan, Julie; Kruske, Sue

    2014-05-01

    to describe the timing, type and duration of initial infant contact and associated demographic and clinical factors in addition to investigating the impact of early contact on breastfeeding and maternal health and well being after birth. data from a recent population survey of women birthing in Queensland, Australia were used to describe the nature of the first hold and associated demographic characteristics. Initial comparisons, with subsequent adjustment for type of birthing facility and mode of childbirth, were used to assess associations between timing, type and duration of initial contact and outcomes. Further analyses were conducted to investigate a dose-response relationship between duration of first contact and outcomes. women who had an unassisted vaginal birth held their infant sooner, and for longer than women who had an assisted vaginal birth or caesarean and were more satisfied with their early contact. Multivariate models showed a number of demographic and clinical interventions contributing to timing, duration and type of first contact with type of birthing facility (public/private), area of residence, and assisted birth as prominent factors. For women who had a vaginal birth; early, skin-to-skin, and longer duration of initial contact were associated with high rates of breastfeeding initiation and breastfeeding at discharge, but not breastfeeding at 13 weeks. Some aspects of early contact were associated with improved maternal well being. However, these associations were not found for women who had a caesarean birth. With longer durations of first contact, a dose-response effect was found for breastfeeding. results of the study provide a description of current practice in Queensland, Australia and factors impacting on early contact. For vaginal births, findings add to the evidence in support of early skin-to-skin contact for an extended period. It is suggested that all research in this area should consider the effects of early contact separately for

  12. Trends in adverse maternal outcomes during childbirth: a population-based study of severe maternal morbidity.

    Science.gov (United States)

    Roberts, Christine L; Ford, Jane B; Algert, Charles S; Bell, Jane C; Simpson, Judy M; Morris, Jonathan M

    2009-02-25

    Maternal mortality is too rare in high income countries to be used as a marker of the quality of maternity care. Consequently severe maternal morbidity has been suggested as a better indicator. Using the maternal morbidity outcome indicator (MMOI) developed and validated for use in routinely collected population health data, we aimed to determine trends in severe adverse maternal outcomes during the birth admission and in particular to examine the contribution of postpartum haemorrhage (PPH). We applied the MMOI to the linked birth-hospital discharge records for all women who gave birth in New South Wales, Australia from 1999 to 2004 and determined rates of severe adverse maternal outcomes. We used frequency distributions and contingency table analyses to examine the association between adverse outcomes and maternal, pregnancy and birth characteristics, among all women and among only those with PPH. Using logistic regression, we modelled the effects of these characteristics on adverse maternal outcomes. The impact of adverse outcomes on duration of hospital admission was also examined. Of 500,603 women with linked birth and hospital records, 6242 (12.5 per 1,000) suffered an adverse outcome, including 22 who died. The rate of adverse maternal outcomes increased from 11.5 in 1999 to 13.8 per 1000 deliveries in 2004, an annual increase of 3.8% (95%CI 2.3-5.3%). This increase occurred almost entirely among women with a PPH. Changes in pregnancy and birth factors during the study period did not account for increases in adverse outcomes either overall, or among the subgroup of women with PPH. Among women with severe adverse outcomes there was a 12% decrease in hospital days over the study period, whereas women with no severe adverse outcome occupied 23% fewer hospital days in 2004 than in 1999. Severe adverse maternal outcomes associated with childbirth have increased in Australia and the increase was entirely among women who experienced a PPH. Reducing or stabilising

  13. Trends in adverse maternal outcomes during childbirth: a population-based study of severe maternal morbidity

    Directory of Open Access Journals (Sweden)

    Algert Charles S

    2009-02-01

    Full Text Available Abstract Background Maternal mortality is too rare in high income countries to be used as a marker of the quality of maternity care. Consequently severe maternal morbidity has been suggested as a better indicator. Using the maternal morbidity outcome indicator (MMOI developed and validated for use in routinely collected population health data, we aimed to determine trends in severe adverse maternal outcomes during the birth admission and in particular to examine the contribution of postpartum haemorrhage (PPH. Methods We applied the MMOI to the linked birth-hospital discharge records for all women who gave birth in New South Wales, Australia from 1999 to 2004 and determined rates of severe adverse maternal outcomes. We used frequency distributions and contingency table analyses to examine the association between adverse outcomes and maternal, pregnancy and birth characteristics, among all women and among only those with PPH. Using logistic regression, we modelled the effects of these characteristics on adverse maternal outcomes. The impact of adverse outcomes on duration of hospital admission was also examined. Results Of 500,603 women with linked birth and hospital records, 6242 (12.5 per 1,000 suffered an adverse outcome, including 22 who died. The rate of adverse maternal outcomes increased from 11.5 in 1999 to 13.8 per 1000 deliveries in 2004, an annual increase of 3.8% (95%CI 2.3–5.3%. This increase occurred almost entirely among women with a PPH. Changes in pregnancy and birth factors during the study period did not account for increases in adverse outcomes either overall, or among the subgroup of women with PPH. Among women with severe adverse outcomes there was a 12% decrease in hospital days over the study period, whereas women with no severe adverse outcome occupied 23% fewer hospital days in 2004 than in 1999. Conclusion Severe adverse maternal outcomes associated with childbirth have increased in Australia and the increase was

  14. Evaluation of Mackey Childbirth Satisfaction Rating Scale in Iran: What Are the Psychometric Properties?

    Science.gov (United States)

    Moudi, Zahra; Tavousi, Mahmoud

    2016-06-01

    With the integration of the evaluation of patient satisfaction in the overall assessment of healthcare services, authorities can be assured about the alignment of these services with patient needs and the suitability of care provided at the local level. This study was conducted in 2013 in Zahedan, Iran, in order to assess the psychometric properties of the Iranian version of the mackey childbirth satisfaction rating scale (MCSRS). For this study, a methodological design was used. After translating the MCSRS and confirming its initial validity, the questionnaires were distributed among women with uncomplicated pregnancies and no prior history of cesarean section. The participants had given birth to healthy, full-term, singletons (with cephalic presentation) via normal vaginal delivery at hospitals within the past six months. Cronbach's alpha and test-retest (via the intraclass correlation coefficient) were applied to analyze the internal consistency and reliability of the scale. Moreover, the validity of the scale was tested via exploratory factor analysis, confirmatory factor analysis, and convergent validity. The MCSRS consists of six subscales. Through the process of validation, two partner-related items ("partner" subscale) of the scale were excluded due to cultural barriers and hospital policies. Cronbach's alpha for the total scale was 0.78. It ranged between 0.70 and 0.86 for five subscales, and was 0.31 for the "baby" subscale. Factor analysis confirmed the subscales of "nurse," "physician," and "baby," which were identified in the original scale. However, in the translated version, the "self" subscale was divided into two separate dimensions. The six subscales explained 70.37% of the variance. Confirmatory factor analysis indicated a good fitness for the new model. Convergent validity showed a significant correlation between the MCSRS and the SERVQUAL scale (r = 0.72, P < 0.001). Moreover, the Farsi version of the MCSRS showed excellent repeatability (r = 0

  15. Generalized Fourier transforms classes

    DEFF Research Database (Denmark)

    Berntsen, Svend; Møller, Steen

    2002-01-01

    The Fourier class of integral transforms with kernels $B(\\omega r)$ has by definition inverse transforms with kernel $B(-\\omega r)$. The space of such transforms is explicitly constructed. A slightly more general class of generalized Fourier transforms are introduced. From the general theory foll...... follows that integral transform with kernels which are products of a Bessel and a Hankel function or which is of a certain general hypergeometric type have inverse transforms of the same structure....

  16. Nordic Walking Classes

    CERN Multimedia

    Fitness Club

    2015-01-01

    Four classes of one hour each are held on Tuesdays. RDV barracks parking at Entrance A, 10 minutes before class time. Spring Course 2015: 05.05/12.05/19.05/26.05 Prices 40 CHF per session + 10 CHF club membership 5 CHF/hour pole rental Check out our schedule and enroll at: https://espace.cern.ch/club-fitness/Lists/Nordic%20Walking/NewForm.aspx? Hope to see you among us! fitness.club@cern.ch

  17. Influence of Rewarding Work a nd Work Hours’ F lexibility on C ontinuous Working a nd Childbirth among Married Women in Japan-U.S. Comparison

    OpenAIRE

    山谷, 真名

    2015-01-01

    In Japan, the difficulty that women experience continuing to work after childbirth is widely known\\and a great deal of research has been conducted on the factors affecting this.\\I will examine how rewarding work and work hours’ flexibility are associated with continuous\\working and childbirth among married women in Japan and U.S.\\The data used for this study was collected in 2011 and 2012 by Ochanomizu University of the\\Program for Promoting Social Science Research Aimed at Solutions of Near ...

  18. Giving birth and returning to work: the impact of work-family conflict on women's health after childbirth.

    Science.gov (United States)

    Grice, Mira M; Feda, Denise; McGovern, Patricia; Alexander, Bruce H; McCaffrey, David; Ukestad, Laurie

    2007-10-01

    Since 1970, women of childbearing age have increasingly participated in the workforce. However, literature on work-family conflict has not specifically addressed the health of postpartum women. This study examined the relationship between work-family conflict and mental and physical health of employed mothers 11 weeks after childbirth. Employed women, 18 years and older, were recruited while in the hospital for childbirth (N = 817; 71% response rate). Mental and physical health at 11 weeks postpartum was measured using SF-12 version 2. General linear models estimated the associations between the independent variables and health. A priori causal models and directed acyclic graphs guided selection of confounding variables. Analyses revealed that high levels of work interference with family were associated with significantly lower mental health scores. Medium and high levels of family interference with work revealed a dose-response relationship resulting in significantly worse mental health scores. Coworker support was strongly and positively associated with better physical health. Work-family conflict was negatively associated with mental health but not significantly associated with physical health. Availability of social support may relieve the burden women can experience when balancing work roles and family obligations.

  19. Content of childbirth-related fear in Swedish women and men--analysis of an open-ended question.

    Science.gov (United States)

    Eriksson, Carola; Westman, Göran; Hamberg, Katarina

    2006-01-01

    The content of childbirth-related fear as described by 308 women and 194 men was analyzed and compared in relation to intensity of fear. The content of fear was similarly described by women and men and concerned the following main categories: the labor and delivery process, the health and life of the baby, the health and life of the woman, own capabilities and reactions, the partner's capabilities and reactions, and the professionals' competence and behavior. Among women, the labor and delivery process was the most frequently reported among the 6 categories of fears, whereas the health and life of the baby was the most frequent among the men. Fears related to own capabilities and reactions were described significantly more often by women with intense fear than by women with mild to moderate fear. The greatest difference between men with intense versus mild to moderate fear was a more frequent expression of concern for the health and life of the woman. Both women and men had fears related to not being treated with respect and not receiving sufficient medical care. This finding suggests that part of the problem with childbirth-related fear is located within the health care system itself.

  20. Premature childbirth: pregnant women's characteristics of a population in the South area of São Paulo

    Directory of Open Access Journals (Sweden)

    Aline Zorzim Berger

    Full Text Available Abstract Objectives: to identify the characteristics of pregnant women who had premature child-birth (PPT in the South region of São Paulo city. Methods: a cross-sectional observational study with a data collection of 122 medical files on pregnant women who had PPT in 2013. The collected data were analyzed by a statistical package, Graphpad Prism 6. As for the variables that were shown to be significant in the multivariate regression, an analysis was performed in a dichotomous form by odds ratio. Results: the mean age of the pregnant women was 24.9 years old. Of the 122 pregnant women, 34.4% were included in the age group considered to be at risk by the Ministry of Health. The predominant race was mixed (46.2%. 41.8% were high school graduates. Regarding to personal background, the history on urinary infection was mostly mentioned (37.5%. In relation to family history regarding clinical conditions, 43% had diabetes history and 61% had hypertension. As for gynecological history, 37.5% reported having dysmenorrhea during menstrual cycles. Multivariate analysis was performed and found that particularly hypertension and dysmenorrhea were the most significant. Conclusions: Regarding to women´s risk factors for premature childbirth, the most determining factor was dysmenorrhea, followed by hypertension.

  1. Coping and help in birth: An investigation into 'normal' childbirth as described by new mothers and their attending midwives.

    Science.gov (United States)

    Darra, Susanne; Murphy, Fiona

    2016-09-01

    to investigate how 'normal' childbirth is described by new mothers and their attending midwives. a qualitative, reflexive, narrative study was used to explore birth stories using in-depth, un-structured interviews. 21 new mothers and their 16 attending midwives were recruited from the locality surrounding a district general hospital in South Wales, United Kingdom (UK). the findings identified that the mothers wanted to cope with labour and birth, by breathing through it and using some birth interventions with the help of knowledgeable midwives. Midwives aimed to achieve 'normality' in birth but also commonly utilised birth interventions. Consequently the notion of 'normal' birth as not involving interventions in birth was not found to be a useful defining concept in this study. Furthermore, current dichotomous models and theories of birth and midwifery in particular those relating to pain management did not fully explain the perspectives of these women and their midwives. dichotomous models and theories for birth and midwifery practice and those which incorporate the term 'normal' birth are shown to be not entirely useful to fully explain the contemporary complexity of childbirth in the UK. Therefore it is now necessary to consider avoiding using dichotomous models of birth and midwifery in the UK and to instead concentrate on developing integrated models that reflect the real life current experiences of women and their midwives. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Expectations and needs of Ugandan women for improved quality of childbirth care in health facilities: A qualitative study.

    Science.gov (United States)

    Kyaddondo, David; Mugerwa, Kidza; Byamugisha, Josaphat; Oladapo, Olufemi T; Bohren, Meghan A

    2017-12-01

    To describe the experiences, expectations, and needs of urban Ugandan women in relation to good-quality facility childbirth. Women who had given birth in the 12 months prior to the study were purposively sampled and interviewed, or included in focus groups. Thematic analysis was used, and the data were interpreted within the context of an existing quality of care framework. Forty-five in-depth interviews and six focus group discussions were conducted. Respect and dignity, timely communication, competent skilled staff, and availability of medical supplies were central to women's accounts of quality care, or a lack of it. The hope for a live baby motivated women to seek facility-based childbirth. They expected to encounter competent, respectful, and caring staff with appropriate skills. In some cases, they could only fulfill these expectations through additional personal financial payments to staff, for clinical supplies, or to guarantee that they would be attended by someone with suitable skills. Long-term improvement in quality of maternity care in Uganda requires enhancement of the interaction between women and health staff in facilities, and investment in staff and resources to ensure that safe, respectful care is not dependent on willingness and/or capacity to pay. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

  3. Midwives' supervisory styles and leadership role as experienced by Norwegian mothers in the context of a fear of childbirth.

    Science.gov (United States)

    Lyberg, Anne; Severinsson, Elisabeth

    2010-05-01

    The aim of the present study was to describe the midwives' supervisory style and leadership role as experienced by pregnant women and new mothers in the context of a fear of childbirth. A service led by midwives can influence the quality of care. The sample consisted of 13 mothers. Data were interpreted by means of qualitative content analysis. The findings revealed that the midwives' supervisory styles were related to their ability to create a trusting and caring relationship, demonstrate problem-solving capacity, and showing willingness, preparedness and courage to support the women. The midwives' leadership role was described as involving a crucial set of professional management skills and techniques. The findings have strengthened the argument for the provision of continuity of care to women who are afraid of childbirth. Further studies should focus more specifically on the implementation of research in practice. It is necessary for midwives to demonstrate leadership in order to develop practice, predict challenges and changes, provide different care delivery models and acquire an evidence base for care. This also demands systematic supervision to improve care outcomes.

  4. Midwife-assisted planned home birth: an essential component of improving the safety of childbirth in Sub-Saharan Africa.

    Science.gov (United States)

    Dayyabu, Aliyu Labaran; Murtala, Yusuf; Grünebaum, Amos; McCullough, Laurence B; Arabin, Birgit; Levene, Malcolm I; Brent, Robert L; Monni, Giovanni; Sen, Cihat; Makatsariya, Alexander; Chervenak, Frank A

    2018-05-29

    Hospital births, when compared to out-of-hospital births, have generally led to not only a significantly reduced maternal and perinatal mortality and morbidity but also an increase in certain interventions. A trend seems to be emerging, especially in the US where some women are requesting home births, which creates ethical challenges for obstetricians and the health care organizations and policy makers. In the developing world, a completely different reality exists. Home births constitute the majority of deliveries in the developing world. There are severe limitations in terms of facilities, health personnel and deeply entrenched cultural and socio-economic conditions militating against hospital births. As a consequence, maternal and perinatal mortality and morbidity remain the highest, especially in Sub-Saharan Africa (SSA). Midwife-assisted planned home birth therefore has a major role to play in increasing the safety of childbirth in SSA. The objective of this paper is to propose a model that can be used to improve the safety of childbirth in low resource countries and to outline why midwife assisted planned home birth with coordination of hospitals is the preferred alternative to unassisted or inadequately assisted planned home birth in SSA.

  5. Life events, social support and depression in childbirth: perspectives from a rural community in the developing world.

    Science.gov (United States)

    Rahman, A; Iqbal, Z; Harrington, R

    2003-10-01

    High rates of depression associated with childbirth have been reported in many parts of the developing world. However, the prevalence and associations of antenatal and post-natal depression in the rural population remain unknown. Disability associated with depression and its impact on infant health and development could have important public health implications for many developing countries where large proportions of the population are rural. All women living in southern Kahuta, Pakistan, in their third trimester of pregnancy were interviewed at 6 weeks before delivery (N = 632) and again at 10-12 weeks after delivery (N = 541), using WHO Schedule for Clinical Assessment in Neuropsychiatry (SCAN), Personal Information Questionnaire (PIQ) and Brief Disability Questionnaire (BDQ). The point prevalence of ICD-10 depressive disorder was 25% in the antenatal period and 28 % in the post-natal period. Depressed mothers were significantly more disabled, had more threatening life events, and poorer social and family support than non-depressed mothers. Vulnerable mothers were more likely to be depressed during pregnancy, rather than have an onset in the post-natal period. Over one-quarter of mothers in a rural sub-district of Pakistan suffer from depression shortly before and after childbirth. Rapidly changing traditional family structures and practices may be increasing the risk of depression in many women. Recognizing and treating depression should be initiated during the antenatal, rather than post-natal period.

  6. Determinants of neonatal death with emphasis on health care during pregnancy, childbirth and reproductive history

    Directory of Open Access Journals (Sweden)

    Samir B. Kassar

    2013-05-01

    Full Text Available Objective: To identify risk factors for neonatal mortality, focusing on factors related to assistance care during the prenatal period, childbirth, and maternal reproductive history. Methods: This was a case-control study conducted in Maceió, Northeastern Brazil. The sample consisted of 136 cases and 272 controls selected from official Brazilian databases. The cases consisted of all infants who died before 28 days of life, selected from the Mortality Information System, and the controls were survivors during this period, selected from the Information System on Live Births, by random drawing among children born on the same date of the case. Household interviews were conducted with mothers. Results: The logistic regression analysis identified the following as determining factors for death in the neonatal period: mothers with a history of previous children who died in the first year of life (OR = 3.08, hospitalization during pregnancy (OR = 2.48, inadequate prenatal care (OR = 2.49, lack of ultrasound examination during prenatal care (OR = 3.89, transfer of the newborn to another unit after birth (OR = 5.06, admittance of the newborn at the ICU (OR = 5.00, and low birth weight (OR = 2.57. Among the socioeconomic conditions, there was a greater chance for neonatal mortality in homes with fewer residents (OR = 1.73 and with no children younger than five years (OR = 10.10. Conclusion: Several factors that were associated with neonatal mortality in this study may be due to inadequate care during the prenatal period and childbirth, and inadequate newborn care, all of which can be modified. Resumo: Objetivo: Identificar fatores de risco para mortalidade neonatal, com especial atenção aos fatores assistenciais relacionados com os cuidados durante o período pré-natal, parto e história reprodutiva materna. Métodos: Trata-se de um estudo caso-controle realizado em Maceió, Nordeste do Brasil. A amostra consistiu de 136 casos e 272

  7. Radioprotective preparation

    International Nuclear Information System (INIS)

    Stefanova, D.; Frattadochi, A.; Gattavecchia, E.; Ferri, E.; Tonnelli, D.

    1988-01-01

    The invention is intended for radiation injuries prophylaxis in mammals. It has an well expressed radioprotective effect against acute gamma irradiation on cellular level as well as a prolonged action when applied up to 48 hours before the acute irradiation. The preparation is a coprecipitate of the natural tripeptide glutathione (reduced form) and polyvinyl pyrrolidone (pvp) in ratio 30-60/70-40. It is obtained by incubation method with subsequent lyophilization from water solution of the initial components. The molecular mass of the pvp is 20 till 360.10 3 . 2 claims

  8. Target preparation

    International Nuclear Information System (INIS)

    Hinn, G.M.

    1984-01-01

    A few of the more interesting of the 210 targets prepared in the Laboratory last year are listed. In addition the author continues to use powdered silver mixed with /sup 9,10/BeO to produce sources for accelerator radio dating of Alaskan and South Polar snow. Currently, he is trying to increase production by multiple sample processing. Also the author routinely makes 3 μg/cm 2 cracked slacked carbon stripper foils and is continuing research with some degree of success in making enriched 28 Si targets starting with the oxide

  9. Safety class methodology

    International Nuclear Information System (INIS)

    Donner, E.B.; Low, J.M.; Lux, C.R.

    1992-01-01

    DOE Order 6430.1A, General Design Criteria (GDC), requires that DOE facilities be evaluated with respect to ''safety class items.'' Although the GDC defines safety class items, it does not provide a methodology for selecting safety class items. The methodology described in this paper was developed to assure that Safety Class Items at the Savannah River Site (SRS) are selected in a consistent and technically defensible manner. Safety class items are those in the highest of four categories determined to be of special importance to nuclear safety and, merit appropriately higher-quality design, fabrication, and industrial test standards and codes. The identification of safety class items is approached using a cascading strategy that begins at the 'safety function' level (i.e., a cooling function, ventilation function, etc.) and proceeds down to the system, component, or structure level. Thus, the items that are required to support a safety function are SCls. The basic steps in this procedure apply to the determination of SCls for both new project activities, and for operating facilities. The GDC lists six characteristics of SCls to be considered as a starting point for safety item classification. They are as follows: 1. Those items whose failure would produce exposure consequences that would exceed the guidelines in Section 1300-1.4, ''Guidance on Limiting Exposure of the Public,'' at the site boundary or nearest point of public access 2. Those items required to maintain operating parameters within the safety limits specified in the Operational Safety Requirements during normal operations and anticipated operational occurrences. 3. Those items required for nuclear criticality safety. 4. Those items required to monitor the release of radioactive material to the environment during and after a Design Basis Accident. Those items required to achieve, and maintain the facility in a safe shutdown condition 6. Those items that control Safety Class Item listed above

  10. Does Maternal Employment Following Childbirth Support or Inhibit Low-Income Children's Long-Term Development?

    Science.gov (United States)

    Coley, Rebekah Levine; Lombardi, Caitlin McPherran

    2013-01-01

    This study assessed whether previous findings linking early maternal employment to lower cognitive and behavioral skills among middle-class and White children generalized to other groups. Using a representative sample of urban, low-income, predominantly African American and Hispanic families ("n" = 444), ordinary least squares regression…

  11. Translation in ESL Classes

    Directory of Open Access Journals (Sweden)

    Nagy Imola Katalin

    2015-12-01

    Full Text Available The problem of translation in foreign language classes cannot be dealt with unless we attempt to make an overview of what translation meant for language teaching in different periods of language pedagogy. From the translation-oriented grammar-translation method through the complete ban on translation and mother tongue during the times of the audio-lingual approaches, we have come today to reconsider the role and status of translation in ESL classes. This article attempts to advocate for translation as a useful ESL class activity, which can completely fulfil the requirements of communicativeness. We also attempt to identify some activities and games, which rely on translation in some books published in the 1990s and the 2000s.

  12. MIDDLE CLASS MOVEMENTS

    OpenAIRE

    Dr. K. Sravana Kumar

    2016-01-01

    The middle class is placed between labour and capital. It neither directly awns the means of production that pumps out the surplus generated by wage labour power, nor does it, by its own labour, produce the surplus which has use and exchange value. Broadly speaking, this class consists of the petty bourgeoisie and the white-collar workers. The former are either self-employed or involved in the distribution of commodities and the latter are non-manual office workers, supervisors and profession...

  13. Talking Class in Tehroon

    DEFF Research Database (Denmark)

    Elling, Rasmus Christian; Rezakhani, Khodadad

    2016-01-01

    Persian, like any other language, is laced with references to class, both blatant and subtle. With idioms and metaphors, Iranians can identify and situate others, and thus themselves, within hierarchies of social status and privilege, both real and imagined. Some class-related terms can be traced...... back to medieval times, whereas others are of modern vintage, the linguistic legacy of television shows, pop songs, social media memes or street vernacular. Every day, it seems, an infectious set of phrases appears that make yesterday’s seem embarrassingly antiquated....

  14. Healthcare professionals' attitudes, knowledge and self-efficacy levels regarding the use of self-hypnosis in childbirth: A prospective questionnaire survey.

    Science.gov (United States)

    McAllister, Sophie; Coxon, Kirstie; Murrells, T; Sandall, J

    2017-04-01

    to examine healthcare professionals' attitudes, knowledge and levels of self-efficacy regarding the use of self-hypnosis in childbirth. a prospective survey. two large maternity units in London, England. healthcare professionals (n=129) involved in the care of childbearing women (anaesthetists, midwives and obstetricians). online questionnaire assessing healthcare professionals' experience, knowledge, attitudes and self-efficacy relating to self-hypnosis in childbirth. attitude, self-efficacy and knowledge. over half of the participants surveyed (56%) reported they had minimal or no knowledge of hypnosis. Higher levels of knowledge were associated with higher levels of self-efficacy (phypnosis than doctors, and more exposure was significantly associated with higher levels of self-efficacy (midwives phypnosis in their own or partners' births had significantly higher self-efficacy scores (phypnosis in childbirth, they need to be confident in their ability to facilitate this method. Previous research has established that self-efficacy is a strong indicator of performance. Professionals with more knowledge of self-hypnosis are also more confident in supporting women using this technique in childbirth. Multi-disciplinary staff training which aims to increase knowledge, and which includes exposure to hypnosis in labour, may be beneficial in assisting staff to support women choosing to use self-hypnosis in labour. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. The diagnostic strength of the 24-h pad test for self-reported symptoms of urinary incontinence in pregnancy and after childbirth

    NARCIS (Netherlands)

    Wijma, Jacobus; Potters, Annemarie E. Weis; Tinga, Dick J.; Aarnoudse, Jan G.

    The clinical impact of incontinence in pregnancy and after childbirth is growing because some studies report the efficacy of physiotherapy in pregnancy and because obstetric choices are supposed to have significant impact on post-reproductive urinary function (Goldberg et al. in Am J Obstet Gynecol

  16. The Role of HIV-Related Stigma in Utilization of Skilled Childbirth Services in Rural Kenya : A Prospective Mixed-Methods Study

    NARCIS (Netherlands)

    Turan, Janet M.; Hatcher, Abigail H.; Wijnveen, José; Onono, Maricianah; Miller, Suellen; Bukusi, Elizabeth A.; Turan, Bulent; Cohen, Craig R.

    Background: Childbirth with a skilled attendant is crucial for preventing maternal mortality and is an important opportunity for prevention of mother-to-child transmission of HIV. The Maternity in Migori and AIDS Stigma Study (MAMAS Study) is a prospective mixed-methods investigation conducted in a

  17. Why is young maternal age at first childbirth a risk factor for persistent delinquency in their male offspring? Examining the role of family and parenting factors

    NARCIS (Netherlands)

    van Vugt, E.; Loeber, R.; Pardini, D.

    2016-01-01

    Background Children born to mothers who were younger than average at their first childbirth are at increased risk for future persistent delinquent behaviour, but explanations for this remain unclear. Aims Our aim was to identify possible family and parenting variables that may help explain this

  18. Marriage Migration Versus Family Reunification : How Does the Marriage and Migration History Affect the Timing of First and Second Childbirth Among Turkish Immigrants in Germany?

    NARCIS (Netherlands)

    Wolf, Katharina

    2016-01-01

    Our study focuses on the fertility of first-generation female and male Turkish migrants in Germany. To evaluate whether timing effects such as fertility disruption or an interrelation of marriage, migration and childbirth occur, we examine first and second births in the years before and after

  19. The incidence of HIV among women recruited during late pregnancy and followed up for six years after childbirth in Zimbabwe

    Directory of Open Access Journals (Sweden)

    Chirenje Mike Z

    2010-11-01

    Full Text Available Abstract Background HIV incidence is a useful tool for improving the targeting of populations for interventions and assessing the effectiveness of prevention strategies. A study in Harare, Zimbabwe reported cumulative incidences of 3.4% (3.0-3.8 and 6.5% (5.7-7.4 among post-partum women followed for 12 and 24 months respectively between 1997 and 2001. According to a Government report on HIV the prevalence of HIV fell from about 30% in 1999 to 14% in 2008. The purpose of this study was to determine the incidence of HIV-1 among women enrolled during late pregnancy and followed for six years after childbirth and to identify risk factors associated with acquisition of HIV. Methods HIV-uninfected pregnant women around 36 weeks gestation were enrolled from primary health care clinics in peri-urban settlements around Harare and followed-up for up to six years after childbirth. At every visit a questionnaire was interview-administered to obtain socio-demographic data and sexual history since the previous visit. A genital examination was performed followed by the collection of biological samples. Results Of the 552 HIV-uninfected women 444 (80.4% were seen at least twice during the six years follow-up and 39 acquired HIV, resulting in an incidence (95% CI of 2.3/100 woman-years-at-risk (wyar (1.1-4.1. The incidence over the first nine months post-partum was 5.7/100 wyar (3.3-8.1. A greater proportion of teenagers (15.3% contributed to a high incidence rate of 2.9/100 (0.6-8.7 wyar. In multivariate analysis lower education of participant, RR 2.1 (1.1-4.3 remained significantly associated with HIV acquisition. Other risk factors associated with acquisition of HIV-1 in univariate analysis were young age at sexual debut, RR 2.3, (1.0-5.6 and having children with different fathers, RR 2.7(1.3-5.8. Women that knew that their partners had other sexual partners were about four times more likely to acquire HIV, RR 3.8 (1.3-11.2. Conclusion The incidence of HIV

  20. How do medical students prepare for flipped classrooms?

    NARCIS (Netherlands)

    Bouwmeester, RAM; de Kleijn, R.A.M.; ten Cate, TJ; van Rijen, HVM; Westerveld, HE

    A flipped classroom, an approach abandoning traditional lectures and having students come together to apply acquired knowledge, requires students to come to class well prepared. The nature of this preparation is currently being debated. Watching web lectures as a preparation has typically been

  1. How women are treated during facility-based childbirth: development and validation of measurement tools in four countries - phase 1 formative research study protocol.

    Science.gov (United States)

    Vogel, Joshua P; Bohren, Meghan A; Tunçalp, Özge; Oladapo, Olufemi T; Adanu, Richard M; Baldé, Mamadou Diouldé; Maung, Thae Maung; Fawole, Bukola; Adu-Bonsaffoh, Kwame; Dako-Gyeke, Phyllis; Maya, Ernest Tei; Camara, Mohamed Campell; Diallo, Alfa Boubacar; Diallo, Safiatou; Wai, Khin Thet; Myint, Theingi; Olutayo, Lanre; Titiloye, Musibau; Alu, Frank; Idris, Hadiza; Gülmezoglu, Metin A

    2015-07-22

    Every woman has the right to dignified, respectful care during childbirth. Recent evidence has demonstrated that globally many women experience mistreatment during labour and childbirth in health facilities, which can pose a significant barrier to women attending facilities for delivery and can contribute to poor birth experiences and adverse outcomes for women and newborns. However there is no clear consensus on how mistreatment of women during childbirth in facilities is defined and measured. We propose using a two-phased, mixed-methods study design in four countries to address these research gaps. This protocol describes the Phase 1 qualitative research activities. We will employ qualitative research methodologies among women, healthcare providers and administrators in the facility catchment areas of two health facilities in each country: Ghana, Guinea, Myanmar and Nigeria. In-depth interviews (IDIs) and focus group discussions (FGDs) will be conducted among women of reproductive age (15-49 years) to explore their perceptions and experiences of facility-based childbirth care, focused on how they were treated by healthcare workers and perceived factors affecting how they were treated. IDIs will also be conducted with healthcare providers of different cadres (e.g.: nurses, midwives, medical officers, specialist obstetricians) and facility administrators working in the selected facilities to explore healthcare providers' perceptions and experiences of facility-based childbirth care and how staff are treated, colleagues and supervisors. Audio recordings will be transcribed and translated to English. Textual data will be analysed using a thematic framework approach and will consist of two levels of analysis: (1) conduct of local analysis workshops with the research assistants in each country; and (2) line-by-line coding to develop a thematic framework and coding scheme. This study serves several roles. It will provide an in-depth understanding of how women are

  2. Childhood Malnutrition is Associated with Maternal Care During Pregnancy and Childbirth: A Cross-Sectional Study in Bauchi and Cross River States, Nigeria.

    Science.gov (United States)

    Hamel, Candyce; Enne, Joseph; Omer, Khalid; Ayara, Ndem; Yarima, Yahaya; Cockcroft, Anne; Andersson, Neil

    2015-02-20

    Malnutrition remains an important cause of childhood morbidity and mortality; the levels of childhood malnutrition in Nigeria are among the highest in the world. The literature supports many direct and indirect causes of malnutrition, but few studies have examined the link between maternal care during pregnancy and childbirth and childhood malnutrition. This study examines this potential link in Bauchi and Cross River states in Nigeria. In 2011, a household survey collected information about children under four years old and their mothers' last pregnancy. Trained fieldworkers measured mid-upper arm circumference (MUAC) of children aged 6-47 months. We examined associations with childhood malnutrition in bivariate and multivariate analysis. Some 4.4% of 3643 children in Cross River, and 14.7% of 2706 in Bauchi were malnourished (MUAC z-score). In both states, a child whose mother had fewer than four government antenatal care visits was more likely to be malnourished (Cross River: OR 1.85, 95%CIca 1.33-2.55; Bauchi: OR 1.29, 95%CIca 1.02-1.63). In Bauchi, a child whose mother who rarely or never discussed pregnancy and childbirth with her husband (OR 1.34, 95%CIca 1.07-1.68), and who did not have her last delivery attended by a skilled health worker was more likely to be malnourished (OR 1.50, 95%CIca 1.09-2.07). These findings, if confirmed in other studies, suggest that poor care of women in pregnancy and childbirth could pose a longer term risk to the health of the child, as well as increasing immediate risks for both mother and child. Significance for public healthChildhood malnutrition is a public health priority, accounting for almost 1/5 of global disease burden among children under five years old. Many studies have examined risk factors for childhood malnutrition, but few have examined the link between maternal care during pregnancy and childbirth and childhood malnutrition. This study, albeit a cross-sectional design, provides evidence of a link between poor

  3. Second class weak currents

    International Nuclear Information System (INIS)

    Delorme, J.

    1978-01-01

    The definition and general properties of weak second class currents are recalled and various detection possibilities briefly reviewed. It is shown that the existing data on nuclear beta decay can be consistently analysed in terms of a phenomenological model. Their implication on the fundamental structure of weak interactions is discussed [fr

  4. World Class Teachers.

    Science.gov (United States)

    Mitchell, Rosalita

    1998-01-01

    School communities are challenged to find ways to identify good teachers and give other teachers a chance to learn from them. The New Mexico World Class Teacher Project is encouraging teachers to pursue certification by the National Board for Professional Teaching Standards. This process sharpens teachers' student assessment skills and encourages…

  5. EPA Web Training Classes

    Science.gov (United States)

    Scheduled webinars can help you better manage EPA web content. Class topics include Drupal basics, creating different types of pages in the WebCMS such as document pages and forms, using Google Analytics, and best practices for metadata and accessibility.

  6. Class Actions in Denmark

    DEFF Research Database (Denmark)

    Werlauff, Erik

    2009-01-01

    The article deals with the relatively new Danish Act on Class Action (Danish: gruppesøgsmål) which was suggested by The Permanent Council on Civil procedure (Retsplejerådet) of which the article's author is a member. The operability of the new provisions is illustrated through some wellknown Danish...

  7. Coming out in Class

    Science.gov (United States)

    McKinnon, Rachel

    2012-01-01

    This article shares how the author explained her trans status to her students. Everyone has been extremely supportive of her decision to come out in class and to completely mask the male secondary-sex characteristics, especially in the workplace. The department chair and the faculty in general have been willing to do whatever they can to assist…

  8. Adeus à classe trabalhadora?

    Directory of Open Access Journals (Sweden)

    Geoff Eley

    2013-12-01

    Full Text Available No início da década de 1980, a política centrada em classes da tradição socialista estava em crise, e comentadores importantes adotaram tons apocalípticos. No final da década, a esquerda permanecia profundamente dividida entre os advogados da mudança e os defensores da fé. Em meados dos anos 1990, os primeiros tinham, de modo geral, ganhado a batalha. O artigo busca apresentar essa mudança contemporânea não como a 'morte da classe', mas como o desa­parecimento de um tipo particular de ­sociedade de classes, marcado pelo ­processo de formação da classe trabalhadora entre os anos 1880 e 1940 e pelo alinhamento político daí resultante, atingindo seu apogeu na construção social-democrata do acordo do pós-guerra. Quando mudanças de longo prazo na economia se combinaram com o ataque ao keynesianismo na política de recessão a partir de meados da década de 1970, a unidade da classe trabalhadora deixou de estar disponível da forma antiga e bastante utilizada, como o terreno natural da política de esquerda. Enquanto uma coletividade dominante da classe trabalhadora entrou em declínio, outra se corporificou de modo lento e desigual para tomar o lugar daquela. Mas a unidade operacional dessa nova agregação da classe trabalhadora ainda está, em grande parte, em formação. Para recuperar a eficácia política da tradição socialista, alguma nova visão de agência política coletiva será necessária, uma visão imaginativamente ajustada às condições emergentes da produção e acumulação capitalista no início do século XXI.

  9. Childbirth traditions and cultural perceptions of safety in Nepal: critical spaces to ensure the survival of mothers and newborns in remote mountain villages.

    Science.gov (United States)

    Kaphle, Sabitra; Hancock, Heather; Newman, Lareen A

    2013-10-01

    to uncover local beliefs regarding pregnancy and birth in remote mountainous villages of Nepal in order to understand the factors which impact on women's experiences of pregnancy and childbirth and the related interplay of tradition, spiritual beliefs, risk and safety which impact on those experiences. this study used a qualitative methodological approach with in-depth interviews framework within social constructionist and feminist critical theories. the setting comprised two remote Nepalese mountain villages where women have high rates of illiteracy, poverty, disadvantage, maternal and newborn mortality, and low life expectancy. Interviews were conducted between February and June, 2010. twenty five pregnant/postnatal women, five husbands, five mothers-in-law, one father-in-law, five service providers and five community stakeholders from the local communities were involved. Nepalese women, their families and most of their community strongly value their childbirth traditions and associated spiritual beliefs and they profoundly shape women's views of safety and risk during pregnancy and childbirth, influencing how birth and new motherhood fit into daily life. These intense culturally-based views of childbirth safety and risk conflict starkly with the medical view of childbirth safety and risk. if maternity services are to improve maternal and neonatal survival rates in Nepal, maternity care providers must genuinely partner with local women inclusive of their cultural beliefs, and provide locally based primary maternity care. Women will then be more likely to attend maternity care services, and benefit from feeling culturally safe and culturally respected within their spiritual traditions of birth supported by the reduction of risk provided by informed and reverent medicalised care. © 2013 Elsevier Ltd. All rights reserved.

  10. Increasing the use of skilled health personnel where traditional birth attendants were providers of childbirth care: a systematic review.

    Science.gov (United States)

    Vieira, Claudia; Portela, Anayda; Miller, Tina; Coast, Ernestina; Leone, Tiziana; Marston, Cicely

    2012-01-01

    Improved access to skilled health personnel for childbirth is a priority strategy to improve maternal health. This study investigates interventions to achieve this where traditional birth attendants were providers of childbirth care and asks what has been done and what has worked? We systematically reviewed published and unpublished literature, searching 26 databases and contacting experts to find relevant studies. We included references from all time periods and locations. 132 items from 41 countries met our inclusion criteria and are included in an inventory; six were intervention evaluations of high or moderate quality which we further analysed. Four studies report on interventions to deploy midwives closer to communities: two studies in Indonesia reported an increase in use of skilled health personnel; another Indonesian study showed increased uptake of caesarean sections as midwives per population increased; one study in Bangladesh reported decreased risk of maternal death. Two studies report on interventions to address financial barriers: one in Bangladesh reported an increase in use of skilled health personnel where financial barriers for users were addressed and incentives were given to skilled care providers; another in Peru reported that use of emergency obstetric care increased by subsidies for preventive and maternity care, but not by improved quality of care. The interventions had positive outcomes for relevant maternal health indicators. However, three of the studies evaluate the village midwife programme in Indonesia, which limits the generalizability of conclusions. Most studies report on a main intervention, despite other activities, such as community mobilization or partnerships with traditional birth attendants. Many authors note that multiple factors including distance, transport, family preferences/support also need to be addressed. Case studies of interventions in the inventory illustrate how different countries attempted to address these

  11. An investigation of the relationship between autonomy, childbirth practices, and obstetric fistula among women in rural Lilongwe District, Malawi.

    Science.gov (United States)

    Kaplan, Julika Ayla; Kandodo, Jonathan; Sclafani, Joseph; Raine, Susan; Blumenthal-Barby, Jennifer; Norris, Alison; Norris-Turner, Abigail; Chemey, Elly; Beckham, John Michael; Khan, Zara; Chunda, Reginald

    2017-06-19

    Obstetric fistula is a childbirth injury caused by prolonged obstructed labor that results in destruction of the tissue wall between the vagina and bladder. Although obstetric fistula is directly caused by prolonged obstructed labor, many other factors indirectly increase fistula risk. Some research suggests that many women in rural Malawi have limited autonomy and decision-making power in their households. We hypothesize that women's limited autonomy may play a role in reinforcing childbirth practices that increase the risk of obstetric fistula in this setting by hindering access to emergency care and further prolonging obstructed labor. A medical student at Baylor College of Medicine partnered with a Malawian research assistant in July 2015 to conduct in-depth qualitative interviews in Chichewa with 25 women living within the McGuire Wellness Centre's catchment area (rural Central Lilongwe District) who had received obstetric fistula repair surgery. This study assessed whether women's limited autonomy in rural Malawi reinforces childbearing practices that increase risk of obstetric fistula. We considered four dimensions of autonomy: sexual and reproductive decision-making, decision-making related to healthcare utilization, freedom of movement, and discretion over earned income. We found that participants had limited autonomy in these domains. For example, many women felt pressured by their husbands, families, and communities to become pregnant within three months of marriage; women often needed to seek permission from their husbands before leaving their homes to visit the clinic; and women were frequently prevented from delivering at the hospital by older women in the community. Many of the obstetric fistula patients in our sample had limited autonomy in several or all of the aforementioned domains, and their limited autonomy often led both directly and indirectly to an increased risk of prolonged labor and fistula. Reducing the prevalence of fistula in Malawi

  12. Study protocol for a randomised controlled trial to test the effectiveness of providing information on childbirth and postnatal period to partners of pregnant women.

    Science.gov (United States)

    Takehara, Kenji; Okamura, Makoto; Sugiura, Naomi; Suto, Maiko; Sasaki, Hatoko; Mori, Rintaro

    2016-07-27

    The objective of this study is to investigate the effect of the distribution of a booklet providing information to fathers during their partners' pregnancies on fathers' and mothers' postpartum mental health and quality of life (QOL), as well as on fathers' childcare participation and living situations. This randomised controlled trial will comprise 554 couples consisting of pregnant women due to give birth at an obstetric institution in Aichi Prefecture, Japan and their partners. Participants will be recruited during prenatal check-ups in the third trimester, and those who provide written consent will be allocated randomly to an intervention and a control group. The pregnant women's partners allocated to the intervention group will be given a booklet written for men containing information on childbirth and postnatal period. Its content will include matters such as what preparations the partner should make before birth and tips for housework and childcare as well as how to prevent unintentional injury to the baby. The control group will not receive any intervention. A baseline survey in the third trimester and follow-up surveys at 1 and 3 months post partum will be carried out using self-administered questionnaires. The primary outcome is the proportion of new mothers' partners at risk for paternal depression (Edinburgh Postnatal Depression Scale score ≥8). Secondary outcomes include the risk of postnatal depression in new mothers, QOL of new mothers and their partners, partners' knowledge of and engagement in housework and childcare, marital relations and parenting stress on the part of new mothers. This study has been approved by the Ethical Committee at the National Center for Child Health and Development, Tokyo, Japan. The results of the study will be widely disseminated as peer-reviewed papers and at international conferences, with the aim of improving public health services in Japan. UMIN000021475; Pre-results. Published by the BMJ Publishing Group

  13. Flexible Word Classes

    DEFF Research Database (Denmark)

    • First major publication on the phenomenon • Offers cross-linguistic, descriptive, and diverse theoretical approaches • Includes analysis of data from different language families and from lesser studied languages This book is the first major cross-linguistic study of 'flexible words', i.e. words...... that cannot be classified in terms of the traditional lexical categories Verb, Noun, Adjective or Adverb. Flexible words can - without special morphosyntactic marking - serve in functions for which other languages must employ members of two or more of the four traditional, 'specialised' word classes. Thus......, flexible words are underspecified for communicative functions like 'predicating' (verbal function), 'referring' (nominal function) or 'modifying' (a function typically associated with adjectives and e.g. manner adverbs). Even though linguists have been aware of flexible world classes for more than...

  14. Storytelling in EFL Classes

    Directory of Open Access Journals (Sweden)

    Emine Bala

    2015-12-01

    Full Text Available Storytelling is one of the oldest ways of education and oral tradition that is continuously being used to transfer the previous nation‘s cultures, tradition and customs. It constructs a bridge between the new and the old. Storytelling in EFL classes usually provides a meaningful context, interesting atmosphere and is used as a tool to highly motivate students. Although it seems to be mostly based on speaking, it is used to promote other skills such as writing, reading, and listening. Storytelling is mainly regarded to be grounded on imitation and repetition; nevertheless many creative activities can be implemented in the classroom since this method directs learners to use their imaginations. This study discusses the importance of storytelling as a teaching method, and it outlines the advantages of storytelling in EFL classes.

  15. Queen elizabeth class battleships

    CERN Document Server

    Brown, Les

    2010-01-01

    The 'ShipCraft' series provides in-depth information about building and modifying model kits of famous warship types. Lavishly illustrated, each book takes the modeller through a brief history of the subject class, highlighting differences between sister-ships and changes in their appearance over their careers. This includes paint schemes and camouflage, featuring colour profiles and highly detailed line drawings and scale plans. The modelling section reviews the strengths and weaknesses of available kits, lists commercial accessory sets for super-detailing of the ships, and provides hints on modifying and improving the basic kit. This is followed by an extensive photographic survey of selected high-quality models in a variety of scales, and the book concludes with a section on research references - books, monographs, large-scale plans and relevant websites.This volume covers the five ships of the highly successful Queen Elizabeth class, a design of fast battleship that set the benchmark for the last generati...

  16. World Class Facilities Management

    DEFF Research Database (Denmark)

    Malmstrøm, Ole Emil; Jensen, Per Anker

    2013-01-01

    Alle der med entusiasme arbejder med Facilities Management drømmer om at levere World Class. DFM drømmer om at skabe rammer og baggrund for, at vi i Danmark kan bryste os at være blandt de førende på verdensplan. Her samles op på, hvor tæt vi er på at nå drømmemålet.......Alle der med entusiasme arbejder med Facilities Management drømmer om at levere World Class. DFM drømmer om at skabe rammer og baggrund for, at vi i Danmark kan bryste os at være blandt de førende på verdensplan. Her samles op på, hvor tæt vi er på at nå drømmemålet....

  17. Storytelling in EFL Classes

    OpenAIRE

    Emine Bala

    2015-01-01

    Storytelling is one of the oldest ways of education and oral tradition that is continuously being used to transfer the previous nation‘s cultures, tradition and customs. It constructs a bridge between the new and the old. Storytelling in EFL classes usually provides a meaningful context, interesting atmosphere and is used as a tool to highly motivate students. Although it seems to be mostly based on speaking, it is used to promote other skills such as writing, reading, and listening. Storytel...

  18. Esmeraldas-Class Corvettes,

    Science.gov (United States)

    1983-04-25

    The series of ships, named after all the provinces of Ecuador , include: --CA 11 ESMERALDAS, laid down 27 September 1979, launched 11 October 1980... LOJA , laid down 25 March 1981, launched 27 February 1982; fitting out at CNR Ancona. The building program, on schedule so far, calls for the entire class...built and are still building in 16 units for foreign navies (Libya, Ecuador , Iraq) with four possible armament alternatives. In particular, they

  19. [Social classes and poverty].

    Science.gov (United States)

    Benach, Joan; Amable, Marcelo

    2004-05-01

    Social classes and poverty are two key social determinants fundamental to understand how disease and health inequalities are produced. During the 90's in Spain there has been a notable oscillation in the inequality and poverty levels, with an increase in the middle of the decade when new forms of social exclusion, high levels of unemployment and great difficulties in accessing the labour market, especially for those workers with less resources, emerged. Today society is still characterized by a clear social stratification and the existence of social classes with a predominance of high levels of unemployment and precarious jobs, and where poverty is an endemic social problem much worse than the EU average. To diminish health inequalities and to improve the quality of life will depend very much on the reduction of the poverty levels and the improvement of equal opportunities and quality of employment. To increase understanding of how social class and poverty affect public health, there is a need to improve the quality of both information and research, and furthermore planners and political decision makers must take into account those determinants when undertaking disease prevention and health promotion.

  20. Prenatal Lipid-Based Nutrient Supplements Do Not Affect Pregnancy or Childbirth Complications or Cesarean Delivery in Bangladesh: A Cluster-Randomized Controlled Effectiveness Trial.

    Science.gov (United States)

    Mridha, Malay K; Matias, Susana L; Paul, Rina Rani; Hussain, Sohrab; Sarker, Mostofa; Hossain, Mokbul; Peerson, Janet M; Vosti, Stephen A; Dewey, Kathryn G

    2017-09-01

    Background: Pregnancy and childbirth complications and cesarean delivery are common in Bangladesh. Objective: We evaluated the effect of lipid-based nutrient supplements for pregnant and lactating women (LNS-PL) on pregnancy and childbirth complications and cesarean delivery. Methods: We conducted the Rang-Din Nutrition Study, a cluster-randomized controlled effectiveness trial within a community health program in rural Bangladesh. We enrolled 4011 pregnant women in early pregnancy. Women in 48 clusters received iron and folic acid (IFA; 60 mg Fe + 400 μg folic acid/d) and women in 16 clusters received LNS-PL (20 g/d, 118 kcal) containing essential fatty acids and 22 vitamins and minerals. Pregnancy and childbirth complications and the cesarean delivery rate were secondary outcomes of the study. Results: Women in the LNS-PL group did not differ significantly from the IFA group with respect to mean systolic blood pressure at 36 wk gestation (113 and 112 mm Hg; P = 0.17), diastolic blood pressure at 36 wk gestation (68.9 and 68.7 mmHg; P = 0.88), or mean total number of pregnancy and childbirth complications (0.32 and 0.31; P = 0.86). They also did not differ significantly with respect to the prevalence of high blood pressure at 36 wk (1.74% and 2.03%; P = 0.62), antepartum hemorrhage (0.83% and 1.39%; P = 0.21), prolonged labor (8.34% and 8.79%; P = 0.68), early rupture of membranes (9.30% and 8.45%; P = 0.43), convulsions (1.57% and 1.08%; P = 0.24), high blood pressure in labor (1.54% and 1.19%; P = 0.46), obstructed labor (2.83% and 2.91%; P = 0.90), any complications during pregnancy or childbirth (35.9% and 37.1%; P = 0.64), episiotomy (6.31% and 6.44%; P = 0.90), or cesarean delivery (15.6% and 14.2%; P = 0.48). Conclusion: Compared with IFA, antenatal LNS-PL did not increase or decrease pregnancy and childbirth complications or cesarean delivery among women in rural Bangladesh. This trial was registered at clinicaltrials.gov as NCT01715038. © 2017 American