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Sample records for surgery live childbirth

  1. 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

  2. EAU Policy on Live Surgery Events

    NARCIS (Netherlands)

    Artibani, W.; Ficarra, V.; Challacombe, B.J.; Abbou, C.C.; Bedke, J.; Boscolo-Berto, R.; Brausi, M.; Rosette, J.J.M.H.C. de la; Deger, S.; Denis, L.; Guazzoni, G.; Guillonneau, B.; Heesakkers, J.P.F.A.; Jacqmin, D.; Knoll, T.; Martinez-Pineiro, L.; Montorsi, F.; Mottrie, A.; Piechaud, P.T.; Rane, A.; Rassweiler, J.; Stenzl, A.; Moorselaar, J. van; Velthoven, R.F. van; Poppel, H. van; Wirth, M.; Abrahamsson, P.A.; Parsons, K.F.

    2014-01-01

    CONTEXT: Live surgery is an important part of surgical education, with an increase in the number of live surgery events (LSEs) at meetings despite controversy about their real educational value, risks to patient safety, and conflicts of interest. OBJECTIVE: To provide a European Association of

  3. EAU policy on live surgery events.

    Science.gov (United States)

    Artibani, Walter; Ficarra, Vincenzo; Challacombe, Ben J; Abbou, Clement-Claude; Bedke, Jens; Boscolo-Berto, Rafael; Brausi, Maurizio; de la Rosette, Jean J M C H; Deger, Serdar; Denis, Louis; Guazzoni, Giorgio; Guillonneau, Bertrand; Heesakkers, John P F A; Jacqmin, Didier; Knoll, Thomas; Martínez-Piñeiro, Luis; Montorsi, Francesco; Mottrie, Alexander; Piechaud, Pierre-Thierry; Rane, Abhay; Rassweiler, Jens; Stenzl, Arnulf; Van Moorselaar, Jeroen; Van Velthoven, Roland F; van Poppel, Hendrik; Wirth, Manfred; Abrahamsson, Per-Anders; Parsons, Keith F

    2014-07-01

    Live surgery is an important part of surgical education, with an increase in the number of live surgery events (LSEs) at meetings despite controversy about their real educational value, risks to patient safety, and conflicts of interest. To provide a European Association of Urology (EAU) policy on LSEs to regulate their organisation during urologic meetings. The project was carried out in phases: a systematic literature review generating key questions, surveys sent to Live Surgery Panel members, and Internet- and panel-based consensus finding using the Delphi process to agree on and formulate a policy. The EAU will endorse LSEs, provided that the EAU Code of Conduct for live surgery and all organisational requirements are followed. Outcome data must be submitted to an EAU Web-based registry and complications reported using the revised Martin criteria. Regular audits will take place to evaluate compliance as well as the educational role of live surgery. This policy represents the consensus view of an expert panel established to advise the EAU. The EAU recognises the educational role of live surgery and endorses live case demonstration at urologic meetings that are conducted within a clearly defined regulatory framework. The overriding principle is that patient safety must take priority over all other considerations in the conduct of live surgery. Controversy exists regarding the true educational value of live surgical demonstrations on patients at surgical meetings. An EAU committee of experts developed a policy on how best to conduct live surgery at urologic meetings. The key principle is to ensure safety for every patient, including a code of conduct and checklist for live surgery, specific rules for how the surgery is organised and performed, and how each patient's results are reported to the EAU. For detailed information, please visit www.uroweb.org. Copyright © 2014 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  4. [Humanized childbirth].

    Science.gov (United States)

    Kuo, Su-Chen

    2005-06-01

    Childbirth is a major event in a family. The expectant parent's perception of the childbirth experience influences his or her development as a parent. Making childbirth a positive and satisfying experience for women is the responsibility of health care providers. Women want to have physical and emotional privacy during labor and delivery, and to experience both in a friendly, comfortable environment. For women expected to undergo normal deliveries, humanized childbirth is one accessible approach. This article explores the definition and evolution of humanized childbirth and the care practice that it involves. It also explores birth plans and birth experiences, and the improvements necessary to routine labor practices to enable women to participate in decision making about their childbirth experiences. The author emphasizes that when health-care providers recognize the value of humanized childbirth and make changes accordingly, the dignity of women's childbirth experiences will be enhanced.

  5. Live three-dimensional transesophageal echocardiography in mitral valve surgery

    Institute of Scientific and Technical Information of China (English)

    MA Ning; LI Zhi-an; MENG Xu; YANG Ya

    2008-01-01

    Background Live three-dimensional transesophageal echocardiography (live-3D-TEE) is a new technique, but its clinical value is unclear at present. This study aimed to investigate the feasibility, imaging quality and accuracy of live-3D-TEE for assessing mitral valve morphology to determine if live-3D-TEE has important value in mitral valve surgery.Methods Twenty-four patients with mitral valve disease (mean age (47.1 rdiography (2D-TEE) before and after mitral valve surgery. Sensitivity, specificity, and total consistency rates of live-3D-TEE for diagnosing ruptured chordae were calculated and compared to surgeon's findings. We also compared the diagnostic accuracy of mitral valve disease between live-3D-TEE and 2D-TEE.Results Live-3D-TEE allowed visualization of the anatomic structure of the heart online and clearly identified the valvular apparatus and their defects. Sensitivity and specificity for the detection of ruptured chordae by live-3D-TEE were 87.5% and 100% respectively, and the total consistency rate was 95.8%. Additional defects not diagnosted by 2D-TEE were found in three cases (12.5%) preoperatively by live-3D-TEE. Live-3D-TEE could evaluate the function of prosthetic or native valves immediately after operation. One case was re-repaired (4.2%) using guidance by live-3D-TEE. Conclusion Live-3D-TEE enabled evaluation of mitral valve function and provided adequate valuable information before and after mitral valve surgery. We conclude that live-3D-TEE can play an important role in mitral valve surgery.

  6. Husband Gatekeeping in Childbirth.

    Science.gov (United States)

    Block, Carolyn R.; And Others

    1981-01-01

    Interviews with new mothers document the husband's role as gatekeeper in his wife's preparing for and coping with childbirth. Social class, race, family stage, and the husband-wife relationship explain about 40 percent of the variance in whether husbands choose to prepare for childbirth. (Author)

  7. Collateral Weight Loss in Children Living with Adult Bariatric Surgery Patients: A Case Control Study

    Science.gov (United States)

    Hirsch, Annemarie G.; Wood, G. Craig; Bailey-Davis, Lisa; Lent, Michelle R.; Gerhard, Glenn S.; Still, Christopher D.

    2014-01-01

    Objective To evaluate the impact of adult bariatric surgery on the Body Mass Index (BMI) of children living in the same household. Design and Methods A retrospective case-control study. Case dyads (n=128) were composed of one adult who had bariatric surgery and one child at the same address. Control dyads (n=384) were composed of an adult with obesity but no bariatric surgery and a child at the same address. We used a two-sample t-test to determine whether the differences between actual and expected BMI at follow-up (post-surgery) differed between children in the case and control dyads. Results Among boys who were overweight, boys who lived with a surgery patient had a lower than expected BMI post-surgery, while boys who did not live with a surgery patient had a higher than expected BMI at follow-up (p=0.045). Differences between actual and expected BMIs of children were not significantly different between cases and controls in girls or in children in other weight classes. Conclusions Overweight boys who lived with an adult bariatric surgery patient had a lower than expected BMI after surgery as compared to controls. Future studies may be warranted to determine the mechanisms by which these children experience collateral weight loss. PMID:24989939

  8. Anesthesia complications as a childbirth patient safety indicator.

    Science.gov (United States)

    El Haj Ibrahim, Samia; Fridman, Moshe; Korst, Lisa M; Gregory, Kimberly D

    2014-10-01

    The Agency for Healthcare Research and Quality (AHRQ) has established multiple sets of indicators for quality monitoring and improvement. One such set is the patient safety indicators (PSIs), which focuses on potentially preventable hospital complications after surgeries, procedures, and childbirth. Our objective in this study was to determine the prevalence of childbirth-related anesthesia complications by method of delivery and to evaluate the variation in complication rates across hospitals using the AHRQ PSI methodology and a modification specific to childbirth with the goal of determining the relevance of tracking anesthesia complications as a potential PSI for childbirth. The technical specifications of the experimental Anesthesia Complication Quality Indicator, one of the PSI defined by AHRQ, were modified to create a childbirth-specific indicator that included all childbirth admissions (vaginal and cesarean deliveries) and complications from general and neuraxial anesthesia/analgesia. Using California hospital discharge data, we calculated hospital-specific rates, adjusting for age, race/ethnicity, and pregnancy complications. A total of 508,842 deliveries occurred in 254 hospitals in California in 2009. Hospitals with anesthesia complications was 0.13% for the standard AHRQ study population (adult surgical admissions, which included cesarean deliveries). The childbirth-specific rate of anesthesia complications was 0.31%. When stratified by method of delivery, complication rates were 0.49% for cesarean delivery and 0.22% for vaginal delivery (P anesthesia complications may provide an opportunity to identify hospitals with extreme rates that may provide insights into systematic ways to improve patient safety.

  9. 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....

  10. Dealing with Pain during Childbirth

    Science.gov (United States)

    ... the baby's head and the stretching of the birth canal and vagina. Pain during labor is different for every woman. Although ... doctor. Natural Childbirth Some women choose to give birth using no ... controlled breathing for pain. If you'd like to experience childbirth without ...

  11. Using music during childbirth.

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    Browning, C A

    2000-12-01

    The application of music in pain management has become popular in the past two decades. This article describes the responses of primiparas to the use of music therapy during the births of their children. Eleven women who attended childbirth education classes in Brantford, Ontario, Canada, volunteered to participate in a music therapy exercise. During pregnancy each participant selected preferred music, listened to it daily, and received instruction about focused listening. Within 72 hours after birth they were interviewed about their use of music as a coping strategy during labor. Women selected the combination of music and labor support as a helpful coping strategy during labor. All women used the music during labor to help distract them from the pain or their current situation. The planned use of music by mothers and caregivers can be an aid to prenatal preparation and an important adjunct in pain and stress management during labor and birth.

  12. Surgery

    Science.gov (United States)

    ... days or even weeks after the surgical procedure. Spinal anesthesia and epidural anesthesia are specific types of regional ... childbirth. Headaches occasionally develop in the days after spinal anesthesia but usually can be treated effectively. General anesthesia ...

  13. The effect of live classical piano music on the vital signs of patients undergoing ophthalmic surgery.

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    Camara, Jorge G; Ruszkowski, Joseph M; Worak, Sandra R

    2008-06-25

    Music and surgery. To determine the effect of live classical piano music on vital signs of patients undergoing ophthalmic surgery. Retrospective case series. 203 patients who underwent various ophthalmologic procedures in a period during which a piano was present in the operating room of St. Francis Medical Center. [Note: St. Francis Medical Center has recently been renamed Hawaii Medical Center East.] Demographic data, surgical procedures, and the vital signs of 203 patients who underwent ophthalmic procedures were obtained from patient records. Blood pressure, heart rate, and respiratory rate measured in the preoperative holding area were compared with the same parameters taken in the operating room, with and without exposure to live piano music. A paired t-test was used for statistical analysis. Mean arterial pressure, heart rate, and respiratory rate. 115 patients who were exposed to live piano music showed a statistically significant decrease in mean arterial blood pressure, heart rate, and respiratory rate in the operating room compared with their vital signs measured in the preoperative holding area (P piano music showed a statistically significant increase in mean arterial blood pressure (P piano music lowered the blood pressure, heart rate, and respiratory rate in patients undergoing ophthalmic surgery.

  14. Wireless live streaming video of laparoscopic surgery: a bandwidth analysis for handheld computers.

    Science.gov (United States)

    Gandsas, Alex; McIntire, Katherine; George, Ivan M; Witzke, Wayne; Hoskins, James D; Park, Adrian

    2002-01-01

    Over the last six years, streaming media has emerged as a powerful tool for delivering multimedia content over networks. Concurrently, wireless technology has evolved, freeing users from desktop boundaries and wired infrastructures. At the University of Kentucky Medical Center, we have integrated these technologies to develop a system that can wirelessly transmit live surgery from the operating room to a handheld computer. This study establishes the feasibility of using our system to view surgeries and describes the effect of bandwidth on image quality. A live laparoscopic ventral hernia repair was transmitted to a single handheld computer using five encoding speeds at a constant frame rate, and the quality of the resulting streaming images was evaluated. No video images were rendered when video data were encoded at 28.8 kilobytes per second (Kbps), the slowest encoding bitrate studied. The highest quality images were rendered at encoding speeds greater than or equal to 150 Kbps. Of note, a 15 second transmission delay was experienced using all four encoding schemes that rendered video images. We believe that the wireless transmission of streaming video to handheld computers has tremendous potential to enhance surgical education. For medical students and residents, the ability to view live surgeries, lectures, courses and seminars on handheld computers means a larger number of learning opportunities. In addition, we envision that wireless enabled devices may be used to telemonitor surgical procedures. However, bandwidth availability and streaming delay are major issues that must be addressed before wireless telementoring becomes a reality.

  15. Activating the Consumer about Pregnancy and Childbirth.

    Science.gov (United States)

    James, Gordon B.

    1980-01-01

    A variety of consumer issues involved in education about pregnancy and childbirth are outlined for inclusion in health education programs. They include consumer concern prior to and during pregnancy, and surrounding childbirth. (JMF)

  16. Evidence for homeopathy in childbirth.

    Science.gov (United States)

    Smith, Valerie

    2013-09-01

    Homeopathy has been described as 'a fascinating field of study and a natural complement to the science and art of midwifery' (Brennan 1999: 298). Supported by the Royal College of Midwives' (RCM) campaign for normal birth and resulting from a growing desire by women to avoid conventional medicine, the use of homeopathic remedies in childbirth is gaining momentum. Midwives are ideally positioned to discuss homeopathy with women. To enable informed discussions, however, midwives must have evidence on homeopathy use. This article explores the evidence on homeopathy use in childbirth.

  17. Vaginal childbirth and pelvic floor disorders

    OpenAIRE

    Memon, Hafsa U.; Handa, Victoria L.

    2013-01-01

    Childbirth is an important event in a woman’s life. Vaginal childbirth is the most common mode of delivery and it has been associated with increased incidence of pelvic floor disorders later in life. In this article, the authors review and summarize current literature associating pelvic floor disorders with vaginal childbirth. Stress urinary incontinence and pelvic organ prolapse are strongly associated with vaginal childbirth and parity. The exact mechanism of injury associating vaginal deli...

  18. Complex uniportal video-assisted thoracoscopic sleeve lobectomy during live surgery broadcasting.

    Science.gov (United States)

    Yang, Yang; Guerrero, William Guido; Algitmi, Iskander; Gonzalez-Rivas, Diego

    2016-06-01

    The uniportal approach for major pulmonary resections began in 2010 with the first case being performed by González-Rivas and colleagues in La Coruña. Since then a number of teams around the world had being performing hundreds of cases, applying it to more advance and complex cases recently. The technique has been reported to be feasible and reliable with similar results to that obtained in early stage lung cancer lobectomies. The case presented in this article is an example of an extreme condition: very obese patient, strong adhesions, fused lower lobe to the diaphragm and enlarged inflammatory adenopathies that made the procedure very technically challenging. In addition, the surgery was performed during a live surgery event and it was broadcasted to an auditorium. However, the case was successfully completed through a uniportal VATS approach with no complications.

  19. How to help women at risk for acute stress disorder after childbirth.

    Science.gov (United States)

    Hall, Michelle Flaum

    2014-12-01

    For some women, childbirth is a traumatic experience that results in significant mental and emotional distress. Whether owing to birth complications, postpartum events such as hemorrhage or pre-existing risk factors such as past history of sexual abuse or rape, the emotional effects of childbirth trauma can lead to acute stress disorder (ASD). To provide the best care for women after childbirth, it's imperative that nurses be able to identify signs of ASD and intervene appropriately. There are many things nurses can do to help women in what could be the most vulnerable time of their lives.

  20. [Mother-friendly childbirth practices and breastfeeding].

    Science.gov (United States)

    Lin, Ya-Wen; Tzeng, Ya-Ling; Yang, Ya-Ling

    2013-02-01

    Childbirth, connecting the stages of pregnancy and postpartum, deeply affects maternal motivation with regard to initiating and continuing postnatal breastfeeding and ultimate breastfeeding success. Although promoting breastfeeding is a strategy critical to achieving wellbeing in both mothers and infants, there remains a lack of professional attention and related research into the effect of childbirth on breastfeeding. Promoting successful breastfeeding is a central component of childbirth-friendly nursing care. Therefore, this paper introduces the origin and concepts of mother-and-infant-friendly childbirth, then analyzes the influences on breastfeeding of medicalized birth practices and suggests how to implement childbirth-friendly interventions. This paper was written to help nurses better understand how the childbirth process affects breastfeeding and provide a reference for creating conditions during childbirth that encourage successful breastfeeding practices.

  1. [Humanization and nursing assistance to normal childbirth].

    Science.gov (United States)

    Moura, Fernanda Maria de Jesus S Pires; Crizostomo, Cilene Delgado; Nery, Inez Sampaio; Mendonça, Rita de Cássia Magalhães; de Araújo, Olívia Dias; da Rocha, Silvana Santiago

    2007-01-01

    Bibliographical study that sought to identify the scientific production about humanization and nursing assistance to normal childbirth. The sources were scientific articles from SCIELO-Brasil's database, from 2000 to 2007. We obtained 13 articles as result from the search, which were grouped in the following categories: childbirth medicalization, humanization of assistance to childbirth, companion during childbirth and performance of the obstetric nurse. The analysis pointed out that the current paradigm is centralized on childbirth intervention, despite of humanization movements defending the natural and physiological childbirth made by the nurse. We concluded that qualified and humanized assistance to childbirth and birth privileges women's respect, dignity and autonomy, regarding women's active role in the birth process.

  2. 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.

  3. 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

  4. My Birth Story is Like a Dream: A Childbirth Educator’s Childbirth

    Science.gov (United States)

    Isbir, Gözde G.

    2013-01-01

    Fear of childbirth is universal. Because of the stories of bad experiences passed down for years, many women fear childbirth. As a result, many women do not believe in the power of their own bodies and often hand over control of their bodies to health-care professionals, resulting in unhappy childbirth experiences because of unnecessary intervention during labor and birth. As a pregnancy trainer who prepares pregnant women for childbirth, the author wrote her personal childbirth story with an autoethnographic narrative method. Her aim is to help motivate pregnant women preparing for childbirth, health-care professionals preparing those pregnant women, and birthing staff. PMID:24381475

  5. Anesthetic complications including two cases of postoperative respiratory depression in living liver donor surgery

    Directory of Open Access Journals (Sweden)

    David Beebe

    2011-01-01

    Full Text Available Background: Living liver donation is becoming a more common means to treat patients with liver failure because of a shortage of cadaveric organs and tissues. There is a potential for morbidity and mortality, however, in patients who donate a portion of their liver. The purpose of this study is to identify anesthetic complications and morbidity resulting from living liver donor surgery. Patients and Methods: The anesthetic records of all patients who donated a segment of their liver between January 1997 and January 2006 at University of Minnesota Medical Center-Fairview were retrospectively reviewed. The surgical and anesthesia time, blood loss, hospitalization length, complications, morbidity, and mortality were recorded. Data were reported as absolute values, mean ± SD, or percentage. Significance (P < 0.05 was determined using Student′s paired t tests. Results: Seventy-four patients (34 male, 40 female, mean age = 35.5 ± 9.8 years donated a portion of their liver and were reviewed in the study. Fifty-seven patients (77% donated the right hepatic lobe, while 17 (23% donated a left hepatic segment. The average surgical time for all patients was 7.8 ± 1.5 hours, the anesthesia time was 9.0 ± 1.3 hours, and the blood loss was 423 ± 253 ml. Forty-six patients (62.2% received autologous blood either from a cell saver or at the end of surgery following acute, normovolemic hemodilution, but none required an allogenic transfusion. Two patients were admitted to the intensive care unit due to respiratory depression. Both patients donated their right hepatic lobe. One required reintubation in the recovery room and remained intubated overnight. The other was extubated but required observation in the intensive care unit for a low respiratory rate. Twelve patients (16.2% had complaints of nausea, and two reported nausea with vomiting during their hospital stay. There were four patients who developed complications related to positioning during the

  6. The comparative safety of legal induced abortion and childbirth in the United States.

    Science.gov (United States)

    Raymond, Elizabeth G; Grimes, David A

    2012-02-01

    To assess the safety of abortion compared with childbirth. We estimated mortality rates associated with live births and legal induced abortions in the United States in 1998-2005. We used data from the Centers for Disease Control and Prevention's Pregnancy Mortality Surveillance System, birth certificates, and Guttmacher Institute surveys. In addition, we searched for population-based data comparing the morbidity of abortion and childbirth. The pregnancy-associated mortality rate among women who delivered live neonates was 8.8 deaths per 100,000 live births. The mortality rate related to induced abortion was 0.6 deaths per 100,000 abortions. In the one recent comparative study of pregnancy morbidity in the United States, pregnancy-related complications were more common with childbirth than with abortion. Legal induced abortion is markedly safer than childbirth. The risk of death associated with childbirth is approximately 14 times higher than that with abortion. Similarly, the overall morbidity associated with childbirth exceeds that with abortion. II.

  7. 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.

  8. 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

  9. Sexuality, birth control and childbirth in orthodox Jewish tradition.

    Science.gov (United States)

    Feldman, P

    1992-01-01

    This paper examines some of the traditional texts that deal with sexuality, birth control and childbirth in the orthodox Jewish tradition and presents the rules governing these areas. For instance, a married woman should avoid being alone with a male physician unless other people are in earshot and have access to the room. A husband and wife must separate during the woman's menses and for the first 7 days afterward. Contraception is permitted if childbearing would endanger a woman's life or health. Termination of pregnancy is also permitted to preserve a woman's health, including her mental health. During childbirth the health of the mother is primary and supercedes all other rules or laws, including those of Sabbath observance. In general, orthodox Jewish women try to live as much as possible within the framework of Halacha. These customs are examined as examples of the need for sensitivity to cultural norms that affect the behaviour of different ethnic groups.

  10. Fear of pregnancy and childbirth.

    Science.gov (United States)

    Hofberg, K; Ward, M R

    2003-09-01

    Pregnancy is a major life event for all women. However, when a psychiatric disorder is added to or exacerbated by the pregnancy then the problem requires expert knowledge from more than one area of medicine. This paper looks at pregnancy and the relationship with depression, eating disorders, and pathological fear of childbirth or tokophobia. It also examines the outcome for these women and their babies. Mental illness is a serious concern. It is now recognised that death from suicide is the leading cause of maternal death overall. Research in these areas is relatively sparse but an attempt is made to collate what is known.

  11. 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.

  12. Hoping for the Best, Preparing for the Worst: The lived experiences of women undergoing ovarian cancer surgery

    DEFF Research Database (Denmark)

    Seibæk, L.; Petersen, L.; Blaakaer, J.;

    2012-01-01

    In this study, the lived experiences of women undergoing ovarian cancer surgery were explored, aiming to provide a patient perspective on being newly diagnosed and starting treatment for ovarian cancer. The study period ran from the first visit in the outpatient clinic, till 8 weeks later, when t....... By offering targeted family counselling and taking good care of the women's general health and well-being, hope could be sustained and early cancer rehabilitation initiated....

  13. Live volumetric (4D) visualization and guidance of in vivo human ophthalmic surgery with intraoperative optical coherence tomography

    Science.gov (United States)

    Carrasco-Zevallos, O. M.; Keller, B.; Viehland, C.; Shen, L.; Waterman, G.; Todorich, B.; Shieh, C.; Hahn, P.; Farsiu, S.; Kuo, A. N.; Toth, C. A.; Izatt, J. A.

    2016-08-01

    Minimally-invasive microsurgery has resulted in improved outcomes for patients. However, operating through a microscope limits depth perception and fixes the visual perspective, which result in a steep learning curve to achieve microsurgical proficiency. We introduce a surgical imaging system employing four-dimensional (live volumetric imaging through time) microscope-integrated optical coherence tomography (4D MIOCT) capable of imaging at up to 10 volumes per second to visualize human microsurgery. A custom stereoscopic heads-up display provides real-time interactive volumetric feedback to the surgeon. We report that 4D MIOCT enhanced suturing accuracy and control of instrument positioning in mock surgical trials involving 17 ophthalmic surgeons. Additionally, 4D MIOCT imaging was performed in 48 human eye surgeries and was demonstrated to successfully visualize the pathology of interest in concordance with preoperative diagnosis in 93% of retinal surgeries and the surgical site of interest in 100% of anterior segment surgeries. In vivo 4D MIOCT imaging revealed sub-surface pathologic structures and instrument-induced lesions that were invisible through the operating microscope during standard surgical maneuvers. In select cases, 4D MIOCT guidance was necessary to resolve such lesions and prevent post-operative complications. Our novel surgical visualization platform achieves surgeon-interactive 4D visualization of live surgery which could expand the surgeon’s capabilities.

  14. Women’s experiences of symptoms of posttraumatic stress disorder (PTSD) after traumatic childbirth: a review and critical appraisal

    OpenAIRE

    James, Stella

    2015-01-01

    This paper critically analyses nine studies on postnatal posttraumatic stress disorder (PTSD) following traumatic childbirth, in order to find common themes of PTSD symptoms, using the cognitive model of PTSD as a guide; it critically appraised one of the studies in depth and it attempted to explain the lived experience of women suffering from postnatal PTSD following traumatic childbirth and the suitability of cognitive behavioural therapy (CBT) for postnatal PTSD. This paper found that wome...

  15. The nocebo effect in childbirth classes

    National Research Council Canada - National Science Library

    Hotelling, Barbara A

    2013-01-01

    .... This column examines ways in which the content and teaching techniques that are often part of Lamaze childbirth education may elicit a nocebo response and negatively influence women's confidence...

  16. [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.

  17. Gems: Nutrition Education in Childbirth Classes.

    Science.gov (United States)

    Easches, Janet G.; And Others

    1983-01-01

    Describes a nutrition education packet for natural childbirth (Lamaze) classes. The packet consists of four 15- to 20-minute lessons, each containing goal, objectives, questions (with answers), activities, and pamphlets. List of goals and sample activities are included. (JN)

  18. Fluorescence-guided surgery with live molecular navigation--a new cutting edge.

    Science.gov (United States)

    Nguyen, Quyen T; Tsien, Roger Y

    2013-09-01

    A glowing new era in cancer surgery may be dawning. Using fluorescently labelled markers, surgical molecular navigation means that tumours and nerves can be displayed in real time intra-operatively in contrasting pseudocolours, which allows more complete tumour resection while preserving important structures. These advances can potentially cause a paradigm shift in cancer surgery, improving patient outcome and decreasing overall health-care costs.

  19. Exploring Partners' Experiences in Living with Patients Who Undergo Bariatric Surgery.

    Science.gov (United States)

    Wallwork, Anna; Tremblay, Lynn; Chi, Monica; Sockalingam, Sanjeev

    2017-08-01

    Bariatric surgery is effective in assisting persons with severe obesity in achieving significant weight loss and improved health; however, success depends on one's lifelong commitment to lifestyle modifications post-operatively. Life partners can be essential to the success of bariatric patients as they can serve as a primary resource to patients and healthcare teams. This study aimed to explore bariatric patients' partner's experiences in order to help inform clinical practice in bariatric care to better address patient and partner needs. This study utilized a grounded theory analysis of ten semi-structured interviews of male partners of bariatric surgery patients to form a general explanatory framework of the partner experience. Participants described three interconnected processes of change that followed after their spouses surgeries: (1) effort put forth to engage in the surgical process with their spouses, (2) adoption of the behavioural changes made by their spouses and (3) adjustment to a "new normal". For those who engaged in all three processes, optimism for the future and an enriching and synergistic harmonized lifestyle with their spouse was reached. Bariatric surgery in one partner can impact couples' dietary behaviours, physical and leisure activities, physical and emotional intimacy and relationship quality as a whole. Pursuing bariatric surgery as a couple is a unique process. This study highlights the necessity to approach bariatric care in a way that targets the whole spousal unit as engaging both members in lifestyle modification may improve the quality of both their health and relationship overall.

  20. Living Within Limits: Unpleasant Experiences From the Perspective of Patients After Cardiac Surgery, a Content Analysis Study

    Directory of Open Access Journals (Sweden)

    Pourghane

    2014-07-01

    Full Text Available Background Cardio vascular diseases (CVDs are the main cause of death around the world and coronary artery bypass grafting (CABG has proven to be the most effective treatment for ischemic coronary heart diseases when other treatments are ineffective. Despite the perceived improvement in the health of patients undergoing CABG, there are problems that result from operations after they are discharged from hospital. Provision of information is an integral part of most psychological interventions. Having a clearer understanding of patients’ experiences will be helpful to healthcare workers with respect to patients’ care and education planning. Caring science places more attention on the patient's everyday life from his/her perspective. Most of the studies conducted in Iran used a quantitative method or measured care needs according to pre-defined criteria. Objectives The aim of this study was to explore the lived experiences of patients who have undergone cardiac surgery, in order to obtain a deeper understanding of what they experienced and what those who provide care for these patients experienced. Patients and Methods A qualitative design, using a content analysis approach, was adapted to collect the data and analyze the experiences of 18 patients after cardiac surgery through a purposive sampling strategy. After the selection of the participants, semi structured interviews were held in order to collect the data. Scientific accuracy, and rigor of the data and research ethics were respected. Results The data analysis revealed three main themes and 11 subthemes, categorized as conceptual and abstract, based on their nature: concern of going out therapeutic framework (Fear of the recurrence of heart attack, Fear of performing more activities than permitted, Fear of taking journeys, Fear of mass communication/Tired of living within the confines of the therapeutic framework (Need to take various medications, Dietary restrictions, Limitations in

  1. Middle Range Theory of Traumatic Childbirth

    Directory of Open Access Journals (Sweden)

    Cheryl Tatano Beck

    2015-03-01

    Full Text Available A middle range theory of traumatic childbirth was developed using Morse’s method of theoretical coalescence. The scope of this qualitative theory was increased by formalizing the connections between 14 individual studies all conducted by the same researcher on the same topic, with different groups, using different research designs and different types of analyses. Axioms were derived from this research program along with attributes of traumatic childbirth, posttraumatic stress, and secondary traumatic stress. This middle range theory addresses the long-term chronic consequences of a traumatic birth for mothers including its impact on breastfeeding, subsequent childbirth, and the anniversary of birth trauma. The impact on fathers and clinicians present at the traumatic birth is highlighted as secondary traumatic stress comes into play. Troubling glimpses of difficulties in mother–infant bonding are revealed.

  2. Functional status after childbirth and related concepts.

    Science.gov (United States)

    Aktan, Nadine M

    2010-05-01

    The purpose of this study was to explore relationships between functional status after childbirth and related concepts. The sample consisted of 177 women. The Personal Resource Questionnaire (PRQ) 85-Part 2, the State Trait Anxiety Inventory (STAI), and the Inventory of Functional Status After Childbirth (IFSAC) were used to measure variables. Data were collected during the third trimester of pregnancy and at 6 weeks postpartum. Overall, this group had relatively low levels of anxiety and high levels of social support and functional status after childbirth. The STAI demonstrated coefficient alphas from .90 to .93, the PRQ 85-Part 2 .87 to .93, and the IFSAC .90. The relationship between state anxiety in the postpartum period and FSAC (r = -.204, p = .008) was significant. Additional significant findings between social support, anxiety, and subscales of the IFSAC were found. Nurses must understand these relationships to develop and implement effective interventions. This study is clinically relevant to nurses involved in caring for pregnant and postpartum clients.

  3. 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

  4. Maternal education and childbirth care in Uganda

    Directory of Open Access Journals (Sweden)

    Bbaale E

    2011-07-01

    Full Text Available BackgroundGlobally, over 500,000 females die of complications relatedto pregnancy and childbirth each year, and of these, over99% of deaths occur in developing countries such asUganda. Utilisation of modern and professional care duringdelivery is important in lowering maternal mortality. Thispaper sets out to investigate the factors associated with theutilisation of modern and professional childbirth care so asto inform policy makers on the pertinent factors that needto be influenced by policy.MethodA nationally representative Uganda Demographic andHealth Survey (UDHS (2006 was used. Sampling was donein two stages. In the first stage 321 clusters were selectedfrom a list of clusters sampled in the 2005/06 UgandaNational Household Survey (UNHS, 17 clusters from the2002 Census frame from Karamoja, and 30 internallydisplaced camps (IDPs. In the second stage, the householdsin each cluster were selected as per the UNHS listing. Inaddition an additional 20 households were randomlyselected in each cluster. Questionnaires were used duringdata collection. During the analysis, a maximum likelihoodprobit technique was employed. Prior to this, a bivariateapproach was used to generate average percentages ofmothers using the childbirth care services by backgroundcharacteristics.ResultsIt is found that maternal education is the strongestpredictor, especially at post-secondary level (highestmarginal effect of 33% and p<0.01, associated with theutilisation of childbirth care. Whereas partner’s education atall levels is important, maternal education is observed toexert a much stronger association. Other factorssignificantly associated with the utilisation of professionalchildbirth care include community infrastructure,occupation, location, and regional differences, wealthstatus, religion, and age cohorts.ConclusionThese findings suggest that whereas all levels of educationare important, the effects of post-secondary education aremore pronounced. Therefore

  5. After colonic surgery: The lived experience of participating in a fast-track programme

    DEFF Research Database (Denmark)

    Norlyk, Annelise; Harder, Ingegerd

    2009-01-01

    Postoperative recovery can be accelerated and hospitalization reduced through fast-track programmes. However, documented knowledge is limited and primarily focusing on a medical perspective whereas the patients' perspective lacks documentation. This study describes the lived experience of partici......Postoperative recovery can be accelerated and hospitalization reduced through fast-track programmes. However, documented knowledge is limited and primarily focusing on a medical perspective whereas the patients' perspective lacks documentation. This study describes the lived experience......; but this role of being a good and cooperative patient had a built-in asymmetric power relationship favouring the professionals' expectations. The complexities of this power relationship were related to both patient factors and contextual factors, e.g. the daily regimen and hospital norms. Although patient...

  6. Secular, Spiritual and religious Existential concerns during final diagnostics and treatment period – The lived experiences of women undergoing ovarian cancer surgery

    DEFF Research Database (Denmark)

    Hounsgaard, Lise; Seibæk, L.; Hvidt, N. C.

    2013-01-01

    Introduction. This paper deals with secular, spiritual, and religious existential concerns during severe illness. Materials and Methods. Qualitative research interviews were made before and after surgery with women who underwent final diagnostics, surgery, and chemotherapy for ovarian cancer...... a woman with ovarian cancer during her first treatment period. Although the women experienced their health to be seriously threatened, they also felt hope, will, and courage. The diagnostic procedures and treatment had comprehensive impact on their lives. However, hope and spirituality were important...

  7. At the edge of vulnerability--lived experience of parents of children with cerebral palsy going through surgery.

    Science.gov (United States)

    Iversen, Anne Solveig; Graue, Marit; Råheim, Målfrid

    2013-02-06

    This study explored the experiences of parents of children with cerebral palsy undergoing surgery as they describe them from a lived experience perspective. When children undergo surgical procedures, they have to stay at hospital for a long time, which represents a great challenge for the children as well as their parents. We collected data by using open-ended interviews with 12 parents of 9 children and analyzed these data in accordance with Max van Manen's methodological themes. Based on the parents' stories, the essential theme is: At the edge of vulnerability-being parents at hospital to a child with CP undergoing surgery, which consisted of three subthemes: establishing trust, awareness of a child who cannot speak, and sensing bodily reactions. Parents experienced demanding challenges as they entered the hospital, in a situation that meant both familiarity and unfamiliarity. Judgments about how to care for the child relied on what they normally did. Sitting bedside for hours and days, thoughts about the legitimacy of letting their child go through the suffering surgery were tormenting the parents. They felt vulnerable and very much dependent on health care workers' competence and at the same time doubting them in seeing and taking care of their child's specific needs. It was experienced as an ambivalent situation, and even more so for the parents of a child without speech. The findings indicate that establishing trust implies being met at an existential level and a deeply felt need for health care workers that are really engaged in taking care of their child and their parents.

  8. At the edge of vulnerability—lived experience of parents of children with cerebral palsy going through surgery

    Science.gov (United States)

    Graue, Marit; Råheim, Målfrid

    2013-01-01

    This study explored the experiences of parents of children with cerebral palsy undergoing surgery as they describe them from a lived experience perspective. When children undergo surgical procedures, they have to stay at hospital for a long time, which represents a great challenge for the children as well as their parents. We collected data by using open-ended interviews with 12 parents of 9 children and analyzed these data in accordance with Max van Manen's methodological themes. Based on the parents’ stories, the essential theme is: At the edge of vulnerability—being parents at hospital to a child with CP undergoing surgery, which consisted of three subthemes: establishing trust, awareness of a child who cannot speak, and sensing bodily reactions. Parents experienced demanding challenges as they entered the hospital, in a situation that meant both familiarity and unfamiliarity. Judgments about how to care for the child relied on what they normally did. Sitting bedside for hours and days, thoughts about the legitimacy of letting their child go through the suffering surgery were tormenting the parents. They felt vulnerable and very much dependent on health care workers’ competence and at the same time doubting them in seeing and taking care of their child's specific needs. It was experienced as an ambivalent situation, and even more so for the parents of a child without speech. The findings indicate that establishing trust implies being met at an existential level and a deeply felt need for health care workers that are really engaged in taking care of their child and their parents. PMID:23395108

  9. At the edge of vulnerability—lived experience of parents of children with cerebral palsy going through surgery

    Directory of Open Access Journals (Sweden)

    Anne Solveig Iversen

    2013-02-01

    Full Text Available This study explored the experiences of parents of children with cerebral palsy undergoing surgery as they describe them from a lived experience perspective. When children undergo surgical procedures, they have to stay at hospital for a long time, which represents a great challenge for the children as well as their parents. We collected data by using open-ended interviews with 12 parents of 9 children and analyzed these data in accordance with Max van Manen's methodological themes. Based on the parents’ stories, the essential theme is: At the edge of vulnerability—being parents at hospital to a child with CP undergoing surgery, which consisted of three subthemes: establishing trust, awareness of a child who cannot speak, and sensing bodily reactions. Parents experienced demanding challenges as they entered the hospital, in a situation that meant both familiarity and unfamiliarity. Judgments about how to care for the child relied on what they normally did. Sitting bedside for hours and days, thoughts about the legitimacy of letting their child go through the suffering surgery were tormenting the parents. They felt vulnerable and very much dependent on health care workers’ competence and at the same time doubting them in seeing and taking care of their child's specific needs. It was experienced as an ambivalent situation, and even more so for the parents of a child without speech. The findings indicate that establishing trust implies being met at an existential level and a deeply felt need for health care workers that are really engaged in taking care of their child and their parents.

  10. Pediatric heart surgery

    Science.gov (United States)

    Heart surgery - pediatric; Heart surgery for children; Acquired heart disease; Heart valve surgery - children ... the type of defect, and the type of surgery that was done. Many children recover completely and lead normal, active lives.

  11. Use of the Barthel index, activities of daily living, in dermatologic surgery in patients aged 80 years and older.

    Science.gov (United States)

    Pascual, José C; Belinchón, Isabel; Ramos, José M

    2015-02-01

    Dermatologists often attend elderly patients with non-melanoma skin cancer (NMSC). There is a lack of information regarding the optimum treatment for elderly patients with NMSC. The objective of this study was to describe changes in the Barthel Index (BI) after dermatologic surgery for NMSC in patients aged 80 years and older. A prospective observational study was carried out in patients aged 80 years and older diagnosed with NMSC and treated with conventional dermatologic surgery. BI was performed by direct interview with the patients and/or their caregiver before the surgery, seven and 30 days after the surgery. A total of 180 dermatologic surgeries were performed in 144 patients. The average age of the patients was 84.2 years. There were 84 men (58.3%) and 60 women (41.7%). Mean BI score was 85.9 at baseline, 85.3 on day 7 after surgery, and 85.6 on day 30, showing minimal changes after dermatologic surgery. Changes in the BI occurred mainly in dressing, toilet use, transfers, mobility (on level surfaces) and walking stairs. Activities of daily living were not significantly affected in patients aged 80 years and older, after dermatologic surgery for NMSC. © 2014 The International Society of Dermatology.

  12. Estudo dos partos e nascidos vivos de mães adolescentes e adultas jovens no Município de Feira de Santana, Bahia, Brasil, 1998 Childbirth and live newborns of adolescent and young adult mothers in the municipality of Feira de Santana, Bahia State, Brazil, 1998

    Directory of Open Access Journals (Sweden)

    Maria Conceição O. Costa

    2002-06-01

    Full Text Available Dados do Ministério da Saúde e pesquisas apontam que adolescentes têm contribuído com a prevalência de morbimortalidade materna e complicações neonatais. O objetivo deste trabalho foi estudar partos e nascidos vivos de mães adolescentes e adultas jovens do Município de Feira de Santana, Bahia, apontando situações de risco para a morbimortalidade. Realizou-se um estudo de corte transversal com base em dados do Sistema de Informação de Nascidos Vivos (SINASC do município, em 1998, totalizando 5.279 nascidos vivos de adolescentes (10 a 19 e adultas jovens (20 a 24 anos. As variáveis foram idade, escolaridade, pré-natal, idade gestacional, parto e peso do bebê. Mediu-se a força de associação entre idade materna e peso ao nascer, controlando-se variáveis confundidoras. Verificaram-se 21,6% de nascidos vivos de adolescentes; 51,2% com ensino fundamental incompleto; associação da faixa 10 a 16 anos e ensino fundamental incompleto, não-realização do pré-natal, baixo peso e peso insuficiente ao nascer, em relação às demais faixas; freqüência elevada de sub-registro do SINASC. Os resultados deste estudo sugerem a necessidade de implementação de ações específicas voltadas à saúde reprodutiva de adolescentes no município.Data from the Brazilian Ministry of Health and the literature indicate that adolescents may be overrepresented in the prevalence of maternal morbidity and mortality and neonatal complications. This study focused on childbirth and live newborns among adolescent and young adult mothers in the municipality of Feira de Santana, Bahia, identifying risk factors for morbidity and mortality. A cross-sectional cohort study was conducted based on data from the Information System on Live Births (SINASC in the municipality in 1998, totaling 5,279 live births among adolescent (10 to 19 years and young adult mothers (20 to 24 years. Variables were age, schooling, prenatal care, gestational care, form of delivery

  13. Birth stories: a way of knowing in childbirth education.

    Science.gov (United States)

    Savage, J S

    2001-01-01

    Birth stories have a lasting impact on expectant mothers. The purpose of this paper is to recognize the influence of birth stories as a key component of informal communication of knowledge about childbirth for expectant mothers. The review of literature and research is related to childbirth education, anthropological thinking, and applied learning theory with foundational concepts from Vygotsky, Bruner, and Bandura. Implications for childbirth educators are included.

  14. Women's experiences of symptoms of posttraumatic stress disorder (PTSD) after traumatic childbirth: a review and critical appraisal.

    Science.gov (United States)

    James, Stella

    2015-12-01

    This paper critically analyses nine studies on postnatal posttraumatic stress disorder (PTSD) following traumatic childbirth, in order to find common themes of PTSD symptoms, using the cognitive model of PTSD as a guide; it critically appraised one of the studies in depth and it attempted to explain the lived experience of women suffering from postnatal PTSD following traumatic childbirth and the suitability of cognitive behavioural therapy (CBT) for postnatal PTSD. This paper found that women following traumatic childbirth do experience postnatal PTSD; postnatal PTSD symptoms are similar to PTSD symptoms of other events and that CBT for PTSD of other events is just as effective for postnatal PTSD. Future recommendations include more qualitative studies with interpretative phenomenological approach in order to establish evidence-based CBT treatment for this client group, and more referrals need to be sent to the psychological services for CBT intervention.

  15. 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).

  16. 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.

  17. Mindfulness approaches to childbirth and parenting

    Science.gov (United States)

    Hughes, Annie; Williams, Mark; Bardacke, Nancy; Duncan, Larissa G.; Dimidjian, Sona; Goodman, Sherryl H.

    2013-01-01

    Mindfulness meditation is increasingly being used as a way of managing pain, reducing stress and anxiety and, in the form of mindfulness-based cognitive therapy (MBCT), as a way of reducing the risk of recurrence in depression (NICE, 2004). This article considers its potential for parents preparing for childbirth focusing on three areas: managing pain during pregnancy and labour; reducing risk of perinatal depression; and increasing ‘availability’ of attention for the infant. The encouraging evidence to date suggests the possibility that mindfulness has an important contribution to make, both for reducing vulnerability in high-risk groups and as a universal intervention. PMID:24307764

  18. Comparison of activities of daily living after osteoporotic hip fracture surgery in patients admitted from home and from geriatric health service facilities

    Directory of Open Access Journals (Sweden)

    Horikawa A

    2014-10-01

    Full Text Available Akira Horikawa,1 Naohisa Miyakoshi,2 Yoichi Shimada,2 Hiroyuki Kodama1 1South Akita Orthopedic Clinic, Katagami, 2Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan Abstract: With the population and proportion of the elderly increasing each year, ­difficulties with postoperative treatment outcomes after osteoporotic hip fracture are increasing. This study focused on activities of daily living (ADL in patients who underwent surgery for hip fracture through an investigation of living arrangements, the presence of dementia, and other complications of aging. Information from 99 patients who lived either at home or in geriatric health service facilities was collected for this trial. Most patients were over 65 years of age and female, and about half of them had dementia. The postoperative ADL score (focusing on patients’ walking ability was significant for those living at home than for those living in facilities. In addition, patients with dementia were divided into the following two categories: an early-rising group, comprising patients who were able to use a wheelchair within 48 hours of their operation; and a late-rising group, who did not start using a wheelchair until more than 48 hours after surgery. The ADL scores for the two groups were compared. Although the preoperative ADL scores were not significantly different between the two groups, postoperative ADL scores were significantly higher in the early-rising group than in the late-rising group, especially in patients who had undergone hemiarthroplasty. These data suggest that ADL in dementia patients following hip fracture depends on the surgical procedure performed and whether they are late or early risers after surgery. Keywords: delirium, dementia, rehabilitation, elderly

  19. Intent and Choice Regarding Maternal Employment Following Childbirth.

    Science.gov (United States)

    Werbel, James

    1998-01-01

    A study of 70 pregnant working mothers before and six months after childbirth found that traditional gender-role values and perceived spousal preference influenced their employment intention before giving birth. Employment intention and spouse's income influenced return to employment after childbirth. (SK)

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

    Science.gov (United States)

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

    2016-12-09

    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.

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

    Science.gov (United States)

    Sharma, Bharati; Giri, Gayatri; Christensson, Kyllike; K V, Ramani; Johansson, Eva

    2013-10-03

    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. 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. 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. In resource poor settings where choices are limited and mortality is high, hospital

  2. 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

    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...... that medical practices should be studied relationally, both humans as well as the non humans should be part of the analysis. As a conse-quence entities multiply; bodies and technologies be-come more than one but less than many. The aim of the dissertation is to produce a "productive feeling of astonishment......" 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...

  3. Maternal age at childbirth and risk for ADHD in offspring: a population-based cohort study

    Science.gov (United States)

    Chang, Zheng; Lichtenstein, Paul; D’Onofrio, Brian M; Almqvist, Catarina; Kuja-Halkola, Ralf; Sjölander, Arvid; Larsson, Henrik

    2014-01-01

    Background: Women who give birth at younger ages (e.g. teenage mothers) are more likely to have children who exhibit behaviour problems, such as attention-deficit/hyperactivity disorder (ADHD). However, it is not clear whether young maternal age is causally associated with poor offspring outcomes or confounded by familial factors. Methods: The association between early maternal age at childbirth and offspring ADHD was studied using data from Swedish national registers. The sample included all children born in Sweden between 1988 and 2003 (N = 1 495 543), including 30 674 children with ADHD. We used sibling- and cousin-comparisons to control for unmeasured genetic and environmental confounding. Further, we used a children-of-siblings model to quantify the genetic and environmental contribution to the association between maternal age and offspring ADHD. Results: Maternal age at first birth (MAFB) was associated with offspring ADHD. Teenage childbirth (ADHD. The association attenuated in cousin-comparison, suggesting unmeasured familial confounding. The children-of-siblings model indicated that the association between MAFB and ADHD was mainly explained by genetic confounding. Conclusions: All children born to mothers who bore their first child early in their reproductive lives were at increased risk of ADHD. The association was mainly explained by genetic factors transmitted from mothers to their offspring that contribute to both age at childbirth and ADHD in offspring. Our results highlight the importance of using family-based designs to understand how early life circumstances affect child development. PMID:25355726

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

    Directory of Open Access Journals (Sweden)

    Diana du Plessis

    2006-02-01

    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.

  5. Childbirth experience of migrants in China: a systematic review.

    Science.gov (United States)

    Cheung, Ngai Fen; Pan, Anshi

    2012-09-01

    As preliminary research into the childbirth experience of migrants in China, this paper presents a systematic review of Chinese and English literature published between 1999 and 2011 on childbirth in migrants in China. Electronic databases were accessed and papers were found by keyword search. A total of 132 Chinese and 9 English papers were catalogued for review. These papers address migrant maternity issues concerning antenatal, intrapartum, postnatal care, institutional issues, family planning or birth control. Since China's economic reforms, the healthcare infrastructure has been inadequate for childbirth in migrants. They experience more adverse birth outcomes than local residents. This suggests that the effects of change upon childbirth and the existing urban and rural care systems cannot meet the needs of the migrants. There is a lack of research in the childbirth experience of women. Knowledge of their childbirth experience will contribute to the understanding of these needs, informing systems' reform. The medical approach results in many unnecessary interventions and higher costs. It is argued here that a midwifery model of care is most appropriate for the childbirth experience of migrant women.

  6. Descriptive analysis of childbirth healthcare costs in an area with high levels of immigration in Spain

    Directory of Open Access Journals (Sweden)

    Sala Maria

    2011-04-01

    Full Text Available Abstract Background The aim of this study was to estimate the cost of childbirth in a teaching hospital in Barcelona, Spain, including the costs of prenatal care, delivery and postnatal care (3 months. Costs were assessed by taking into account maternal origin and delivery type. Methods We performed a cross-sectional study of all deliveries in a teaching hospital to mothers living in its catchment area between October 2006 and September 2007. A process cost analysis based on a full cost accounting system was performed. The main information sources were the primary care program for sexual and reproductive health, and hospital care and costs records. Partial and total costs were compared according to maternal origin and delivery type. A regression model was fit to explain the total cost of the childbirth process as a function of maternal age and origin, prenatal care, delivery type, maternal and neonatal severity, and multiple delivery. Results The average cost of childbirth was 4,328€, with an average of 18.28 contacts between the mother or the newborn and the healthcare facilities. The delivery itself accounted for more than 75% of the overall cost: maternal admission accounted for 57% and neonatal admission for 20%. Prenatal care represented 18% of the overall cost and 75% of overall acts. The average overall cost was 5,815€ for cesarean sections, 4,064€ for vaginal instrumented deliveries and 3,682€ for vaginal non-instrumented deliveries (p Conclusions Neither immigration nor prenatal care were associated with a substantial difference in costs. The most important predictors of cost were delivery type and neonatal severity. Given the impact of cesarean sections on the overall cost of childbirth, attempts should be made to take into account its higher cost in the decision of performing a cesarean section.

  7. NIH's National Institute of Nursing Research Is Changing Lives

    Science.gov (United States)

    ... Current Issue Past Issues NIH's National Institute of Nursing Research Is Changing Lives Past Issues / Spring 2008 Table ... on. From childbirth to end-of-life care, nursing research is aimed at helping patients across the entire ...

  8. Concurrent analysis of choice and control in childbirth

    Directory of Open Access Journals (Sweden)

    Martin Caroline

    2011-06-01

    Full Text Available Abstract Background This paper reports original research on choice and control in childbirth. Eight women were interviewed as part of a wider investigation into locus of control in women with pre-labour rupture of membranes at term (PROM 1. Methods The following study uses concurrent analysis to sample and analyse narrative aspects of relevant literature along with these interviews in order to synthesise a generalisable analysis of the pertinent issues. The original PROM study had found that women experienced a higher degree of control in hospital, a finding that appeared at odds with contemporary notions of choice. However, this paper contextualises this finding by presenting narratives that lucidly subscribe to the dominant discourse of hospital as the safest place to give birth, under the premise of assuring a live healthy baby irrespective of their management type. Results This complex narrative is composed of the following themes: 'perceiving risk', 'being prepared', 'reflecting on experience', maintaining control' and relinquishing control'. These themes are constructed within and around the medical, foetocentric, risk averse cultural context. Primary data are presented throughout to show the origins and interconnected nature of these themes. Conclusions Within this context it is clear that there is a highly valued role for competent health professionals that respect, understand and are capable of facilitating genuine choice for women.

  9. Quality of antenatal and childbirth care in northern Ghana.

    Science.gov (United States)

    Duysburgh, E; Williams, A; Williams, J; Loukanova, S; Temmerman, M

    2014-09-01

    The QUALMAT research project aims to improve maternal and newborn health by improving the quality of antenatal and childbirth care provided in primary healthcare facilities. Within the frame of this project, a comprehensive quality assessment took place in selected health centres in northern Ghana. The results of this assessment showed that overall quality of routine antenatal and childbirth care was satisfactory, although some critical gaps were identified. Counselling and health education practices need to be improved; laboratory investigations are often not performed; examination and monitoring of mother and newborn during childbirth are inadequate; partographs are often not used and poorly completed; and equipment to provide assisted vaginal deliveries was absent.

  10. Cultural childbirth practices, beliefs, and traditions in postconflict Liberia.

    Science.gov (United States)

    Lori, Jody R; Boyle, Joyceen S

    2011-06-01

    In this qualitative study we used an interpretive, critical ethnographic approach to provide an understanding of childbirth and maternal illness and death in Liberia through the lens of women, families, and communities. We identified three major themes from the data: (a) secrecy surrounding pregnancy and childbirth; (b) power and authority; and (c) distrust of the health care system. The interpretive theory, Behind the House, generated from data analysis provides an understanding of the larger social and cultural context of childbirth in Liberia. Our findings provide a more complete understanding of the contextual factors that impact on the intractable problem of maternal mortality.

  11. 罗哌卡因联合芬太尼行硬-腰麻醉在无痛分娩手术中的临床效果%Clinical Effect of Ropivacaine Combined with Fentanyl Hard-waist Anesthesia for Painless Childbirth Surgery

    Institute of Scientific and Technical Information of China (English)

    李长江

    2013-01-01

      目的:探讨罗哌卡因联合芬太尼行硬-腰麻醉在无痛分娩手术过程中的临床效果。方法:将我院2011年1月至2012年6月行经产道自然分娩的患者120例随机分为观察组与对照组,观察组使用罗哌卡因联合芬太尼行硬-腰麻醉,对照组单纯行经产道自然分娩,对照两组术中镇痛效果、第一产程及第二产程时间的差异。结果:观察组在镇痛效果、第一产程及第二产程时间方面明显优于对照组,两组存在统计学差异(P<0.05)。结论:罗哌卡因联合芬太尼行硬-腰麻醉应用在无痛分娩过程中具有明显效果,值得推广。%Objective:To investigate the effect of ropivacaine combined with fentanyl hard-waist clinical anesthesia in painless childbirth surgical procedure.Methods:Patients in our hospital from January 2011 to June 2012 passing through the birth canal of natural childbirth 120 cases were randomly divided into observation group and control group,the observation group ropivacaine combined with fentanyl hard-lumbar anesthesia, thecontrol group simply passing through the birth canal natural childbirth,control groups analgesic effect,the first stage and the second stage of the time difference.Results:The analgesic effect of the first stage and the second stage of labor time significantly better than the control group, two groups there was significant difference (P<0.05).Conclusion:Ropivacaine combined with fentanyl hard-spinal anesthesia application has a significant effect in the process of painless childbirth,worthy of promotion.

  12. Restoration of hand function and ability to perform activities of daily living following surgery for carpal tunnel syndrome

    National Research Council Canada - National Science Library

    Szczechowicz, Jakub; Pieniazek, Marek; Pelczar-Pieniazek, Maria

    2008-01-01

    The aim of the study was to assess treatment efficacy in patients following surgery for carpal tunnel syndrome and compare hand function with patients' subjective evaluation and their ability to carry...

  13. Unassisted childbirth: why mothers are leaving the system.

    Science.gov (United States)

    Dannaway, Jasan; Dietz, Hans Peter

    2014-12-01

    Unassisted childbirth is a topical subject that has sparked ethical and legal debate. Although there are little data surrounding unassisted birthing practice, concerns over consent, procedural intervention and loss of the birthing experience may be driving women away from formal healthcare. The healthcare system needs to work toward understanding this practice and, perhaps with the support of legislation, address the concerns of mothers in order to ensure optimal childbirth outcomes.

  14. Development of a questionnaire for assessing the childbirth experience (QACE).

    Science.gov (United States)

    Carquillat, Pierre; Vendittelli, Françoise; Perneger, Thomas; Guittier, Marie-Julia

    2017-08-30

    Due to its potential impact on women's psychological health, assessing perceptions of their childbirth experience is important. The aim of this study was to develop a multidimensional self-reporting questionnaire to evaluate the childbirth experience. Factors influencing the childbirth experience were identified from a literature review and the results of a previous qualitative study. A total of 25 items were combined from existing instruments or were created de novo. A draft version was pilot tested for face validity with 30 women and submitted for evaluation of its construct validity to 477 primiparous women at one-month post-partum. The recruitment took place in two obstetric clinics from Swiss and French university hospitals. To evaluate the content validity, we compared item responses to general childbirth experience assessments on a numeric, 0 to 10 rating scale. We dichotomized two group assessment scores: "0 to 7" and "8 to 10". We performed an exploratory factor analysis to identify underlying dimensions. In total, 291 women completed the questionnaire (response rate = 61%). The responses to 22 items were statistically significant between the 0 to 7 and 8 to 10 groups for the general childbirth experience assessments. An exploratory factor analysis yielded four sub-scales, which were labelled "relationship with staff" (4 items), "emotional status" (3 items), "first moments with the new born," (3 items) and "feelings at one month postpartum" (3 items). All 4 scales had satisfactory internal consistency levels (alpha coefficients from 0.70 to 0.85). The full 25-item version can be used to analyse each item by itself, and the short 4-dimension version can be scored to summarize the general assessment of the childbirth experience. The Questionnaire for Assessing the Childbirth Experience (QACE) could be useful as a screening instrument to identify women with negative childbirth experiences. It can be used as both a research instrument in its short version

  15. 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.

  16. Live surgery and teleconferencing at the 19th World Congress of the International Association of Surgeons, Gastroenterologists and Oncologists (IASGO) in Beijing.

    Science.gov (United States)

    Shimizu, Shuji; Han, Ho-Seong; Okamura, Koji; Bao, Congxiao; Kitamura, Yasuichi; Nakashima, Naoki; Tanaka, Masao

    2011-01-01

    Advanced technologies were introduced for the first time at the 19th World Congress of the Inter-national Association of Surgeons, Gastroenterologists and-Oncologists (IASGO) in Beijing, China. Live surgery and multi-station teleconferencing were performed using the super high-speed inter-net to transmit and preserve the high quality life- like images of surgical operations. This is the first time in the history of IASGO that use has been made of this worldwide academic network and user friendly digital video transport system, which has many advantages over traditional telemedicine systems. Here we briefly report these epoch-making sessions and their future expectations

  17. 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

  18. Dis-appearance and dys-appearance anew: living with excess skin and intestinal changes following weight loss surgery.

    Science.gov (United States)

    Groven, Karen Synne; Råheim, Målfrid; Engelsrud, Gunn

    2013-08-01

    The aim of this article is to explore bodily changes following weight loss surgery. Our empirical material is based on individual interviews with 22 Norwegian women. To further analyze their experiences, we build primarily on the phenomenologist Drew Leder`s distinction between bodily dis-appearance and dys-appearance. Additionally, our analysis is inspired by Simone de Beauvoir, Merleau-Ponty and Julia Kristeva. Although these scholars have not directed their attention to obesity operations, they occupy a prime framework for shedding light on different dimensions of bodily change. In doing so, we were able to identify two main themes: The felt "inner" body versus the visible "surface" body and the "old" body versus the "new" body. In different, though interconnected ways, these main themes encompass tensions between changes the women experienced as contributing to a more "normal" and active life, feeling more accepted, and changes that generated ambivalence. In particular, their skin became increasingly problematic because it did not "shrink" like the rest of the body. On the contrary, it became looser and looser. Moreover, badsmelling folds of skin that wobbled, sweated and chafed at the smallest movement, aprons of fat hanging in front of their stomachs, batwing arms, thick flabby thighs and sagging breasts were described as a huge contrast to the positive response they received to their changed body shape when they were out and about with their clothes on. At the same time, they expressed ambivalence with regards to removing the excess skin by means of plastic surgery. Through their own and other women`s experiences they learned removing the excess skin by means of surgery could be a double-edged sword. By illuminating the experiences of the ones undergoing such changes our article offers new insight in a scholarly debate predominated by medical research documenting the positive outcomes of weight loss surgery.

  19. Weather and childbirth: A further search for relationships

    Science.gov (United States)

    Driscoll, Dennis M.

    1995-09-01

    Previous attempts to find relationships between weather and parturition (childbirth) and its onset (the beginning of labor pains) have revealed, firstly, limited but statistically significant relationships between weather conditions much colder than the day before, with high winds and low pressure, and increased onsets; and secondly, increased numbers of childbirths during periods of atmospheric pressure rise (highly statistically significant). To test these findings, this study examined weather data coincident childbirth data from a hospital at Bryan-College Station, Texas (for a period of 30 cool months from 1987 to 1992). Tests for (1) days of cold fronts, (2) a day before and a day after the cold front, (3) days with large temperature increases, and (4) decreases from the day before revealed no relationship with mean daily rate of onset. Cold days with high winds and low pressure had significantly fewer onsets, a result that is the opposite of previous findings. The postulated relationship between periods of pressure rise and increased birth frequency was negative, i.e., significantly fewer births occurred at those times — again, the opposite of the apparent occurrence in an earlier study. The coincidence of diurnal variations in both atmospheric pressure and frequency of childbirths, was shown to account for fairly strong negative associations between the two variables. This same reasoning might explain the positive association found in an earlier study. A comparison has been made between childbirth and onset as the response variable, and the advantage is emphasized of using data from women whose labor is not induced.

  20. 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.

  1. 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...

  2. 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

    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...... that medical practices should be studied relationally, both humans as well as the non humans should be part of the analysis. As a conse-quence entities multiply; bodies and technologies be-come more than one but less than many. The aim of the dissertation is to produce a "productive feeling of astonishment......" 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...

  3. 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

  4. Socioeconomic and Marital Outcomes of Adolescent Marriage, Adolescent Childbirth, and Their Co-Occurrence.

    Science.gov (United States)

    Teti, Douglas M.; Lamb, Michael E.

    1989-01-01

    Examined adolescent marriage, adolescent childbirth, and their co-occurrence in adult women. Poorest socioeconomic outcomes were associated with adolescent childbirth regardless of presence or timing of first marriage. Marital instability was associated with both adolescent marriage and adolescent childbirth. Findings suggest that risk associated…

  5. 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.

  6. Psychological and social aspects of pregnancy, childbirth and early parenting after assisted conception: a systematic review.

    Science.gov (United States)

    Hammarberg, K; Fisher, J R W; Wynter, K H

    2008-01-01

    It is known that infertility affects emotional well-being, satisfaction with life and self-esteem and that failed assisted reproductive technology (ART) treatment is associated with diminished life satisfaction, reduced self-confidence and substantial psychological distress. Investigations of whether these persist when treatment results in a pregnancy and live birth have been undertaken. A systematic search for English-language research articles on psychological and social aspects of pregnancy, childbirth and the first post-partum year after ART conception. Of 466 retrieved papers, 46 met inclusion criteria. These reported data from 28 studies. There is consistent evidence that marital satisfaction, emotional well-being and self-regard in pregnancy, attachment to the fetus and parent-infant relationship in ART groups are similar to comparison groups. Anxiety about the survival of the fetus and early parenting difficulties appear to be higher and post-natal self-confidence lower. Evidence about adjustment to pregnancy and parenthood and the experience of childbirth is inconclusive and reports of parental perceptions of infant temperament and behaviour are contradictory. Between-study methodological differences may explain the lack of consistency in findings of the influence of infertility and ART on some aspects of the transition to parenthood. Overall, this body of evidence is best described as emergent. It is possible that in pregnancy after ART, parenthood might be idealized and this might then hinder adjustment and the development of a confident parental identity.

  7. Lamaze Childbirth among the Amish People

    OpenAIRE

    Bing, Elisabeth

    2002-01-01

    This paper is an account of the author's observation of three Amish births in 1972, one in a home and two in a hospital. This 30-year-old story illustrates normal birth among a group dedicated to “low-tech” living. Although some aspects of Amish life and birth may have changed in the past 30 years, the basic philosophy of life and birth has not. This philosophy serves as a living reminder to us that generations of women from many cultures have given birth in a similar manner.

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

    African Journals Online (AJOL)

    AJRH Managing Editor

    study was to assess whether compliance with childbirth care based on the mothers' ... soins de l'accouchement basé sur la perception des mères contribue au ... births attended by skilled health personnel in the world. Reduction of the ... relationship with maternal satisfaction17. ... simultaneously providing some activities to.

  9. International Human Rights and the Mistreatment of Women During Childbirth.

    Science.gov (United States)

    Khosla, Rajat; Zampas, Christina; Vogel, Joshua P; Bohren, Meghan A; Roseman, Mindy; Erdman, Joanna N

    2016-12-01

    International human rights bodies have played a critical role in codifying, setting standards, and monitoring human rights violations in the context of sexual and reproductive health and rights. In recent years, these institutions have developed and applied human rights standards in the more particular context of maternal mortality and morbidity, and have increasingly recognized a critical human rights issue in the provision and experience of care during and after pregnancy, including during childbirth. However, the international human rights standards on mistreatment during facility-based childbirth remain, in an early stage of development, focused largely on a discrete subset of experiences, such as forced sterilization and lack of access to emergency obstetric care. As a consequence, the range of mistreatment that women may experience has not been adequately addressed or analyzed under international human rights law. Identifying human rights norms and standards related to the full range of documented mistreatment is thus a first step towards addressing violations of human rights during facility-based childbirth, ensuring respectful and humane treatment, and developing a program of work to improve the overall quality of maternal care. This article reviews international human rights standards related to the mistreatment of women during childbirth in facility settings under regional and international human rights law and lays out an agenda for further research and action.

  10. Prenatal Exposure to Maternal Bereavement and Childbirths in the Offspring

    DEFF Research Database (Denmark)

    Plana-Ripoll, Oleguer; Olsen, Jørn; Andersen, Per Kragh;

    2014-01-01

    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. MATERIALS AND METHODS: This population-based cohort study included all subjects born in Denmark after 1968 and in Sweden after 1973...

  11. 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,

  12. Maternal Age at Childbirth and Social Development in Infancy

    Science.gov (United States)

    Koyama, Tomonori; Kamio, Yoko; Inada, Naoko; Inokuchi, Eiko

    2011-01-01

    Difficulties in social communication are not necessarily observed only in individuals with autism spectrum disorders (ASD), and there are many subclinical cases in the general populations. Although advanced parental age at childbirth has often been considered a possible risk factor of ASD, it might contribute to poor social functioning in…

  13. Beliefs about Child Support Modification Following Remarriage and Subsequent Childbirth

    Science.gov (United States)

    Hans, Jason D.

    2009-01-01

    Framed by equity theory, fairness beliefs regarding child support modification to account for the financial impact of remarriage and subsequent childbirth were assessed. Based on a random sample of 407 Kentucky residents using a multiple segment factorial vignette approach, modification was supported by 57% of respondents following remarriage, but…

  14. 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…

  15. Explaining Changes in Mothers' Job Satisfaction Following Childbirth.

    Science.gov (United States)

    Holtzman, Mellisa; Glass, Jennifer

    1999-01-01

    Pregnant women (n=227) interviewed before and six and 12 months after childbirth reported declines in job satisfaction following birth. The following factors positively or negatively affected satisfaction: length of leave, ability to work at home, 30 to 35-hour work week, evening/rotating shifts, supervisor support, and child-care environment. (SK)

  16. Anger after Childbirth: An Overlooked Reaction to Postpartum Stressors

    Science.gov (United States)

    Graham, Jennifer E.; Lobel, Marci; DeLuca, Robyn Stein

    2002-01-01

    Other than postpartum depression, little is known about women's emotional responses to childbirth and subsequent stressors. Anger was explored on the basis of theory and evidence that it is a likely emotional response in this context. During their third trimester of pregnancy and approximately six weeks after delivery, 163 participants completed…

  17. International Human Rights and the Mistreatment of Women During Childbirth

    Science.gov (United States)

    Zampas, Christina; Vogel, Joshua P.; Bohren, Meghan A.; Roseman, Mindy; Erdman, Joanna N.

    2016-01-01

    Abstract International human rights bodies have played a critical role in codifying, setting standards, and monitoring human rights violations in the context of sexual and reproductive health and rights. In recent years, these institutions have developed and applied human rights standards in the more particular context of maternal mortality and morbidity, and have increasingly recognized a critical human rights issue in the provision and experience of care during and after pregnancy, including during childbirth. However, the international human rights standards on mistreatment during facility-based childbirth remain, in an early stage of development, focused largely on a discrete subset of experiences, such as forced sterilization and lack of access to emergency obstetric care. As a consequence, the range of mistreatment that women may experience has not been adequately addressed or analyzed under international human rights law. Identifying human rights norms and standards related to the full range of documented mistreatment is thus a first step towards addressing violations of human rights during facility-based childbirth, ensuring respectful and humane treatment, and developing a program of work to improve the overall quality of maternal care. This article reviews international human rights standards related to the mistreatment of women during childbirth in facility settings under regional and international human rights law and lays out an agenda for further research and action. PMID:28559681

  18. Preparedness of pregnant women for childbirth and the postpartum period: their knowledge and fear.

    Science.gov (United States)

    Tugut, N; Tirkes, D; Demirel, G

    2015-05-01

    The aim of the study was to identify knowledge and fear related to childbirth and the postpartum period in pregnant women. The sample consisted of 114 pregnant women. It was determined that pregnant women had insufficient levels of knowledge related to childbirth and the postpartum period. The Fear of Childbirth and Postpartum Anxiety Scale score for childbirth and the postpartum period related to 'fear regarding the action of childbirth', was found to be the highest. The highest causes for concern were determined to be 'infant-related anxiety' and 'fear regarding infant and puerperal health'. No statistically significant correlation was observed between the perceived sufficiency of the knowledge of pregnant women in terms of maintaining their own health and care, and their mean childbirth and postpartum period concern score. These findings indicate that the level of concern among pregnant women with relation to the postpartum period and childbirth is rather high.

  19. Performative Rituals for Conception and Childbirth in England, 900–1500

    Science.gov (United States)

    Jones, Peter Murray; Olsan, Lea T

    2015-01-01

    Summary This study proposes that performative rituals—that is, verbal and physical acts that reiterate prior uses—enabled medieval women and men to negotiate the dangers and difficulties of conception and childbirth. It analyzes the rituals implicated in charms, prayers, amulets, and prayer rolls and traces the circulation of such rituals within medieval English society. Manuscript records from the Anglo-Saxon period to the late Middle Ages offer evidence of the interaction of oral and written means of communicating these rituals. Certain rituals were long-lived, though variants were introduced over time that reflected changing religious attitudes and the involvement of various interested parties, including local healers, doctors, and medical practitioners, as well as monks, friars, and users of vernacular remedy books. Although many of those who recommended or provided assistance through performative rituals were males, the practices often devolved upon women themselves, and their female companions or attendants. PMID:26521667

  20. 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.

  1. [Physical activity and childbirth classes during a pregnancy and the level of perceived stress and depressive symptoms in women after childbirth].

    Science.gov (United States)

    Kowalska, Joanna; Olszowa, Daria; Markowska, Dominika; Teplik, Marzena; Rymaszewska, Joanna

    2014-01-01

    The aim of this study was to answer the question of whether physical activity during pregnancy and participation in childbirth classes prepare women for childbirth; further, does it influence the levels of perceived stress and the occurrence of depressed mood. 100 women participated in the study. Half of the women had taken part in the childbirth classes before giving birth. A questionnaires of own authorship, Edinburgh Postnatal Depressioni Scale (EPDS) and Perceived Stress Scale (PSS-10) were used. There was no significant relationship observed between participation in childbirth classes and the results of EPDS and PSS-10. The mood of women after childbirth correlated significantly with the level of stress in the whole study group (pstress were observed in women who stayed in a relationship (p =0.0029, p = 0.0008). Women physically active during pregnancy were also characterized by better mood and lower levels of perceived stress (6.7 and 14.4 vs. 8.4 and 16.0). Among women exercising during pregnancy the participants in childbirth classes was far more numerous (ppregnancy was linked to lower levels of stress experienced by women and less severe depressive symptoms after childbirth,; espe- cially in the group of childbirth classes participants.

  2. 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.

  3. Traumatic Childbirth from the Perspective of the Healthcare Professional

    DEFF Research Database (Denmark)

    Schrøder, Katja

    2016-01-01

    Summary The overall purpose of this PhD project was to investigate traumatic childbirth from the perspective of midwives and obstetricians. Both professions have been described to have a high incidence of stress, burnout and depression, but only few studies have investigated whether or how the expe......-rience of traumatic childbirth influences the psychosocial wellbeing of the healthcare professionals involved. Healthcare professionals who experience an unanticipated adverse event are often referred to as ‘second victims’, as opposed to ‘first victims’, who are the patients and their relatives. The experience...... of exoneration in subsequent complaint cases, a profound sense of guilt would still torment some of the participants. The final aim was to explore how theories on forgiveness can contribute to the understanding of the complexities of guilt and for-giveness from the perspective of the midwife or obstetrician...

  4. Childbirth care: contributing to the debate on human development.

    Science.gov (United States)

    Garcia de Lima Parada, Cristina Maria; Leite Carvalhaes, Maria Antonieta de Barros

    2007-01-01

    This study aimed to evaluate care during childbirth and neonatal development in the interior of São Paulo in order to support managers responsible for formulating public policies on human development and allocating public resources to the women's healthcare. This epidemiological study focused on the evaluation of health services based on the observation of the assistance delivered by the Single Health System in 12 maternities and 134 delivers. The Brazilian Health Ministry or World Health Organization standards were adopted for comparison. The results revealed problems related to the structure of some maternities, where some well-proven practices in normal childbirth are still little used, whereas other prejudicial or ineffective ones are routinely used. Reversing this picture is essential in order to offer humanized quality care to women with consequent reductions in maternal and neonatal mortality rates, in such a way that the region achieves the millennium goals established for improving human development.

  5. Pelvic pain after childbirth: a longitudinal population study.

    Science.gov (United States)

    Bjelland, Elisabeth Krefting; Owe, Katrine Mari; Pingel, Ronnie; Kristiansson, Per; Vangen, Siri; Eberhard-Gran, Malin

    2016-03-01

    In this longitudinal population study, the aims were to study associations of mode of delivery with new onset of pelvic pain and changes in pelvic pain scores up to 7 to 18 months after childbirth. We included 20,248 participants enrolled in the Norwegian Mother and Child Cohort Study (1999-2008) without preexisting pelvic pain in pregnancy. Data were obtained by 4 self-administered questionnaires and linked to the Medical Birth Registry of Norway. A total of 4.5% of the women reported new onset of pelvic pain 0 to 3 months postpartum. Compared to unassisted vaginal delivery, operative vaginal delivery was associated with increased odds of pelvic pain (adjusted odds ratio [OR]: 1.30; 95% confidence interval [CI]: 1.06-1.59). Planned and emergency cesarean deliveries were associated with reduced odds of pelvic pain (adjusted OR: 0.48; 95% CI: 0.31-0.74 and adjusted OR: 0.65; 95% CI: 0.49-0.87, respectively). Planned cesarean delivery, young maternal age, and low Symptom Checklist-8 scores were associated with low pelvic pain scores after childbirth. A history of pain was the only factor associated with increased pelvic pain scores over time (P = 0.047). We conclude that new onset of pelvic pain after childbirth was not commonly reported, particularly following cesarean delivery. Overall, pelvic pain scores were rather low at all time points and women with a history of pain reported increased pelvic pain scores over time. Hence, clinicians should follow up women with pelvic pain after a difficult childbirth experience, particularly if they have a history of pain.

  6. 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...... lend to future research on family outcome, as well as the balance they may offer in the information provided to parents of premature children....

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

    OpenAIRE

    Lokugamage, A. U.; Pathberiya, S. D. C.

    2017-01-01

    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 happe...

  8. Releasing and relieving encounters: experiences of pregnancy and childbirth.

    Science.gov (United States)

    Lundgren, Ingela

    2004-12-01

    The experience of childbirth is an important life event for women, memories of which may follow them throughout life. The aim of the study reported here was to synthesize the results from four selected studies describing these experiences by focusing on women's and midwives' experiences of the encounter during childbirth, as well as experiences of pregnancy from the women's perspective. The setting was the Alternative Birth Care Centre (Sahlgrenska University Hospital, Goteborg) and Karolinska Hospital (Stockholm, Sweden). A qualitative method grounded in phenomenology and hermeneutics was used as a basis for the studies and synthesis. The essential structure may be conceptualized under the heading 'releasing and relieving encounters', which, for the woman, constitutes an encounter with herself as well as with the midwife, and includes stillness as well as change. Stillness is expressed as presence and being one's body. Change is expressed as transition to the unknown and to motherhood. In the releasing and relieving encounter, for the midwife stillness and change equals being both anchored and a companion. To be a companion is to be an available person who listens to and follows the woman through the process of childbirth. To be anchored is to be the person who respects the limits of the woman's ability as well as her own professional limits in the transition process. A releasing and relieving encounter implies a sharing of responsibility and participation for women. This may be understood as a unique feature, which differs from other caring encounters and should be further studied.

  9. Proportion of neonatal readmission attributed to length of stay for childbirth: a population-based cohort study

    Science.gov (United States)

    Metcalfe, Amy; Mathai, Matthews; Liu, Shiliang; Leon, Juan Andres; Joseph, K S

    2016-01-01

    Objective Most literature on length of stay (LOS) for childbirth focuses on ‘early’ discharge as opposed to ‘optimal’ time of discharge and has conflicting results due to heterogeneous definitions of ‘early’ discharge and differing eligibility criteria for these programmes. We aimed to determine the LOS associated with the lowest neonatal readmission rate following childbirth by examining the incidence pattern of neonatal readmission for different LOS using the Kitagawa decomposition. Design Retrospective cohort study using administrative hospitalisation data. Setting Canada (excluding Quebec) from 2003 to 2010. Patients Term, singleton live births without congenital anomalies. Interventions LOS for childbirth. Main outcome measure Neonatal readmissions within 30 days of birth. Results 1 875 322 live births were included. Neonatal LOS peaked at day 1 (47.3%) after vaginal birth and day 3 (49.3%) following caesarean section; 4.2% of infants were readmitted following vaginal birth and 2.2% after caesarean section. In 2008–2010, most readmissions occurred among infants discharged in the first 2 days (83.8%) following a vaginal birth and among infants discharged in the first 3 days (81.7%) following a caesarean birth. Readmissions increased from 4.1% in 2003–2005 to 4.6% in 2008–2010 among vaginal births and from 2.0% to 2.4% among caesarean births and occurred mostly due to changes in the day-specific readmission rates and not due to reductions in LOS. Conclusions Patterns of readmission suggest that readmission rates are lowest following a 1–2-day stay following a vaginal birth and a 2–4-day stay following a caesarean birth given the outpatient support in the community. PMID:27630070

  10. 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

  11. Assessment of women's perspectives and experiences of childbirth and postnatal care using Q-methodology.

    Science.gov (United States)

    Shabila, N P; Ahmed, H M; Yasin, M Y

    2015-10-02

    To complement standard measures of maternity care outcomes, an assessment of women's satisfaction with care is needed. The aim of this study was to elicit the perspectives and experiences of Iraqi women about childbirth and postnatal care services. The study participants were a sample of 37 women of different educational and socioeconomic status who had given birth during the previous 6 months. Q-methodology was used for data collection and analysis. Three distinct viewpoints and experiences of childbirth and postnatal care services were identified: a general perception of poor childbirth and postnatal care with lack of appropriate interpersonal care and support; a high satisfaction and positive experience with childbirth and postnatal care services among the confident and well-supported women; and poor satisfaction with the childbirth and postnatal care services in terms of meeting traditional cultural practices. Needs assessment around providers' skills and attitudes and the wider sociocultural environment of childbirth and postnatal care is necessary in Iraq.

  12. 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.

  13. Becoming a mother: the meaning of childbirth for African-Canadian women.

    Science.gov (United States)

    Etowa, Josephine Bassey

    2012-04-01

    Increasingly, with globalization, various countries including Canada are becoming ethno-racially and culturally diverse. Health professionals face the challenge of working effectively across these ethno-racial and cultural boundaries. In acknowledgement of the need to generate knowledge that informs the development of effective health care policies, this paper discusses the findings of a qualitative study that examined the childbirth experiences of African-Canadian women. The meaning of childbirth, which is the primary focus of this paper, includes: sense of responsibility, childbirth as a positive life event, the uniqueness of childbirth as a life experience, childbirth as a bitter-sweet paradox, and childbirth as a spiritual event. The paper will conclude with a discussion of study implications including the need to provide opportunity for nurses to learn about the client's values, beliefs, and practices. This is necessary for the attainment of desired health outcomes such as having a healthy mother and the safe birth of a healthy baby.

  14. Effects of continuous midwifery labour support for women with severe fear of childbirth

    OpenAIRE

    Sydsjö, Gunilla; Blomberg, Marie; Palmquist, Sofie; Angerbjörn, Louise; Bladh, Marie; Josefsson, Ann

    2015-01-01

    Background: Continuous support by a midwife during childbirth has shown positive effects on the duration of active labour, use of pain relief and frequency of caesarean section (CS) in women without fear of childbirth (FOC). We have evaluated how continuous support by a specially assigned midwife during childbirth affects birth outcome and the subjective experience of women with severe FOC. Methods: A case-control pilot study with an index group of 14 women with severe FOC and a reference gro...

  15. Unassisted childbirth or homicide--different appraisals of severe injuries in a newborn.

    Science.gov (United States)

    Gehb, Iris; Rittner, Christian; Püschel, Klaus

    2009-04-01

    A case of a 24-year-old woman who gave birth to a mature newborn is reported. Many injuries at the head, neck and shoulders, back, mouth and throat which at least partly indicated unassisted childbirth were observed during autopsy. Some injuries, especially the different scull fractures were discussed controversially on trial. One expert postulated a coaction of unassisted childbirth and blunt head trauma to be responsible for the exitus. The other expert considered it possible that all injuries could originate from unassisted childbirth. The court consented to the opinion that all injuries could be the consequence of unassisted childbirth and the woman was exculpated from the accusation of manslaughter.

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

    National Research Council Canada - National Science Library

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

    2017-01-01

    .... 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...

  17. Severe fear of childbirth: Its features, assesment, prevalence, determinants, consequences and possible treatments

    Directory of Open Access Journals (Sweden)

    Gert A. Klabbers

    2016-04-01

    Full Text Available The review summarizes the relevant literature regarding fear of childbirth. A substantial number of (pregnant women are more or less afraid of childbirth and a significant minority; report a severe fear of childbirth. The focus will be on definition problems, its features, prevalence, assessment methods and measurements, determinants, consequences and treatment methods. To date, there is still no consensus about the exact definition of severe fear of childbirth. However, there is agreement that women with severe fear of childbirth are concerned about the well-being of themselves and their infants, the labor process, and other personal and external conditions. In studies on prenatal anxiety and fear of childbirth, various kinds of diagnostic methods have been used in the past. Recently, there is a consensus to determine severe fear of childbirth by using the Wijma Delivery Expectancy/Experience Questionnaire. The aetiology of fear of childbirth is likely to be multi-factorial and may be related to more general anxiety proneness, as well as to very specific fears. Furthermore, pregnant women are influenced by the many healthcare professionals, such as midwives, nurses, gynaecologists, therapists and pregnancy counselors and the interactions with them. Trying to design a universal treatment for fear of childbirth will not likely be the ultimate solution; therefore, future research is needed into multidisciplinary treatment and predictors to establish which therapies at the individual level are most effective and appropriate.

  18. The sociology of childbirth: an autobiographical journey through four decades of research.

    Science.gov (United States)

    Oakley, Ann

    2016-06-01

    The sociology of childbirth emerged in the 1970s largely as a result of influences from outside sociology. These included feminism, maternity care activism, the increasing medicalisation of childbirth, and evidence-based health care. This paper uses the author's own sociological 'career' to map a journey through four decades of childbirth research. It demonstrates the importance of social networks and interdisciplinary work, particularly across the medical-social science divide and including cross-cultural perspectives, argues that the study of reproduction has facilitated methodological development within the social sciences, and suggests that childbirth remains on the periphery of mainstream sociological concerns.

  19. '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.

  20. A Narrative Synthesis of Women's Out-of-Body Experiences During Childbirth.

    Science.gov (United States)

    Bateman, Lynda; Jones, Catriona; Jomeen, Julie

    2017-07-01

    Some women have a dissociated, out-of-body experience (OBE) during childbirth, which may be described as seeing the body from above or floating above the body. This review examines this phenomenon using narratives from women who have experienced intrapartum OBEs. A narrative synthesis of qualitative research was employed to systematically synthesize OBE narratives from existing studies. Strict inclusion and exclusion criteria were applied. The included papers were critiqued by 2 of the authors to determine the appropriateness of the narrative synthesis method, procedural transparency, and soundness of the interpretive approach. Women experiencing OBEs during labor and birth report a disembodied state in the presence of stress or trauma. Three forms of OBEs are described: floating above the scene, remaining close to the scene, or full separation of a body part from the main body. Women had clear recall of OBEs, describing the experience and point of occurrence. Women who reported OBEs had experienced current or previous traumatic childbirth, or trauma in a non-birth situation. OBEs as prosaic experiences were not identified. OBEs are part of the lived experience of some women giving birth. The OBEs in this review were trauma related with some women disclosing previous posttraumatic stress disorder (PTSD). It is not evident whether there is a connection between PTSD and OBEs at present, and OBEs may serve as a potential coping mechanism in the presence of trauma. Clinicians should legitimize women's disclosure of OBEs and explore and ascertain their impact, either as a normal coping mechanism or a precursor to perinatal mental illness. Research into the function of OBEs and any relationship to PTSD may assist in early interventions for childbearing women. © 2017 by the American College of Nurse-Midwives.

  1. The effect of childbirth on carcinogenesis of DMBA-induced breast cancer in female SD rats

    Institute of Scientific and Technical Information of China (English)

    Ji-An Zhao; Jin-Jun Chen; Ying-Chao Ju; Jian-Hua Wu; Cui-Zhi Geng; Hui-Chai Yang

    2011-01-01

    Many epidemiologic and clinical studies have indicated that the frequency of breast cancer was lower in parous women than in nulliparous women.Moreover,the incidence of breast cancer has been reported to be lower in women with early childbirth than in women with late childbirth.To verify the effect of childbirth and the age at first childbirth on carcinogenesis and progression of breast cancer,we induced breast cancer by 7,12-dimethylbenanthracene (DMBA) in 120 female Sprague-Dawley (SD) rats,and divided them into control or experimental (DMBA-treated) nulliparous,early childbirth,and late childbirth groups to observe the incidence,latency,and size of breast cancer.Argyrophilic nucleolar organizer regions (AgNOR) count and the expression of C-erbB-2,proliferating cell nuclear antigen (PCNA),Ki-67,and minichromosome maintenance protein 2 (MCM2) in breast cancer tissues were detected by immunohistochemistry.The breast cancer incidences were 95.0%,16.7%,and 58.8% in the experimental nulliparous,early childbirth,and late childbirth groups,respectively (all P < 0.05).Between any two of these groups,the latency was significantly different,but tumor size was similar.AgNOR count and the expression of C-erbB-2,PCNA,Ki-67,and MCM2 were significantly higher in the experimental nulliparous group than in the experimental early or late childbirth groups (P < 0.05),but no significant differences were observed between the latter two groups.Taken together,the results suggest that childbirth,especially early childbirth,can reduce the incidence and postpone the onset of DMBA-induced breast cancer.

  2. Psychological Factors in Experience of Pain During Childbirth.

    Science.gov (United States)

    Mestrović, Ana Havelka; Bilić, Morana; Loncar, Larisa Buhin; Micković, Vlatko; Loncar, Zoran

    2015-09-01

    Pain during delivery is unique because it is accompanied by powerful emotions. Emotions that occur in women during labor and delivery are closely tied to upbringing and culture in which they were raised and consequently with the sensation of experienced pain. According to the Melzack-Wall Theory of Pain, general mood is directly related to the intensity and quality of pain and it is therefore justifiable to presuppose that certain psychosocial factors will be linked with the intensity and quality of pain experienced during childbirth. (Melzack et al., 1981). We endeavored to show the effect of psychosocial factors that influence the intensity and quality of labor pain. Data was collected in a sample of 176 parturient women who delivered without Cesarean sections or epidural anesthesia. The intensity and quality of pain were obtained through the administration of the McGill Pain Questionnaire-Short Form. Psychosocial factors included: number of births, presence of partner, self-evaluation of knowledge of physio-anatomical aspects of birth and the completion of a pregnancy course. Labor and delivery pain is of high intensity anl the quality of pain is most frequently characterized as smarting, cramping, exhausting, and sharp. The presence of a partner and the completion of a pregnancy course is exercised by a small number of parturients. Self-evaluation of preexisting knowledge of physio-anatomical aspects of delivery is predictive of the affective component of intensity of childbirth pain. Psychosocial factors have been shown as significant for the intensity and quality of experienced childbirth pain.

  3. Women's engagement with mobile device applications in pregnancy and childbirth.

    Science.gov (United States)

    Robinson, Fiona; Jones, Catriona

    2014-01-01

    Childbearing women are increasingly engaging with social media and technology. The use of apps for pregnancy and childbirth advice is a new approach to maternity provision, and has potential to impact upon midwifery. Apps are ideally placed to provide opportunities for women to access information; however, there are concerns about the quality of mobile app data in relation to evidence based midwifery. This discussion paper presents a general overview of the use of apps as an information resource, and provides a platform for debate about their position in midwifery care.

  4. The Epidemiology of Pelvic Floor Disorders and Childbirth: An Update.

    Science.gov (United States)

    Hallock, Jennifer L; Handa, Victoria L

    2016-03-01

    Using a lifespan model, this article presents new scientific findings regarding risk factors for pelvic floor disorders (PFDs), focusing on the role of childbirth in the development of single or multiple coexisting PFDs. Phase I of the model includes predisposing factors, such as genetic predisposition and race. Phase II includes inciting factors, such as obstetric events. Prolapse, urinary incontinence (UI), and fecal incontinence (FI) are more common among vaginally parous women, although the impact of vaginal delivery on risk of FI is less dramatic than prolapse and UI. Phase III includes intervening factors, such as age and obesity.

  5. Using The Official Lamaze Guide in Childbirth Education Classes

    OpenAIRE

    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 e...

  6. Using the official lamaze guide in childbirth education classes.

    Science.gov (United States)

    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.

  7. '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.

  8. 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...

  9. 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…

  10. 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....

  11. Perceived control and maternal satisfaction with childbirth: a measure development study.

    Science.gov (United States)

    Stevens, Natalie R; Wallston, Kenneth A; Hamilton, Nancy A

    2012-03-01

    The purpose of this study was to develop and validate two instruments: one to assess patient perceptions of control of the childbirth environment and the other, global satisfaction with the childbirth experience. Participants were 187 women recruited from obstetric clinics, breast-feeding support groups and online who had given birth in the past 4 months. Scale development involved item construction, exploratory factor analysis (EFA) of the Perceived Control in Childbirth Scale (PCCh), confirmatory factor analysis (CFA) of the Satisfaction with Childbirth Scale (SWCh), reliability analysis and construct validity analyses. EFA identified a single factor underlying a set of items reflecting the patient's belief that her actions influenced the birth environment (i.e. perceived control). CFAs supported a single-factor model reflecting the degree to which the birth experience met the patient's ideal (i.e. satisfaction). Perceived control was associated with childbirth self-efficacy. Childbirth satisfaction was associated with both affective reactions to birth and childbirth-related posttraumatic stress disorder (PTSD) symptoms. Results support the validity and reliability of two new scales that assess perceived control of the birth environment and global satisfaction with childbirth.

  12. Initiating a Caregiving Relationship: Pregnancy and Childbirth Factors as Predictors of Maternal Sensitivity

    Science.gov (United States)

    Bernier, Annie; Jarry-Boileau, Veronique; Tarabulsy, George M.; Miljkovitch, Raphaele

    2010-01-01

    The aim of this study was to investigate the relations between pregnancy and childbirth factors and subsequent quality of maternal interactive behavior in a sample of 116 full-term infants and their mothers. Mothers reported on the conditions of childbirth when infants were 6-8 months of age, and their interactive behavior was observed during a…

  13. Influences by Sound and Light to Mind and Body during Delivery, and Future of Childbirth Environment

    Science.gov (United States)

    Kameyama, Miyuki

    I, who is a musician, was stimulated by own childbirth experience, and developed the ultimate “delivery room” which enabled relaxation support using sound and light. This paper explains regarding its development and the improvement of childbirth environment in Department of Obstetrics and Gynecology in Japan.

  14. The Role of Demand Factors in Utilization of Professional Care during Childbirth: Perspectives from Yemen

    Science.gov (United States)

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

    2011-01-01

    Background. Utilization of professional care during childbirth by women in low-income countries is important for the progress towards MDG 5. In Yemen, home births have decreased minimally during the past decades. Objective. The study investigates the influence of socio-demographic, birth outcome and demand factors on women's future preference of a home or institutional childbirth. Method. We interviewed 220 women with childbirth experience in urban/rural Yemen. We performed bivariate chi-square tests and multiple logistic regression analysis. A multistage sampling process was used. Results. The issues of own choice, birth support and birth complications were the most important for women's preference of future location of childbirth. Women who had previously been able to follow their own individual choice regarding birth attendance and/or location of childbirth were six times more likely to plan a future childbirth in the same location and women who received birth support four times more likely. Birth complications were associated with a 2.5-fold decrease in likelihood. Conclusions. To offer women with institutional childbirth access to birth support is crucial in attracting women to professional care during childbirth. Yemeni women's low utilization of modern delivery care should be seen in the context of women's low autonomy and status. PMID:21941663

  15. The effect of childbirth on carcinogenesis of DMBA-induced breast cancer in female SD rats.

    Science.gov (United States)

    Zhao, Ji-An; Chen, Jin-Jun; Ju, Ying-Chao; Wu, Jian-Hua; Geng, Cui-Zhi; Yang, Hui-Chai

    2011-11-01

    Many epidemiologic and clinical studies have indicated that the frequency of breast cancer was lower in parous women than in nulliparous women. Moreover, the incidence of breast cancer has been reported to be lower in women with early childbirth than in women with late childbirth. To verify the effect of childbirth and the age at first childbirth on carcinogenesis and progression of breast cancer, we induced breast cancer by 7,12-dimethylbenanthracene (DMBA) in 120 female Sprague-Dawley (SD) rats, and divided them into control or experimental (DMBA-treated) nulliparous, early childbirth, and late childbirth groups to observe the incidence, latency, and size of breast cancer. Argyrophilic nucleolar organizer regions (AgNOR) count and the expression of C-erbB-2, proliferating cell nuclear antigen (PCNA), Ki-67, and minichromosome maintenance protein 2 (MCM2) in breast cancer tissues were detected by immunohistochemistry. The breast cancer incidences were 95.0%, 16.7%, and 58.8% in the experimental nulliparous, early childbirth, and late childbirth groups, respectively (all P induced breast cancer.

  16. 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.

  17. Atmospheric conditions, lunar phases, and childbirth: a multivariate analysis

    Science.gov (United States)

    Ochiai, Angela Megumi; Gonçalves, Fabio Luiz Teixeira; Ambrizzi, Tercio; Florentino, Lucia Cristina; Wei, Chang Yi; Soares, Alda Valeria Neves; De Araujo, Natalucia Matos; Gualda, Dulce Maria Rosa

    2012-07-01

    Our objective was to assess extrinsic influences upon childbirth. In a cohort of 1,826 days containing 17,417 childbirths among them 13,252 spontaneous labor admissions, we studied the influence of environment upon the high incidence of labor (defined by 75th percentile or higher), analyzed by logistic regression. The predictors of high labor admission included increases in outdoor temperature (odds ratio: 1.742, P = 0.045, 95%CI: 1.011 to 3.001), and decreases in atmospheric pressure (odds ratio: 1.269, P = 0.029, 95%CI: 1.055 to 1.483). In contrast, increases in tidal range were associated with a lower probability of high admission (odds ratio: 0.762, P = 0.030, 95%CI: 0.515 to 0.999). Lunar phase was not a predictor of high labor admission ( P = 0.339). Using multivariate analysis, increases in temperature and decreases in atmospheric pressure predicted high labor admission, and increases of tidal range, as a measurement of the lunar gravitational force, predicted a lower probability of high admission.

  18. Fear of childbirth: predictors and temporal changes among nulliparous women in the Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Laursen, M.; Hedegaard, M.; Johansen, C.

    2008-01-01

    OBJECTIVES: To describe the association between fear of childbirth and social, demographic and psychological factors in a cohort of 30 480 healthy nulliparous women with uncomplicated singleton pregnancies. DESIGN: Nationwide population-based study. SETTING: The Danish National Birth Cohort....... POPULATION: Healthy nulliparous women (n= 30 480) with singleton pregnancies. METHODS: Data from computer-assisted telephone interviews twice in pregnancy linked with national health registers. MAIN OUTCOME MEASURES: Characteristics of women with fear of childbirth in early (mean, 16 weeks) and late...... pregnancy (mean, 32 weeks) and changes in fear of childbirth between 1997 and 2003. RESULTS: Low educational level, lack of a social network, young age and unemployment were associated with fear of childbirth, as were being a smoker and having low self-rated health. The odds ratio for fear of childbirth...

  19. 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

  20. Effect of application of Lamaze childbirth method in childbirth%拉玛泽分娩法产时应用指导的效果观察

    Institute of Scientific and Technical Information of China (English)

    零恒莉; 潘敏; 雪丽霜; 饶倩羽; 余利

    2010-01-01

    Objective To observe the effect of application of Lamaze childbirth method in childbirth. Methods The observation group(110 cases)was trained by Lamaze childbirth method in late pregnancy period. The control group (110 cases) was not trained by Lamase childbirth method in antepartum period, and were given regular observation and nursing. Mastering of natural childbirth knowledge, pain intensity, childbirth time, mode of delivery and amount of bleeding post- childbirth 2h were observed in the two groups. Results The observation group mastered more natural birth knowledge than the control group, childbirth pain was obviously reduced, natural birth rate was higher than the control group, the first and second labor time was shorter than the control group, the amount of bleeding was obviously less than the control group 2 hours post childbirth. Conclusions Pregnant women need Lamaze childbirth method training before childbirth and instruction of maternity nurses. These may relieve pain, shorten childbirth time and reduce amount of bleeding post childbirth by application of Lamaze childbirth method.%目的 观察拉玛泽分娩法的产时应用指导对分娩的影响.方法 对观察组110例孕妇在孕晚期实施拉玛泽分娩法训练,临产后助产士给予个性化拉玛泽分娩法指导.对照组110例孕妇未行产前拉玛泽训练,产时给予常规的产程观察和护理.观察2组产妇自然分娩知识的认知程度、分娩疼痛强度、产程时间、分娩方式、产后2 h出血量.结果 观察组产妇自然分娩知识的认知程度好于对照组,分娩疼痛较对照组明显减轻,自然分娩率高于对照组,第一、第二产程时间明显短于对照组,产后2 h出血量明显少于对照组.结论 孕妇不仅需要在产前接受拉玛泽分娩法训练,更需要助产士在产时提供个性化的拉玛泽分娩方法 指导,才能使产妇准确应用拉玛泽分娩法,达到减轻产妇分娩疼痛,缩短产程,减少产后

  1. About Hand Surgery

    Science.gov (United States)

    ... us eat, dress, write, earn a living, create art and do many other activities. To accomplish these ... 2009 American Society for Surgery of the Hand. Definition developed by ASSH Council. Other Links CME Mission ...

  2. 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

  3. Evaluating the effect of childbirth education class: a mixed-method study.

    Science.gov (United States)

    Lee, Linda Y K; Holroyd, Eleanor

    2009-09-01

    To examine Chinese women's satisfaction with and the perceived effect of childbirth education class on their labour experience. Attending childbirth education classes is a common activity for pregnant women. Nonetheless, evidence reveals that evaluation of the effects of childbirth education classes is inconsistent. Moreover, women's perceived effect of these classes has not been systematically examined. This two-phase study adopted a mixed-method design with Donadedian's model as the theoretical framework. In Phase One, a random sample of 40 Chinese women was invited to complete a questionnaire after attending a childbirth education class. The questionnaire was focused on their satisfaction with specific aspects of the class. Descriptive statistics were performed to summarize participants' response. In Phase Two, six of the original 40 women were purposely selected for a semi-structured interview pertaining to the perceived effect of the childbirth education class on their labour experience. Thematic analysis was conducted on the interview data. The participants expressed overall satisfaction with the class. The area that satisfied them the most was the performance of the midwife. The areas that satisfied them the least were the date, length, size and time of the class. Three themes emerged from the interview data, namely, 'learning about labour', 'contributing to a smooth labour process' and 'coping with uncertainty and handling anxiety. This study supports using a mixed-method approach to evaluate client education activity, and highlights the importance of cultivating positive coping measures among the Chinese women after attending childbirth education class when facing childbirth-related anxiety.

  4. Traditional beliefs and practices of pregnancy and childbirth.

    Science.gov (United States)

    Logan, C

    1985-01-01

    Traditional taboos and beliefs regarding pregnancy and childbirth in Botswana were collected by an essay competition in 1983. They are listed in tables by topic: nutrition, position, matrimonial, communal, obstetrical and general, with consequences. Most of the food-related beliefs are taboos, almost all of them meat, although salt, sweets, bread, corn, and fats are also prohibited. Some obstetrical practices include attendance by an elderly female relative, massage, delivering on a bed of cow dung, dressing the cord with cow dung or ash, and use of a traditional drink. There are some beneficial practices listed, such as the prohibition against the woman eating leftover food and marital infidelity by the husband during pregnancy, and social isolation during the delivery and puerperium. The essays often suggested alternative practices that could be employed to cancel out the dire consequences of the original food eaten or posture taken. Few positive preventive measures were offered.

  5. "Humanizing" childbirth: the discovery and implementation of bonding theory.

    Science.gov (United States)

    DeVries, R G

    1984-01-01

    Recent changes in methods of childbirth attendance represent one example of an emerging emphasis on the humanization of medical treatment. Although many have observed this trend toward humanization, the process of medical accommodation--including rationales provided for change, the nature and limitations of humanization, and the consequences of "humanized" medicine--is not well understood. This paper explores the process of medical accommodation by focusing on the ways in which the issue of parent-infant bonding has contributed to the humanization of obstetric care. The bonding issue has provided a rationale for change in a specialty area facing criticisms on several fronts. Acknowledging consumer demands for change in traditional styles of maternity care, medical professionals have responded by offering alternative programs based largely in the conclusions of research on the attachment process. It is demonstrated that these medically proposed alternatives suffer from many organizational constraints and that the emphasis on bonding fostered by these new programs has potentially negative consequences.

  6. Development and validating an educational booklet for childbirth companions

    Directory of Open Access Journals (Sweden)

    Liana Mara Rocha Teles

    2014-12-01

    Full Text Available Objective The article describes the steps in producing and validating an educational booklet for childbirth companions. Method Methodological study conducted in 2011 consisting of the following steps: situational assessment; establishing brochure content; content selection and referencing; drafting the text; design of illustrations; layout; consultation of specialists; consultation of target audience; amendments; proofreading; evaluation using the Flesch Reading Ease Formula. The topics portrayed the sequence of events involving support from gestation to the postpartum period. Results The concordance rate among companions was greater than or equal to 81.8% for the topics organisation, writing style, presentation and motives. The overall Content Validity Index of the booklet was 0.94. The booklet was classified as easy reading or very easy reading according to the results of the Flesch Reading Ease Formula. Conclusion The presentation and content of the manual were validated for use with the target audience by the specialists and representatives of the target audience.

  7. Childbirth on Kiriwina, Trobriand Islands, Milne Bay Province.

    Science.gov (United States)

    Pöschl, R; Pöschl, U

    1985-09-01

    This study presents the first true documentation of birthgiving among the Trobriand Islanders of Papua New Guinea. In contrast to other research projects where interviews only provide a rather imprecise and partly contradictory picture of childbirth, the information here is based upon participant observation and photographs taken of three birthing processes. The advantages and disadvantages of both the traditional and Western birthing systems are compared and analyzed. Suggestions for a Traditional Birth Attendant programme are presented with the aim of improving village deliveries in ways that are consistent with deeply ingrained aspects of culture. They are meant to initiate further discussions based on this topic and do not provide a final structure of such a Traditional Birth Attendant programme.

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

    Science.gov (United States)

    Dencker, Anna; Taft, Charles; Bergqvist, Liselotte; Lilja, Håkan; Berg, Marie

    2010-12-10

    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. 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. 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. The CEQ measures important dimensions of the first childbirth experience and may be used to measure different aspects of

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

    Science.gov (United States)

    Wilunda, Calistus; Scanagatta, Chiara; Putoto, Giovanni; Takahashi, Risa; Montalbetti, Francesca; Segafredo, Giulia; Betrán, Ana Pilar

    2016-01-01

    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.

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

    Science.gov (United States)

    Wilunda, Calistus; Scanagatta, Chiara; Putoto, Giovanni; Takahashi, Risa; Montalbetti, Francesca; Segafredo, Giulia; Betrán, Ana Pilar

    2016-01-01

    Background 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. Methods 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. Results 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. Conclusions 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. PMID:27977745

  11. 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

  12. Stress debriefing after childbirth: a randomised controlled trial.

    Science.gov (United States)

    Priest, Susan R; Henderson, Jenni; Evans, Sharon F; Hagan, Ronald

    2003-06-02

    To test whether critical incident stress debriefing after childbirth reduces the incidence of postnatal psychological disorders. Randomised single-blind controlled trial stratified for parity and delivery mode. Two large maternity hospitals in Perth. 1745 women who delivered healthy term infants between April 1996 and December 1997 (875 allocated to intervention and 870 to control group). An individual, standardised debriefing session based on the principles of critical incident stress debriefing carried out within 72 hours of delivery. Diagnosis of stress disorders or depression in the 12 months postpartum, using structured psychological interview and criteria of the Diagnostic and statistical manual of mental disorders, 4th edition. Follow-up information was available for 1730 women (99.1%), 482 of whom underwent psychological interview. There were no significant differences between control and intervention groups in scores on Impact of Events or Edinburgh Postnatal Depression Scales at 2, 6 or 12 months postpartum, or in proportions of women who met diagnostic criteria for a stress disorder (intervention, 0.6% v control, 0.8%; P = 0.58) or major or minor depression (intervention, 17.8% v control, 18.2%; relative risk [95% CI], 0.99 [0.87-1.11]) during the postpartum year. Nor were there differences in median time to onset of depression (intervention, 6 [interquartile range, 4-9] weeks v control, 4 [3-8] weeks; P = 0.84), or duration of depression (intervention, 24 [12-46] weeks v control, 22 [10-52] weeks; P = 0.98). There is a high prevalence of depression in women during the first year after childbirth. A session of midwife-led, critical incident stress debriefing was not effective in preventing postnatal psychological disorders, but had no adverse effects.

  13. 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

    OBJECTIVES: To examine the associations between fear of childbirth and emergency caesarean section and between fear of childbirth and dystocia or protracted labour and fetal distress. DESIGN: Prospective cohort study. SETTING: Danish National Birth Cohort. POPULATION: A total of 25 297 healthy...... 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...

  14. Bariatric Surgery

    Science.gov (United States)

    ... Metabolic and Bariatric Surgery MedlinePlus What is bariatric surgery? Bariatric surgery helps people who are very obese to ... What are the endocrine-related benefits of bariatric surgery? Bariatric surgery and the weight loss that results can: ...

  15. Professional quality of life of Japanese nurses/midwives providing abortion/childbirth care.

    Science.gov (United States)

    Mizuno, Maki; Kinefuchi, Emiko; Kimura, Rumiko; Tsuda, Akiko

    2013-08-01

    This study explored the relationship between professional quality of life and emotion work and the major stress factors related to abortion care in Japanese obstetric and gynecological nurses and midwives. Between October 2011 and January 2012, questionnaires that included questions concerning eight stress factors, the Professional Quality of Life Scale, and the Japanese version of the Frankfurt Emotional Work Scale, were answered by 255 nurses and midwives working in abortion and childbirth services. Professional Quality of Life scores (compassion fatigue, compassion satisfaction, burnout) were significantly associated with stress factors and emotion work. Multiple regression analysis revealed that of all the evaluated variables, the Japanese version of the Frankfurt Emotional Work Scale score for negative emotions display was the most significant positive predictor of compassion fatigue and burnout. The stress factors "thinking that the aborted fetus deserved to live" and "difficulty in controlling emotions during abortion care" were associated with compassion fatigue. These findings indicate that providing abortion services is a highly distressing experience for nurses and midwives.

  16. 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.

  17. Audit of Childbirth Emergency Referrals by Trained Traditional Birth Attendants in Enugu, Southeast, Nigeria

    Science.gov (United States)

    Okafor, II; Arinze-Onyia, SU; Ohayi, SAR; Onyekpa, JI; Ugwu, EO

    2015-01-01

    Background: 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. Aim: The aim was to audit childbirth emergency referrals by trained TBAs to a specialist hospital in Enugu, Nigeria. Subjects and Methods: 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. Results: 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. Conclusion: 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

  18. How does multilevel upper airway surgery influence the lives of dogs with severe brachycephaly? Results of a structured pre- and postoperative owner questionnaire.

    Science.gov (United States)

    Pohl, Sabine; Roedler, Frauke S; Oechtering, Gerhard U

    2016-04-01

    Brachycephalic airway syndrome in dogs is typified by a variety of anatomical abnormalities causing a diverse spectrum of clinical signs of varying intensity. This variability makes the assessment of the surgical outcome after upper airway surgery difficult. Using a structured questionnaire, the present study investigated the dog owner-perceived severity and frequency of a broad spectrum of welfare-relevant impairments 2 weeks before and 6 months after brachycephalic dogs underwent a recently developed multi-level upper airway surgery. All dogs underwent surgical treatment of stenotic nares (ala-vestibuloplasty), the nasal cavity (laser-assisted turbinectomy, LATE), the pharynx (palatoplasty and tonsillotomy), and if indicated, laryngeal surgery (laser-assisted ablation of everted ventricles and partial cuneiformectomy). Owners of brachycephalic dogs (n = 102) referred for upper airway surgery were eligible to participate. Questionnaire data from owners of 37 Pugs and 25 French bulldogs were evaluated. In all dogs, the clinical signs associated with brachycephaly improved markedly after surgery. Most encouraging was the striking reduction in life-threatening events by 90% (choking fits decreased from 60% to 5% and collapse from 27% to 3%). The incidence of sleeping problems decreased from 55% to 3%, and the occurrence of breathing sounds declined by approximately 50%. There was a marked improvement in exercise tolerance and a modest improvement in heat tolerance. Dogs with severe brachycephaly benefitted substantially from multi-level surgery, and there were particular improvements in the incidences of severe impairment and life-threatening events. However, despite the marked improvement perceived by dog owners, these dogs remained clinically affected and continued to show welfare-relevant impairments caused by these hereditary disorders.

  19. Living in Living Cities

    CERN Document Server

    Gershenson, Carlos

    2011-01-01

    This paper presents and overview of current and potential applications of living technology to urban problems. Living technology can be described as technology that exhibits the core features of living systems. These features can be useful to solve dynamic problems. In particular, urban problems concerning mobility, logistics, telecommunications, governance, safety, sustainability, and society and culture are presented, while solutions involving living technology are reviewed. Finally, the usefulness of describing cities as living systems is discussed.

  20. From 'culture of dehumanization of childbirth' to 'childbirth as a transformative experience': changes in five municipalities in north-east Brazil.

    Science.gov (United States)

    Misago, C; Kendall, C; Freitas, P; Haneda, K; Silveira, D; Onuki, D; Mori, T; Sadamori, T; Umenai, T

    2001-11-01

    Brazil has become a country known as having one of the most extreme examples of the consequences of the hospital-based medicalization of delivery care, while a model of humanization of birth was developed in the State of Ceará in the 1970s. The Government of Japan, through the Japanese International Cooperation Agency (JICA), collaborated with the Federal Ministry of Health of Brazil and the Government of the State of Ceará, in implementing the Maternal and Child Health Improvement Project in north-east Brazil (1996-2001). This project focused on 'humanization of childbirth', with training based intervention activities. Behavioral changes among health professionals who received the project's participatory type of training were described using rapid anthropological assessment procedure (RAP) survey results. Changes from 'a culture of dehumanization of childbirth' to 'childbirth as a transformative experience' were observed.

  1. 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

    OBJECTIVES: This study set out to compare the prevalence, content and associated factors of fear of childbirth in six European countries. METHOD: A cross-sectional study of 6870 pregnant women attending routine antenatal care in Belgium, Iceland, Denmark, Estonia, Norway and Sweden (Bidens). MAIN...... OUTCOME MEASURE: Severe fear of childbirth, defined as a Wijma Delivery Expectancy Questionnaire score of ≥85. RESULTS: Eleven percent of all women reported severe fear of childbirth, 11.4% among primiparous and 11.0% among multiparous women. There were significant differences between the countries...... 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...

  2. Childbirth education in rural haiti: reviving low-tech teaching strategies.

    Science.gov (United States)

    Gibson, Martha; Bowles, Betty Carlson; Jansen, Lauren; Leach, Jane

    2013-01-01

    On a medical mission into rural mountainous regions of Haiti, the authors were charged with teaching safer childbirth practices to untrained, mostly illiterate traditional birth attendants (TBA) who spoke Haitian Creole. In this isolated region with no physician or accessible hospital, almost all births occur at home. With no electricity, safe water supply, or sanitation facilities, childbirth education was a challenge. Accustomed to electronic, high-tech teaching aids, these childbirth educators had to modify educational strategies for these extraordinary circumstances. A successful solution was to revive decades-old teaching techniques and visual aids once used in Lamaze classes. The purpose of this article is to describe the teaching environment, the target audience, and the low-tech approach to childbirth education in Haiti.

  3. C-Section Raises Risk of Blood Clots After Childbirth: Review

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_161301.html C-Section Raises Risk of Blood Clots After Childbirth: ... international studies found that women who had a C-section were four times more likely to develop ...

  4. 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...

  5. Do childbirth classes influence decision making about labor and postpartum issues?

    Science.gov (United States)

    Handfield, B; Bell, R

    1995-09-01

    This study investigated the role of childbirth education for women attending the Royal Women's Hospital Family Birth Center, Melbourne, Australia, in relation to making decisions about breastfeeding, pain medication, and length of hospital stay. Fifty-nine primiparous women completed a questionnaire after delivery about the influence of childbirth education classes on their decisions during pregnancy, birth, and the postnatal period. The results indicated that although the women enjoyed childbirth education classes, the information they received had minimal effect on their decision to breastfeed and the appropriateness of a 24-hour stay. Information gained about the use of pain medication in labor was clearly helpful when women made decisions about pain relief. Educational strategies have failed to address the tendency of nulliparous women to postpone making decisions about the postnatal period such as early discharge, and further investigation on this aspect of a childbirth education program is suggested.

  6. [The paradoxes of humanized childbirth care in a public maternity ward in Brazil].

    Science.gov (United States)

    Tornquist, Carmen Susana

    2003-01-01

    The maternity ward of the University Hospital in Florianópolis, Santa Catarina, Brazil, attempts to follow World Health Organization guidelines for humanized childbirth care, including the encouragement of non-surgical delivery, breastfeeding, rooming-in, extended family visitation, and reduction of excessive technological intervention in the delivery process. The study focuses specifically on the choice of delivery procedure and on family presence during labor/childbirth, as well as women's experience with labor and breastfeeding.

  7. Local cooling for relieving pain from perineal trauma sustained during childbirth

    OpenAIRE

    East, CE; Begg, L.; Henshall, NE; Marchant, PR; Wallace, K.

    2012-01-01

    Background: Perineal trauma is common during childbirth and may be painful. Contemporary maternity practice includes offering women numerous forms of pain relief, including the local application of cooling treatments.\\ud \\ud Objectives: To evaluate the effectiveness and side effects of localised cooling treatments compared with no treatment, other forms of cooling treatments and non-cooling treatments.\\ud \\ud Search strategy: We searched the Cochrane Pregnancy and Childbirth Group's Trials Re...

  8. Childbirth information feeds for first time Malawian mothers who attended antenatal clinics

    OpenAIRE

    Malata, Address; Chirwa, Ellen

    2011-01-01

    Childbirth information received by mothers during antenatal period influences their satisfaction with the care during perinatal period. It is important for the midwives to know the type of information that satisfies their clients. This study found that the childbirth information that mothers received during antenatal period did not satisfy them. On the other hand, although some of the information received at home was useful, some information had potential to cause fear, anxiety and ill health...

  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. Thyroid Surgery

    Science.gov (United States)

    ... Fax/Phone Home » Thyroid Surgery Leer en Español Thyroid Surgery GENERAL INFORMATION Your doctor may recommend that ... made in conjunction with your endocrinologist and surgeon. Thyroid Surgery FAQs QUESTIONS AND CONSIDERATIONS When thyroid surgery ...

  11. Plastic Surgery

    Science.gov (United States)

    ... Surgery? A Week of Healthy Breakfasts Shyness Plastic Surgery KidsHealth > For Teens > Plastic Surgery Print A A ... forehead lightened with a laser? What Is Plastic Surgery? Just because the name includes the word "plastic" ...

  12. Feelings of women in return of sexual life after childbirth

    Directory of Open Access Journals (Sweden)

    Ana Carolina Macedo de Oliveira

    2014-12-01

    Full Text Available This study aimed to describe the experience of the mothers in relation to the feeling experienced in return of sexual life after childbirth. This is a descriptive and qualitative research. The instrument used was the technical work of the Collective Subject Discourse. Were addressed fifteen mothers of normal birth residents in the municipality of Sorocaba. The interviews were recorded in the Basic Health - UBS of Neighborhoods Sabia, Vila Haro and Barcelona. In the analysis, the reports were grouped into core ideas, totaling nine: body awareness, influence pain, feeling the mother to the child, her husband's involvement in resuming sexual activity, involvement of women in return of sexual life, the woman's felling about her sexual life, the woman feeling regarding pain, reasons for waiting until the return of sexual life. The results show that during this period the woman is more concerned about the changes that occur in your body, not only associated with weight gain, but also linked self image and low self esteem, fear of pain and division of roles as wife and mother.

  13. [Childbirth without pain. Politics in France during the cold war. ].

    Science.gov (United States)

    Caron-Leulliez, Marianne

    2006-01-01

    Dr. Lamaze introduced Natural Childbirth (ASD) in France in 1951. While this event is significant to the history of obstetrics and women's experience, we would like to concentrate upon another aspect here: how it is situated within the political debates of the period. In the midst of the Cold War, Lamaze was a sympathizer, although not a member of the Communist Party (PCF). He ran a maternity clinic for the CGT, a union affiliated with the PCE During a trip to Russia in 1951, he discovered a new method to relieve pain in labour through a psychological technique inspired by Pavlov. Upon his return, when he dedicated his energies towards the popularization of ASD, he looked for support from the PCF and to draw upon their propaganda network; this subsequently aroused suspicion and hostility. A few years later, ASD received the blessing of women's groups won over by its improvements to birthing. At the moment of Lamaze's triumph, he fell victim to a resurgence of Stalinism. With his team, he denounced the Soviet invasion of Hungary and lost the financial support of the unions which owned the clinic. Exhausted and profoundly disappointed, he died in March 1957.

  14. Psychological factors modifying pain with particular reference to childbirth.

    Science.gov (United States)

    Lawrence, J M

    1973-06-01

    Pain is one of those strange concepts wherein we use the word daily, each and every one of us has some understanding and indeed personal experience of the concept, and yet it is an extremely difficult problem to define accurately what is meant by pain. This highlights the fact that pain is very much a subjective experience by an individual and, for this reason, we immediately strike problems in any scientific study because of the difficulty, indeed impossibility, of measuring accurately the inner experience of another individual. For many years, writers have discoursed on pain without ever attempting to define the concept. That there is an emotional component involved in pain has been recognised not only by physicians and other medical people, but by writers through the ages. Shakespeare says in Macbeth - "the labour we delight in physics pain", and again in Romeo and Juliet - "One fire burns out another's burning, one pain is lessened by another's anguish" - and in 1590 Montaigne wrote "we feel a cut from the surgeon's scalpel more than 10 blows of the sword in the heat of battle. The pains of childbirth considered so great both by doctors and by God are held in no account amongst entire nations. The wives of our Swiss infantry trudging after their husbands may be seen today carrying on the shoulder the infant which was yesterday in the womb."

  15. 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.

  16. The impact of premature childbirth on parental bonding.

    Science.gov (United States)

    Hoffenkamp, Hannah N; Tooten, Anneke; Hall, Ruby A S; Croon, Marcel A; Braeken, Johan; Winkel, Frans Willem; Vingerhoets, Ad J J M; van Bakel, Hedwig J A

    2012-08-17

    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.

  17. Still living with fistula: an exploratory study of the experience of women with obstetric fistula following corrective surgery in West Pokot, Kenya.

    Science.gov (United States)

    Khisa, Anne M; Nyamongo, Isaac K

    2012-12-01

    Obstetric fistula is a complication of pregnancy that affects women following prolonged obstructed labour. Although there have been achievements in the surgical treatment of obstetric fistula, the long-term emotional, psychological, social and economic experiences of women after surgical repair have received less attention. This paper documents the challenges faced by women following corrective surgery and discusses their needs within the broader context of women's health. We interviewed a small sample of women in West Pokot, Kenya, during a two-month period in 2010, including eight in-depth interviews with fistula survivors and two focus group discussions, one each with fistula survivors and community members. The women reported continuing problems following corrective surgery, including separation and divorce, infertility, stigma, isolation, shame, reduced sense of worth, psychological trauma, misperceptions of others, and unemployment. Programmes focusing on the needs of the women should address their social, economic and psychological needs, and include their husbands, families and the community at large as key actors. Nonetheless, a weak health system, poor infrastructure, lack of focus, few resources and weak political emphasis on women's reproductive health do not currently offer enough support for an already disempowered group. Copyright © 2012 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  18. Promoting family planning use after childbirth and desire to limit childbearing in Ethiopia.

    Science.gov (United States)

    Sathiya Susuman, A; Bado, Aristide; Lailulo, Yishak Abraham

    2014-07-16

    In Ethiopia the average fertility rate in rural areas is about 6 children per woman, while it is 2.4 children per woman in urban areas. It is with this concept in mind that the investigators of this study wanted to correlate the promotion of after-child-birth-use of family planning and desire to limit childbearing in Ethiopia. Postpartum amenorrhea signifies the interval between childbirth and the return of menstruation. The specific objective is to examine the desire to limit family size, along with cases of sterilized, fecund, postpartum amenorrhoea, declared in-fecund and menopausal women within the study area. The study is based on the analysis of secondary data obtained from the 2011 Ethiopian Demographic and Health Survey (EDHS). This study is concentrated on couples because we need to know more about married people's desire to limit their family size. The bivariate, ANOVA, and multivariate analyses were used to analyse the association. The total number of respondents was 6,745 (78.3% rural and 21.7% urban), with 93.6% of them being currently married and 6.4% of them living with a partner. The mean duration of amenorrhea among women who gave birth in the five years preceding the survey is 16 months. Women with equal numbers of sons and daughters were found to be 75.4% (OR=0.25) less likely to desire more children, compared to women with more sons than daughters. Achievable resolutions include increasing females' ages at marriage, avoiding unwanted teenage pregnancies, completely eradicating home delivery, and inspiring young people to use modern methods of family planning to achieve Millennium Development Goals 4 & 5.

  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. Modelling the pelvic floor for investigating difficulties during childbirth

    Science.gov (United States)

    Li, Xinshan; Kruger, Jennifer A.; Chung, Jae-Hoon; Nash, Martyn P.; Nielsen, Poul M. F.

    2008-03-01

    Research has suggested that athletes involved in high-intensity sports for sustained periods have a higher probability of experiencing prolonged second stage of labour compared to non-athletes. The mechanism responsible for this complication is unknown but may depend on the relative size or tone of the pelvic floor muscles. Prolonged training can result in enlargement and stiffening of these muscles, providing increased resistance as the fetal head descends through the birth canal during a vaginal birth. On the other hand, recent studies have suggested an association between increased muscle bulk in athletes and higher distensibility. This project aims to use mathematical modelling to study the relationship between the size and tone of the pelvic floor muscles and the level of difficulty during childbirth. We obtained sets of magnetic resonance (MR) images of the pelvic floor region for a female athlete and a female non-athlete. Thirteen components of the pelvic floor were segmented and used to generate finite element (FE) models. The fetal head data was obtained by laser scanning a skull replica and a FE model was fitted to these data. We used contact mechanics to simulate the motion of the fetal head moving through the pelvic floor, constructed from the non-athlete data. A maximum stretch ratio of 3.2 was induced in the muscle at the left lateral attachment point to the pubis. We plan to further improve our modelling framework to include active muscle contraction and fetal head rotations in order to address the hypotheses that there is a correlation between the level of difficulty and the size or tone of the pelvic floor muscles.

  1. [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.

  2. Avaliação das atividades da vida diária dos pacientes com doença de Parkinson submetidos a cirurgia estereotáxica Daily living activities in Parkinson's disease patients underwent to stereotactic surgery

    Directory of Open Access Journals (Sweden)

    Roberta Arb Saba Rodrigues Pinto

    2002-06-01

    left hemisphere and seven on the right; 17 ventrolateral thalamotomies (VLT, 12 on the left and five on the right; two VLT on the left associated with PVP on the right at the same surgical procedure. The mean "off" phase scores of Schwab & England scale were: 60.6 before surgery, 74 after the first, 76.6 after the third, 75.6 after the sixth, 72.3 after the twelfth and 71.1 after the twenty fourth months after surgery. The mean "off" phase scores of UPDRS - part II scale were: 21 before surgery, 12.3 after the first, 14.7 after the third, 15.27 after the sixth, 17.1 after the twelfth and 17.5 after the twenty fourth months after surgery. CONCLUSION: VTL and PVP are useful procedures to improve daily living activities of the PD patients and the best results are seen by six months after surgery.

  3. Maternal goals for childbirth associated with planned vaginal and planned cesarean birth.

    Science.gov (United States)

    Quiroz, Lieschen H; Blomquist, Joan L; Macmillan, Deborah; McCullough, Alexis; Handa, Victoria L

    2011-10-01

    We describe maternal childbirth goals among women planning either cesarean or vaginal birth. Women in the third trimester planning cesarean or vaginal birth were asked to report up to five childbirth goals. Goal achievement was assessed postpartum. Based on free-text responses, discrete goal categories were identified. Goals and goal achievement were compared between the two groups. Satisfaction was rated on a visual analogue scale and was compared with goal achievement. The sample included 163 women planning vaginal birth and 69 women planning cesarean. Twelve goal categories were identified. Only women planning vaginal birth reported a desire to achieve fulfillment related to childbirth. Women planning cesarean were less likely to express a desire to maintain control over their own responses during childbirth and more likely to report a desire to avoid complications. The 72 women who achieved all stated goals reported significantly higher mean satisfaction scores than the 94 women reporting that at least one goal was not achieved (P  =  0.001). Goal achievement was higher among women planning cesarean than among those planning vaginal birth (52.2% versus 23.1%, P  <  0.001). This research furthers our understanding of women's attitudes regarding cesarean childbirth and definitions of a successful birth experience. © Thieme Medical Publishers.

  4. How Baloch Women Make Decisions About the Risks Associated With Different Childbirth Settings in Southeast Iran

    Science.gov (United States)

    Moudi, Zahra; Abed Saeedi, Zhila; Ghazi Tabatabaie, Mahmoud

    2015-01-01

    Background: In Zahedan City in Southeast Iran, some women prefer to give birth at home despite the availability of the equipped hospitals and expert advice that hospital births are safer. Objectives: This study explains how Baloch women make decisions regarding the risks associated with childbirth at home versus a hospital. This study identifies and defines the factors that influence the choice of the place of delivery by Baloch women. Materials and Methods: The article draws on data from a grounded theory. In particular, on in-depth interviews with 25 Baloch women, 21 of whom had planned home births and 4 planned hospital births in their most recent childbirth. Results: Six categories emerged from the data as follows: 1) deliberation and risk assessment; 2) obstacles to hospital births; 3) preference for hospital births; 4) obstacles to homebirth; 5) preference for homebirth; and 6) risk management. The core category was deliberation and risk assessment. Our interviews showed that Baloch woman weighed the negative and positive aspects of each option when deciding on a childbirth setting. In this process, their assessment of risk included physical wellbeing and sociao-cultural values. Furthermore, their assessment of risk can, in some circumstances, result in delays or avoidance of having hospital childbirth. Conclusions: Managers and service providers need to know an ordinary woman’s perception of risk to address the gap between current and desired childbirth services and encourage women to use current hospital services. PMID:25830159

  5. Concomitant ovarian drilling and oocyte retrieval by laparoendoscopic single-site surgery led to live birth using in vitro maturation of oocyte and transfer of frozen-thawed blastocyst in woman with polycystic ovary syndrome.

    Science.gov (United States)

    Hirata, Tetsuya; Fujimoto, Akihisa; Koga, Kaori; Wada-Hiraike, Osamu; Fujii, Tomoyuki; Osuga, Yutaka

    2014-05-01

    This case report describes a case of concomitant ovarian drilling and retrieval of oocytes using laparoendoscopic single-site surgery and the resultant birth of a healthy infant after transfer of frozen-thawed blastocyst from in vitro matured oocyte in a woman with polycystic ovary syndrome. A 33-year-old woman presented with anovulatory, clomiphene-resistant polycystic ovary syndrome, and 1-year history of infertility. Thirty-seven immature oocytes were retrieved and multiperforation of ovaries was performed at the same time by laparoendoscopic single-site surgery. Twenty-three oocytes reached metaphase II after 24-h culture in in vitro maturation medium, which was followed by intracytoplasmic sperm injection. Eventually, seven embryos were vitrified and spontaneous ovulation was restored after the operation. Although the first single frozen-thawed blastocyst transferred in a natural cycle ended up a biochemical pregnancy, the second frozen-thawed blastocyst transfer resulted in successful pregnancy, followed by live birth of a healthy male infant. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

  6. Pain and emotions reported after childbirth and recalled 6 months later: the role of controllability.

    Science.gov (United States)

    Tinti, Carla; Schmidt, Susanna; Businaro, Nicoletta

    2011-06-01

    The aim of this longitudinal study was twofold: to investigate the relationship between subjectively evaluated control, positive and negative emotional feelings, and pain intensity during childbirth; to assess the recall of these aspects of childbirth experience 6 months after delivery. Participants were 123 women who delivered naturally and spoke fluent Italian. Results showed that both immediately after delivery and 6 months later, higher subjective controllability was related to less severe reported pain, more intense positive emotions and less intense negative emotions. Furthermore, although there was no significant bias in the vividness of the recall, 6 months after delivery women reported higher subjective controllability, more intense positive emotions, less intense negative emotions and less intense pain. It is concluded that in preparing women for childbirth, two aspects deserve particular attention: the enhancement of subjectively perceived controllability and the possibility to work on both negative and positive emotions.

  7. Incidence of maternal near miss in hospital childbirth and postpartum: data from the Birth in Brazil study.

    Science.gov (United States)

    Dias, Marcos Augusto Bastos; Domingues, Rosa Maria Soares Madeira; Schilithz, Arthur Orlando Corrêa; Nakamura-Pereira, Marcos; Diniz, Carmen Simone Grilo; Brum, Ione Rodrigues; Martins, Alaerte Leandro; Theme Filha, Mariza Miranda; Gama, Silvana Granado Nogueira da; Carmo Leal, Maria do

    2014-08-01

    This study evaluated data on the incidence of maternal near miss identified on World Health Organization (WHO) criteria from the Birth in Brazil survey. The study was conducted between February 2011 and October 2012. The results presented are estimates for the study population (2,337,476 births), based on a sample of 23,894 women interviewed. The results showed an incidence of maternal near miss of 10.21 per 1,000 live births and a near-miss-to-mortality ratio of 30.8 maternal near miss to every maternal death. Maternal near miss was identified most prevalently by clinical criteria, at incidence of 5.2 per 1,000 live births. Maternal near miss was associated with maternal age 35 or more years (RR=1.6; 95%CI: 1.1-2.5), a history of previous cesarean delivery (RR=1.9; 95%CI: 1.1-3.4) and high-risk pregnancy (RR=4.5; 95%CI: 2.8-7.0). incidence of maternal near miss was also higher at hospitals in capital cities (RR=2.2; 95%CI: 1.3-3.8) and those belonging to Brazil's national health service, the Brazilian Unified National Health System (SUS) (RR=3.2; 95%CI: 1.6-6.6). Improved quality of childbirth care services can help reduce maternal mortality in Brazil.

  8. Fear of childbirth and duration of labour: a study of 2206 women with intended vaginal delivery.

    Science.gov (United States)

    Adams, S S; Eberhard-Gran, M; Eskild, A

    2012-09-01

    To assess the association between fear of childbirth and duration of labour. A prospective study of women from 32 weeks of gestation through to delivery. Akershus University Hospital, Norway. A total of 2206 pregnant women with a singleton pregnancy and intended vaginal delivery during the period 2008-10. Fear of childbirth was assessed by the Wijma Delivery Expectancy Questionnaire (W-DEQ) version A at 32 weeks of gestation, and defined as a W-DEQ sum score ≥ 85. Information on labour duration, use of epidural analgesia and mode of delivery was obtained from the maternal ward electronic birth records. Labour duration in hours: from 3-4 cm cervical dilatation and three uterine contractions per 10 minutes lasting ≥ 1 minute, until delivery of the child. Fear of childbirth (W-DEQ sum score ≥ 85) was present in 7.5% (165) of women. Labour duration was significantly longer in women with fear of childbirth compared with women with no such fear using a linear regression model (crude unstandardized coefficient 1.54; 95% confidence interval 0.87-2.22, corresponding to a difference of 1 hour and 32 minutes). After adjustment for parity, counselling for pregnancy concern, epidural analgesia, labour induction, labour augmentation, emergency caesarean delivery, instrumental vaginal delivery, offspring birthweight and maternal age, the difference attenuated, but remained statistically significant (adjusted unstandardized coefficient 0.78; 95% confidence interval 0.20-1.35, corresponding to a 47-minute difference). Duration of labour was longer in women with fear of childbirth than in women without fear of childbirth. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

  9. Association between childbirth attitudes and fear on birth preferences of a future generation of Australian parents.

    Science.gov (United States)

    Hauck, Yvonne L; Stoll, Kathrin H; Hall, Wendy A; Downie, Jill

    2016-12-01

    The reality of childbirth fear is recognised for expectant parents but we lack knowledge about the childbirth attitudes of the next generation of Australian parents. Examination of adults' attitudes toward childbirth including influencing contributing factors, fear scores, birth preferences and reasons for this preference. A cross-sectional online study was conducted with 654 Western Australian students attending one tertiary institution. Students (male and female) were eligible to participate if they were less than 40 years of age and did not currently have children but confirmed their intention to become parents. To assess associations or comparison of means, bi-variable analyses (Chi square test, Fisher's Exact test, Independent Student's t-test or one way ANOVA) were used. Factors associated with childbirth fear and birth preferences were assessed with binary logistic regression analysis. Childbirth attitudes were shaped by family members' (82.0%) and friends' experiences (64.4%) plus media (TV, YouTube, and movies) (63.5%). Furthermore, 15.6% of adults indicated a preference for a caesarean birth, even without obstetric complications. Likewise, 26.1% reported elevated fear; students with elevated fear scores had 2.6 times greater odds of wanting a caesarean birth. Only 23.4% of students felt confident about their childbirth knowledge. Adults reported fear levels that warrant attention prior to a future pregnancy. Although the majority would choose a vaginal birth, they require awareness of benefits and risks for both vaginal and caesarean births to ensure their decisions reflect informed choice rather than influences of inadequate knowledge or fear. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  10. Lung surgery

    Science.gov (United States)

    ... Pneumonectomy; Lobectomy; Lung biopsy; Thoracoscopy; Video-assisted thoracoscopic surgery; VATS ... You will have general anesthesia before surgery. You will be asleep and unable to feel pain. Two common ways to do surgery on your lungs are thoracotomy and video- ...

  11. Turbinate surgery

    Science.gov (United States)

    Turbinectomy; Turbinoplasty; Turbinate reduction; Nasal airway surgery; Nasal obstruction - turbinate surgery ... There are several types of turbinate surgery: Turbinectomy: All or ... This can be done in several different ways, but sometimes a ...

  12. Cataract Surgery

    Science.gov (United States)

    ... and Videos: What Do Cataracts Look Like? Cataract Surgery Written By: Kierstan Boyd Reviewed By: Elena M ... how they work. What to expect with cataract surgery Before surgery: Your ophthalmologist will measure your eye ...

  13. Attitudes of New Parents towards Child and Spouse with Lamaze or Non-Lamaze Methods of Childbirth.

    Science.gov (United States)

    McClure, Robert F.; Brewer, R. Thomas

    1980-01-01

    Lamaze childbirth training was found to have no significant effects on attitudes towards spouse or child. It did have a significant anxiety-reducing effect with respect to childbirth. Parents using the Lamaze method had a more positive attitude about having a baby. (Author/CS)

  14. 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

    to ANC services and HIV related counselling and testing were positively associated with health facility deliveries. Perceived distance was negatively associated with facility childbirth in rural areas of Malindi and urban areas of Kapiri Mposhi. CONCLUSION: Strong socio-economic inequities...... in the likelihood of facility childbirths were revealed in all the districts added to geographic inequities in two of the three districts. This strongly suggests an urgent need to strengthen services targeting disadvantaged and remote populations. The finding of a positive association between HIV counselling...

  15. Some peculiarities of hemodynamic indices in pregnant women with rheumatic heart disease during childbirth

    Directory of Open Access Journals (Sweden)

    Tashpulat Abdukarimov

    2012-05-01

    Full Text Available During childbirth some pronounced hemodynamic displacements take place increasing together with the aggravation of uterine contractions, in such a way leading to the increased heart loading. We carried out the comparative investigation of hemodynamic indices in women with rheumatic heart disease depending on their bodies’ posture during labor. The obtained results testify the facts of decreasing of venous blood relapse during every birth pang in women in childbirth with heart valvular disease in supine posture during labor, and that impedes the providing of necessary extension of cardiac output and, correspondingly, adequate blood supply of uterus and oxygenation of foetus.

  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......, or perineal suturing. CONCLUSION: Not only the process of childbirth itself but also processes during pregnancy seem to be strongly associated with prevalent urinary incontinence. Perineal suturing may be associated with prevalent urinary incontinence, whereas other obstetric techniques inspected do not seem...

  17. Childbirth education and doula care during times of stress, trauma, and grieving.

    Science.gov (United States)

    Pascali-Bonaro, Debra

    2003-01-01

    A collaborative, interspecialty volunteer program extending for nine months after September 11, 2001, provided free support and service to pregnant women widowed by the attacks on the World Trade Center. Participating providers studied the physiological and psychological effects of stress. Group sharing, discussions about the effects of emotions on labor progress, and other techniques were incorporated into sessions. The program's success suggests that childbirth educators should prepare all pregnant women to cope with stress. Subsequent national and international events have reinforced the importance of such training. The childbirth educator can also help by maintaining a referral list of local trauma counselors and other resources.

  18. 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

    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...... of delivery and factors that might influence health care seeking behaviour. A total of 1800 women who had childbirth in the previous five years were analysed. The distal and proximate conceptual framework for analysing determinants of maternal mortality was modified for studying factors associated with place...

  19. The experience of pregnancy and childbirth for unmarried mothers in London, 1760-1866.

    Science.gov (United States)

    Williams, Samantha

    2011-01-01

    This article explores the experience of pregnancy and childbirth for unmarried mothers in the metropolis in the eighteenth and nineteenth centuries. It draws upon, in particular, the infanticide cases heard at the Old Bailey between 1760 and 1866. Many of the women in these records found themselves alone and afraid as they coped with the pregnancy and birth of their first child. A great deal is revealed about the birthing body: the ambiguity surrounding the identification of and signs of pregnancy, labour and delivery, the place of birth and the degree of privacy, and the nature of, and dangers associated with, solitary childbirth.

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

    Directory of Open Access Journals (Sweden)

    Bracke Piet

    2007-10-01

    Full Text Available Abstract Background 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. Methods 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. Results 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. Conclusion Our

  1. Weight Loss Surgery (Bariatric Surgery) (For Parents)

    Science.gov (United States)

    ... to Be Smart About Social Media Weight Loss Surgery (Bariatric Surgery) KidsHealth > For Parents > Weight Loss Surgery (Bariatric Surgery) ... bariatric surgery might be an option. About Bariatric Surgery Bariatric surgery had its beginnings in the 1960s, ...

  2. Cleft Lip and Palate Surgery

    Science.gov (United States)

    ... correct a physical defect caused by a cleft lip or cleft palate, which occur once in every 600 live ... recommend additional treatment for complications caused by cleft lip and cleft palate. Additional treatments may include: • Surgery to correct ...

  3. Job Changes Following Childbirth: Are Women Trading Compensation for Family-Responsive Work Conditions?

    Science.gov (United States)

    Estes, Sarah Beth; Glass, Jennifer L.

    1996-01-01

    Investigation of differences between women who change jobs after childbirth and those who stay with employers reveals that women are motivated to change by both financial and family reasons. A trade of compensation for greater family accommodation may be more necessary for those with lower levels of skill, education, and experience. (SK)

  4. Differences in childbirth satisfaction in relation with sociodemographic and clinical variables

    Directory of Open Access Journals (Sweden)

    Francisco Javier Carmona Monge

    2013-03-01

    Full Text Available A lot research has focused on the study of women satisfaction with delivery. Different events are related to childbirth satisfaction, unplanned cesarean deliveries, instrumental vaginal deliveries, pain and lack of control during labor can generate a negative delivery experience. The aim of the present study was to assess the relationship between mode of delivery and childbirth satisfaction. The final sample was composed of 106 women in early postpartum, which voluntarily agreed to participate in the study. A total of 34,9% were instrumental deliveries, and 17% were cesarean sections. The Mackey Childbirth Satisfaction Rating Scale was used to measure women’ satisfaction. A significant difference was found in the baby scale between the groups of eutocic and non-eutocic delivery (p = ,045. A significant difference was found in the baby scale (p < ,001 and the partner scale (p = ,006 between the groups of vaginal and cesarean section delivery. Mode of delivery can be a variable that affects the childbirth experience, influencing the overall experience in a negative way, thus conditioning women’ mode of delivery in future pregnancies.

  5. "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.

  6. 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…

  7. 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 birth preparation program and the level of pain perceived during labor were found to have a significant effect on the birth satisfaction. Systematic birth preparation program improves satisfaction with childbirth experience by enabling 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.

  8. Innovative Access Programme for Young Mothers Wishing to Train in Childbirth Education: From Concept to Evaluation

    Science.gov (United States)

    Nolan, Mary L.

    2008-01-01

    This paper describes the conception, planning, implementation and evaluation of an access programme arising out of an innovative collaboration between two charities, Straight Talking and the National Childbirth Trust. The access programme was designed at the request of a group of young mothers who had finished compulsory education and subsequently…

  9. A Model of Maternal Coping with Childbirth: Implications for Research and Methodology.

    Science.gov (United States)

    Nicholson, Joanne

    A conceptual model of the childbirth experience is developed which emphasizes: (1) maternal coping during labor and delivery; (2) postpartum evaluation of the experience; (3) stress and coping; (4) health and illness behavior; (5) interactions between individual physiological and psychological characteristics; and (6) physical and social…

  10. Offering Women Childbirth Choices: A Case for Nurse-Midwives and Free-Standing Birth Centers.

    Science.gov (United States)

    Heffron, Marsha S.

    2002-01-01

    Describes the use of Certified Nurse Midwives and birth centers, examining how they present a safe, alternative maternity care option for low-risk women and discussing safety issues to consider with alternative childbirth experiences, birth center licensure and accreditation, cost effectiveness of freestanding birth centers, and client…

  11. Mindfulness-Based Childbirth and Parenting Education: Promoting Family Mindfulness during the Perinatal Period

    Science.gov (United States)

    Duncan, Larissa G.; Bardacke, Nancy

    2010-01-01

    We present the conceptual and empirical foundation and curriculum content of the Mindfulness-Based Childbirth and Parenting (MBCP) program and the results of a pilot study of n = 27 pregnant women participating in MBCP during their third trimester of pregnancy. MBCP is a formal adaptation of the Mindfulness-Based Stress Reduction program and was…

  12. Timing of First Childbirth and Young Women's Postsecondary Education in an Inner-City Minority Cohort

    Science.gov (United States)

    Ou, Suh-Ruu; Reynolds, Arthur J.

    2013-01-01

    The present study investigated the relationships between the timing of women's first childbirth and their postsecondary education using an inner-city minority cohort. The study sample (695 females) was drawn from the Chicago Longitudinal Study (CLS), an ongoing investigation of a panel of low-income minority children (94% African American) born in…

  13. A Method for Naturalistic Observation of the Childbirth Environment: With Application to Theory Building and Research.

    Science.gov (United States)

    Nicholson, Joanne; Standley, Kay

    An instrument for naturalistic observation in the childbirth environment is presented. Observable features of the parturient woman's physical state, stimulus contact she experiences, and themes of conversations with the woman are recorded using a system of categories to time-sample in cycles of 30 seconds for observing followed by 30 seconds for…

  14. 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.

  15. Funiculars anomalies during childbirth: about 562 cases collected in Pikine National Hospital

    Directory of Open Access Journals (Sweden)

    Moussa Diallo

    2016-12-01

    Conclusions: This study has allowed us to see that the funicular abnormalities impede the smooth running of childbirth. Their occurrence is facilitated by the excess amniotic fluid, prematurity and low birth weight. Their research during prenatal ultrasounds should be systematic. [Int J Reprod Contracept Obstet Gynecol 2016; 5(12.000: 4232-4235

  16. Genetic predisposition, parity, age at first childbirth and risk for breast cancer

    Directory of Open Access Journals (Sweden)

    Butt Salma

    2012-08-01

    Full Text Available Abstract Background Recent studies have identified several single-nucleotide polymorphisms (SNPs associated with the risk of breast cancer and parity and age at first childbirth are well established and important risk factors for breast cancer. The aim of the present study was to examine the interaction between these environmental factors and genetic variants on breast cancer risk. Methods The Malmö Diet and Cancer Study (MDCS included 17 035 female participants, from which 728 incident breast cancer cases were matched to 1448 controls. The associations between 14 SNPs and breast cancer risk were investigated in different strata of parity and age at first childbirth. A logistic regression analysis for the per allele risk, adjusted for potential confounders yielded odds ratios (OR with 95% confidence intervals (CI. Results Six of the previously identified SNPs showed a statistically significant association with breast cancer risk: rs2981582 (FGFR2, rs3803662 (TNRC9, rs12443621 (TNRC9, rs889312 (MAP3K1, rs3817198 (LSP1 and rs2107425 (H19. We could not find any statistically significant interaction between the effects of tested SNPs and parity/age at first childbirth on breast cancer risk after adjusting for multiple comparisons. Conclusions The results of this study are in agreement with previous studies of null interactions between tested SNPs and parity/age at first childbirth with regard to breast cancer risk.

  17. 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 ...

  18. Understanding the Intentions of Pregnant Nullipara to Not Smoke Cigarettes after Childbirth.

    Science.gov (United States)

    Godin, Gaston; Lepage, Linda

    1988-01-01

    Administered questionnaires to 63 pregnant nullipara to determine factors that may influence their decision to stop smoking following childbirth. Results revealed three factors which contributed equally to explaining variance: perceived self-efficacy, smoking habits during pregnancy, and attitude. Also found significant differences between…

  19. What about me? The loss of self through the experience of traumatic childbirth.

    Science.gov (United States)

    Byrne, Veronica; Egan, Jonathan; Mac Neela, Pádraig; Sarma, Kiran

    2017-08-01

    birth trauma has become an increasingly recognised maternal mental health issue and has important implications for both mother and infant. The importance of subjective birth experience in the development of birth trauma has been identified and may mediate the lack of theoretical consistency in this area. The current study aims to explore the subjective experience of birth trauma among first time mothers in Ireland. It aims to separate the potential effects of peripartum depression (PPD) from this in limiting this qualitative investigation to women who reported birth trauma, without PPD. mixed methods: Quantitative methods facilitated the recruitment of participants, the selection of a homogenous sample and addressed previous methodological flaws in birth trauma research. Interpretative Phenomenological Analysis (IPA) was used to explore the subjective experience of traumatic childbirth. seven, first- time mothers who reported a traumatic childbirth, without significant symptoms of PPD participated. screening measures of birth trauma and PPD were completed by participants. A semi-structured interview was then conducted with each participant about their childbirth experience. Interviews were transcribed and analysed using IPA. The primary superordinate theme recounted how the identity and individuality of women is ignored and discounted, throughout the process of childbirth. Identity is challenged and altered as a result of women's incompatibility with the maternity system. this study supports the existence of birth trauma in an Irish context and highlights the subjective experience of women as central to the development of birth trauma. acknowledgement and inclusion of the mother as an individual throughout the process of childbirth may be protective in limiting the experience of birth trauma. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. 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.

  1. 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.

  2. How perceptions of HIV-related stigma affect decision-making regarding childbirth in rural Kenya.

    Directory of Open Access Journals (Sweden)

    José S Medema-Wijnveen

    Full Text Available HIV prevalence among pregnant women in Kenya is high. Furthermore, there is a high risk of maternal mortality, as many women do not give birth with a skilled healthcare provider. Previous research suggests that fears of HIV testing and unwanted disclosure of HIV status may be important barriers to utilizing maternity services. We explored relationships between women's perceptions of HIV-related stigma and their attitudes and intentions regarding facility-based childbirth.1,777 pregnant women were interviewed at their first antenatal care visit. We included socio-demographic characteristics, stigma scales, HIV knowledge measures, and an 11-item scale measuring health facility birth attitudes (HFBA. HFBA includes items on cost, transport, comfort, interpersonal relations, and services during delivery at a health facility versus at home. A higher mean HFBA score indicates a more positive attitude towards facility-based childbirth. The mean HFBA score was dichotomized at the median and analyses were conducted with this dichotomized HFBA score using mixed effects logit models.Women who anticipated HIV-related stigma from their male partner had lower adjusted odds of having positive attitudes about giving birth at the health facility (adjusted OR = .63, 95% CI 0.50-0.78 and less positive attitudes about health facility birth were strongly related to women's intention to give birth outside a health facility (adjusted OR = 5.56, 95% CI 2.69-11.51.In this sample of pregnant women in rural Kenya, those who anticipated HIV-related stigma were less likely to have positive attitudes towards facility-based childbirth. Furthermore, negative attitudes about facility-based childbirth were associated with the intention to deliver outside a health facility. Thus, HIV-related stigma reduction efforts might result in more positive attitudes towards facility-based childbirth, and thereby lead to an increased level of skilled birth attendance, and reductions

  3. Case-loading midwifery in New Zealand: making space for childbirth.

    Science.gov (United States)

    Davis, Deborah L; Walker, Kim

    2010-12-01

    to explore the way in which case-loading midwives in New Zealand construct midwifery (and in so doing, the concepts of woman and childbirth) and, given these constructions, to examine their practice within the obstetric hospital. in-depth interviews were conducted with 48 case-loading midwives. Along with relevant professional, regulatory and contractual documents, transcripts of these interviews comprise the 'texts' which were analysed using a feminist, poststructuralist framework drawing, particularly on the work of Foucault and Grosz. midwives practising throughout New Zealand participated in this study. case-loading midwives. case-loading midwives in New Zealand work across various places as they move from community to primary or obstetric hospitals. They must also negotiate a variety of discursive spaces as they develop a plan of care with the childbearing woman. However, the biomedical discourse of childbirth is most dominant in the obstetric hospital. Therefore, midwives employ a number of strategies as they work to 'make space' for childbirth. These include re-constructing the maternal body as a competent body, re-positioning the woman at the centre of care, disrupting the obstetric gaze, and creating an oasis of privacy, calm and 'woman centeredness' within the birthing room. midwives 'make space' for the childbearing woman. This space often, although not always, challenges obstetric constructions of childbirth and woman, creating an opportunity for alternatives that are less constraining and hopefully more enabling of an enjoyable and successful birth. it is important to recognise and articulate the work that midwives do, to facilitate childbirth. Copyright © 2009 Elsevier Ltd. All rights reserved.

  4. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ...

  5. Dental Implant Surgery

    Science.gov (United States)

    ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ...

  6. Satisfacción de las mujeres con la experiencia del parto: validación de la Mackey Satisfaction Childbirth Rating Scale Women's satisfaction with the experience of childbirth: validation of the Mackey Childbirth Satisfaction Rating Scale

    Directory of Open Access Journals (Sweden)

    Rosa Mas-Pons

    2012-06-01

    Full Text Available Objetivos: Determinar la fiabilidad y validez de contenido y concepto de la Mackey Childbirth Satisfaction Rating Scale, escala para medir la satisfacción de las mujeres con el parto y el nacimiento. Métodos: Se utilizó el método de traducción-retrotraducción para obtener una versión adaptada de la escala. Para la validación se seleccionó una muestra de 325 mujeres que habían tenido un hijo sano mediante parto vaginal. La recogida de datos se realizó con un cuestionario autocumplimentado que incluía la escala adaptada, expectativas ante el parto y variables obstétricas y sociodemográficas. Se valoró la fiabilidad en una submuestra de 45 mujeres que cumplimentaron de nuevo la escala a los 15-30 días. Se analizó la estructura factorial y la consistencia interna. Se evaluó la validez de concepto analizando la relación entre la satisfacción con la experiencia y el cumplimiento de las expectativas y preferencias en el manejo del dolor. Resultados: En el estudio test-retest se obtuvo un coeficiente de correlación intraclase de 0,93 para la escala global. El análisis factorial identificó seis factores que explicaban el 69,42% de la varianza. El coeficiente alfa de Cronbach fue de 0,94 para la escala global, oscilando entre 0,72 y 0,96 en las subescalas. La satisfacción con la experiencia del parto fue superior en las mujeres cuyas expectativas se habían cumplido, así como en las que accedieron al método de alivio del dolor elegido. Conclusiones: Se ha obtenido un instrumento de medida de la satisfacción con la experiencia del parto y el nacimiento, adaptado a nuestro contexto y con buenas características psicométricas.Objectives To determine the reliability and the content and construct validity of the Mackey Childbirth Satisfaction Rating Scale to measure women's satisfaction with labor and delivery. Methods The translation-back translation method was used to obtain an adapted version of the scale. For the validation

  7. Nose Surgery

    Science.gov (United States)

    ... Patient Health Home Copyright © 2017 American Academy of Otolaryngology–Head and Neck Surgery. Reproduction or republication strictly ... Terms of Use © Copyright 2017. American Academy of Otolaryngology — Head and Neck Surgery 1650 Diagonal Rd Alexandria, ...

  8. After Surgery

    Science.gov (United States)

    ... side effects. There is usually some pain with surgery. There may also be swelling and soreness around ... the first few days, weeks, or months after surgery. Some other questions to ask are How long ...

  9. Indications for Emergency Intervention, Mode of Delivery, and the Childbirth Experience.

    Science.gov (United States)

    Handelzalts, Jonathan E; Waldman Peyser, Avigail; Krissi, Haim; Levy, Sigal; Wiznitzer, Arnon; Peled, Yoav

    2017-01-01

    Although the impact of emergency procedures on the childbirth experience has been studied extensively, a possible association of childbirth experience with indications for emergency interventions has not been reported. To compare the impacts on childbirth experience of 'planned' delivery (elective cesarean section and vaginal delivery) versus 'unplanned' delivery (vacuum extraction or emergency cesarean section); the intervention itself (vacuum extraction versus emergency cesarean section); and indications for intervention (arrest of labor versus risk to the mother or fetus). A total of 469 women, up to 72 hours post-partum, in the maternity ward of one tertiary health care institute completed the Subjective Childbirth Experience Questionnaire (score: 0-4, a higher score indicated a more negative experience) and a Personal Information Questionnaire. Intra-partum information was retrieved from the medical records. One-way analysis of variance and two-way analysis of variance, followed by analysis of covariance, to test the unique contribution of variables, were used to examine differences between groups in outcome. Tukey's Post-Hoc analysis was used when appropriate. Planned delivery, either vaginal or elective cesarean section, was associated with a more positive experience than unplanned delivery, either vacuum or emergency cesarean section (mean respective Subjective Childbirth Experience scores: 1.58 and 1.49 vs. 2.02 and 2.07, P Experience scores following elective cesarean section and vaginal delivery was not significant; nor was the difference following vacuum extraction and emergency cesarean section. Interventions due to immediate risk to mother or fetus resulted in a more positive birth experience than interventions due to arrest of labor (Subjective Childbirth Experience: 1.9 vs. 2.2, P experience. However, the indication for unplanned intervention appears to have a greater effect than the nature of the intervention on the birth experience. Women who

  10. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment of jaws and ... Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, and is best performed by ...

  11. Effect of Maternal Age at Childbirth on Obesity in Postmenopausal Women: A Nationwide Population-Based Study in Korea.

    Science.gov (United States)

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

    2016-05-01

    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/m, nongeneral obesity; BMI ≤25 kg/m, 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 and Nutrition Examination Survey. Data from a total of 4382 postmenopausal women were analyzed using multivariate regression analysis with complex survey design sampling. And, the subjects were subdivided into groups according to obesity or not. Age, smoking, alcohol consumption, exercise, education, income level, number of pregnancies, oral contraceptive uses, breast feeding experience were adjusted as the confounders.The prevalence of general obesity among Korean postmenopausal women was 37.08%. Women with general obesity and abdominal obesity were significantly younger at first childbirth compared with women with nongeneral obesity and no abdominal obesity (23.89 ± 0.1 vs. 23.22 ± 0.1, P childbirth was inversely associated with obesity, while age at last childbirth was not associated with obesity or abdominal obesity. Women with a higher number of pregnancies were also more likely to have obesity and abdominal obesity. Age at first childbirth remained significantly associated with obesity, after adjusting for confounding factors.Obesity in postmenopausal women is associated with first childbirth at a young age, and higher parity. Further research is needed to clarify the association between obesity and reproductive characteristics.

  12. 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.

  13. 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...

  14. Are freestanding midwifery units a safe alternative to obstetric units for low-risk, primiparous childbirth?

    DEFF Research Database (Denmark)

    Christensen, Louise Fischer; Overgaard, Charlotte

    2017-01-01

    BACKGROUND: Intrapartum complications and the use of obstetric interventions are more common in primiparous childbirth than in multiparous childbirth, leading to concern about out of hospital birth for primiparous women. The purpose of this study was to determine whether the effect of birthplace...... ratios and effect ratios with 95% confidence intervals for matched pairs stratified by parity. RESULTS: On no outcome did the effect of birthplace differ significantly between primiparous and multiparous women. Compared with their counterparts intending birth in an obstetric unit, both primiparous...... for multiparas remained stable. CONCLUSIONS: Freestanding midwifery units appear to confer significant advantages over obstetric units to both primiparous and multiparous mothers, while their infants are equally safe in both settings. Our findings thus support the provision of care in freestanding midwifery...

  15. 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.

  16. 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...... Psychosocial Questionnaire (COPSOQII). Responses were assessed on six scales: burnout, sleep disorders, general stress, depressive symptoms, somatic stress and cognitive stress. Associations between COPSOQII scales and participant characteristics were analysed using linear regression. Results midwives reported...

  17. [Childbirth practices and challenges for humanization of care in two public hospitals in Southern Brazil].

    Science.gov (United States)

    Nagahama, Elizabeth Eriko Ishida; Santiago, Silvia Maria

    2008-08-01

    The aim of this study was to characterize hospital care for childbirth in two hospitals affiliated with the Unified National Health System in Maringá, Paraná, Brazil, and identify both obstacles and facilitating factors for the implementation of humanized care, based on women's perception of the care received. This was an exploratory and descriptive study with a cross-sectional design, analyzing hospital patient charts and interviews with 569 women who gave birth at the two hospitals from March 2005 to February 2006. Hospital care was characterized on the basis of WHO quality-of-care guidelines for labor and delivery. The data pointed to a healthcare model marked by the hygienist legacy in physician-centered hospital protocols and professional practices. Institutional factors, identified as difficulties in institutional and infrastructure organization, hospital protocols, and health professionals' individual practices and stances, denote barriers that jointly hinder the implementation of a humanized model for childbirth care.

  18. At what cost to health? Tlicho women's medical travel for childbirth.

    Science.gov (United States)

    Moffitt, Pertice M; Vollman, Ardene Robinson

    2006-09-01

    Medical travel policies are instituted in all rural and remote areas of Canada as a means of providing universal health care services to residents. These policies are framed, developed and implemented from a colonial perspective and require re-examination through a more inclusive and collaborative postcolonial lens. The purpose of this paper is to discuss the medical travel policy for childbirth in Canada's Northwest Territories from a postcolonial perspective and in consideration of the cultural safety of pregnant Tlicho women. The context within which Tlicho birthing and this policy thrives is reviewed along with the exploration of future possibilities. Personal, socioeconomic, political and legal factors surrounding birthing are highlighted. It is anticipated, that by illuminating the oppressive and paternalistic nature of this childbirth policy, there will be heightened awareness that fosters transitions within the system to transform current risk discourse creating new possibilities for Tlicho women in the birth of their babies.

  19. 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.

  20. Comparative study analysing women's childbirth satisfaction and obstetric outcomes across two different models of maternity care

    OpenAIRE

    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 (biom...

  1. Pregnancy, Childbirth and Midwifery Care among Women with Intellectual Disability in Sweden : Epidemiological and Descriptive Studies

    OpenAIRE

    Höglund, Berit

    2012-01-01

    The overall aim of this thesis was to investigate pregnancy and childbirth in women with intellectual disability (ID), in Sweden, the health of their newborns and midwifery care for these women. Two register studies and two descriptive studies are included. Pregnancy and birth outcomes as well as data on the newborns’ health were examined by linking data from the National Patient Register and the Medical Birth Register (I-II). The women’s experience of pregnancy and delivery was investigated ...

  2. The association between labour variables and primiparous women's experience of childbirth; a prospective cohort study.

    Science.gov (United States)

    Ulfsdottir, Hanna; Nissen, Eva; Ryding, Elsa-Lena; Lund-Egloff, Doris; Wiberg-Itzel, Eva

    2014-06-18

    Studies have suggested several risk factors for a negative birth experience among primiparas. Factors that are mentioned frequently include labour dystocia, operative intervention such as acute caesarean section or vacuum extraction, or the infant being transferred to neonatal care. Another important factor mentioned is lack of support from the midwife. A study was made of the deliveries of 446 healthy primiparas in a prospective cohort study performed at Soder Hospital, Stockholm, Sweden. Samples of amniotic fluid were collected at delivery and the levels of amniotic fluid lactate (AFL) were measured to give an indication of the metabolism of the uterine tissue. Obstetrical data were collected from birth records.Postpartum, all the women included in the study were asked to complete the Wijma Delivery Experience Questionnaire (W-DEQ B) that measures the experience of a woman's delivery. The main objective of the project was to study well-known as well as new factors associated with negative experience of childbirth among a group of healthy primiparas. Risk factors for reporting a higher level of negative childbirth experience were shown to be a high level of AFL (AOR 3.1, 95%, CI; 1.1-8.9), a longer latent phase (AOR 1.8, 95%, CI; 1.03-3.1), and a low Apgar score (labour (p = 0.003). A high AFL level, as a marker of uterine metabolic status, and a longer latent phase are strongly associated with a negative experience of childbirth. A low 1 minute Apgar score of the newborn seems to have the strongest negative influence on the woman's experience of childbirth, even when the infant recovers immediately.

  3. The color of pain: racial iniquities in prenatal care and childbirth in Brazil.

    Science.gov (United States)

    Leal, Maria do Carmo; Gama, Silvana Granado Nogueira da; Pereira, Ana Paula Esteves; Pacheco, Vanessa Eufrauzino; Carmo, Cleber Nascimento do; Santos, Ricardo Ventura

    2017-07-24

    Few studies on the influence of race/color on pregnancy and birthcare experiences have been carried out in Brazil. Additionally, none of the existing studies are of national scope. This study sought to evaluate inequities in prenatal and childbirth care according to race/color using propensity score matching. The data comes from the study Birth in Brazil: National Survey into Labor and Birth, a national population study comprised of interviews and revisions of medical records that included 23,894 women in 2011/2012. We used logistic regressions to estimate odds ratios (OR) and respective 95% confidence intervals (95%CI) of race/color associated with the outcomes were analyzed. When compared with white-skinned women, black-skinned women were more likely to have inadequate prenatal care (OR = 1.6; 95%CI: 1.4-1.9), to not be linked to a maternity hospital for childbirth (OR = 1.2 95%CI: 1.1-1.4), to be without a companion (OR = 1.7; 95%CI: 1.4-2.0), to seek more than one hospital for childbirth (OR =1.3; 95%CI: 1.2-1.5), and less likely to receive local anesthesia for an episiotomy (OR = 1.5; 95%CI: 1.1-2.1). Brown-skinned women were also more likely to have inadequate prenatal care (OR = 1.2; 95%CI: 1.1-1.4) and to lack a companion (OR = 1.4; 95%CI: 1.3-1.6) when compared with white-skinned women. We identified racial disparities in care during pregnancy and childbirth, which displayed a gradient going from worst to best care provided to black, brown and white-skinned women.

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

    Science.gov (United States)

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

    2017-08-30

    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%, CI95%: 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%, CI95%: 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.

  5. Women's Use of Private and Government Health Facilities for Childbirth in Nairobi's Informal Settlements

    OpenAIRE

    Bazant, Eva S.; Koenig, Michael A; Fotso, Jean-Christophe; Mills, Samuel

    2009-01-01

    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 g...

  6. The lay midwife care to woman upon delivery and her childbirth

    OpenAIRE

    Reginatto Vieira, Marisa; de Lourenzi Bonilha, Ana Lúcia

    2008-01-01

    It is a research aimed at finding out the lay midwives’ practices while attending women upon delivery and their childbirth. The methodology was supported by the oral history of the midwives, using Bardin’s thematic analysis. The findings regarding the midwives’ activities reveal the domestic character of their practices, being themselves one of these resources, besides others that they have adopted to perform their practices. The rescue of those practices may lead health professionals to thin...

  7. 生育价值观探究%A Research on Value of Childbirth

    Institute of Scientific and Technical Information of China (English)

    史雅静; 张灵聪

    2016-01-01

    在回顾以往文献和研究的基础上,对生育价值观的相关概念、理论及其影响因素进行了概括和总结。生育价值观是指在一定的社会文化环境中,个体对于生育现象重要性的认知与评价。研究方法采用社会科学所采用的调查、个体访谈及开放性问卷调查。研究对象针对某一地区或某一职业的特殊群体展开。生育价值观的理论较少,就影响生育价值观的因素而言,也仅局限于社会文化环境和人口学变量。%Value of childbirth refers to one’s cognition and evaluation on the importance of childbirth in certain social cultural environment.Based on the review of previous researches,by the methods of inter-views and an open questionnaire,taking some special groups in certain region or profession as the subjects, the paper illustrates the definition,related theories and the influencing factors of values of childbirth.There are very few theories related to value of childbirth and the influencing factors are only limited to the social and cultural environment and demographic variables.

  8. 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

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

    Science.gov (United States)

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

    2010-05-27

    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 identified 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. 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. 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. 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. Importantly, the cultural values and beliefs of Japanese women regarding

  10. The Mistreatment of Women during Childbirth in Health Facilities Globally: A Mixed-Methods Systematic Review

    Science.gov (United States)

    Bohren, Meghan A.; Vogel, Joshua P.; Hunter, Erin C.; Lutsiv, Olha; Makh, Suprita K.; Souza, João Paulo; Aguiar, Carolina; Saraiva Coneglian, Fernando; Diniz, Alex Luíz Araújo; Tunçalp, Özge; Javadi, Dena; Oladapo, Olufemi T.; Khosla, Rajat; Hindin, Michelle J.; Gülmezoglu, A. Metin

    2015-01-01

    Background Despite growing recognition of neglectful, abusive, and disrespectful treatment of women during childbirth in health facilities, there is no consensus at a global level on how these occurrences are defined and measured. This mixed-methods systematic review aims to synthesize qualitative and quantitative evidence on the mistreatment of women during childbirth in health facilities to inform the development of an evidence-based typology of the phenomenon. Methods and Findings We searched PubMed, CINAHL, and Embase databases and grey literature using a predetermined search strategy to identify qualitative, quantitative, and mixed-methods studies on the mistreatment of women during childbirth across all geographical and income-level settings. We used a thematic synthesis approach to synthesize the qualitative evidence and assessed the confidence in the qualitative review findings using the CERQual approach. In total, 65 studies were included from 34 countries. Qualitative findings were organized under seven domains: (1) physical abuse, (2) sexual abuse, (3) verbal abuse, (4) stigma and discrimination, (5) failure to meet professional standards of care, (6) poor rapport between women and providers, and (7) health system conditions and constraints. Due to high heterogeneity of the quantitative data, we were unable to conduct a meta-analysis; instead, we present descriptions of study characteristics, outcome measures, and results. Additional themes identified in the quantitative studies are integrated into the typology. Conclusions This systematic review presents a comprehensive, evidence-based typology of the mistreatment of women during childbirth in health facilities, and demonstrates that mistreatment can occur at the level of interaction between the woman and provider, as well as through systemic failures at the health facility and health system levels. We propose this typology be adopted to describe the phenomenon and be used to develop measurement tools

  11. Freud, females, childbirth, and dissidence: Margarete Hilferding, Karen Horney, and Otto Rank.

    Science.gov (United States)

    Balsam, Rosemary

    2013-10-01

    These three early psychoanalysts, who differed in important ways from Freud, each tried to shift his fundamental beliefs about women's bodies in basic developmental theory. This paper illustrates this point by elaborating their materials concerning the centrality of childbirth. One thematic aspect of Freud's disruptive fights with colleagues lay in his loyalty to phallocratic certainties. These problems still affect us, a century later, even in today's clinically pluralistic climate.

  12. Bypassing health facilities for childbirth: a multilevel study in three districts of Gujarat, India

    OpenAIRE

    2016-01-01

    Background: Bypassing available facilities for childbirth has important implications for maternal health service delivery and human resources within a health system. The results are the additional expenses imposed on the woman and her family, as well as the inefficient use of health system resources. Bypassing often indicates a lack of confidence in the care provided by the facility nearest to the mother, which implies a level of dysfunctionality that the health system needs to address. Over ...

  13. Pregnancy and childbirth: What changes in the lifestyle of women who become mothers?

    OpenAIRE

    Emília de Carvalho Coutinho; Cristina Bastos da Silva; Cláudia Margarida Balula Chaves; Paula Alexandra Batista Nelas; Vitória Barros Castro Parreira; Maria Odete Amaral; João Carvalho Duarte

    2014-01-01

    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 life...

  14. Prediction of perineal tear during childbirth by assessment of striae gravidarum score

    OpenAIRE

    Shital Kapadia; Swena Kapoor; Kartikeya Parmar; Kavita Patadia; Monark Vyas

    2014-01-01

    Background: The objective of this study was to explore the association between striae gravidarum and the risk for perineal tear during childbirth. Methods: Three hundred patients delivered normally were included in this study. Striae gravidarum score was assessed using the Atwal numerical scoring system. The association was examined between striae and perineal tear as the outcome measure, defined by tears or laceration, and the total striae scores (TSS) was obtained. Results: Mean age...

  15. Recommendations to increase the impact of maternal and childbirth health systematic reviews in the Americas.

    Science.gov (United States)

    Jacquérioz, Frédérique A; Belizán, José M; Buekens, Pierre

    2008-01-01

    This paper summarises the discussions and the recommendations formulated during a meeting in March 2007 on the challenges and strategies to increase the impact of maternal and childbirth health systematic reviews in the Americas. The discussions addressed three specific themes: (1) performing systematic reviews (2) updating existing reviews, and (3) diffusing and implementing evidence into practice. Practical recommendations were devised for each theme in small group discussions.

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

    Science.gov (United States)

    1992-01-01

    of midwifery on the island of Borneo, according to legend, started when a husband and his pregnant wife were hunting food in the jungle. He came upon a...classes on base or in the local community . Patients were excluded if they were scheduled for an elective Cesarean section prior to the onset of labor...Row. Broome, M. E., & Koehler, C. (1986). Childbirth education: A review of effects on the woman and her family. Family and Community Health, 9(1

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

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    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.

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

    Science.gov (United States)

    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.

  19. '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.

  20. Effects of birth ball exercise on pain and self-efficacy during childbirth: a randomised controlled trial in Taiwan.

    Science.gov (United States)

    Gau, Meei-Ling; Chang, Ching-Yi; Tian, Shu-Hui; Lin, Kuan-Chia

    2011-12-01

    To examine the effectiveness of a birth ball exercise programme during childbirth by measuring childbirth self-efficacy and childbirth pain. In addition, it tested the mediating effects of childbirth self-efficacy on the relationship between the birth ball exercise programme and childbirth pain. Randomised controlled trial. The study was conducted from December 2008 to November 2009, at two birth units, one at a regional hospital and one at a medical centre, with 600 and 1022 annual births, respectively. One hundred and eighty-eight expectant mothers were recruited (recruitment rate: 47%) and were allocated by block randomisation into the two arms of the study, but only 48 intervention and 39 control group participants completing the trial. The birth ball exercise programme consisted of a 26-page booklet and a 19-minute videotape, with periodic follow-ups during prenatal checks. All members of the experimental group were asked to practise the exercises and positions at home for at least 20 minutes three times a week for a period of 6-8 weeks. Each woman in the experimental group was given a birth ball for use during labour and encouraged every hour to choose the most comfortable positions, movements, and exercises. Both the experimental and control groups received standard nursing and midwifery care from hospital staff nurses in all aspects of pregnancy and childbirth. When cervical dilations were four centimetres and eight centimetres, the women completed demographic and obstetrics information, the Childbirth Self-efficacy Inventory (CBSEI), and the short form of the McGill Pain Questionnaire (SF-MPQ). Our study revealed that birth ball exercises provided statistically significant improvements in childbirth self-efficacy and pain. Specifically, self-efficacy had a 30-40% mediating effect on relationships between birth ball exercises and childbirth pain. Mothers in the experimental group had shorter first-stage labour duration, less epidural analgesia, and fewer

  1. Bypassing health facilities for childbirth: a multilevel study in three districts of Gujarat, India.

    Science.gov (United States)

    Salazar, Mariano; Vora, Kranti; Costa, Ayesha De

    2016-01-01

    Bypassing available facilities for childbirth has important implications for maternal health service delivery and human resources within a health system. The results are the additional expenses imposed on the woman and her family, as well as the inefficient use of health system resources. Bypassing often indicates a lack of confidence in the care provided by the facility nearest to the mother, which implies a level of dysfunctionality that the health system needs to address. Over the past decade, India has experienced a steep rise in the proportion of facility births. The initiation of programs promoting facility births resulted in a rise from 39% in 2005 to 85% in 2014. There have been no reports on bypassing facilities for childbirth from India. In the context of steeply rising facility births, it is important to quantify the occurrence of and study the relative contributions of maternal characteristics and facility functionality to bypassing. 1) To determine the extent of bypassing health facilities for childbirth among rural mothers in three districts of Gujarat, India, 2) to identify associations between the functionality of an obstetric care (OC) facility and it being bypassed, and 3) to assess the relative contribution of maternal and facility characteristics to bypassing. A cross-sectional survey of 166 public and private OC facilities reporting ≥30 births in the 3 months before the survey was conducted in three purposively selected districts (Dahod, Sabarkantha, and Surendranagar) in the state of Gujarat, India. Besides information on each facility, data from 946 women giving birth at these facilities were also gathered. Data were analyzed using a multilevel mixed-effects logistic regression model. Off all mothers, 37.7% bypassed their nearest facility for childbirth. After adjusting for maternal characteristics, for every one-unit increase in the facility's emergency obstetric care (EmOC) signal functions, the odds of bypassing a facility for childbirth

  2. Bypassing health facilities for childbirth: a multilevel study in three districts of Gujarat, India.

    Science.gov (United States)

    Salazar, Mariano; Vora, Kranti; De Costa, Ayesha

    2016-01-01

    Background Bypassing available facilities for childbirth has important implications for maternal health service delivery and human resources within a health system. The results are the additional expenses imposed on the woman and her family, as well as the inefficient use of health system resources. Bypassing often indicates a lack of confidence in the care provided by the facility nearest to the mother, which implies a level of dysfunctionality that the health system needs to address. Over the past decade, India has experienced a steep rise in the proportion of facility births. The initiation of programs promoting facility births resulted in a rise from 39% in 2005 to 85% in 2014. There have been no reports on bypassing facilities for childbirth from India. In the context of steeply rising facility births, it is important to quantify the occurrence of and study the relative contributions of maternal characteristics and facility functionality to bypassing. Objectives 1) To determine the extent of bypassing health facilities for childbirth among rural mothers in three districts of Gujarat, India, 2) to identify associations between the functionality of an obstetric care (OC) facility and it being bypassed, and 3) to assess the relative contribution of maternal and facility characteristics to bypassing. Design A cross-sectional survey of 166 public and private OC facilities reporting ≥30 births in the 3 months before the survey was conducted in three purposively selected districts (Dahod, Sabarkantha, and Surendranagar) in the state of Gujarat, India. Besides information on each facility, data from 946 women giving birth at these facilities were also gathered. Data were analyzed using a multilevel mixed-effects logistic regression model. Results Off all mothers, 37.7% bypassed their nearest facility for childbirth. After adjusting for maternal characteristics, for every one-unit increase in the facility's emergency obstetric care (EmOC) signal functions, the odds

  3. Bypassing health facilities for childbirth: a multilevel study in three districts of Gujarat, India

    Directory of Open Access Journals (Sweden)

    Mariano Salazar

    2016-08-01

    Full Text Available Background: Bypassing available facilities for childbirth has important implications for maternal health service delivery and human resources within a health system. The results are the additional expenses imposed on the woman and her family, as well as the inefficient use of health system resources. Bypassing often indicates a lack of confidence in the care provided by the facility nearest to the mother, which implies a level of dysfunctionality that the health system needs to address. Over the past decade, India has experienced a steep rise in the proportion of facility births. The initiation of programs promoting facility births resulted in a rise from 39% in 2005 to 85% in 2014. There have been no reports on bypassing facilities for childbirth from India. In the context of steeply rising facility births, it is important to quantify the occurrence of and study the relative contributions of maternal characteristics and facility functionality to bypassing. Objectives: 1 To determine the extent of bypassing health facilities for childbirth among rural mothers in three districts of Gujarat, India, 2 to identify associations between the functionality of an obstetric care (OC facility and it being bypassed, and 3 to assess the relative contribution of maternal and facility characteristics to bypassing. Design: A cross-sectional survey of 166 public and private OC facilities reporting ≥30 births in the 3 months before the survey was conducted in three purposively selected districts (Dahod, Sabarkantha, and Surendranagar in the state of Gujarat, India. Besides information on each facility, data from 946 women giving birth at these facilities were also gathered. Data were analyzed using a multilevel mixed-effects logistic regression model. Results: Off all mothers, 37.7% bypassed their nearest facility for childbirth. After adjusting for maternal characteristics, for every one-unit increase in the facility's emergency obstetric care (EmOC signal

  4. Endodontic surgery.

    Science.gov (United States)

    Chong, B S; Rhodes, J S

    2014-03-01

    A better understanding of endodontic disease and the causes of treatment failure has refined the role of surgery in endodontics. The advent of newer materials, advances in surgical armamentarium and techniques have also led to an improved endodontic surgical outcome. The aim of this article is to provide a contemporary and up-to-date overview of endodontic surgery. It will focus primarily on the procedures most commonly performed in endodontic surgery.

  5. A Benefit of Back Pain Surgery: Better Sex

    Science.gov (United States)

    ... html A Benefit of Back Pain Surgery: Better Sex Operation often leads to more comfortable lovemaking, study ... Surgery for back pain can often improve patients' sex lives, researchers report. "The impetus behind our study ...

  6. 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

  7. Born Too Soon: Care during pregnancy and childbirth to reduce preterm deliveries and improve health outcomes of the preterm baby

    Science.gov (United States)

    2013-01-01

    Abstract Pregnancy and childbirth represent a critical time period when a woman can be reached through a variety of mechanisms with interventions aimed at reducing her risk of a preterm birth and improving her health and the health of her unborn baby. These mechanisms include the range of services delivered during antenatal care for all pregnant women and women at high risk of preterm birth, services provided to manage preterm labour, and workplace, professional and other supportive policies that promote safe motherhood and universal access to care before, during and after pregnancy. The aim of this paper is to present the latest information about available interventions that can be delivered during pregnancy to reduce preterm birth rates and improve the health outcomes of the premature baby, and to identify data gaps. The paper also focuses on promising avenues of research on the pregnancy period that will contribute to a better understanding of the causes of preterm birth and ability to design interventions at the policy, health care system and community levels. At minimum, countries need to ensure equitable access to comprehensive antenatal care, quality childbirth services and emergency obstetric care. Antenatal care services should include screening for and management of women at high risk of preterm birth, screening for and treatment of infections, and nutritional support and counselling. Health workers need to be trained and equipped to provide effective and timely clinical management of women in preterm labour to improve the survival chances of the preterm baby. Implementation strategies must be developed to increase the uptake by providers of proven interventions such as antenatal corticosteroids and to reduce harmful practices such as non-medically indicated inductions of labour and caesarean births before 39 weeks of gestation. Behavioural and community-based interventions that can lead to reductions in smoking and violence against women need to be

  8. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Dental Implant Surgery Dental implant surgery is, of course, surgery, and is best performed by a trained ... Dental Implant Surgery Dental implant surgery is, of course, surgery, and is best performed by a trained ...

  9. 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

  10. Partner experiences of "near-miss" events in pregnancy and childbirth in the UK: a qualitative study.

    Directory of Open Access Journals (Sweden)

    Lisa Hinton

    Full Text Available OBJECTIVE: Severe life-threatening complications in pregnancy that require urgent medical intervention are commonly known as "near-miss" events. Although these complications are rare (1 in 100 births, there are potentially 8,000 women and their families in the UK each year who live through a life-threatening emergency and its aftermath. Near-miss obstetric emergencies can be traumatic and frightening for women, and their impact can last for years. There is little research that has explored how these events impact on partners. The objective of this interview study was to explore the impact of a near-miss obstetric emergency, focusing particularly on partners. DESIGN: Qualitative study based on narrative interviews, video and audio recorded and transcribed for analysis. A qualitative interpretative approach was taken, combining thematic analysis with constant comparison. The analysis presented here focuses on the experiences of partners. PARTICIPANTS: Maximum variation sample included 35 women, 10 male partners, and one lesbian partner who had experienced a life-threatening obstetric emergency. SETTING: Interviews were conducted in participants' own homes. RESULTS: In the hospital, partner experiences were characterized by powerlessness and exclusion. Partners often found witnessing the emergency shocking and distressing. Support (from family or staff was very important, and clear, honest communication from medical staff highly valued. The long-term emotional effects for some were profound; some experienced depression, flashbacks and post-traumatic stress disorder months and years after the emergency. These, in turn, affected the whole family. Little support was felt to be available, nor acknowledgement of their ongoing distress. CONCLUSION: Partners, as well as women giving birth, can be shocked to experience a life-threatening illness in childbirth. While medical staff may view a near-miss as a positive outcome for a woman and her baby, there

  11. How Can Childbirth Care for the Rural Poor Be Improved? A Contribution from Spatial Modelling in Rural Tanzania.

    Directory of Open Access Journals (Sweden)

    Piera Fogliati

    Full Text Available Maternal and perinatal mortality remain a challenge in resource-limited countries, particularly among the rural poor. To save lives at birth health facility delivery is recommended. However, increasing coverage of institutional deliveries may not translate into mortality reduction if shortage of qualified staff and lack of enabling working conditions affect quality of services. In Tanzania childbirth care is available in all facilities; yet maternal and newborn mortality are high. The study aimed to assess in a high facility density rural context whether a health system organization with fewer delivery sites is feasible in terms of population access.Data on health facilities' location, staffing and delivery caseload were examined in Ludewa and Iringa Districts, Southern Tanzania. Geospatial raster and network analysis were performed to estimate access to obstetric services in walking time. The present geographical accessibility was compared to a theoretical scenario with a 40% reduction of delivery sites.About half of first-line health facilities had insufficient staff to offer full-time obstetric services (45.7% in Iringa and 78.8% in Ludewa District. Yearly delivery caseload at first-line health facilities was low, with less than 100 deliveries in 48/70 and 43/52 facilities in Iringa and Ludewa District respectively. Wide geographical overlaps of facility catchment areas were observed. In Iringa 54% of the population was within 1-hour walking distance from the nearest facility and 87.8% within 2 hours, in Ludewa, the percentages were 39.9% and 82.3%. With a 40% reduction of delivery sites, approximately 80% of population will still be within 2 hours' walking time.Our findings from spatial modelling in a high facility density context indicate that reducing delivery sites by 40% will decrease population access within 2 hours by 7%. Focused efforts on fewer delivery sites might assist strengthening delivery services in resource-limited settings.

  12. Cardiac surgery 2015 reviewed.

    Science.gov (United States)

    Doenst, Torsten; Strüning, Constanze; Moschovas, Alexandros; Gonzalez-Lopez, David; Essa, Yasin; Kirov, Hristo; Diab, Mahmoud; Faerber, Gloria

    2016-10-01

    For the year 2015, almost 19,000 published references can be found in PubMed when entering the search term "cardiac surgery". The last year has been again characterized by lively discussions in the fields where classic cardiac surgery and modern interventional techniques overlap. Lacking evidence in the field of coronary revascularization with either percutaneous coronary intervention or bypass surgery has been added. As in the years before, CABG remains the gold standard for the revascularization of complex stable triple-vessel disease. Plenty of new information has been presented comparing the conventional to transcatheter aortic valve implantation (TAVI) demonstrating similar short- and mid-term outcomes at high and low risk, but even a survival advantage with transfemoral TAVI at intermediate risk. In addition, there were many relevant and interesting other contributions from the purely operative arena. This review article will summarize the most pertinent publications in the fields of coronary revascularization, surgical treatment of valve disease, heart failure (i.e., transplantation and ventricular assist devices), and aortic surgery. While the article does not have the expectation of being complete and cannot be free of individual interpretation, it provides a condensed summary that is intended to give the reader "solid ground" for up-to-date decision-making in cardiac surgery.

  13. Thyroid Surgery

    Science.gov (United States)

    ... etc.). Surgery is also an option for the treatment of hyperthyroidism (Grave’s disease or a “toxic nodule” (see Hyperthyroidism brochure ), for large and multinodular goiters and for any goiter that may be causing ... MEANS OF TREATMENT? Surgery is definitely indicated to remove nodules suspicious ...

  14. Choosing surgery

    DEFF Research Database (Denmark)

    Thorstensson, Carina; Lohmander, L; Frobell, Richard

    2009-01-01

    ABSTRACT: BACKGROUND: The objective was to understand patients' views of treatment after acute anterior cruciate ligament (ACL) injury, and their reasons for deciding to request surgery despite consenting to participate in a randomised controlled trial (to 'cross-over'). METHODS: Thirty-four in......-depth qualitative interviews were conducted with young (aged 18-35), physically active individuals with ACL rupture who were participating in a RCT comparing training and surgical reconstruction with training only. 22/34 were randomised to training only but crossed over to surgery. Of these, 11 were interviewed...... before surgery, and 11 were interviewed at least 6 months after surgery. To provide additional information, 12 patients were interviewed before randomisation. Interviews were audio-recorded, transcribed and analysed using the Framework approach. RESULTS: Strong preference for surgery was commonplace...

  15. Living Technology

    DEFF Research Database (Denmark)

    2010-01-01

    This book is aimed at anyone who is interested in learning more about living technology, whether coming from business, the government, policy centers, academia, or anywhere else. Its purpose is to help people to learn what living technology is, what it might develop into, and how it might impact...... our lives. The phrase 'living technology' was coined to refer to technology that is alive as well as technology that is useful because it shares the fundamental properties of living systems. In particular, the invention of this phrase was called for to describe the trend of our technology becoming...... increasingly life-like or literally alive. Still, the phrase has different interpretations depending on how one views what life is. This book presents nineteen perspectives on living technology. Taken together, the interviews convey the collective wisdom on living technology's power and promise, as well as its...

  16. Living Technology

    DEFF Research Database (Denmark)

    2010-01-01

    This book is aimed at anyone who is interested in learning more about living technology, whether coming from business, the government, policy centers, academia, or anywhere else. Its purpose is to help people to learn what living technology is, what it might develop into, and how it might impact...... our lives. The phrase 'living technology' was coined to refer to technology that is alive as well as technology that is useful because it shares the fundamental properties of living systems. In particular, the invention of this phrase was called for to describe the trend of our technology becoming...... increasingly life-like or literally alive. Still, the phrase has different interpretations depending on how one views what life is. This book presents nineteen perspectives on living technology. Taken together, the interviews convey the collective wisdom on living technology's power and promise, as well as its...

  17. Does childbirth after fertility treatment influence sense of coherence? A longitudinal study of 1,934 men and women

    DEFF Research Database (Denmark)

    Habroe, Maria; Schmidt, Lone; Holstein, Bjørn Evald

    2007-01-01

    study, we focused on 2 research questions: (i) Does childbirth after assisted reproductive technology (ART) result in high SOC? (ii) Does the level of SOC at baseline influence the association between childbirth after ART and SOC at 1-year follow-up? Methods. The study included a consecutive sample...... of patients in ART from a prospective, longitudinal survey in Denmark; baseline response rate 80.0%, 1-year follow-up 87.7% (n=1,934). The dependent variable was SOC at 1-year follow-up measured by Setterlind's 9-item scale. The independent variable was having achieved childbirth after ART. Data were analysed...... by logistic regression analysis adjusted for baseline SOC. Results. Having achieved childbirth after ART was associated with higher SOC at 1-year follow-up (women OR=1.81, 95% CI: 1.20-2.74; men OR=1.27, 95% CI: 0.88-1.86). Unexpectedly, the association between achieving childbirth after ART and high SOC at 1...

  18. 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

    2017-06-14

    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.

  19. A retrospective study on persistent pain after childbirth in the Netherlands

    Directory of Open Access Journals (Sweden)

    Bijl RC

    2016-01-01

    Full Text Available Rianne C Bijl,1,2 Liv M Freeman,2 Philomeen TM Weijenborg,3 Johanna M Middeldorp,2 Albert Dahan,1 Eveline LA van Dorp1 1Department of Anesthesiology, 2Department of Obstetrics, 3Department of Gynecology, Leiden University Medical Center, Leiden, The NetherlandsAbstract: Reported prevalence rates of persistent postpartum pain (PPP range from less than 1% to almost 20%. The aim of this study was to examine the prevalence of PPP in a Dutch cohort and to evaluate a possible causal role for specific risk factors on the development of chronic pain after childbirth. A questionnaire was sent to 960 postpartum women approximately 2 years after delivery. Primary outcome was pain that arose from childbirth at follow-up, and secondary outcomes included quality of life (QoL and Hospital Anxiety and Depression Scale scores. Tested risk factors included mode of labor analgesia, history of negative effect, history of chronic pain, delivery route, parity, and ethnicity. A total of 495 (51.6% women participated. At a mean time of 2.3 postpartum years, 7.3% of women reported any pain and 6.1% reported significant pain related to the delivery. Compared to spontaneous delivery, cesarean delivery provided protection against persistent pain (odds ratio, 0.12; 95% CI, 0.01–0.63, P<0.05. None of the other risk factors, including remifentanil use for labor pain, were of influence on the prevalence of persistent pain. Women with PPP experienced greater negative effects and had lower QoL scores compared to women without pain. In this cohort of Dutch patients, PPP is a serious problem with a great impact on the physical and mental health of women. Keywords: chronic pain after childbirth, chronic pain, partus, labor analgesia, remifentanil, epidural analgesia, risk factors

  20. 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

  1. Childbirth policies and practices in Ireland and the journey towards midwifery-led care.

    Science.gov (United States)

    Devane, Declan; Murphy-Lawless, Jo; Begley, Cecily M

    2007-03-01

    To describe the dominant policies and practices that have governed childbirth in Ireland, and to outline the progress made towards the introduction of midwifery-led care in one health region. A review of maternity-care policies in Ireland was conducted using government and regional health-authority documents and two historical reviews of government policies. A search was also carried out in PubMed and cinahl databases, using the keywords 'maternity care', 'childbirth', 'policy', 'midwifery-led', 'Ireland/Irish', with relevant Boolean and string operands. Childbirth as a social process is influenced by the model of care, and affects the physical and psychological outcomes for the woman and her family. In Ireland, routine intervention in labour is common, but, since the early 1990s, some changes in the Irish maternity services have taken place. Pilot projects on community midwifery have been introduced in some areas. Challenges to the provision of maternity care in the Health Service Executive, North Eastern area (formerly the North-Eastern Health Board) led to the production of the Kinder report, which included a recommendation to introduce pilot midwifery-led units (MLUs). THE INTRODUCTION OF MIDWIFERY-LED CARE: A Maternity Services Taskforce was established in January 2002 with a wide remit, including facilitation of the establishment of MLUs in Cavan General Hospital, Cavan and Our Lady of Lourdes Hospital, Drogheda, Co. Louth. The MLUs are being evaluated within the context of a randomised trial known as 'the MidU study', which compares midwife-led care with the present system of medical-led care for women who are at low risk of complications during pregnancy and labour. The journey to midwifery-led care in Ireland has been a long one. The phased introduction of MLUs, which are subject to rigorous evaluation, will provide quality evidence upon which to base the future development of maternity care across Ireland.

  2. 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.

  3. Mindfulness-Based Childbirth and Parenting Education: Promoting Family Mindfulness During the Perinatal Period

    OpenAIRE

    Duncan, Larissa G.; Bardacke, Nancy

    2009-01-01

    We present the conceptual and empirical foundation and curriculum content of the Mindfulness-Based Childbirth and Parenting (MBCP) program and the results of a pilot study of n = 27 pregnant women participating in MBCP during their third trimester of pregnancy. MBCP is a formal adaptation of the Mindfulness-Based Stress Reduction program and was developed and refined over the course of 11 years of clinical practice with 59 groups of expectant couples. MBCP is designed to promote family health...

  4. Risk factors for developing post-traumatic stress disorder following childbirth

    DEFF Research Database (Denmark)

    Andersen, Louise B; Melvaer, Lisa B; Videbech, Poul

    2012-01-01

    Background. Approximately 1-2% of women suffer from post-traumatic stress disorder (PTSD) postnatally. This review aims to elucidate how women at risk can be identified. Methods. A systematic search of the published literature was carried out using the MEDLINE database (November 2003 to 29(th...... in pregnancy, previous traumatic experiences, and obstetrical emergencies were identified as the most important risk factors. Conclusions. We have identified both strongly associated and non-associated factors that are associated with PTSD following childbirth. While the literature is limited by methodological...

  5. The OptiMUM-study: EMDR therapy in pregnant women with posttraumatic stress disorder after previous childbirth and pregnant women with fear of childbirth: design of a multicentre randomized controlled trial

    Science.gov (United States)

    Baas, M. A. M.; Stramrood, C. A. I.; Dijksman, L. M.; de Jongh, A.; van Pampus, M. G.

    2017-01-01

    ABSTRACT Background: Approximately 3% of women develop posttraumatic stress disorder (PTSD) after giving birth, and 7.5% of pregnant women show a pathological fear of childbirth (FoC). FoC or childbirth-related PTSD during (a subsequent) pregnancy can lead to a request for an elective caesarean section as well as adverse obstetrical and neonatal outcomes. For PTSD in general, and several subtypes of specific phobia, eye movement desensitization and reprocessing (EMDR) therapy has been proven effective, but little is known about the effects of applying EMDR during pregnancy. Objective: To describe the protocol of the OptiMUM-study. The main aim of the study is to determine whether EMDR therapy is an effective and safe treatment for pregnant women with childbirth-related PTSD or FoC. In addition, the cost-effectiveness of this approach will be analysed. Method: The single-blind OptiMUM-study consists of two two-armed randomized controlled trials (RCTs) with overlapping design. In several hospitals and community midwifery practices in Amsterdam, the Netherlands, all eligible pregnant women with a gestational age between eight and 20 weeks will be administered the Wijma delivery expectations questionnaire (WDEQ) to asses FoC. Multiparous women will also receive the PTSD checklist for DSM-5 (PCL-5) to screen for possible PTSD. The clinician administered PTSD scale (CAPS-5) will be used for assessing PTSD according to DSM-5 in women scoring above the PCL-5 cut-off value. Fifty women with childbirth-related PTSD and 120 women with FoC will be randomly allocated to either EMDR therapy carried out by a psychologist or care-as-usual. Women currently undergoing psychological treatment or women younger than 18 years will not be included. Primary outcome measures are severity of childbirth-related PTSD or FoC symptoms. Secondary outcomes are percentage of PTSD diagnoses, percentage caesarean sections, subjective childbirth experience, obstetrical and neonatal complications

  6. CARDIOTHORACIC SURGERY

    African Journals Online (AJOL)

    lbadan, Nigeria. Reprint requests to: Dr. V. O. Adegboye, Department Of Surgery, University College Hospital, Iberian,. Nigeria. ... been shown to be related to the rate of bleeding. .... patients after an interval of conservative/medical treatment.

  7. General Surgery

    African Journals Online (AJOL)

    bbshehu

    underwent major colonic restorative resection between July 1997 and September 199 in order to ... factors, the level of anastomosis and the experience of the surgeon are perhaps the ... indications for surgery and cancer stage were similar.

  8. Brain surgery

    Science.gov (United States)

    Craniotomy; Surgery - brain; Neurosurgery; Craniectomy; Stereotactic craniotomy; Stereotactic brain biopsy; Endoscopic craniotomy ... cut depends on where the problem in the brain is located. The surgeon creates a hole in ...

  9. Hemorrhoid surgery

    Science.gov (United States)

    ... and hemorrhoidectomy. In: Delaney CP, ed. Netter's Surgical Anatomy and Approaches . Philadelphia, PA: Elsevier Saunders; 2014:chap 26. Review Date 4/5/2015 Updated by: Debra G. Wechter, MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason ...

  10. GENERAL SURGERY

    African Journals Online (AJOL)

    The traditional operative approach is an open surgical one to drain the cysts and ... early outcomes of laparoscopic treatment of liver hydatid cysts at our institution. .... O. Radical vs. conservative surgery for hydatid liver cysts: Experience from ...

  11. Outpatient Surgery

    Science.gov (United States)

    ... thirds of all operations are performed in outpatient facilities, according to the Centers for Disease Control and Prevention. Outpatient surgery provides patients with the convenience of recovering at home, and can cost less. ...

  12. Laparoscopic Surgery

    Science.gov (United States)

    ... surgeon’s perspective, laparoscopic surgery may allow for easier dissection of abdominal scar tissue (adhesions), less surgical trauma, ... on Facebook About ACG ACG Store ACG Patient Education & Resource Center Home GI Health and Disease Recursos ...

  13. Emergency surgery

    DEFF Research Database (Denmark)

    Stoneham, M; Murray, D; Foss, N

    2014-01-01

    National reports recommended that peri-operative care should be improved for elderly patients undergoing emergency surgery. Postoperative mortality and morbidity rates remain high, and indicate that emergency ruptured aneurysm repair, laparotomy and hip fracture fixation are high-risk procedures...... undertaken on elderly patients with limited physiological reserve. National audits have reported variations in care quality, data that are increasingly being used to drive quality improvement through professional guidance. Given that the number of elderly patients presenting for emergency surgery is likely...

  14. [Robotic surgery].

    Science.gov (United States)

    Moreno-Portillo, Mucio; Valenzuela-Salazar, Carlos; Quiroz-Guadarrama, César David; Pachecho-Gahbler, Carlos; Rojano-Rodríguez, Martín

    2014-12-01

    Medicine has experienced greater scientific and technological advances in the last 50 years than in the rest of human history. The article describes relevant events, revises concepts and advantages and clinical applications, summarizes published clinical results, and presents some personal reflections without giving dogmatic conclusions about robotic surgery. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) defines robotic surgery as a surgical procedure using technology to aid the interaction between surgeon and patient. The objective of the surgical robot is to correct human deficiencies and improve surgical skills. The capacity of repeating tasks with precision and reproducibility has been the base of the robot´s success. Robotic technology offers objective and measurable advantages: - Improving maneuverability and physical capacity during surgery. - Correcting bad postural habits and tremor. - Allowing depth perception (3D images). - Magnifying strength and movement limits. - Offering a platform for sensors, cameras, and instruments. Endoscopic surgery transformed conceptually the way of practicing surgery. Nevertheless in the last decade, robotic assisted surgery has become the next paradigm of our era.

  15. [Aesthetic surgery].

    Science.gov (United States)

    Bruck, Johannes C

    2006-01-01

    The WHO describes health as physical, mental and social well being. Ever since the establishment of plastic surgery aesthetic surgery has been an integral part of this medical specialty. It aims at reconstructing subjective well-being by employing plastic surgical procedures as described in the educational code and regulations for specialists of plastic surgery. This code confirms that plastic surgery comprises cosmetic procedures for the entire body that have to be applied in respect of psychological exploration and selection criteria. A wide variety of opinions resulting from very different motivations shows how difficult it is to differentiate aesthetic surgery as a therapeutic procedure from beauty surgery as a primarily economic service. Jurisdiction, guidelines for professional conduct and ethical codes have tried to solve this question. Regardless of the intention and ability of the health insurances, it has currently been established that the moral and legal evaluation of advertisements for medical procedures depends on their purpose: advertising with the intent of luring patients into cosmetic procedures that do not aim to reconstruct a subjective physical disorder does not comply with a medical indication. If, however, the initiative originates with the patient requesting the amelioration of a subjective disorder of his body, a medical indication can be assumed.

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    and proportions of obstetricians and midwives involved in such traumatic childbirth and explored their experiences with guilt, blame, shame and existential concerns. MATERIAL AND METHODS: A mixed methods study comprising a national survey of Danish obstetricians and midwives and a qualitative interview study...... with selected survey participants. RESULTS: 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...

  17. 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....

  18. Maternity blues in Italian primipara women: symptoms and mood states in the first fifteen days after childbirth.

    Science.gov (United States)

    Grussu, Pietro; Quatraro, Rosa Maria

    2013-07-01

    The maternity blues is the most commonly observed puerperal mood disturbance. In Italy, the mother's daily affective experience after childbirth has not yet been published. During each of the first 15 days after the birth of the child, 36 primipara women completed the Kellner Symptoms Questionnaire (SQ) and the Profile of Mood States (POMS). We found that the mothers studied showed both psychological symptoms and mood disturbances of slight entity. Conversely, somatic symptoms were particularly acute in the first few days after childbirth. In this same period, slight anxiety symptoms, confusion, and bewilderment may develop.

  19. 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....

  20. Applying a participatory approach to the promotion of a culture of respect during childbirth.

    Science.gov (United States)

    Ratcliffe, Hannah L; Sando, David; Mwanyika-Sando, Mary; Chalamilla, Guerino; Langer, Ana; McDonald, Kathleen P

    2016-07-18

    Disrespect and abuse (D&A) during facility-based childbirth is a topic of growing concern and attention globally. Several recent studies have sought to quantify the prevalence of D&A, however little evidence exists about effective interventions to mitigate disrespect and abuse, and promote respectful maternity care. In an accompanying article, we describe the process of selecting, implementing, and evaluating a package of interventions designed to prevent and reduce disrespect and abuse in a large urban hospital in Tanzania. Though that study was not powered to detect a definitive impact on reducing D&A, the results showed important changes in intermediate outcomes associated with this goal. In this commentary, we describe the factors that enabled this effect, especially the participatory approach we adopted to engage key stakeholders throughout the planning and implementation of the program. Based on our experience and findings, we conclude that a visible, sustained, and participatory intervention process; committed facility leadership; management support; and staff engagement throughout the project contributed to a marked change in the culture of the hospital to one that values and promotes respectful maternity care. For these changes to translate into dignified care during childbirth for all women in a sustainable fashion, institutional commitment to providing the necessary resources and staff will be needed.

  1. Heteronormative communication with lesbian families in antenatal care, childbirth and postnatal care.

    Science.gov (United States)

    Röndahl, Gerd; Bruhner, Elisabeth; Lindhe, Jenny

    2009-11-01

    Heteronormative communication with lesbian families in antenatal care, childbirth and postnatal care. This paper is a report of a study of lesbian parents' experience of antenatal care, childbirth and postnatal care. In a strictly heteronormative-based care system, 'parents' naturally implies a man and a woman, and all communication and routines are based on heterosexual couples. A qualitative interview study was carried out in 2008. Ten mothers, eight of whom were in a relationship with another woman, participated. The participants had experience from several care facilities from three different cities in central Sweden. Most participants had positive experiences but also complained that the focus was not always on the pregnancy and that no parenthood education had been offered. Heteronormativity was communicated by midwives and nursing staff throughout the process - from antenatal care to postnatal care, via forms, journals, verbal communication and orientation visits. This was experienced as embarrassing for the participant parents, and they also described encountering what they interpreted as embarrassment on the part of care providers. Participants called for increased knowledge about lesbian parenting, since they believed this would influence and facilitate communication, not least with midwives in antenatal care. Midwives educated in lesbian issues could ask questions and communicate in a more neutral way at the first meeting, and thereby make prospective parents feel less insecure. Special parenthood education groups for lesbians are recommended so that lesbian couple can meet others with similar experiences and so that the focus will be on prospective parenthood and not on their sexual orientation.

  2. 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.

  3. Impact of the mode of delivery on female sexual function after childbirth.

    Science.gov (United States)

    Eid, M A; Sayed, A; Abdel-Rehim, R; Mostafa, T

    2015-01-01

    This cohort study aimed to assess the effect of the mode of delivery on female sexual function (FSF) after childbirth. Out of 256 primiparous women, 200 subjects that completed the study were divided into two groups; women that delivered vaginally and women that had elective cesarean section (CS). They were subjected to a translated version of female sexual function index (FSFI) questionnaire evaluating desire, lubrication, orgasm, satisfaction, pain both antenatally and 12 weeks postpartum. The mean FSFI total score of the two investigated groups demonstrated nonsignificant difference 12 weeks after delivery compared with these scores antenatally. Women that delivered vaginally demonstrated significant decreases in the scores of desire, arousal and lubrication domains 12 weeks after delivery compared with these scores antenatally where other scores demonstrated nonsignificant differences. Women that delivered by CS demonstrated a significant difference in desire domain 12 weeks after delivery compared with these scores antenatally where other scores demonstrated nonsignificant differences. It is concluded that the mode of delivery has nonsignificant effect on the FSF 12 weeks after childbirth. Specifically, vaginal delivery is associated with significant decrease in the desire, arousal and lubrication domains where elective CS is associated with significant decrease in the desire domain.

  4. Uterine contractility of plants used to facilitate childbirth in Nigerian ethnomedicine

    Science.gov (United States)

    Attah, Alfred F.; O'Brien, Margaret; Koehbach, Johannes; Sonibare, Mubo A.; Moody, Jones O.; Smith, Terry J.; Gruber, Christian W.

    2012-01-01

    Ethnopharmacological relevance Pregnant women in Nigeria use plant preparations to facilitate childbirth and to reduce associated pain. The rationale for this is not known and requires pharmacological validation. Aim of study Obtain primary information regarding the traditional use of plants and analyze their uterine contractility at cellular level. Materials and methods Semi-structured, open interviews using questionnaires of traditional healthcare professionals and other informants triggered the collection and identification of medicinal plant species. The relative traditional importance of each medicinal plant was determined by its use-mention index. Extracts of these plants were analyzed for their uterotonic properties on an in vitro human uterine cell collagen model. Result The plants Calotropis procera, Commelina africana, Duranta repens, Hyptis suaveolens, Ocimum gratissimum, Saba comorensis, Sclerocarya birrea, Sida corymbosa and Vernonia amygdalina were documented and characterized. Aqueous extracts from these nine plants induced significant sustained increases in human myometrial smooth muscle cell contractility, with varying efficiencies, depending upon time and dose of exposure. Conclusion The folkloric use of several plant species during childbirth in Nigeria has been validated. Seven plants were for the first time characterized to have contractile properties on uterine myometrial cells. The results serve as ideal starting points in the search for safe, longer lasting, effective and tolerable uterotonic drug leads. PMID:22766472

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

    Science.gov (United States)

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

    2014-10-01

    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 focus groups with caregivers, pregnant women, and women who recently gave birth were conducted. Psychometric properties of 23 candidate items derived from the interviews were tested with explorative factor analysis (EFA) (N = 495). Confirmatory factor analysis (CFA) was performed in another sample of women (N = 483) and confirmed a 12-item CPS. The EFA in sample I suggested a two-component solution: a subscale 'perception of delivery' (six items) and a subscale 'perception of the first postpartum week' (six items). The CFA in sample II confirmed an adequate model fit and a good internal consistency (α = .82). Multivariate linear regression showed a positive effect of home delivery on perception of delivery in multiparous but not in primiparous women. The 12-item CPS with two dimensions (perception of delivery and perception of first postpartum week) has adequate psychometric properties. In multiparous women, home delivery showed to be independently related to more positive perception of delivery.

  6. Childbirth and symptoms of postpartum depression and anxiety: a prospective birth cohort study.

    Science.gov (United States)

    Bell, A F; Carter, C S; Davis, J M; Golding, J; Adejumo, O; Pyra, M; Connelly, J J; Rubin, L H

    2016-04-01

    We investigated associations between aspects of childbirth and elevated postpartum symptoms of depression and anxiety. We employed secondary analysis of perinatal data (N = 4657-4946) from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. Multivariable logistic regression models (adjusted for covariates) examined predictors of elevated symptoms of postpartum depression and anxiety. Predictors included the following: type of delivery (normal physiological vs. interventive non-physiological), immediate postpartum complications, and maternal perception of the recent birth experience. The Edinburgh Postnatal Depression Scale assessed elevated symptoms of depression (score ≥ 13), and the Crown-Crisp Experiential Index assessed elevated symptoms of anxiety (score ≥ 9) at 2 and 8 months after delivery. A more negative perception of the recent birth experience was associated with elevated symptoms of anxiety at 2 months [odds ratio (OR) 1.52, 95 % confidence interval (CI) 1.25-1.85] and 8 months (OR 1.30, 95 % CI 1.06-1.60) postpartum but was not associated with elevated symptoms of depression at either time point. Type of delivery (physiological vs. non-physiological) and immediate postpartum complications were not associated with elevated symptoms of depression or anxiety. Our findings suggest that improving women's childbirth experience may decrease the likelihood of postpartum anxiety, but not postpartum depression.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... find out more. Dental and Soft Tissue Surgery Dental and Soft Tissue Surgery Oral and facial surgeons ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, ...

  10. Tennis elbow surgery

    Science.gov (United States)

    Lateral epicondylitis - surgery; Lateral tendinosis - surgery; Lateral tennis elbow - surgery ... Surgery to repair tennis elbow is usually an outpatient surgery. This means you will not stay in the hospital overnight. You will be given ...

  11. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require one or more ... find out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment ...

  12. Mohs micrographic surgery

    Science.gov (United States)

    Skin cancer - Mohs surgery; Basal cell skin cancer - Mohs surgery; Squamous cell skin cancer - Mohs surgery ... Mohs surgery usually takes place in the doctor's office. The surgery is started early in the morning and is ...

  13. Corrective Jaw Surgery

    Science.gov (United States)

    ... and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require one or more ... find out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment ...

  14. Evaluation of the Bonapace Method: a specific educational intervention to reduce pain during childbirth

    Directory of Open Access Journals (Sweden)

    Bonapace J

    2013-09-01

    Full Text Available Julie Bonapace,1 Nils Chaillet,2 Isabelle Gaumond,3,4 Émilie Paul-Savoie,5 Serge Marchand3,41Département des Sciences de l'Éducation, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, Québec, 2Centre de Recherche de l'Hôpital Sainte-Justine, Université de Montréal, Montréal, Québec, 3Département de chirurgie, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Québec, 4Département des Sciences de la Santé, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, Québec, 5École des sciences infirmières, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec, CanadaObjective: As pain during childbirth is very intense, several educational programs exist to help women prepare for the event. This study evaluates the efficacy of a specific pain management program, the Bonapace Method (BM, to reduce the perception of pain during childbirth. The BM involves the father, or a significant partner, in the use of several pain control techniques based on three neurophysiological pain modulation models: (1 controlling the central nervous system through breathing, relaxation, and cognitive structuring; (2 using non-painful stimuli as described in the Gate Control Theory; and (3 recruiting descending inhibition by hyperstimulation of acupressure trigger points.Methods: A multicenter case control study in Quebec on pain perception during labor and delivery compared traditional childbirth training programs (TCTPs and the BM. Visual analog scales were used to measure pain perception during labor. In all, 25 women (TCTP: n = 12; BM: n = 13 successfully reported their perceptions of pain intensity and unpleasantness every 15 minutes.Results: A positive correlation between the progression of labor and pain was found (pain intensity: P < 0.01; pain unpleasantness: P < 0.01. When compared to TCTP, the BM showed an overall significant lower pain

  15. Human resource and funding constraints for essential surgery in district hospitals in Africa: a retrospective cross-sectional survey.

    OpenAIRE

    Kruk, Margaret E; Andreas Wladis; Naboth Mbembati; S Khady Ndao-Brumblay; Hsia, Renee Y.; Moses Galukande; Sam Luboga; Alphonsus Matovu; Helder de Miranda; Doruk Ozgediz; Ana Romàn Quiñones; Rockers, Peter C; Johan von Schreeb; Fernando Vaz; Debas, Haile T.

    2010-01-01

    Editors' Summary Background Infectious diseases remain the major killers in developing countries, but traumatic injuries, complications of childbirth, and other conditions that need surgery are important contributors to the overall burden of disease in these countries. Unfortunately, the provision of surgical services in low- and middle-income countries is often insufficient. There are many fewer operations per a head of population in developing countries than in developed countries, essentia...

  16. Natural Childbirth

    Science.gov (United States)

    ... relievers such as epidurals using few or no artificial medical interventions such as continuous fetal monitoring or ... probably feel cramping in your uterus, especially with breastfeeding, and you'll have some pain and discomfort ...

  17. Natural Childbirth

    Science.gov (United States)

    ... this method is the avoidance of medications unless absolutely necessary. The Bradley method also focuses on good ... keep the mind otherwise occupied listening to soothing music visual imagery previous continue What Will It Feel ...

  18. Perioperatory antibiotic prophylaxis in Pediatric Surgery (Part I: abdominal surgery

    Directory of Open Access Journals (Sweden)

    Sergio Luis González López

    2005-12-01

    Full Text Available The surgical wound infection is the biggest cause of infectious morbility in surgical patients. It is an important cause of morbility that causes lincreased hospital demurrages, increased cost of medical attention and serious inconveniences to the patients and their familiies. 25% of all nosocomial infections are surgical wound infection. One of the big advances of the surgery in the last three decades is an introduction of antibiotic prophylaxis in the surgical practice. Is considered that it has saved more lives than any other novel procedure in surgery in the last 20 years. We presented the Good Clinical Practices Guideline for Antibiotic prophylaxis in abdominal surgery, approved by consensus in the 1st National Good Clinical Practices Workshop in Pediatric Surgery (Cienfuegos, Cuba, March 7 – 9, 2002.

  19. ‘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

  20. Robotic surgery.

    Science.gov (United States)

    Diana, M; Marescaux, J

    2015-01-01

    Proficiency in minimally invasive surgery requires intensive and continuous training, as it is technically challenging for unnatural visual and haptic perceptions. Robotic and computer sciences are producing innovations to augment the surgeon's skills to achieve accuracy and high precision during complex surgery. This article reviews the current use of robotically assisted surgery, focusing on technology as well as main applications in digestive surgery, and future perspectives. The PubMed database was interrogated to retrieve evidence-based data on surgical applications. Internal and external consulting with key opinion leaders, renowned robotics laboratories and robotic platform manufacturers was used to produce state-of-the art business intelligence around robotically assisted surgery. Selected digestive procedures (oesophagectomy, gastric bypass, pancreatic and liver resections, rectal resection for cancer) might benefit from robotic assistance, although the current level of evidence is insufficient to support widespread adoption. The surgical robotic market is growing, and a variety of projects have recently been launched at both academic and corporate levels to develop lightweight, miniaturized surgical robotic prototypes. The magnified view, and improved ergonomics and dexterity offered by robotic platforms, might facilitate the uptake of minimally invasive procedures. Image guidance to complement robotically assisted procedures, through the concepts of augmented reality, could well represent a major revolution to increase safety and deal with difficulties associated with the new minimally invasive approaches. © 2015 BJS Society Ltd. Published by John Wiley & Sons Ltd.

  1. Orthognathic Surgery

    DEFF Research Database (Denmark)

    Kjærgaard Larsen, Marie; Thygesen, Torben Henrik

    2016-01-01

    The literature shows that the indications for orthognathic surgery (OS) are often functional problems and unsatisfactory facial esthetics. This study investigated the esthetic outcomes and overall satisfaction following OS. Somatosensory change is a relatively common complication and its influence...... on the level of satisfaction was studied. The social-networking web site Facebook was used to identify the study population. An online questionnaire was performed using the website SurveyMonkey. In all, 105 (9%) respondents from the Danish Facebook group about OS, called Kaebeoperation (jaw surgery), were...... in beauty than women (P = 0.030). Sixty-four percent replied that their attractiveness had been increased after OS. Eighty-six percent were happy with the results and 89% would recommend the surgery to others in need. No significant differences in esthetic results and satisfaction were seen with regard...

  2. Assisted Living

    Science.gov (United States)

    ... term care and institutional living. Sheltered Housing Sheltered housing is often in a home that offers personal-care support, housekeeping services, and meals. Social work services and coordination for activities can be ...

  3. Assisted Living

    Science.gov (United States)

    ... if needs change. Assisted living costs less than nursing home care. It is still fairly expensive. Older people or their families usually pay for it. Health and long-term care insurance policies may cover ...

  4. Live Well

    Science.gov (United States)

    ... message, please visit this page: About CDC.gov . HIV Treatment Works Get In Care HIV 101 Locate a ... Sharing Your Status Stay In Care Understanding Care HIV Treatment Cost of HIV Treatment Related Health Conditions Live ...

  5. The impact of childbirth pain on maternal psychological factors and childbirth%分娩阵痛对产妇心理因素及分娩的影响

    Institute of Scientific and Technical Information of China (English)

    魏穗英; 林岸芸; 钟龙

    2013-01-01

    目的:探讨分娩阵痛对产妇心理因素及分娩的影响。方法:收集在我院分娩的225例产妇,用自行设计的基于患者对产科优质护理指征问卷进行调查,对自然分娩与剖宫产产妇满意度比较。结果:提供支持减轻疼痛方面,剖宫产产妇的满意程度显著低于自然分娩产妇(Z=2.110,P=0.0035),对于助产服务的其他方面的满意度评价无显著差异(P>0.05)。结论:给产妇提供更多的支持、减轻分娩疼痛,促进自然分娩。%Objective To explore the impact of childbirth pain on maternal psychological factors and childbirth. Methods 225 normal inpatients were investigated via a self-designed high quality nursing care indications questionnaire and compared the difference of satisfaction of natural childbirth and cesarean section. Results With providing support to reduce pain, the satisfaction in caesarean section maternal was significantly lower than in natural childbirth maternal(Z=2.110,P=0.0035). the other satisfaction in midwife nursing service is not significantly difference (P > 0.05). Conclusion To provide more support to the pregnant woman could reduce the labor pain and promote natural childbirth.

  6. [Geriatric surgery].

    Science.gov (United States)

    Paulino-Netto, Augusto

    2005-10-01

    Modern medicine, which is evidence-based and overly scientific, has forgotten its artistic component, which is very important for surgery in general and for geriatric surgery in particular. The surgeon treating an old patient must be a politician more than a technician, more an artist than a scientist. Like Leonardo da Vinci, he or she must use scientific knowledge with intelligence and sensitivity, transforming the elderly patient's last days of life into a beautiful and harmonious painting and not into something like an atomic power station which, while no doubt useful, is deprived of beauty and sometimes very dangerous.

  7. 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…

  8. 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.

  9. 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…

  10. 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.

  11. 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…

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

    Directory of Open Access Journals (Sweden)

    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.

  13. 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

  14. The impact on neonatal mortality of shifting childbirth services among levels of hospitals: Taiwan's experience

    Directory of Open Access Journals (Sweden)

    Hsu Sylvia H

    2009-06-01

    Full Text Available Abstract Background There is considerable discussion surrounding whether advanced hospitals provide better childbirth care than local community hospitals. This study examines the effect of shifting childbirth services from advanced hospitals (i.e., medical centers and regional hospitals to local community hospitals (i.e., clinics and district hospitals. The sample population was tracked over a seven-year period, which includes the four months of the 2003 severe acute respiratory syndrome (SARS epidemic in Taiwan. During the SARS epidemic, pregnant women avoided using maternity services in advanced hospitals. Concerns have been raised about maintaining the quality of maternity care with increased demands on childbirth services in local community hospitals. In this study, we analyzed the impact of shifting maternity services among hospitals of different levels on neonatal mortality and maternal deaths. Methods A population-based study was conducted using data from Taiwan's National Health Insurance annual statistics of monthly county neonatal morality rates. Based on a pre-SARS sample from January 1998 to December 2002, we estimated a linear regression model which included "trend," a continuous variable representing the effect of yearly changes, and two binary variables, "month" and "county," controlling for seasonal and county-specific effects. With the estimated coefficients, we obtained predicted neonatal mortality rates for each county-month. We compared the differences between observed mortality rates of the SARS period and predicted rates to examine whether the shifting in maternity services during the SARS epidemic significantly affected neonatal mortality rates. Results With an analysis of a total of 1,848 observations between 1998 and 2004, an insignificantly negative mean of standardized predicted errors during the SARS period was found. The result of a sub-sample containing areas with advanced hospitals showed a significant negative

  15. Developing a Questionnaire for Iranian Women’s Attitude on Medical Ethics in Vaginal Childbirth

    Directory of Open Access Journals (Sweden)

    Mirzaee Rabor

    2015-12-01

    Full Text Available Background 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. Objectives 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. Patients and Methods 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. Results 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

  16. GENERAL SURGERY

    African Journals Online (AJOL)

    Globally, the entry of female students into medical schools has ... how female registrars perceived the impact of gender on their training and practice of surgery. ... male-dominated specialty, their choice of mentors and the challenges that they encountered ..... Social Determinants of Health2007 (Accessed on 23 Sep 2016).

  17. Relation between postpartum depression and childbirth practices recommended by Estrategia de atención al parto normal

    Directory of Open Access Journals (Sweden)

    Ana Belén Laviña Castán

    2013-03-01

    Full Text Available The high prevalence of postpartum depression (PPD (rates between 10-20% in developed countries and its serious consequences for both women and children, highlight the need to continue studying the factors affecting DPP.Many studies have looked for factors related to this disorder, but none has carried out a comprehensive analysis to find out its relationship with childbirth practices, despite the possible relationship between the childbirth experiences and the emotional disorders in mothers, and the early alteration of the link between mother and child, that we have seen during our professional lifes.The objective of this research is to determine the prevalence of PPD among women whose childbirth took place at Miguel Servet Hospital, in Zaragoza, during October and November 2011, and to analyse its connection to carrying out clinical practice based on the best know-how available recommended by “Estrategia del parto normal del Ministerio de Sanidad y Consumo (2007”. An observational and transverse study based was carried out that consisted of an initial survey to an approximate sample of 600 women with a later phone call between the sixth and eighth week after the childbirth to detect women suffering from PPD, using the Edinburgh Postnatal Depression Scale (EPDS. The relationship between each variable defined within “Estrategia de atención del parto normal” and the existance of PPD will be studied; the following variables will be taken into account too, due to its high importance: parity, gestational pathology, prematurity, nationality and fulfilment of her childbirth.

  18. Carotid artery surgery

    Science.gov (United States)

    Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery ... through the catheter around the blocked area during surgery. Your carotid artery is opened. The surgeon removes ...

  19. 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

  20. 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.

  1. Genital trauma during a complicated domiciliary childbirth assisted by a non-expert midwife

    Directory of Open Access Journals (Sweden)

    Ada Arleny Pérez Mayo

    2015-06-01

    Full Text Available The study presents the case of a 20-year-old puerpera seen at San Pedro Necta National Hospital of the Department of Huehuetenango, Guatemala, due to a persisting vaginal bleeding and genital tear. The clinical picture was determined as a genital trauma by domiciliary childbirth assisted by a midwife. As there was no abdominal echography and there were signs of hypovolemia, a gynecological checkup was performed at the operating room, having circulatory support with intravenous crystalloid solutions. A careful preoperative preparation was carried out which included local antisepsis with tincture of iodine and hydrogen peroxide, as well as the administration of ceftriaxone as a prophylactic antibiotic for the infection. The surgical intervention consisted in repairing the cervical tears, as well as the traumatic lesions caused by an inadequate manipulation of the external genitals, with absorbable suture material. No complications were reported and the patient progressed satisfactorily, with a 5-day hospital stay.

  2. Childbirth-induced trauma to the urethral continence mechanism: review and recommendations.

    Science.gov (United States)

    Baessler, Kaven; Schuessler, Bernhard

    2003-10-01

    To summarize the literature on immediate pelvic floor damage from childbirth and episiotomy, a MEDLINE search of English language articles published from 1983 to 2001 was performed. Vaginal delivery causes varying degrees of muscular, neuromuscular, and connective tissue damage. This damage may result in urinary and/or fecal incontinence. Routine midline episiotomy increases the risk of third- and fourth-degree perineal lacerations, which may lead to fecal incontinence. Routine use of mediolateral episiotomy does not prevent urinary incontinence (UI) or severe perineal tears. It is possible to reduce the rate of mediolateral episiotomy to as low as 20% in primiparas without increasing the risk of anal sphincter damage. Control of obesity before delivery, as well as pelvic floor exercises and regular physical exercise both before and after delivery, seem to reduce the risk of postpartum UI.

  3. Benefits of massage therapy and use of a doula during labor and childbirth.

    Science.gov (United States)

    Keenan, P

    2000-01-01

    This article reviews the most recent literature on touch support and one-to-one support during labor and childbirth. The positive and negative aspects of the traditional birth attendant are presented. Research in one-to-one care and touch support during labor is examined with respect to husband/partner, nurses, nurse-midwives, and doulas (trained labor attendants). According to recent studies, women supported by doulas or midwives benefit by experiencing shorter labors and lower rates of epidural anesthesia and cesarean section deliveries. Also, a smaller percentage of their newborns experience fetal distress and/or are admitted to neonatal intensive care units. Women whose husbands or partners massage them during labor experience shorter labors. Nursing one-to-one support results in no significant obstetric outcomes. Antenatal perineal massage was found to reduce the rates of tears, cesarean section, and instrumental deliveries. Research in perineal massage during labor has shown no benefit.

  4. Pelvic Organ Distribution of Mesenchymal Stem Cells Injected Intravenously after Simulated Childbirth Injury in Female Rats

    Directory of Open Access Journals (Sweden)

    Michelle Cruz

    2012-01-01

    Full Text Available The local route of stem cell administration utilized presently in clinical trials for stress incontinence may not take full advantage of the capabilities of these cells. The goal of this study was to evaluate if intravenously injected mesenchymal stem cells (MSCs home to pelvic organs after simulated childbirth injury in a rat model. Female rats underwent either vaginal distension (VD or sham VD. All rats received 2 million GFP-labeled MSCs intravenously 1 hour after injury. Four or 10 days later pelvic organs and muscles were imaged for visualization of GFP-positive cells. Significantly more MSCs home to the urethra, vagina, rectum, and levator ani muscle 4 days after VD than after sham VD. MSCs were present 10 days after injection but GFP intensity had decreased. This study provides basic science evidence that intravenous administration of MSCs could provide an effective route for cell-based therapy to facilitate repair after injury and treat stress incontinence.

  5. 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

    2017-08-05

    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.

  6. [Case of successful pregnancy and childbirth in a rheumatoid arthritis patient treated with etanercept].

    Science.gov (United States)

    Furukawa, Kanako; Maeshima, Etsuko; Ichinose, Masakazu

    2013-01-01

    The patient was a 34-year-old woman who, at age 23, was diagnosed with rheumatoid arthritis (RA) presenting with morning stiffness, swelling and tenderness of bilateral knee joints and metacarpophalangeal (MP) joints of the right second and third fingers, increased C-reactive protein (CRP) levels, and a high level of rheumatoid factor (RF). The patient was maintaining remission with oral dose of bucillamine (BUC; 300 mg/day); however, due to the deterioration of arthralgia at age 26, she was additionally administered 8 mg/week of methotrexate (MTX), which improved the symptoms. Thereafter, the prescription of BUC was discontinued. At age 31, she experienced onsets of swelling and tenderness in both the knee joints and wrists and in MP joints of the right second and third fingers; further, CRP levels increased to 5.44 mg/dL, resulting in increased RA activity. The concomitant administration of infliximab was started at a dose of 3 mg/kg, which helped achieve favorable RA control. At age 32, approximately 2 years before childbirth, the prescription of infliximab was changed to 25 mg/dose of etanercept administered twice a week because the patient wished to conceive. Remission was maintained even after the drug change; therefore, MTX was discontinued and the patient was treated with etanercept alone. After she was confirmed to be pregnant in March of the following year, administration of etanercept was continued for treating of RA even during pregnancy. During that time, RA was favorably controlled, and the patient gave birth to a baby boy weighing 3192 g in October of the same year. The Apgar score of the baby was favorable. This case is considered important because, to the best of our knowledge, this may be the first report of a planned pregnancy and childbirth in a patient under administration of a biological preparation.

  7. The impact of early age at first childbirth on maternal and infant health.

    Science.gov (United States)

    Gibbs, Cassandra M; Wendt, Amanda; Peters, Stacey; Hogue, Carol J

    2012-07-01

    The objective of this review was to assess whether early age at first childbirth is associated with increased risk of poor pregnancy outcomes. Early age at childbirth is variously defined in studies of its effect on maternal and infant health. In this systematic review, we limit analysis to studies of at least moderate quality that examine first births among young mothers, where young maternal age is defined as low gynaecological age (≤ 2 years since menarche) or as a chronological age ≤ 16 years at conception or delivery. We conduct meta-analyses for specific maternal or infant health outcomes when there are at least three moderate quality studies that define the exposure and outcome in a similar manner and provide odds ratios or risk ratios as their effect estimates. We conclude that the overall evidence of effect for very young maternal age (effect or precision but not to change the conclusion. Evidence points to an impact of young maternal age on low birthweight and preterm birth, which may mediate other infant outcomes such as neonatal mortality. The evidence that young maternal age increases risk for maternal anaemia is also fairly strong, although information on other nutritional outcomes and maternal morbidity/mortality is less clear. Many of the differences observed among older teenagers with respect to infant outcomes may be because of socio-economic or behavioural differences, although these may vary by country/setting. Future, high quality observational studies in low income settings are recommended in order to address the question of generalisability of evidence. In particular, studies in low income countries need to consider low gynaecological age, rather than simply chronological age, as an exposure. As well, country-specific studies should measure the minimum age at which childbearing for teens has similar associations with health as childbearing for adults. This 'tipping point' may vary by the underlying physical and nutritional health of girls

  8. 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.

  9. Women's perspective in the evaluation of the Program for the Humanization of Antenatal Care and Childbirth.

    Science.gov (United States)

    Almeida, Cristiane Andréa Locatelli de; Tanaka, Oswaldo Yoshimi

    2009-02-01

    To analyze the importance of inclusion, from women's perspective, in the evaluation of the Program for the Humanization of Antenatal Care and Childbirth, carried out by the Brazilian Ministry of Health. This qualitative study was based on primary data collected in 2003 in an evaluation of the Program conducted in seven towns spread out among Brazil's five geographic regions. These sites were selected from a Federal Government data base utilized for quantitative analysis. Women attended by the Program were considered key informants when primary data was collected. Sixteen focal groups were performed in the primary care units. The Collective Subject Speech (CSS) method was used for qualitative analysis. The theoretical concepts of accessibility and Paideia Health within the framework of public health were used to interpret the findings. The Program standardizes procedures to be taken in antenatal care and childbirth for all health services in the country, including the flow among these services. However, analysis of women's discourse in the focal groups elucidated the existence of dissonances between their needs and desires and many of the program's recommendations. Pregnant women thus choose among available services and professionals and try to set up their own schedules which, in turn, do not correspond to those set up by the program. This discrepancy damages the bond women establish with the health services and creates obstacles for the control of the activities actually provided by the health services to the women. Analysis of the Program based on women's perspective identified aspects that might result in more humanized and effective antenatal care, if they are taken into account in the redefinition or correction of the Program schedule Miolo abstract Miolo abstract Miolo abstract.

  10. Mode of childbirth in low-risk pregnancies: Nicaraguan physicians' viewpoints.

    Science.gov (United States)

    Colomar, Mercedes; Cafferata, Maria Luisa; Aleman, Alicia; Castellano, Graciela; Elorrio, Ezequiel Garcia; Althabe, Fernando; Engelbrecht, Susheela

    2014-12-01

    To explore attitudes of physicians attending births in the public and private sectors and at the managerial level toward cesarean birth in Nicaragua. A qualitative study was conducted consisting of four focus groups with 17 physicians and nine in-depth interviews with decision-makers. Although study participants listed many advantages of vaginal birth and disadvantages of cesarean birth, they perceived that the increase in the cesarean birth rate in Nicaragua has resulted in a reduction in perinatal morbidity and mortality. They ascribed high cesarean birth rates to a web of interrelated provider, patient, and health system factors. They identified five actions that would facilitate a reduction in the number of unnecessary cesarean operations: establishing standards and protocols; preparing women and their families for labor and childbirth; incorporating cesarean birth rate monitoring and audit systems into quality assurance activities at the facility level; strengthening the movement to humanize birth; and promoting community-based interventions to educate women and families about the benefits of vaginal birth. Study participants believe that by performing cesarean operations they are providing the best quality of care feasible within their context. They do not perceive problems with their current practice. The identified causes of unnecessary cesarean operations in Nicaragua are multifactorial, so it appears that a multi-layered strategy is needed to safely reduce cesarean birth rates. The recent Nicaraguan Ministry of Health guidance to promote parto humanizado ("humanization of childbirth") could serve as the basis for a collaborative effort among health care professionals, government, and consumer advocates to reduce the number of unnecessary cesarean births in Nicaragua.

  11. 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.

  12. Mothers' level of education and childbirth interventions: A population-based study in Flanders, Northern Belgium.

    Science.gov (United States)

    Cammu, Hendrik; Martens, Guy; Keirse, Marc J N C

    2011-09-01

      Interventions to influence the time and way to be born have been a global concern for decades. Yet, limited information is available on what drives these interventions and their variation in frequency among countries, institutions, and practitioners. The objective of this study was to examine to what extent first-time mothers' educational achievement contributes to the frequency of childbirth interventions.   Childbirth interventions, including induction of labor, cesarean section, instrumental delivery, and epidural analgesia, registered by the Flemish Study Center for Perinatal Epidemiology for Belgian-born nulliparous women from 1999 to 2006, were linked to the level of maternal education, recorded by the Belgian civil birth registration. Education was divided into four levels based on the highest diploma attained and adjusted for marital and occupational status.   Frequencies of all interventions were inversely related to the level of maternal education. The effect remained after adjustment for birth year, maternal age, marital status, occupation, infant birthweight, gestational age, assisted conception, and type of hospital. Effect sizes between highest and lowest levels of education were relatively small for operative (31% vs 36%) and instrumental vaginal birth (20.7% vs 22.3%) compared with "initiated delivery" (defined as labor induction and prelabor cesarean section; 30.2% vs 40.3%) and epidural analgesia (66.8% vs 78.0%). The educational gradient in initiated delivery occurred at all gestational ages, contributing to lower gestational age and lower birthweight of term infants with decreasing levels of education.   In an affluent society with universal and equitable access to maternity care, the more educated women are, the more likely they are to have a spontaneous labor and spontaneous birth without intervention. (BIRTH 38:3 September 2011). © 2011, Copyright the Authors. Journal compilation © 2011, Wiley Periodicals, Inc.

  13. 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?

    Science.gov (United States)

    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 immigration to Germany. The Turkish sample of the Generations and Gender Survey which was conducted in 2006 offers the unique opportunity to examine Turkish immigrants as a single immigrant category. We question the common understanding that Turkish immigrants who arrived to Germany after 1973 mainly arrived for family reunification resulting in high birth intensities immediately after immigration. To distinguish different circumstances under which male and female immigrants have arrived to Germany, we include the combined marriage and migration history of the couple. We find that first birth probabilities are elevated during the years immediately following migration. But this effect is not universal among migrants with different marriage and migration histories. It appears that the arrival effect of high birth intensities is particularly high among female immigrants and is evident only among marriage migrants, that is Turks who married a partner who already lived in Germany at the time of the wedding. By contrast, among those who immigrated for family reunification, we do not find such an arrival effect.

  14. Living language

    CERN Document Server

    Shuttleworth, John

    2008-01-01

    Living Language 3rd edition' has been devised to meet all the new specifications for AS and A level English Language. The best-selling previous edition has been comprehensively revised to ensure full assessment objectives coverage and fulfilment, and delivery of the new four-unit courses from 2008 onwards. 'Living Language 3rd edition' provides linguistic theory, information and ideas which are easily accessed via supported activities and investigations. The text will actively develop students' skills in reading, listening and responding to an extensive range of text genres and data. Building

  15. What Is Refractive Surgery?

    Science.gov (United States)

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ...

  16. LASIK - Laser Eye Surgery

    Science.gov (United States)

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ...

  17. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... implant surgery is, of course, surgery, and is best performed by a trained surgeon with specialized education ... implant surgery is, of course, surgery, and is best performed by a trained surgeon with specialized education ...

  18. Surgery for Breast Cancer

    Science.gov (United States)

    ... Pregnancy Breast Cancer Breast Cancer Treatment Surgery for Breast Cancer Surgery is a common treatment for breast cancer, ... Relieve symptoms of advanced cancer Surgery to remove breast cancer There are two main types of surgery to ...

  19. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ...

  20. Preparing for Surgery

    Science.gov (United States)

    ... Events Advocacy For Patients About ACOG Preparing for Surgery Home For Patients Search FAQs Preparing for Surgery ... Surgery FAQ080, August 2011 PDF Format Preparing for Surgery Gynecologic Problems What is the difference between outpatient ...

  1. Refractive corneal surgery - discharge

    Science.gov (United States)

    Nearsightedness surgery - discharge; Refractive surgery - discharge; LASIK - discharge; PRK - discharge ... You had refractive corneal surgery to help improve your vision. This surgery uses a laser to reshape your cornea. It corrects mild-to-moderate nearsightedness, ...

  2. Preparing for Surgery

    Science.gov (United States)

    ... Events Advocacy For Patients About ACOG Preparing for Surgery Home For Patients Search FAQs Preparing for Surgery ... Surgery FAQ080, August 2011 PDF Format Preparing for Surgery Gynecologic Problems What is the difference between outpatient ...

  3. Corrective Jaw Surgery

    Science.gov (United States)

    ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ...

  4. Dental Implant Surgery

    Science.gov (United States)

    ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ...

  5. Facial Cosmetic Surgery

    Science.gov (United States)

    ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ...

  6. Facial Cosmetic Surgery

    Science.gov (United States)

    ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ...

  7. Outdoor Living.

    Science.gov (United States)

    Cotter, Kathy

    Course objectives and learning activities are contained in this curriculum guide for a 16-week home economics course which teaches cooking and sewing skills applicable to outdoor living. The course goals include increasing male enrollment in the home economics program, developing students' self-confidence and ability to work in groups, and…

  8. [Living donor transplantation. Surgical complications].

    Science.gov (United States)

    Karam, Georges

    2008-02-01

    Although nephrectomy by open surgery is the most used technique for the extraction of kidney transplants in the living donor, nephrectomy under laparaoscopy is increasingly practiced. Laparoscopic nephrectomy is less invasive and performed under videoscopy control, after insufflation of the peritoneal cavity. Three to four incisions are done in order to enter the surgical instruments. The kidney is extracted through a horizontal sus-pubic incision. The exposition is either exclusively transperitoneal, retroperitoneal or hand assisted. The advantages of laparoscopy are esthetical, financial due to a shorter hospitalisation and a quicker recovery, as well a confort for the donor. The disadvantages are a longer warm ischemia time and possibly a higher risk of delayed graft function. Randomised studies having compared laparoscopy and open surgery in the living donor have not find any significant difference regarding the per- and perioperative in the complications.

  9. Induced abortion: a means of postponing childbirth? Changes in maternal age at induced abortion and child birth in Norway during 1979-2007.

    Science.gov (United States)

    Vlietman, Marianne; Sarfraz, Aashi Ambareen; Eskild, Anne

    2010-12-01

    the maternal age at child birth is increasing. If induced abortion is an important means of postponing childbirth in a population, it is to be expected that in young women the rate of conceived pregnancies is stable over time, but the induced abortion rate is increasing. We studied birth rates, induced abortion rates and the sum of these rates by maternal age during four decades. register-based study. all women 15-49 years living in Norway. we present temporal changes in birth rates and induced abortion rates within age groups during the period 1979-2007. We also estimated the sum rate of births and induced abortions. Data were obtained from national statistics. live births and induced abortions per 1000 women per year. the induced abortion rates have been relatively stable within age groups, except for a decrease in women 15-19 years (from 24.2 in 1979 to 17.0 in 2007) and an increase in women 20-24 years (from 23.2 to 29.5). The birth rates however, have decreased dramatically in women 20-24 years old (from 113.6 to 60.5). Hence, the sum rate of births and induced abortions in women 20-24 years old has decreased from 136.8 to 90.0. In women 30 years old or older, the birth rates have increased. the induced abortion rate has been relatively stable in all age groups over time, suggesting a limited influence of induced abortions on the postponement of childbearing.

  10. Living Lands

    DEFF Research Database (Denmark)

    Christensen, Suna Møller

    2014-01-01

    , hunters attended to questions like safe-journeying on ice or the role of natural surroundings in children’s education, in ways revealing a relational perception of ‘nature’ and dissolving culture-nature dualisms. Hunters’ experiences in living the land afforded children a dwelling position from which...... of the social world pushes questions about education and life, disregarding being educated as human control of nature....

  11. The Modernization of Childbirth and the Indoctrination of Motherhood in Prewar Japan : the "Aiiku-son" Project of Imperial Gift Foundation "Aiiku-kai"

    OpenAIRE

    吉長, 真子

    1997-01-01

    In preceding historical studies on the relation of childbirth and the state in modern Japan, the transformation of the institution and the measures about midwives, or the legal preparation for maternal-child health has been focused on. In this paper, the writer has attempted to show the modernization in childbirth by educational activity for motherhood, especially by the "Aiiku-son" (Aiiku village) project. The project started from 1936 in order to diminish the infant mortality rate all over ...

  12. 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.

  13. 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.

  14. Role of different childbirth strategies on pelvic organ prolapse and stress urinary incontinence: a prospective study

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Background Traumatic damage to fascial and muscular support structures during childbirth may be a major factor of the development of stress urinary incontinence (SUI) and pelvic organ prolapse (POP).The aim of this study was to prospectively investigate the role of different childbirth strategies on POP and SUI.Methods A total of 120 selected pregnant women were recruited and divided into two groups:vaginal delivery group (n=72)and selective cesarean delivery group(n=48).The women were questioned with SUI sheet and estimated with POP quantification (POP-Q) within 6-8 weeks after delivery.The correlations of SUI and results of POP-Q with the strategies of delivery were analyzed.ttest,X2 test,and the Mann-Witney test were used for statistical analysis.Results Among the 120 women,SUI was developed during 29-30 gestational weeks in 20 patients (16.6%),of whom 14 (70%) had symptoms of SUI till 6 weeks postpartum. Totally 20 (16.6%) women had SUI symptoms after delivery.The prevalence of postpartum SUI was positively correlated with the occurrence of SUI during 29-30 gestational weeks (P<0.001).In the vaginal delivery group,100% of the women suffered form urinary prolapse 6 weeks postpartum,while 87.5% of those in the selective cesarean delivery group developed POP (P<0.01). The percentages of the first-and second-degree urinary prolapse in the vaginal delivery group were 20.8% and 79.2% respectively,which were significantly different from those in the selective cesarean delivery group (64.6% and 22.9%;both P=0.000).Conclusions Pregnancy and delivery play an etiologic role in the development of SUI and POP. The onset of SUI during late pregnancy implies a significant risk of postpartum SUI symptoms.The prevalence of POP is significantly higher after vaginal delivery than after cesarean delivery.

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

    Science.gov (United States)

    Fisher, Colleen; Hauck, Yvonne; Bayes, Sara; Byrne, Jean

    2012-11-13

    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. 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. 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 facilitated their sense of control during birth, and the content and

  16. 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

  17. 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

    2016-12-28

    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.

  18. 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.

  19. Childbirth and consequent atopic disease: emerging evidence on epigenetic effects based on the hygiene and EPIIC hypotheses.

    Science.gov (United States)

    Dahlen, H G; Downe, S; Wright, M L; Kennedy, H P; Taylor, J Y

    2016-01-13

    In most high and middle income countries across the world, at least 1:4 women give birth by cesarean section. Rates of labour induction and augmentation are rising steeply; and in some countries up to 50% of laboring women and newborns are given antibiotics. Governments and international agencies are increasingly concerned about the clinical, economic and psychosocial effects of these interventions. There is emerging evidence that certain intrapartum and early neonatal interventions might affect the neonatal immune response in the longer term, and perhaps trans-generationally. Two theories lead the debate in this area. Those aligned with the hygiene (or 'Old Friends') hypothesis have examined the effect of gut microbiome colonization secondary to mode of birth and intrapartum/neonatal pharmacological interventions on immune response and epigenetic phenomena. Those working with the EPIIC (Epigenetic Impact of Childbirth) hypothesis are concerned with the effects of eustress and dys-stress on the epigenome, secondary to mode of birth and labour interventions. This paper examines the current and emerging findings relating to childbirth and atopic/autoimmune disease from the perspective of both theories, and proposes an alliance of research effort. This is likely to accelerate the discovery of important findings arising from both approaches, and to maximize the timely understanding of the longer-term consequences of childbirth practices.

  20. Living edge

    DEFF Research Database (Denmark)

    Earon, Ofri

    2014-01-01

    of the involved actors at the border. By doing so, the study underlines a forgotten, yet important, role of this edge zone – being a zone of commonality between the house and city, between indoors and outdoors, between the man at home and the man at the street. The city of Copenhagen promotes porous borders...... is a collection of material from the case study of an ongoing PhD study titled: LIVING EDGE - The Architectural and Urban Prospect of Domestic Borders. The paper includes a description of the problem analysis, research question, method, discussion and conclusion....

  1. 孕晚期干预支持对孕妇产时认知行为及分娩结局的影响%Effect of third trimester intervention on primiparas' childbirth knowledge,attitude,behaviors and childbirth outcomes

    Institute of Scientific and Technical Information of China (English)

    顾春怡; 张铮; 朱新丽; 王滟

    2011-01-01

    Objective To explore the effect of third trimester intervention on primiparas' childbirth knowledge,attitude,behaviors and childbirth outcomes. Methods One hundred primiparas who had made registrations in Obstetrics & Gynecology Hospital of Fudan University were randomly divided into two groups,with 50 women in each group. The primiparas in the control group received routine antenatal examinations. In addition,the primiparas in the experimental group received a special course named “easy birth” during the third trimester. The primiparas' childbirth knowledge,attitude and behaviors,delivery mode,2 hours postpartum hemorrhage,neonatal Apgar scores were compared between the two rgoups. Results Before the intervention,there were no significant differences in the scores of childbirth knowledge and attitude(P>0.05). After the intervention,the scores of childbirth knowledge,attitude and behavior in the experimental group were significantly higher than that in the control group (P<0.01 or P<0.05). Compared with the control group,the rate of vaginal birth in the experimental group was significantly higher(P<0.05)and the amount of 2 hours postpartum hemorrhage was lower(P<0.05). Conclusions The interventions and support in third trimester can effectively promote primiparas' childbirth knowledge,attitude and behavior,improve the birth outcomes to some extent,increase the satisfaction of primiparas and their family members,and thus promoting natural birth and enhancing women's positive experience of childbirth.%目的 探讨孕晚期干预支持对孕妇产时认知行为及分娩结局的影响.方法 选择在妇产医院建卡并定期产检的初产妇100例,分为观察组和对照组,每组50例.观察组除接受常规产前检查和孕期指导外,还在孕晚期参加互动式分娩教育课程,对照组只进行常规产前检查和孕期指导.比较两组认知行为情况、分娩方式、产后2h出血量、新生儿Apgar评分等.结果 干预前

  2. 拉玛泽分娩法在构建自然分娩法则中的作用%The Function of Lamaze Childbirth Method in Constructing Natural Childbirth Law

    Institute of Scientific and Technical Information of China (English)

    邵艳丽; 蔺香云; 刘冉冉; 张洪芹

    2013-01-01

    Objective Investigate the effect of Lamaze childbirth method used at different phrases during the whole birth process on maternal mood, the pain level and delivery outcomes, in order to explore its function in constructing natural childbirth law. Methods 269 primiparas, taking regularly examination, accepting Lamaze childbirth method training from gestational age at 28 weeks, willing to take spontaneous delivery with natural childbirth conditions in our hospitals from March 2010 to May 2011 were assigned to the observation group. Another 280 primiparas under the same conditions were set as the control group, in which the primiparas received neither training through pregnant period nor any instructions related to it even during childbirth process. The two groups were compared in respect of the SDS, SAS,the pain level and delivery outcomes. Results The observation group was signiifcantly superior to the control group in respect of the SDS,SAS, pain level, delivery time and asphyxia of newborns. The cesarean section rate and the amount of vaginal bleeding decreased obviously in the observation group. Conclusions The Lamaze childbirth method may effectively reduce fears and pain leve1s, shorten the stage of labor, facilitate natural childbirth, lower the rate of uterine-incision delivery and decrease postpartum hemorrhage and the rate of asphyxia of newborns. Consequently, it is of great practical value in maternity and can be safely used for a wide range.%目的探讨拉玛泽分娩法在全产程分阶段应用对产妇情绪、疼痛程度及分娩结局的影响,以探寻拉玛泽分娩法在构建自然分娩法则中的作用。方法选取2010年3月至2011年5月在本院定期产前检查,孕周28周即开始接受拉玛泽分娩技巧培训,具备自然分娩条件,且有自然分娩意愿,分娩时开始接受拉玛泽分娩法训练的初产妇269例作为观察组;选取同期具备自然分娩条件,且有自然分娩意愿,但孕期未

  3. A multidisciplinary program of preparation for childbirth and motherhood: maternal anxiety and perinatal outcomes

    Directory of Open Access Journals (Sweden)

    Prevedel Tânia TS

    2010-10-01

    Full Text Available Abstract Background To study maternal anxiety and perinatal outcomes in pregnant women submitted to a Multidisciplinary Program for Childbirth and Motherhood Preparation (MPCM. Methods This is a not randomized controlled trial on 67 nulliparous pregnant women divided into two groups according to participation (MPCM Group; n = 38 or not (Control Group; n = 29 in MPCM. The program consisted of 10 meetings (between the 18th and the 38th gestational week during which educational, physiotherapeutic and interaction activities were developed. Anxiety was quantified at the beginning and at the end of the gestational period by the Trace-State Anxiety Inventory (STAI. Results Initial maternal anxiety was equivalent between the groups. At the end of the gestational period, it was observed that anxiety levels increased in the Control Group and were maintained in the MPCM Group. A higher occurrence of vaginal deliveries (83.8% and hospital discharge of three-day-older newborns (81.6% as a result of MPCM was also significant. Levels of state-anxiety at the end of pregnancy showed a negative correlation with vaginal delivery, gestational age, birth weight and Apgar index at the first minute and positive correlation with the hospital period remaining of the newborns. Conclusion In the study conditions, MPCM was associated with lower levels of maternal anxiety, a larger number of vaginal deliveries and shorter hospitalization time of newborns. It was not related to adverse perinatal outcomes.

  4. 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.

  5. 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.

  6. Numerical simulation of the damage evolution in the pelvic floor muscles during childbirth.

    Science.gov (United States)

    Oliveira, Dulce A; Parente, Marco P L; Calvo, Begoña; Mascarenhas, Teresa; Natal Jorge, Renato M

    2016-02-29

    Several studies have shown that pelvic floor injuries during a vaginal delivery can be considered a significant factor in the development of pelvic floor dysfunction. Such disorders include a group of conditions affecting women like urinary incontinence, pelvic organ prolapse and fecal incontinence. Numerical simulations are valuable tools that are contributing to the clarification of the mechanisms behind pelvic floor disorders. The aim of this work is to propose a mechanical model implemented in the finite element method context to estimate the damage in the pelvic floor muscles by mechanical effects during a vaginal delivery of a fetus in vertex presentation and occipitoanterior position. The constitutive model adopted has already been successfully used in the simulation of childbirth and the structural damage model added has previously been applied to characterize the damage process in biological soft tissues undergoing finite deformations. The constitutive parameters were fit to experimental data available in the literature and the final proposed material model is suitable to estimate the mechanical damage in the pelvic floor muscle during a vaginal delivery. The computational model predicts that even an apparently uneventful vaginal delivery inflicts injuries to the pelvic floor muscles, particularly during the extension of the fetus head, having been obtained more than 10% of damaged fibers. As a clinical evidence, the present work allows to conclude that the puborectalis component of the levator ani muscle is the most prone to damage.

  7. The impact of fecal and urinary incontinence on quality of life 6 months after childbirth

    Science.gov (United States)

    Handa, Victoria L.; Zyczynski, Halina M.; Burgio, Kathryn L.; Fitzgerald, Mary Pat; Borello-France, Diane; Janz, Nancy K.; Fine, Paul M.; Whitehead, William; Brown, Morton B.; Weber, Anne M.

    2011-01-01

    Objective The objective of the study was to investigate the impact of postpartum fecal incontinence (FI) and urinary incontinence (UI) on quality of life (QOL). Study Design Seven hundred fifty-nine primiparous women in the Childbirth and Pelvic Symptoms study were interviewed 6 months postpartum. FI and UI were assessed with validated questionnaires. We measured QOL with SF-12 summary scores, health utility index score (a measure of self-rated overall health), and the modified Manchester Health Questionnaire. Results Women with FI had worse self-rated health utility index scores (85.1 ± 9.8 vs 88.0 ± 11.6, P = .02) and Medical Outcomes Study Short Form Health Survey (SF-12) mental summary scores (46.8 ± 9.2 vs 51.1 ± 8.7, P < .0001) than women without FI or flatal incontinence. Women with UI had worse SF-12 mental summary scores (48.3 ± 9.8 vs 51.6 ± 7.8, P < .01) and self-rated health utility index scores (84.1 ± 12.5 vs 88.7 ± 10.1, P < .01) than women without UI. Women with both FI and UI had the lowest SF-12 mental summary scores (44.5 ± 9.0). Conclusion Six months after delivery, women experiencing FI or UI reported negative effects on health-related QOL. FI and UI together have a greater impact than either condition alone. PMID:18060960

  8. Geographic Distribution of Childbirth among Adolescents in Cameroon from 2003 to 2005

    Directory of Open Access Journals (Sweden)

    P. M. Tebeu

    2010-01-01

    Full Text Available Objective. To determine the frequency and the trend of adolescents (10–19 years in childbirth within a period of 3 years in referral maternity units in Cameroon. Method. Descriptive and retrospective study for a 3-year period (2003–2005 in referral maternity units headed by a qualified Obstetrician-Gynecologist. We analyzed the trend and geographic distribution of 8222 adolescent deliveries over 3 years. Epi Info 3.5 software was used for data analysis. Chi square test for trend was used to assess the contribution of adolescent deliveries over years. The trend was considered significant if P<.05. Results. During the period of the study, there was a total of 8387 deliveries. We excluded 165 women because of lack of information about age. We therefore included a total of 8222 adolescent deliveries. Overall, the contribution of adolescents to deliveries ranged from 6.87% to 26.51%, depending on the region with a national mean of 14.23%. Adolescents aged 16 or less contributed to 2.82% of deliveries while those aged from 17 to 19 contributed to 11.41%. The contribution of adolescents to deliveries decreased significantly over 3 years (P<.0001. Conclusion. The study underscores the importance of Public Health programs in strengthening maternity services for adolescents in Cameroon while taking into consideration geographic differences.

  9. Obstetric interventions during labor and childbirth in Brazilian low-risk women.

    Science.gov (United States)

    Carmo Leal, Maria do; Pereira, Ana Paula Esteves; Domingues, Rosa Maria Soares Madeira; Theme Filha, Mariza Miranda; Dias, Marcos Augusto Bastos; Nakamura-Pereira, Marcos; Bastos, Maria Helena; Gama, Silvana Granado Nogueira da

    2014-08-01

    This study evaluated the use of best practices (eating, movement, use of nonpharmacological methods for pain relief and partograph) and obstetric interventions in labor and delivery among low-risk women. Data from the hospital-based survey Birth in Brazil conducted between 2011 and 2012 was used. Best practices during labor occurred in less than 50% of women and prevalence of the use of these practices was lower in the North, Northeast and Central West Regions. The rate of use of oxytocin drips and amniotomy was 40%, and was higher among women admitted to public hospitals and in women with a low level of education. The uterine fundal pressure, episiotomy and lithotomy were used in 37%, 56% and 92% of women, respectively. Caesarean section rates were lower in women using the public health system, nonwhites, women with a low level of education and multiparous women. To improve the health of mothers and newborns and promote quality of life, a change of approach to labor and childbirth that focuses on evidence-based care is required in both the public and private health sectors.

  10. Wartime women giving birth: narratives of pregnancy and childbirth, Britain c. 1939-1960.

    Science.gov (United States)

    Davis, Angela

    2014-09-01

    Women in Second World War Britain benefitted from measures to improve maternal and child health. Infant and maternal mortality rates continued to fall, new drugs became available, and efforts were made to improve the health of mothers and babies through the provision of subsidised milk and other foodstuffs. However, in return, women were also expected to contribute to the war effort through motherhood, and this reflected wider cultural ideas in the North Atlantic world in the first half of the twentieth century which equated maternity with military service. The aim of this article is to examine the interplay between narratives of birth and narratives of war in the accounts of maternity from women of the wartime generation. It will explore how the military-maternity analogy sheds light on women's experiences of pregnancy and childbirth in Britain during the Second World War, whilst also considering maternity within women's wider role as 'domestic soldiers', contributing to the war effort through their traditional work as housewives and mothers. In doing so, the article reveals the complexity of women's narratives. It demonstrates that they do not simply conform to the 'medical vs. social' binary, but reflect the wider cultural context in which women gave birth. Women incorporated the dominant discourses of the period, namely those around war, into their accounts. Copyright © 2012 Elsevier Ltd. All rights reserved.

  11. [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.

  12. No safe place for childbirth: women and midwives bearing witness, Gaza 2008-09.

    Science.gov (United States)

    Wick, Laura; Hassan, Sahar

    2012-12-01

    Women seek to give birth in a place where they feel safe, protected and secure. However, in conflict settings, many are forced to give birth in dangerous and frightening situations, where even the most rudimentary help and protection is unavailable. This study, based on interviews with women who gave birth and midwives during the 22-day Israeli attack on Gaza in December 2008 - January 2009, illustrates the vulnerability and trauma women experience when there is no safe place for childbirth. They recounted their overwhelming fear of not knowing when they would go into labour, not reaching a hospital or skilled attendant during the bombing, complications in labour without emergency care, and fear for the safety of their families and being separated from them. Most of the midwives were unprepared both materially and psychologically to attend births outside a hospital setting, while physicians were overwhelmed with severely injured patients. The capacity of midwifery care to keep birth normal whenever possible is particularly crucial in situations of political instability, conflict, poverty and disaster. Planning for emergency care by mapping the location of midwives, supplying them with basic equipment and medications, and legitimizing their profession with an appropriate scope of practice, licensing, back-up, and incentives would facilitate their ability to respond to birthing women's needs.

  13. 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.

  14. Introduction-Pediatric epilepsy surgery techniques.

    Science.gov (United States)

    Rydenhag, Bertil; Cukiert, Arthur

    2017-04-01

    This supplement includes the proceedings from the Pediatric Epilepsy Surgery Techniques Meeting held in Gothenburg (July 4-5, 2014), which focused on presentations and discussions regarding specific surgical technical issues in pediatric epilepsy surgery. Pediatric epilepsy neurosurgeons from all over the world were present and active in very fruitful and live presentations and discussions. These articles represent a synopsis of the areas and subjects dealt with there. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  15. Evaluation of the effects of a birth plan on Taiwanese women's childbirth experiences, control and expectations fulfilment: a randomised controlled trial.

    Science.gov (United States)

    Kuo, Su-Chen; Lin, Kuan-Chia; Hsu, Chi-Ho; Yang, Cherng-Chia; Chang, Min-Yu; Tsao, Chien-Ming; Lin, Lie-Chu

    2010-07-01

    In many western countries, pregnant women often prepare birth plans, outlining how they would like their childbirth experiences to proceed. However there have been no experimental studies to evaluate the effect of birth plans. The objective of this research was to evaluate the effects of birth plans on women's fulfilment of their childbirth expectations, their control over the birth process, and overall experiences. A randomised, single-blind controlled trial study design was used. This study involved seven hospitals and 10 obstetricians in Taiwan. Participants included primiparous women, each under the care of one of seven Taiwanese medical facilities, and who had been pregnant for at least 32 weeks. They were also at least 18 years old, and had no pregnancy complications. An exclusion criterion was elective caesarean as a mode of delivery. A total of 296 women in hospital clinics who met the study criteria were allocated by block randomisation to experimental (n=155) or control (n=141) groups. The women completed their basic personal information and a childbirth expectations questionnaire when they were recruited. One day after delivery, all the participants completed a questionnaire about the childbirth experience, control and fulfilment of their childbirth expectations. The experimental group had a statistically higher degree of positive childbirth experiences than that of the control group (t=2.48, p=0.01). The experimental group also showed a higher degree of childbirth control (t=9.60, pcontrol groups in prenatal birth expectations, but a significant difference (t=2.63, p=0.01) in the degree of fulfilment of their childbirth expectations after delivery. On a subscale measuring the fulfilment of childbirth expectations, there was a statistically higher degree of mastery and participation (t=3.74, pcontrol group. The results justify the clinical implementation of birth plans. Providing birth plans in medical facilities is an effective means of fulfilling

  16. 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

  17. 无痛分娩术联合体位管理纠正胎头位置异常的护理研究%Nursing Care of Pregnant Women Accept-ing Painless Childbirth in Combination with Body Position Management to Correct Abnormal Position of Fetal Head

    Institute of Scientific and Technical Information of China (English)

    庞建红; 杨月仙; 陈丽颜

    2015-01-01

    Objective Discussion the clinical nursing effect of painless childbirth in combination with body position man‐agement to correct abnormal position of fetal head in order to improve the quality and delivery of natural childbirth rate of maternal .Methods Select 216 cases of pregancy with the vaginal deliveries posterior position or occiput transverse position of maternal in our hospital from February 2013 to August 2014 ,including 108 cases by the use of painless childbirth surgery in combination with body position management as the study group ,while without acceptived surgery painless childbirth and body position management as a control observed group .Two groups of maternal fetal abnormalities corrected efficiency ,ce‐sarean section rate ,time of stages of labor and the incidence of adverse reactions and complications were compared .Result The validity of the study group in correcting abnormal maternal fetal position ,cesarean section rate ,vaginal operative deliv‐ery rates ,postpartum complications and birth process observation time performance than the control group ,in which correct abnormal fetal position effective rate of 75 .93% in the study group ,significantly higher than 49 .07% of the observation group ,the difference was statistically significant (P 0 .05) in adverse reaction incidence of maternal in two groups .Conclusion painless childbirth in combination with body position man‐agement can significantly improve the quality and delivery of natural childbirth rate of maternal and safe ,with good pregnan‐cy outcome and should be introduced in clinical practice .%目的:探讨无痛分娩术联合体位管理纠正胎头位置异常的临床护理疗效,以期提高产妇的分娩质量和纠正胎位异常的有效率。方法选取2013年2月~2014年8月我科行阴道分娩的枕后位或枕横位产妇216例,依据产妇自愿原则分为研究组和对照组,各108例。研究组采用无痛分娩术联合体位管理。对照

  18. [Minimally invasive surgery and robotic surgery: surgery 4.0?].

    Science.gov (United States)

    Feußner, H; Wilhelm, D

    2016-03-01

    Surgery can only maintain its role in a highly competitive environment if results are continuously improved, accompanied by further reduction of the interventional trauma for patients and with justifiable costs. Significant impulse to achieve this goal was expected from minimally invasive surgery and, in particular, robotic surgery; however, a real breakthrough has not yet been achieved. Accordingly, the new strategic approach of cognitive surgery is required to optimize the provision of surgical treatment. A full scale integration of all modules utilized in the operating room (OR) into a comprehensive network and the development of systems with technical cognition are needed to upgrade the current technical environment passively controlled by the surgeon into an active collaborative support system (surgery 4.0). Only then can the true potential of minimally invasive surgery and robotic surgery be exploited.

  19. Serviced Living

    Institute of Scientific and Technical Information of China (English)

    LIU BO

    2006-01-01

    @@ As recently as ten years ago,the term serviced apartment made no sense to most people living in Beijing and residing in hotels was the only options for foreign visitors. But since then, serviced apartments have begun to appear in big cities all around China. In Beijing alone, it is estimated that there are more than 30,000service apartments spread across dozens of properties occupying a space of more than I million square meters. Concentrating in the Financial Street, the Central Business District and Zhongguancun, also known as China's Silicon Valley, the explosion in service apartments in the city continues to be fueled by the influx of overseas and domestic business people.

  20. Live CMS

    CERN Document Server

    2017-01-01

    CMS live from Facebook. The Pixel Tracker (or Pixel Detector) is the innermost instrument in the very heart of the CMS apparatus, installed around the LHC beampipe. This is the very point where new particles, such as the Higgs boson, are produced by the energy of the proton proton collisions, and so the Pixel detector receives the largest particle-flux of any sub-component of CMS. The new component is made up of two “parts”: a central barrel region (called BPIX), made of two cylindrical halves, and forward discs on either side of the collision point (FPIX). The new BPIX was manufactured by a consortium of European institutes from Switzerland, Italy and Germany, supported by CERN. The new FPIX was manufactured by 14 institutes in the USA.

  1. Open heart surgery

    Science.gov (United States)

    Heart surgery - open ... lung machine is used in most cases during open heart surgery. While the surgeon works on the ... with these procedures, the surgeon may have to open the chest to do the surgery.

  2. Bariatric Surgery Procedures

    Science.gov (United States)

    ... Center Access to Care Toolkit EHB Access Toolkit Bariatric Surgery Procedures Bariatric surgical procedures cause weight loss by restricting the ... Online Education Directory Search Patient Learning Center Bariatric Surgery ... Surgery Procedures BMI Calculator Childhood and Adolescent Obesity ...

  3. Tennis elbow surgery - discharge

    Science.gov (United States)

    ... epicondylitis surgery - discharge; Lateral tendinosis surgery - discharge; Lateral tennis elbow surgery - discharge ... long as you are told. This helps ensure tennis elbow will not return. You may be prescribed a ...

  4. Plastic Surgery Statistics

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    ... PSN PSEN GRAFT Contact Us News Plastic Surgery Statistics Plastic surgery procedural statistics from the American Society of Plastic Surgeons. Statistics by Year Print 2016 Plastic Surgery Statistics 2015 ...

  5. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Soft Tissue Surgery Dental Implant Surgery Facial Cosmetic Surgery Head, Neck and Oral Pathology Obstructive Sleep Apnea TMJ and Facial Pain Treatment of Facial Injury Wisdom Teeth Management Procedures Administration of Anesthesia Administration of Anesthesia Oral ...

  6. Who Needs Heart Surgery?

    Science.gov (United States)

    ... this page from the NHLBI on Twitter. Who Needs Heart Surgery? Heart surgery is used to treat ... will work with you to decide whether you need heart surgery. A cardiologist specializes in diagnosing and ...

  7. Gastric Sleeve Surgery

    Science.gov (United States)

    ... A Week of Healthy Breakfasts Shyness Gastric Sleeve Surgery KidsHealth > For Teens > Gastric Sleeve Surgery Print A ... buying healthy food ) continue Preparing for Gastric Sleeve Surgery Preparing for this major operation takes months of ...

  8. Cavus Foot Surgery

    Science.gov (United States)

    ... All Site Content AOFAS / FootCareMD / Treatments Cavus Foot Surgery Page Content What is a cavus foot? A ... problems. What are the goals of cavus foot surgery? The main goal of surgery is to reduce ...

  9. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Do Who We Are News Videos Contact Find a Surgeon What We Do Administration of Anesthesia Administration ... Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require one or more surgeries ...

  10. Laser surgery - skin

    Science.gov (United States)

    Surgery using a laser ... used is directly related to the type of surgery being performed and the color of the tissue ... Laser surgery can be used to: Close small blood vessels to reduce blood loss Remove warts , moles , sunspots, and ...

  11. Smoking and surgery

    Science.gov (United States)

    Surgery - quitting smoking; Surgery - quitting tobacco; Wound healing - smoking ... Smokers who have surgery have a higher chance than nonsmokers of blood clots forming in their legs. These clots may travel to and ...

  12. Lung surgery - discharge

    Science.gov (United States)

    ... Lung biopsy - discharge; Thoracoscopy - discharge; Video-assisted thoracoscopic surgery - discharge; VATS - discharge ... milk) for 2 weeks after video-assisted thoracoscopic surgery and 6 to 8 weeks after open surgery. ...

  13. Weight Loss Surgery (Bariatric Surgery) (For Parents)

    Science.gov (United States)

    ... Health Growth & Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & ... Surgery Types of Surgery Gastric Bypass ... or intestines removed due to ulcers or cancer tended to lose a lot of weight after ...

  14. Fatores culturais que interferem nas experiências das mulheres durante o trabalho de parto e parto Los factores que interfieren en las experiencias de las mujeres durante el trabajo de parto y parto Factors interfering in the experience of women in childbirth process and in childbirth

    Directory of Open Access Journals (Sweden)

    Maria Gorette Andrade Bezerra

    2006-06-01

    understanding the factors that interfere in the experience lived by childbearing women. Seven women who gave birth through normal childbirth in a public maternity in Fortaleza-Ceará participated in the study. Data were collected from June to August, 2003. Ethnonursing was the method used for data collection and analysis. The findings were reflected in the framework of Leininger's Diversity and Universality of Cultural Care Theory, which were organized in three categories: Fear; Influence of the beliefs and religiosity; previous pregnancy. The practice of cultural care to women showed the importance of communication and consideration of women's beliefs and values at the moment of the childbirth process and delivery.

  15. Diplopia after strabismus surgery.

    Science.gov (United States)

    Holgado, Sandra

    2012-01-01

    The presence of diplopia is an undesirable result following strabismus surgery. There are a variety of scenarios where diplopia exists prior to strabismus surgery, and, after surgery, has either been alleviated or decreased to a magnitude amenable to prism correction. In other cases, the patient does not experience diplopia prior to the strabismus surgery, but there exists a definite risk of diplopia after the surgery. In the current review, I examine the literature to help determine the incidence of diplopia after strabismus surgery.

  16. Single incision laparoscopic surgery

    Institute of Scientific and Technical Information of China (English)

    Arun; Prasad

    2010-01-01

    As a complement to standard laparoscopic surgery and a safe alternative to natural orifice transluminal endoscopic surgery,single incision laparoscopic surgery is gaining popularity.There are expensive ports,disposable hand instruments and flexible endoscopes that have been suggested to do this surgery and would increase the cost of operation.For a simple surgery like laparoscopic cholecystectomy,these extras are not needed and the surgery can be performed using standard ports,instruments and telescopes.Tri...

  17. 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.

  18. 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

    2016-08-26

    To describe the differences in obstetrical results and women's childbirth satisfaction across 2 different models of maternity care (biomedical model and humanised birth). 2 university hospitals in south-eastern Spain from April to October 2013. A correlational descriptive study. A convenience sample of 406 women participated in the study, 204 of the biomedical model and 202 of the humanised model. 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. 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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  19. 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

  20. Effects of nonlinear muscle elasticity on pelvic floor mechanics during vaginal childbirth.

    Science.gov (United States)

    Li, Xinshan; Kruger, Jennifer A; Nash, Martyn P; Nielsen, Poul M F

    2010-11-01

    The role of the pelvic floor soft tissues during the second stage of labor, particularly the levator ani muscle, has attracted much interest recently. It has been postulated that the passage of the fetal head through the pelvis may cause excessive stretching of the levator ani muscle, which may lead to pelvic floor dysfunction and pelvic organ prolapse later in life. In order to study the complex biomechanical interactions between the levator ani muscle and the fetal head during the second stage of labor, finite element models have been developed for quantitative analysis of this process. In this study we have simulated vaginal delivery using individual-specific anatomical computer models of the pelvic floor interacting with a fetal head model with minimal restrictions placed upon its motion. Two constitutive relations were considered for the levator ani muscle (of exponential and neo-Hookean forms). For comparison purposes, the exponential relation was chosen to exhibit much greater stiffening at higher strains beyond the range of the experimental data. We demonstrated that increased nonlinearity in the elastic response of the tissues leads to considerably higher (56%) estimated force required for delivery, accompanied by a more homogeneous spatial distribution of maximum principal stretch ratio across the muscle. These results indicate that the form of constitutive relation beyond the presently available experimental data markedly affects the estimated function of the levator ani muscle during vaginal delivery, due to the large strains that occur. Further experimental data at higher strains are necessary in order to more reliably characterize the constitutive behavior required for modeling vaginal childbirth.

  1. 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

  2. Midwives' personal experiences of pregnancy and childbirth: Exploring issues of autonomy and agency in relation to the use of professional knowledge.

    Science.gov (United States)

    Church, Sarah

    2014-09-01

    This paper seeks to explore midwives' experiences of pregnancy and childbirth. It draws on interviews with nine midwives who completed their midwifery training prior to becoming mothers, to discuss how midwives use their professional knowledge to exercise agency (the choices made about their own care), and assume autonomy (the control and responsibility in relation to their own care), in pregnancy and childbirth. It illustrates that a reliance on professional knowledge may create opportunities for choice and increased autonomy in some situations, although the need for intervention during childbirth, for example, may challenge the degree of autonomy exercised by midwives and the choices available to them. As knowledgeable experts, midwives demonstrate a very different understanding of risk and safety in relation to their own experiences of childbirth. Professional knowledge may increase their anxieties which may not be addressed appropriately by caregivers due to their professional status. The use of knowledge in this way highlights potential conflict between their position as midwives and their experience as mothers, illustrating that midwives' ability to exercise agency and autonomy in relation to their pregnancy and childbirth experiences is potentially problematic.

  3. Effects of prenatal childbirth education for partners of pregnant women on paternal postnatal mental health and couple relationship: A systematic review.

    Science.gov (United States)

    Suto, Maiko; Takehara, Kenji; Yamane, Yumina; Ota, Erika

    2017-03-01

    Partner education during pregnancy may be able to prevent postnatal mental health problems, and support expectant fathers in their transition to parenthood. The aim of this systematic review is to investigate the effects of prenatal childbirth education among partners of pregnant women, particularly regarding paternal postnatal mental health and couple relationship. We searched Medline, CINAHL, EMBASE, PsycINFO, ERIC, and CENTRAL using terms such as "partners of pregnant women," "education," and "prenatal support." Searches were limited to randomized trials. We included 11 trials out of 13 reports that addressed the following topics: childbirth preparation, couple relationship, infants and parenting, postpartum psychosocial issues, and housework sharing. Overall risk of bias was low or unclear. Study outcomes, including parents' mental health (e.g., anxiety, depression, distress), couple relationship, parents' transition adjustment and parenting stress, and parents' satisfaction with their experience of childbirth and prenatal childbirth education programs were reported. The studies included in this review were very diverse regarding intervention intensity and content, outcome types, measurement tools, and outcome timing. This impeded evaluation of the interventions' effectiveness. No sufficient evidence was identified that prenatal childbirth education for partners of pregnant women protects against paternal postnatal depression and couple relationship; however, paternal postnatal mental health is important to maternal and perinatal healthcare. The results of this review suggest that further research and intervention are required to provide partners of pregnant women with evidence-based information and support whole families during the perinatal period. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. Effect of Training Preparation for Childbirth on Fear of Normal Vaginal Delivery and Choosing the Type of Delivery Among Pregnant Women in Hamadan, Iran: A Randomized Controlled Trial

    Science.gov (United States)

    Masoumi, Seyedeh Zahra; Kazemi, Farideh; Oshvandi, Khodayar; Jalali, Mozhgan; Esmaeili-Vardanjani, Ali; Rafiei, Hossein

    2016-01-01

    Objective: To examine effect of an educational program on pregnant women’s fear of normal vaginal delivery. Fear of natural childbirth during pregnancy may increase the risk of caesarean section. Educational programs may be effective in reducing women fear of natural childbirth. Materials and methods: This randomized controlled trial conducted from September 2012 to January 2013 in Hamadan, Iran. One hundred fifty eligible women were randomly assigned to group "A" (Intervention group, n = 75) or group "B" (Control group, n = 75). Women in group A, participated in an antenatal educations program for physiologic childbirth in 8 two-hour sessions. A self-designed questionnaire was used to examine women's fear of natural childbirth. Data were analyzed with SPSS.16 software. Results: Baseline characteristics of women were similar in both groups. After intervention the mean fear score in group A compared to group B was significantly reduced (51.7 ± 22.4 vs. 58.7 ± 21.7) (p = 0.007). Physiologic delivery was the first choice of type of child birth after training in pregnant women in group A (58.7%). But delivery in physiologic form had lowest rate in group A (8%). Conclusion: Results of present study showed that educational program could be serving as an important tool in reducing women fear from natural childbirth and in choosing of physiologic birth. And for delivery as a physiological, education and counseling of pregnant women, doctors and midwives are required. PMID:28101112

  5. Effect of Training Preparation for Childbirth on Fear of Normal Vaginal Delivery and Choosing the Type of Delivery Among Pregnant Women in Hamadan, Iran: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Seyedeh Zahra Masoumi

    2016-12-01

    Full Text Available Objective: To examine effect of an educational program on pregnant women’s fear of normal vaginal delivery. Fear of natural childbirth during pregnancy may increase the risk of caesarean section. Educational programs may be effective in reducing women fear of natural childbirth.Materials and methods: This randomized controlled trial conducted from September 2012 to January 2013 in Hamadan, Iran. One hundred fifty eligible women were randomly assigned to group "A" (Intervention group, n = 75 or group "B" (Control group, n = 75. Women in group A, participated in an antenatal educations program for physiologic childbirth in 8 two-hour sessions. A self-designed questionnaire was used to examine women's fear of natural childbirth. Data were analyzed with SPSS.16 software.Results: Baseline characteristics of women were similar in both groups. After intervention the mean fear score in group A compared to group B was significantly reduced (51.7 ± 22.4 vs. 58.7 ± 21.7 (p = 0.007. Physiologic delivery was the first choice of type of child birth after training in pregnant women in group A (58.7%. But delivery in physiologic form had lowest rate in group A (8%.Conclusion: Results of present study showed that educational program could be serving as an important tool in reducing women fear from natural childbirth and in choosing of physiologic birth. And for delivery as a physiological, education and counseling of pregnant women, doctors and midwives are required.

  6. Estimation of health benefits from a local living wage ordinance.

    Science.gov (United States)

    Bhatia, R; Katz, M

    2001-09-01

    This study estimated the magnitude of health improvements resulting from a proposed living wage ordinance in San Francisco. Published observational models of the relationship of income to health were applied to predict improvements in health outcomes associated with proposed wage increases in San Francisco. With adoption of a living wage of $11.00 per hour, we predict decreases in premature death from all causes for adults aged 24 to 44 years working full-time in families whose current annual income is $20,000 (for men, relative hazard [RH] = 0.94, 95% confidence interval [CI] = 0.92, 0.97; for women, RH = 0.96, 95% CI = 0.95, 0.98). Improvements in subjectively rated health and reductions in the number of days sick in bed, in limitations of work and activities of daily living, and in depressive symptoms were also predicted, as were increases in daily alcohol consumption. For the offspring of full-time workers currently earning $20,000, a living wage predicts an increase of 0.25 years (95% CI = 0.20, 0.30) of completed education, increased odds of completing high school (odds ratio = 1.34, 95% CI = 1.20, 1.49), and a reduced risk of early childbirth (RH = 0.78, 95% CI = 0.69, 0.86). A living wage in San Francisco is associated with substantial health improvement.

  7. Application research of painless childbirth in obstetrics%无痛分娩在产科的应用研究

    Institute of Scientific and Technical Information of China (English)

    赖瑶纯; 黄树彬; 郭晓瑛; 陈秋燕; 凡学龙

    2015-01-01

    目的:研究无痛分娩法用于分娩镇痛的疗效和对母婴的影响。方法:将2013年4月~2015年5月在我院分娩无产科及内科并发症的产妇随机抽取400例,将自愿要求行镇痛分娩者予采用硬膜外麻醉分娩镇痛分为试验组200例和未用任何止痛措施地对照组各200例。观察无痛分娩对产程中镇痛效果、产程时间、出血情况、分娩并发症及对新生儿的影响。结果:无痛分娩组第一产程、第二产程及总产程用时均明显短于常规分娩组,两组比较具有统计学意义,观察组镇痛总有效率明显高于对照组,差异有统计学意义,与对照组比较,观察组助产率、剖宫产率组间差异有统计学有意义,而产后2h出血量、住院时间、胎儿窘迫及新生儿窒组间比较无显著性差异。结论:无痛分娩法镇痛效果良好,对母婴无不良影响,安全、有效、值得推广。%ObjectiveTo study the efficacy and impact of painless childbirth for labor analgesia on maternal and child. Methods From April 2013 to May 2015 in our hospital obstetric and childbirth without medical complications of maternal ran-domly selected 400 cases, wil voluntarily request line analgesic deliveries to epidural anesthesia for labor analgesia divided into two groups 200 cases and did not use any pain relief measures to control group of 200 cases observed painless childbirth anal-gesic effect on the production process, labor time, bleeding, childbirth complications and effects on newborns.ResultsPainless Childbirth Group first stage, the second stage of labor and total labor time was shorter than with conventional delivery group, the two groups was statisticaly significant,the total efficiency of the observation group was significantly higher analgesic the differ-ence was statisticaly significant, compared with the control group, the observation group delivery rate, cesarean section rate be-tween groups was statisticaly

  8. Quality of antenatal and childbirth care in rural health facilities in Burkina Faso, Ghana and Tanzania: an intervention study.

    Science.gov (United States)

    Duysburgh, Els; Temmerman, Marleen; Yé, Maurice; Williams, Afua; Massawe, Siriel; Williams, John; Mpembeni, Rose; Loukanova, Svetla; Haefeli, Walter E; Blank, Antje

    2016-01-01

    To assess the impact of an intervention consisting of a computer-assisted clinical decision support system and performance-based incentives, aiming at improving quality of antenatal and childbirth care. Intervention study in rural primary healthcare (PHC) facilities in Burkina Faso, Ghana and Tanzania. In each country, six intervention and six non-intervention PHC facilities, located in one intervention and one non-intervention rural districts, were selected. Quality was assessed in each facility by health facility surveys, direct observation of antenatal and childbirth care, exit interviews, and reviews of patient records and maternal and child health registers. Findings of pre- and post-intervention and of intervention and non-intervention health facility quality assessments were analysed and assessed for significant (P < 0.05) quality of care differences. Post-intervention quality scores do not show a clear difference to pre-intervention scores and scores at non-intervention facilities. Only a few variables had a statistically significant better post-intervention quality score and when this is the case this is mostly observed in only one study-arm, being pre-/post-intervention or intervention/non-intervention. Post-intervention care shows similar deficiencies in quality of antenatal and childbirth care and in detection, prevention, and management of obstetric complications as at baseline and non-intervention study facilities. Our intervention study did not show a significant improvement in quality of care during the study period. However, the use of new technology seems acceptable and feasible in rural PHC facilities in resource-constrained settings, creating the opportunity to use this technology to improve quality of care. © 2015 John Wiley & Sons Ltd.

  9. First pregnancies, live birth, and in vitro fertilization outcomes after transplantation of frozen-banked ovarian tissue with a human extracellular matrix scaffold using robot-assisted minimally invasive surgery.

    Science.gov (United States)

    Oktay, Kutluk; Bedoschi, Giuliano; Pacheco, Fernanda; Turan, Volkan; Emirdar, Volkan

    2016-01-01

    Ovarian tissue cryopreservation is an experimental fertility preservation method and the transplantation techniques are still evolving. We attempted to improve the technique with the utility of a human decellularized extracellular tissue matrix (ECTM) scaffold, robot-assisted minimally invasive surgery, and perioperative pharmacological support. We prospectively studied 2 subjects with hemophagocytic lymphohistiocytosis (patient A) and non-Hodgkin lymphoma (patient B) who underwent ovarian tissue cryopreservation at the age of 23 years, before receiving preconditioning chemotherapy for hematopoietic stem cell transplantation. Both experienced ovarian failure postchemotherapy and we transplanted ovarian cortical tissues to the contralateral menopausal ovary 7 and 12 years later, using a human ECTM scaffold and robotic assistance. The ECTM scaffold tissue compatibility was shown in preclinical studies. Patients also received estrogen supplementation and baby aspirin preoperatively to aid in the revascularization process. Ovarian follicle development was observed approximately 10 (patient A) and 8 (patient B) weeks after ovarian tissue transplantation. Following 8 and 7 cycles of in vitro fertilization, 9 and 10 day-3 embryos were cryopreserved (patients A and B, respectively). While the baseline follicle-stimulating hormone (range 3.6-15.4 mIU/mL) levels near normalized by 7 months and remained steady postovarian transplantation in patient A, patient B showed improved but elevated follicle-stimulating hormone levels throughout (range 21-31 mIU/mL). Highest follicle yield was achieved 14 (8 follicles; patient A) and 11 (6 follicles; patient B) months postintervention. Patient A experienced a chemical pregnancy after the third frozen embryo transfer attempt. She then conceived following her first fresh in vitro fertilization embryo transfer and the pregnancy is currently ongoing. Patient B conceived after the first frozen embryo transfer attempt and delivered a

  10. Between the foreign and the local: French midwifery, traditional practitioners, and vernacular medical knowledge about childbirth in Lima, Peru.

    Science.gov (United States)

    Warren, Adam

    2015-01-01

    This article examines the politics of midwifery and the persecution of untitled female assistants in childbirth in early republican Peru. A close reading of late colonial publications and the works of Benita Paulina Cadeau Fessel, a French obstetriz director of a midwifery school in Lima, demonstrates both trans-Atlantic and local influences in the campaign against untitled midwives. Cadeau Fessel's efforts to promote midwifery built upon debates among writers in Peru's enlightened press, who vilified untrained midwives' and wet nurses' vernacular medical knowledge and associated them with Lima's underclass. One cannot understand the transfer of French knowledge about professional midwifery to Peru without reference to the social, political, and cultural context.

  11. 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

    2010-10-01

    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. 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. 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. in total, 58 (out of 125 eligible) hospitals responded to the survey (46% total response rate). Only hospital-level aggregate data were collected. 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. 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 and newborn health care is widely available in Lebanon, but

  12. Pregnancy after Bariatric Surgery: Obstetric and Perinatal Outcomes and the Growth and Development of Children.

    Science.gov (United States)

    Dell'Agnolo, Cátia Millene; Cyr, Caroline; de Montigny, Francine; de Barros Carvalho, Maria Dalva; Pelloso, Sandra Marisa

    2015-11-01

    Several outcomes of pregnancy after bariatric surgery are currently being studied. This cross-sectional, retrospective study evaluated the obstetric and perinatal outcomes of pregnancies in 19 women who underwent bariatric surgery, as well as the growth and development of their children, in the Southern Brazil. Among these women, 11 children were born prior to surgery and 32 were born post-surgery. The mean time between the surgery and the first pregnancy was 42.96 months. Preterm newborns were more common among the pre-surgery childbirths. Regarding growth, normal weights were observed in 27.3 % of the children in the pre-surgery births and obesity was observed in 54.5 %. In contrast, normal weights were observed in 59.4 % of the children born during the postoperative period and obesity was observed in 31.2 %. The average excess weight that the women lost prior to pregnancy was 64.88. Speech delays were found in three male children evaluated using the Denver Developmental Screening Test II. A statistical association was found between the interval from the surgery to the pregnancy and the outcome of the questionable Denver II test results (p = 0.011). Except for the large index of low birth weight, it can be concluded that pregnancy after bariatric surgery is safe. The growth rate was found to be adequate in the children born after the surgery, with reduced obesity. Although changes in speech development were detected, no factors were supported an association with pregnancy after bariatric surgery.

  13. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... of jaws and teeth. Surgery can improve chewing, speaking and breathing. While the patient's appearance may be dramatically enhanced as a result of their surgery, orthognathic surgery is performed to correct functional problems. Jaw Surgery can have a dramatic effect on ...

  14. Gastric bypass surgery

    Science.gov (United States)

    ... Roux-en-Y; Weight-loss surgery - gastric bypass; Obesity surgery - gastric bypass ... bypass surgery is not a quick fix for obesity. It will greatly change your lifestyle. After this surgery, you must eat healthy foods, control portion sizes of ...

  15. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require ...

  16. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ...

  17. Living Nanomachines

    Science.gov (United States)

    Carlier, M.-F.; Helfer, E.; Wade, R.; Haraux, F.

    The living cell is a kind of factory on the microscopic scale, in which an assembly of modular machines carries out, in a spatially and temporally coordinated way, a whole range of activities internal to the cell, including the synthesis of substances essential to its survival, intracellular traffic, waste disposal, and cell division, but also activities related to intercellular communication and exchanges with the outside world, i.e., the ability of the cell to change shape, to move within a tissue, or to organise its own defence against attack by pathogens, injury, and so on. These nanomachines are made up of macromolecular assemblies with varying degrees of complexity, forged by evolution, within which work is done as a result of changes in interactions between proteins, or between proteins and nucleic acids, or between proteins and membrane components. All these cell components measure a few nanometers across, so the mechanical activity of these nanomachines all happens on the nanometric scale. The directional nature of the work carried out by biological nanomachines is associated with a dissipation of energy. As examples of protein assemblies, one could mention the proteasome, which is responsible for the degradation of proteins, and linear molecular motors such as actomyosin, responsible for muscle contraction, the dynein-microtubule system, responsible for flagellar motility, and the kinesin-microtubule system, responsible for transport of vesicles, which transform chemical energy into motion. Nucleic acid-protein assemblies include the ribosome, responsible for synthesising proteins, polymerases, helicases, elongation factors, and the machinery of DNA replication and repair; the mitotic spindle is an integrated system involving several of these activities which drive chromosome segregation. The machinery coupling membranes and proteins includes systems involved in the energy metabolism, such as the ATP synthase rotary motor, signalling cascades, endocytosis

  18. [Laparoscopic surgery in Europe. Where are we going?].

    Science.gov (United States)

    Cuschieri, Alfred

    2006-01-01

    The most important factors that have facilitated the development of laparoscopic surgery (LS) are technological innovations and the vision of a small number of surgeons who took advantage of these advances. There are few surgical innovations that have stimulated such controversies and concerns and have raised so many medico-legal issues as LS. Although much progress has been made in LS, some important controversies remain unresolved, which are reviewed in the present article: 1. Evolution of the laparoscopic approach: total laparoscopic approach through positive-pressure capnoperitoneum, gasless laparoscopy, hand-assisted laparoscopy, and laparoscopy-assisted surgery. 2. Classification of current instrumental technology in laparoscopic surgery: a) facilitating instruments (high-power ultrasonic dissection systems); b) enabling instruments (endostapling and linear dissection devices), and c) complementary instruments: the Da Vinci robotic system. 3. Current laparoscopic surgical practice: a) interventions that definitively improve the patient's outcome (diagnostic and staging laparoscopy, cholecystectomy, adrenalectomy, splenectomy, antireflux surgery, cardiomyotomy, bariatric surgery, laparoscopic colon surgery, living donor nephrectomy); b) interventions that seem to be useful to the patient (distal pancreatic surgery, laparoscopic left hepatic resection, gastric and esophageal resections, hernioplasty), and c) interventions with uncertain benefit (right hepatectomy, pancreatoduodenectomy). 4. Future lines of development: video monitors in laparoscopic surgery, endoluminal surgery, robotic surgery, and finally, 5. Problems faced by laparoscopic surgery: quality guarantees in laparoscopic surgery, training the future laparoscopic generation, and allocation of sufficient material and human resources to laparoscopic surgery and its subspecialties.

  19. Age at first childbirth and newly diagnosed diabetes among postmenopausal women: a cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

    Science.gov (United States)

    Yarmolinsky, James; Duncan, Bruce Bartholow; Barreto, Sandhi Maria; Diniz, Maria de Fátima Sander; Chor, Dora; Schmidt, Maria Inês

    2017-01-01

    It has been reported that earlier age at first childbirth may increase the risk of adult-onset diabetes among postmenopausal women, a novel finding with important public health implications. To date, however, no known studies have attempted to replicate this finding. We aimed to test the hypothesis that age at first childbirth is associated with the risk of adult-onset diabetes among postmenopausal women. Cross-sectional analysis using baseline data from 2919 middle-aged and elderly postmenopausal women in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Age at first childbirth was determined from self-reporting and newly diagnosed diabetes through a 2-hour 75-g oral glucose tolerance test and/or glycated hemoglobin. Logistic regression was performed to examine associations between age at first childbirth and newly diagnosed diabetes among postmenopausal women. We did not find any association between age at first childbirth and diabetes, either when minimally adjusted for age, race and study center (odds ratio, OR [95% confidence interval, CI]: ≤ 19 years: 1.15 [0.82-1.59], 20-24 years: 0.90 [0.66-1.23] and ≥ 30 years: 0.86 [0.63-1.17] versus 25-29 years; P = 0.36) or when fully adjusted for childhood and adult factors (OR [95% CI]: ≤ 19 years: 0.95 [0.67-1.34], 20-24 years: 0.78 [0.56-1.07] and ≥ 30 years: 0.84 [0.61-1.16] versus 25-29 years; P = 0.40). Our current analysis does not support the existence of an association between age at first childbirth and adult-onset diabetes among postmenopausal women, which had been reported previously.

  20. 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.

  1. Evaluation of Mackey Childbirth Satisfaction Rating Scale in Iran: What Are the Psychometric Properties?

    Directory of Open Access Journals (Sweden)

    Moudi

    2016-05-01

    Full Text Available Background 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. Objectives 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. Patients and Methods 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. Results 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

  2. The role of HIV-related stigma in utilization of skilled childbirth services in rural Kenya: a prospective mixed-methods study.

    Directory of Open Access Journals (Sweden)

    Janet M Turan

    Full Text Available 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 high HIV prevalence area in rural Kenya, in which we examined the role of women's perceptions of HIV-related stigma during pregnancy in their subsequent utilization of maternity services.From 2007-2009, 1,777 pregnant women with unknown HIV status completed an interviewer-administered questionnaire assessing their perceptions of HIV-related stigma before being offered HIV testing during their first antenatal care visit. After the visit, a sub-sample of women was selected for follow-up (all women who tested HIV-positive or were not tested for HIV, and a random sample of HIV-negative women, n = 598; 411 (69% were located and completed another questionnaire postpartum. Additional qualitative in-depth interviews with community health workers, childbearing women, and family members (n = 48 aided our interpretation of the quantitative findings and highlighted ways in which HIV-related stigma may influence birth decisions. Qualitative data revealed that health facility birth is commonly viewed as most appropriate for women with pregnancy complications, such as HIV. Thus, women delivering at health facilities face the risk of being labeled as HIV-positive in the community. Our quantitative data revealed that women with higher perceptions of HIV-related stigma (specifically those who held negative attitudes about persons living with HIV at baseline were subsequently less likely to deliver in a health facility with a skilled attendant, even after adjusting for other known predictors of health facility delivery (adjusted odds ratio = 0.44, 95% CI 0.22-0.88.Our findings point to the urgent need for interventions to reduce HIV-related stigma, not only for improving quality of

  3. The prevalence, incidence and risk factors of herpes simplex virus type 2 infection among pregnant Zimbabwean women followed up nine months after childbirth

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    Mashavave Grace V

    2010-01-01

    Full Text Available Abstract Background Herpes simplex virus type 2 (HSV-2 is the leading cause of genital ulcer disease worldwide. The virus can be transmitted to neonates and there are scarce data regarding incidence of HSV-2 among women in pregnancy and after childbirth. The aim of this study is to measure the incidence and risk factors for HSV-2 infection in women followed for 9 months after childbirth. Methods Pregnant women were consecutively enrolled late in pregnancy and followed at six weeks, four and nine months after childbirth. Stored samples were tested for HSV-2 at baseline and again at nine months after childbirth and HSV-2 seropositive samples at nine months after childbirth (seroconverters were tested retrospectively to identify the seroconversion point. Results One hundred and seventy-three (50.9% of the 340 consecutively enrolled pregnant women were HSV-2 seronegative at baseline. HSV-2 incidence rate during the 10 months follow up was 9.7 (95% CI 5.4-14.4/100 and 18.8 (95% CI 13.9-26.1/100 person years at risk (PYAR at four months and nine months after childbirth respectively. Analysis restricted to women reporting sexual activity yielded higher incidence rates. The prevalence of HSV-2 amongst the HIV-1 seropositive was 89.3%. Risk factors associated with HSV-2 seropositivity were having other sexual partners in past 12 months (Prevalence Risk Ratio (PRR 1.8 (95% CI 1.4-2.4 and presence of Trichomonas vaginalis (PRR 1.7 95% CI 1.4-2.1. Polygamy (Incidence Rate Ratio (IRR 4.4, 95% CI 1.9-10.6 and young age at sexual debut (IRR 3.6, 95% CI 1.6-8.3 were associated with primary HSV-2 infection during the 10 months follow up. Conclusions Incidence of HSV-2 after childbirth is high and the period between late pregnancy and six weeks after childbirth needs to be targeted for prevention of primary HSV-2 infection to avert possible neonatal infections.

  4. Oral surgery: part 2. Endodontic surgery.

    Science.gov (United States)

    Pop, I

    2013-09-01

    In the past, the interaction between dentoalveolar surgery and restorative dentistry has been limited to the removal of teeth with pulp and/or periradicular disease or those that were unrestorable. However, with the increasing dental awareness of the population and the retention of teeth into later life, the interaction between dentoalveolar surgery and restorative dentistry is becoming a fundamental aspect of clinical practice. Indeed, endodontic and implant surgery are core activities that facilitate the retention of a functional dentition.

  5. Premature childbirth: pregnant women's characteristics of a population in the South area of São Paulo

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    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.

  6. 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.

  7. Analysis of a humanization proposal to the childbirth - doi 10.4025/actascihealthsci.v34i2.9476

    Directory of Open Access Journals (Sweden)

    Alexandrina Aparecida Maciel Cardelli

    2012-09-01

    Full Text Available The objective of this research study was to analyze the continuity of activities implemented in a maternity ward in the city of Londrina to improve humanized childbirth assistance. This is an observational study, with a qualitative approach, featuring a study sample of 30 parturient women diagnosed with impending labor, as well as staff, faculty and students, totaling 28 health professionals. The instrument for data collection was based on categories of obstetrical practices of the practical guide for normal delivery assistance from the OMS (1996, which were checked through the observation technique during labor, delivery and postpartum, consisting of variables related to patient obstetric history transcribed from medical records. We observed some positive point; for instance, all women had the company of another person during moments of assistance, privacy in the form of screens and curtains, relaxation techniques, among others. We observed some negative points when the parturient was not given the right to decide on a preferred position for labor, as well as frequent vaginal tests, performed by more than one person. It can be assumed that all implemented measures have discouraged medical-assisted childbirth, and encouraged biomechanical practices and interventions during labor, which are considered more appropriate to the physiology of the procedure.  

  8. Traditions and plant use during pregnancy, childbirth and postpartum recovery by the Kry ethnic group in Lao PDR

    Science.gov (United States)

    2011-01-01

    Background Activities and diet during the postpartum period are culturally dictated in many Southeast Asian cultures, and a period of confinement is observed. Plants play an important role in recovery during the postpartum period in diet and traditional medicine. Little is known of the Kry, a small ethnic group whose language was recently described, concerning its traditions and use of plants during pregnancy, parturition, postpartum recovery and infant healthcare. This research aims to study those traditions and identify medicinal plant use. Methods Data were collected in the 3 different Kry villages in Khammouane province, Lao PDR, through group and individual interviews with women by female interviewers. Results A total of 49 different plant species are used in women's healthcare. Plant use is culturally different from the neighboring Brou and Saek ethnic groups. Menstruation, delivery and postpartum recovery take place in separate, purpose-built, huts and a complex system of spatial restrictions is observed. Conclusions Traditions surrounding childbirth are diverse and have been strictly observed, but are undergoing a shift towards those from neighboring ethnic groups, the Brou and Saek. Medicinal plant use to facilitate childbirth, alleviate menstruation problems, assist recovery after miscarriage, mitigate postpartum haemorrhage, aid postpartum recovery, and for use in infant care, is more common than previously reported (49 species instead of 14). The wealth of novel insights into plant use and preparation will help to understand culturally important practices such as traditional delivery, spatial taboos, confinement and dietary restrictions, and their potential in modern healthcare. PMID:21569234

  9. Traditions and plant use during pregnancy, childbirth and postpartum recovery by the Kry ethnic group in Lao PDR

    Directory of Open Access Journals (Sweden)

    de Boer Hugo J

    2011-05-01

    Full Text Available Abstract Background Activities and diet during the postpartum period are culturally dictated in many Southeast Asian cultures, and a period of confinement is observed. Plants play an important role in recovery during the postpartum period in diet and traditional medicine. Little is known of the Kry, a small ethnic group whose language was recently described, concerning its traditions and use of plants during pregnancy, parturition, postpartum recovery and infant healthcare. This research aims to study those traditions and identify medicinal plant use. Methods Data were collected in the 3 different Kry villages in Khammouane province, Lao PDR, through group and individual interviews with women by female interviewers. Results A total of 49 different plant species are used in women's healthcare. Plant use is culturally different from the neighboring Brou and Saek ethnic groups. Menstruation, delivery and postpartum recovery take place in separate, purpose-built, huts and a complex system of spatial restrictions is observed. Conclusions Traditions surrounding childbirth are diverse and have been strictly observed, but are undergoing a shift towards those from neighboring ethnic groups, the Brou and Saek. Medicinal plant use to facilitate childbirth, alleviate menstruation problems, assist recovery after miscarriage, mitigate postpartum haemorrhage, aid postpartum recovery, and for use in infant care, is more common than previously reported (49 species instead of 14. The wealth of novel insights into plant use and preparation will help to understand culturally important practices such as traditional delivery, spatial taboos, confinement and dietary restrictions, and their potential in modern healthcare.

  10. Perioperative management of facial bipartition surgery

    Directory of Open Access Journals (Sweden)

    Caruselli M

    2015-11-01

    Full Text Available Marco Caruselli,1 Michael Tsapis,1,2 Fabrice Ughetto,1 Gregoire Pech-Gourg,3 Dario Galante,4 Olivier Paut1 1Anesthesia and Intensive Care Unit, La Timone Children’s Hospital, 2Pediatric Transport Team, SAMU 13, La Timone Hospital, 3Pediatric Neurosurgery Unit, La Timone Children’s Hospital, Marseille, France; 4Anesthesia and Intensive Care Unit, University Hospital Ospedali Riuniti of Foggia, Foggia, Italy Abstract: Severe craniofacial malformations, such as Crouzon, Apert, Saethre-Chotzen, and Pfeiffer syndromes, are very rare conditions (one in 50,000/100,000 live births that often require corrective surgery. Facial bipartition is the more radical corrective surgery. It is a high-risk intervention and needs complex perioperative management and a multidisciplinary approach. Keywords: craniofacial surgery, facial bipartition surgery, craniofacial malformations, pediatric anesthesia

  11. Exploring the Mental Health of Living Kidney Donors

    NARCIS (Netherlands)

    L. Timmerman (Lotte)

    2015-01-01

    markdownabstractAbstract Living donor kidney transplantation is the best option for extending and improving the lives of patients with end-stage renal disease. The benefits for the donor are less straightforward: a donor is a healthy person who undergoes a surgery in the first place for the benef

  12. Exploring the Mental Health of Living Kidney Donors

    NARCIS (Netherlands)

    L. Timmerman (Lotte)

    2015-01-01

    markdownabstractAbstract Living donor kidney transplantation is the best option for extending and improving the lives of patients with end-stage renal disease. The benefits for the donor are less straightforward: a donor is a healthy person who undergoes a surgery in the first place for the

  13. Infections in outpatient surgery.

    Science.gov (United States)

    Nazarian Mobin, Sheila S; Keyes, Geoffrey R; Singer, Robert; Yates, James; Thompson, Dennis

    2013-07-01

    In the plastic surgery patient population, outpatient surgery is cost effective and will continue to grow as the preferred arena for performing surgery in healthy patients. Although there is a widespread myth that outpatient surgery centers may suffer from increased infection rates due to lax infection control, the data presented from American Association for Accreditation of Ambulatory Surgery Facilities-accredited facilities prove the contrary. There is a lack of data investigating infection prevention in the perioperative period in plastic surgery patients. As data collection becomes more refined, tracking the postoperative care environment should offer additional opportunities to lower the incidence of postoperative infections.

  14. [Thymus surgery in a general surgery department].

    Science.gov (United States)

    Mega, Raquel; Coelho, Fátima; Pimentel, Teresa; Ribero, Rui; Matos, Novo de; Araújo, António

    2005-01-01

    Evaluation of thymectomy cases between 1990-2003, in a General Surgery Department. Evaluation of the therapeutic efficacy in Miastenia Gravis patients. Retrospective study based on evaluation of data from Serviço de Cirurgia, Neurologia and Consult de Neurology processes, between 1990-2003, of 15 patients submitted to total thymectomy. 15 patients, aged 17 to 72, 11 female and 4 male. Miastenia Gravis was the main indication for surgery, for uncontrollable symptoms or suspicion of thymoma. In patients with myasthenia, surgery was accomplish after compensation of symptoms. There weren't post-surgery complications. Pathology were divided in thymic hyperplasia and thymoma. Miastenia patients have there symptoms diminished or stable with reduction or cessation of medical therapy. Miastenia was the most frequent indication for thymectomy. Surgery was good results, with low morbimortality, as long as the protocols are respected.

  15. Living Gluten Free

    Science.gov (United States)

    ... please turn JavaScript on. Feature: Celiac Disease Living Gluten Free Past Issues / Spring 2015 Table of Contents ... Learning to Live Well with Celiac Disease / Living Gluten-Free Spring 2015 Issue: Volume 10 Number 1 ...

  16. Hand Hygiene Saves Lives

    Medline Plus

    Full Text Available ... children, parents, and public health professionals. More > Hand Hygiene Saves Lives (5:10) Recommend on Facebook Tweet Share Compartir Hand Hygiene Saves Lives Hand Hygiene Saves Lives Transcript [28 KB, 2 pages] High ...

  17. Hand Hygiene Saves Lives

    Medline Plus

    Full Text Available ... including, children, parents, and public health professionals. More > Hand Hygiene Saves Lives (5:10) Recommend on Facebook Tweet Share Compartir Hand Hygiene Saves Lives Hand Hygiene Saves Lives Transcript [28 KB, 2 pages] High ...

  18. Hand Hygiene Saves Lives

    Science.gov (United States)

    ... including, children, parents, and public health professionals. More > Hand Hygiene Saves Lives (5:10) Recommend on Facebook Tweet Share Compartir Hand Hygiene Saves Lives Hand Hygiene Saves Lives Transcript [28 KB, 2 pages] High ...

  19. Living with endometriosis

    Science.gov (United States)

    Pelvic pain - living with endometriosis; Endometrial implant - living with endometriosis; Endometrioma - living with endometriosis ... counter pain relievers can reduce the pain of endometriosis. These include: Ibuprofen (Advil) Naproxen (Aleve) Acetaminophen (Tylenol) ...

  20. Living with an Arrhythmia

    Science.gov (United States)

    ... from the NHLBI on Twitter. Living With an Arrhythmia Many arrhythmias are harmless. It's common to have an occasional ... heartbeat or mild palpitations . People who have harmless arrhythmias can live healthy lives. They usually don't ...

  1. Bariatric Surgery Procedures

    Science.gov (United States)

    ... Center Access to Care Toolkit EHB Access Toolkit Bariatric Surgery Procedures Bariatric surgical procedures cause weight loss by ... Bariatric procedures also often cause hormonal changes. Most weight loss surgeries today are performed using minimally invasive techniques (laparoscopic ...

  2. Complications of Sinus Surgery

    Science.gov (United States)

    ... further intracranial surgeries. Impaired sense of taste or smell : The sense of smell usually improves after the procedure because airflow is ... in their voice after sinus surgery. Impairment of smell or taste: (see above) Infection: The most common ...

  3. Bariatric Surgery Misconceptions

    Science.gov (United States)

    ... from depression or anxiety and to have lower self-esteem and overall quality of life than someone who ... is a Candidate for Bariatric Surgery? Childhood and Adolescent Obesity Find a Provider Benefits of Bariatric Surgery ...

  4. Pediatric heart surgery - discharge

    Science.gov (United States)

    ... discharge; Heart valve surgery - children - discharge; Heart surgery - pediatric - discharge; Heart transplant - pediatric - discharge ... Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 434. ...

  5. Breast Reduction Surgery

    Science.gov (United States)

    ... breastfeeding: A systematic review. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2010;63:1688. Kerrigan CL, et al. Evidence-based medicine: Reduction mammoplasty. Plastic and Reconstructive Surgery. 2013;132: ...

  6. Aids and Surgery

    African Journals Online (AJOL)

    user

    HIV/AIDS patients require surgery sometimes during their illness. ... risks to surgical equipes and analysing preventive strategies to HIV ... problems in patients presenting HIV, AIDS and ... Dentistry, Surgery of Awolowo University in Nigeria3.

  7. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... best performed by a trained surgeon with specialized education and training. Click here to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures involving skin, muscle, ...

  8. Weight Loss Surgery

    Science.gov (United States)

    Weight loss surgery helps people with extreme obesity to lose weight. It may be an option if you ... caused by obesity. There are different types of weight loss surgery. They often limit the amount of food ...

  9. Ear Plastic Surgery

    Science.gov (United States)

    ... ENTCareers Marketplace Find an ENT Doctor Near You Ear Plastic Surgery Ear Plastic Surgery Patient Health Information ... they may improve appearance and self-confidence. Can Ear Deformities Be Corrected? Formation of the ear during ...

  10. Scoliosis surgery - child

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007383.htm Scoliosis surgery - child To use the sharing features on this page, please enable JavaScript. Scoliosis surgery repairs abnormal curving of the spine ( scoliosis ). ...

  11. Cosmetic breast surgery - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000273.htm Cosmetic breast surgery - discharge To use the sharing features on this page, please enable JavaScript. You had cosmetic breast surgery to change the size or shape ...

  12. LASIK Eye Surgery

    Science.gov (United States)

    ... are nearsighted. You may need another refractive surgery (enhancement surgery) within a year to remove more tissue. ... may happen due to certain conditions, such as abnormal wound healing, hormonal imbalances or pregnancy. Visual loss ...

  13. Laparoscopic Spine Surgery

    Science.gov (United States)

    ... Exhibit Opportunities Sponsorship Opportunities Log In Laparoscopic Spine Surgery Patient Information from SAGES Download PDF Find a SAGES Surgeon Laparoscopic Spine Surgery Your spine surgeon has determined that you need ...

  14. Types of Heart Surgery

    Science.gov (United States)

    ... from the NHLBI on Twitter. Types of Heart Surgery Coronary Artery Bypass Grafting Coronary artery bypass grafting ( ... TAHs) might be used to treat these patients. Surgery To Place Ventricular Assist Devices or Total Artificial ...

  15. Cosmetic ear surgery

    Science.gov (United States)

    Otoplasty; Ear pinning; Ear surgery - cosmetic; Ear reshaping; Pinnaplasty ... Cosmetic ear surgery may be done in the surgeon's office, an outpatient clinic, or a hospital. It can be performed under ...

  16. Hip fracture surgery

    Science.gov (United States)

    ... neck fracture repair; Trochanteric fracture repair; Hip pinning surgery; Osteoarthritis - hip ... You may receive general anesthesia for this surgery. This means you ... spinal anesthesia . With this kind of anesthesia, medicine is ...

  17. Surgery for Testicular Cancer

    Science.gov (United States)

    ... Stage Testicular Cancer Treating Testicular Cancer Surgery for Testicular Cancer Surgery is typically the first treatment for all ... Testicular Cancer, by Type and Stage More In Testicular Cancer About Testicular Cancer Causes, Risk Factors, and Prevention ...

  18. Heart valve surgery

    Science.gov (United States)

    ... Tricuspid valve stenosis Risks The risks of having cardiac surgery include: Death Heart attack Heart failure Bleeding requiring ... and the A.D.A.M. Editorial team. Heart Surgery Read more Heart Valve Diseases Read more Latest ...

  19. Otoplasty (Cosmetic Ear Surgery)

    Science.gov (United States)

    ... By Mayo Clinic Staff Otoplasty — also known as cosmetic ear surgery — is a procedure to change the ... Society of Plastic Surgeons. http://www.plasticsurgery.org/Cosmetic-Procedures/Ear-Surgery.html. Accessed June 16, 2015. ...

  20. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... best performed by a trained surgeon with specialized education and training. Click here to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures involving skin, muscle, ...

  1. Cellular-level surgery using nano robots.

    Science.gov (United States)

    Song, Bo; Yang, Ruiguo; Xi, Ning; Patterson, Kevin Charles; Qu, Chengeng; Lai, King Wai Chiu

    2012-12-01

    The atomic force microscope (AFM) is a popular instrument for studying the nano world. AFM is naturally suitable for imaging living samples and measuring mechanical properties. In this article, we propose a new concept of an AFM-based nano robot that can be applied for cellular-level surgery on living samples. The nano robot has multiple functions of imaging, manipulation, characterizing mechanical properties, and tracking. In addition, the technique of tip functionalization allows the nano robot the ability for precisely delivering a drug locally. Therefore, the nano robot can be used for conducting complicated nano surgery on living samples, such as cells and bacteria. Moreover, to provide a user-friendly interface, the software in this nano robot provides a "videolized" visual feedback for monitoring the dynamic changes on the sample surface. Both the operation of nano surgery and observation of the surgery results can be simultaneously achieved. This nano robot can be easily integrated with extra modules that have the potential applications of characterizing other properties of samples such as local conductance and capacitance.

  2. The Joanna Briggs Institute best practice information sheet: the effectiveness of pelvic floor muscle exercises on urinary incontinence in women following childbirth.

    Science.gov (United States)

    2011-09-01

    This Best Practice Information Sheet is derived from 21 studies and aims to synthesize the best available evidence on the effectiveness of pelvic floor muscle exercises on urinary incontinence in women following childbirth. The information that is contained in this sheet has been derived from studies that were included in a systematic review that was conducted by the Joanna Briggs Institute. The original references can be sourced from the systematic review. Pregnancy and childbirth are major risk factors for the development of urinary incontinence as the muscles of the pelvic floor become stretched and weakened. For some women, such incontinence after childbirth is temporary, but for others, their suffering can be of much longer-term duration. A number of risk factors has been identified for urinary incontinence following childbirth, including antenatal urinary incontinence, obesity, and significant perineal trauma. The aim of pelvic floor muscle exercises is to strengthen the perivaginal and perianal musculature in order to increase a woman's control of urinary leakage.

  3. 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.

    2008-01-01

    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

  4. Clinical Study: Change in Outlook Towards Birth After a Midwife Led Antenatal Education Programme Versus Hypnoreflexogenous Self-Hypnosis Training for Childbirth

    Science.gov (United States)

    Streibert, L. A.; Reinhard, J.; Yuan, J.; Schiermeier, S.; Louwen, F.

    2015-01-01

    Aim: To compare the change of maternal outlook towards birth due to a midwife led antenatal education programme versus hypnoreflexogenous self-hypnosis training for childbirth. Method: Before beginning of the classes and after the last class maternal perception on birth was evaluated using Osgood semantic differential questionnaire. The Gießen personality score was evaluated once. Results: 213 patients were enrolled in this study. 155 were in the midwife led education programme and 58 in the self-hypnosis training programme. There was no statistically significant difference between the two groups in regard of participantsʼ characteristics, Gießen personality score and initial Osgood semantic differential scores. After the midwife led course childbirth was emotionally more negatively scored (displeasure, tarnishing, dimension evaluation [p hypnosis course childbirth was emotionally more positively evaluated (pleasure, harmony, dimension evaluation [p hypnosis training resulted in a positive maternal outlook towards childbirth, in comparison to the midwife led course. Further prospective randomised studies are required to test these initial results. PMID:26719600

  5. 自由体位分娩对促进自然分娩的影响分析%Analysis on the impact of liberal position childbirth on promoting natural childbirth

    Institute of Scientific and Technical Information of China (English)

    曾彩贤; 何倩佞

    2015-01-01

    目的:总结分析自由体位在促进自然分娩中的应用效果。方法选择2010年6月至2012年11月期间我院产科收治的100例待产孕妇为研究对象,随机分为观察组和对照组各50例,对照组孕妇选择常规体位分娩,观察组孕妇选择自由体位,比较两组分娩方式、各产程时间以及母婴并发症情况。结果观察组阴道自然分娩率86.00%明显高于对照组62.00%,差异具有统计学意义(P<0.05);观察组第一、二产程及总产程时间明显低于对照组,差异具有统计学意义(P<0.05);观察组产妇并发症发生率18.0%明显低于对照组56.0%,差异具有统计学意义(P<0.05)。结论在第一产程中产妇选择自由体位有利于自然分娩的进程,有利于母婴结局和产后康复,值得推广使用。%Objective This article was to investigate the clinical efficacy of liberal position childbirth in naturalchildbirth.Methods 100 cases of pregnant women hospitalized in our hospital during June 2010 and November 2012 were selected as study subjects and they were divided into the control group (50) and observation group ( 50 ) , pregnant women in control group adopted general position during the childbirth process and the women in observation group(50) adopted liberal position childbirth.The mode of delivery, each stage of labor and maternal and neonatal complications of the two groups were analyzed.Results Natural vaginal delivery rate of the observation group( 86.00%) was significantly higher than that of the control group (62.00%)(P<0.05. The first, second and total stage of labor time of observation group was significantly less than the control group ( P<0.05).Maternal morbidity of observation group (18.0%) was significantly lower than the control group(56. 0%)(P<0.05).Conclusions In the first stage of delivery liberal position is in favor of natural childbirth process and maternal and neonatal outcomes

  6. 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

  7. Breast Cancer Surgery

    Science.gov (United States)

    FACTS FOR LIFE Breast Cancer Surgery The goal of breast cancer surgery is to remove the whole tumor from the breast. Some lymph nodes ... might still be in the body. Types of breast cancer surgery There are two types of breast cancer ...

  8. Relaxation strategies for patients during dermatologic surgery.

    Science.gov (United States)

    Shenefelt, Philip D

    2010-07-01

    Patient stress and anxiety are common preoperatively and during dermatologic procedures and surgeries. Stress and anxiety can occasionally interfere with performance of procedures or surgery and can induce hemodynamic instability, such as elevated blood pressure or syncope, as well as producing considerable discomfort for some patients. Detection of excess stress and anxiety in patients can allow the opportunity for corrective or palliative measures. Slower breathing, biofeedback, progressive muscular relaxation, guided imagery, hypnosis, meditation and music can help calm and rebalance the patient's autonomic nervous system and immune functioning. Handheld miniaturized heart rate variability biofeedback devices are now available. The relaxation response can easily be taught. Guided imagery can be recorded or live. Live rapid induction hypnosis followed by deepening and then self-guided imagery requires no experience on the part of the patient but does require training and experience on the part of a provider. Recorded hypnosis inductions may also be used. Meditation generally requires more prior experience and training, but is useful when the patient already is skilled in it. Live, guided meditation or meditation recordings may be used. Relaxing recorded music from speakers or headphones or live performance music may also be employed to ease discomfort and improve the patient's attitude for dermatologic procedures and surgeries.

  9. The effects of women's knowledge about painless childbirth on their fear of childbirth and delivery way%无痛分娩认知度对分娩恐惧及分娩方式选择的影响

    Institute of Scientific and Technical Information of China (English)

    朱江妃

    2016-01-01

    Objective We aimed to study the effects of women's knowledge about painless childbirth on their fear of childbirth (FOC)and delivery way,so as to provide reference for antenatal education.Methods the pregnant women came to our hospital for childbirth were selected as study objects.Their obstetric characteristics,the FOC, knowledge about painless childbirth,and delivery way were investigated by W -DEQ questionnaire and our designed questionnaire,and then according to their information,these subjects were divided into different groups and were com-pared.Results The mean W -DEQ score of the cognitive group was (65.76 ±10.53)points,which was higher than (72.45 ±9.28)points of the non -cognitive group (t =8.7,P <0.05).The number of pregnant women with FOC in the cognitive group was 54cases(13.27%),while the number of pregnant women with FOC in the non -cognitive group was 59 cases (20.14%),and the difference between the two groups was statistically significant (χ2 =5.94, P <0.05).The numbers of cesarean section and vaginal delivery in the pregnant women with FOC in the cognitive group were 6 cases (11.11%)and 48 cases (88.89%),respectively,while the corresponding numbers in the preg-nant women with FOC in the non -cognitive group were 54 cases (91.53%)and 5 cases (8.47%),respectively, and the difference between the two groups was statistically significant (χ2 =73.21,P <0.01).The numbers of cesar-ean section and vaginal delivery in the pregnant women without FOC in the cognitive group were 42 cases (11.89%) and 311 cases (88.11%),respectively,while the corresponding numbers in the pregnant women without FOC in the non -cognitive group were 78 cases (33.33%)and 156 cases (66.67%),respectively,and the difference between the two groups was statistically significant (χ2 =39.74,P <0.01).Conclusion Women's knowledge about painless childbirth will reduce their FOC,and then urge them to choose the delivery way they like for childbirth (vaginal deliv-ery).Thus,it is

  10. Surgery Videos: MedlinePlus

    Science.gov (United States)

    ... Winston-Salem, NC, 1/15/2009) Weight Loss Surgery Laparoscopic Gastric Bypass Surgery (University of Miami Hospital ... Boston, Boston, MA, 6/08/2010) Weight Loss Surgery Laparoscopic Gastric Bypass Surgery (University of Miami Hospital ...

  11. Laparoscopic nephrectomy in live donor

    Directory of Open Access Journals (Sweden)

    Mitre Anuar I.

    2004-01-01

    Full Text Available OBJECTIVE: To present the initial experience of videolaparoscopic nephrectomy in live renal donor. MATERIALS AND METHODS: In the period from April 2000 to August 2003, 50 left nephrectomies in live donor were performed by videolaparoscopy for transplantation. Twenty-eight patients were male (56% and 22 female (44%. Mean age was 37.2 years, and the mean body mass index (BMI was 27.1 kg/m². RESULTS: Mean surgical time was 179.5 minutes, and warm ischemia time of the graft was 3.79 minutes. The mean estimated bleeding was 141 mL. There was no need of blood transfusion or conversion to open surgery. In 42 cases (84%, the vascular portion of the graft was considered good by the recipient's surgical team and in all cases, the ureter was considered of proper size, though in one of them (2% its vascularization was considered improper. The transplanted kidneys produced urine still in the surgical room in 46 of the 50 transplantations considered. In only 2 cases opioid was required for analgesia. In average, 3.1 doses of dipyrone were used for each patient during hospital stay, and hospital discharge occurred, in average, after 3.2 days post-operatively. Two patients required re-operations and one of them evolved to death. CONCLUSIONS: The laparoscopic nephrectomy in live donor for renal transplantation is an alternative to conventional open surgery. In relation to the graft, no alteration, either anatomic or functional, was detected. Though there is already a large documentation in the international literature regarding this procedure, in our setting a prospective randomized study with the usual surgical study is still necessary in order to prove the advantages and disadvantages of the method.

  12. Factors associated with maternal near miss in childbirth and the postpartum period: findings from the birth in Brazil National Survey, 2011–2012

    Directory of Open Access Journals (Sweden)

    Rosa Maria Soares Madeira Domingues

    2016-10-01

    Full Text Available Abstract Background Maternal near-miss (MNM audits are considered a useful approach to improving maternal healthcare. The aim of this study was to evaluate the factors associated with maternal near-miss cases in childbirth and the postpartum period in Brazil. Methods The study is based on data from a nationwide hospital-based survey of 23,894 women conducted in 2011–2012. The data are from interviews with mothers during the postpartum period and from hospital medical files. Univariate and multivariable logistic regressions were performed to analyze factors associated with MNM, including estimation of crude and adjusted odds ratios and their respective 95 % confidence intervals (95 % CI. Results The estimated incidence of MNM was 10.2/1,000 live births (95 % CI: 7.5–13.7. In the adjusted analyses, MNM was associated with the absence of antenatal care (OR: 4.65; 95 % CI: 1.51–14.31, search for two or more services before admission to delivery care (OR: 4.49; 95 % CI: 2.12–9.52, obstetric complications (OR: 9.29; 95 % CI: 6.69–12.90, and type of birth: elective C-section (OR: 2.54; 95 % CI: 1.67–3.88 and forceps (OR: 9.37; 95 % CI: 4.01–21.91. Social and demographic maternal characteristics were not associated with MNM, although women who self-reported as white and women with higher schooling had better access to antenatal and maternity care services. Conclusion The high proportion of elective C-sections performed among women in better social and economic situations in Brazil is likely attenuating the benefits that could be realized from improved prenatal care and greater access to maternity services. Strategies for reducing the rate of MNM in Brazil should focus on: 1 increasing access to prenatal care and delivery care, particularly among women who are at greater social and economic risk and 2 reducing the rate of elective cesarean section, particularly among women who receive services at private maternity facilities, where

  13. A study of marital satisfaction among non-depressed and depressed mothers after childbirth in Jahrom, Iran, 2014.

    Science.gov (United States)

    Kargar Jahromi, Marzieh; Zare, Azam; Taghizadeganzadeh, Mahboobeh; Rahmanian Koshkaki, Afifeh

    2014-11-26

    Birth is one of the most wonderful events in nature and pregnancy and delivery are major developments for most married women. Similar to the pregnancy period, the period of time following delivery is accompanied by certain mental and physical changes in women. During this time, mothers experience a full range of mental disorders, varying from minor to psychotic. The objective of this study was to examine marital satisfaction among non-depressed and depressed mothers who visited primary health centers in Jahrom after childbirth in 2014. This is a descriptive cross-sectional study. The study population consisted of 80 mothers, who were in the 6 to 12 weeks of delivery and had visited primary health centers in Jahrom from April to July, 2014.To select the participants, the researcher looked thorough the files at each center and chose the mothers who were qualified for the study based on convenience sampling. The criteria for participation were: being aged from 20 to 40; being in the 6-12 weeks since delivery; having a healthy newborn; willingness to participate in the study. The participants were divided into the two groups of mothers suffering from postpartum depression (40 women) and mothers not affected by postpartum depression (40 women) on basis of questionnaire. The study follows the ethics in a scientific study. The researcher personally visited the primary health centers and explained the objectives of the study to the participants. Subsequently, the participants were asked to complete a demographic questionnaire, Enrich Marital Satisfaction Scale, and Edinburgh Postpartum Depression Scale. The participants were allowed one hour to complete the questionnaires. The results showed that the average age of depressed and non-depressed women was respectively 28.1 ± 5 and 29.4 ± 5.5. Regarding the sex of the newborns, 53% of the depressed women had a son and 46.7% had a daughter. In the non-depressed group, 43.3% of the mothers had a son and 56.7% had a daughter

  14. The effect of four-phase teaching method on midwifery students' emotional intelligence in managing the childbirth.

    Science.gov (United States)

    Mohamadirizi, Soheila; Fahami, Fariba; Bahadoran, Parvin; Ehsanpour, Soheila

    2015-01-01

    An active teaching method has been used widely in medical education. The aim of this study was to determine the effectiveness of the four-phase teaching method on midwifery students' emotional intelligence (EQ) in managing the childbirth. This was an experimental study that performed in 2013 in Isfahan University of Medical Sciences. Thirty midwifery students were involved in this study and selected through a random sampling method. The EQ questionnaire (43Q) was completed by both the groups, before and after the education. The collected data were analyzed using SPSS 14, the independent t-test, and the paired t-test. The statistically significant level was considered to be teaching method can increase the EQ levels of midwifery students. Therefore, the conduction of this educational model is recommended as an effective learning method.

  15. Allergy, living and learning

    DEFF Research Database (Denmark)

    Chivato, T; Valovirta, E; Dahl, R;

    2012-01-01

    Allergy Living and Learning (ALL) is a European initiative designed to increase knowledge and understanding of people living with allergies in order to improve respiratory allergy care.......Allergy Living and Learning (ALL) is a European initiative designed to increase knowledge and understanding of people living with allergies in order to improve respiratory allergy care....

  16. Bariatric surgery for obesity and diabetes.

    Science.gov (United States)

    Azizi, Fereidoun

    2013-03-01

    With the imminent threat of a global health crisis of obesity and diabetes or "diabesity" as it is referred to today, healthcare professionals urgently need an effective range of treatment options for management of these two epidemics. After many decades in obscurity, bariatric surgery has emerged as an impressive treatment of obesity and type 2 diabetes. The field of bariatric surgery has seen a rapid evolution over the last 30 years and current procedures are safe, effective, less invasive, and relatively cost- effective. Bariatric procedures produce durable weight loss, long -term remission of type 2 diabetes, and beneficial effects on other comorbidities; they lead to a significant reduction in mortality in the long term. The adverse events after surgery are not uncommon but in majority of cases are not fatal. Bariatric surgery is costly, but cost-efficacy analysis consistently shows that the additional years of lives gained through bariatric surgery can be obtained at a reasonable and affordable cost. However, universal surgical treatment of obesity is not achievable with the world's current healthcare and surgical resources. The conclusion of this review is that although bariatric surgery is a good addition to management of obesity and diabetes, these epidemics must be addressed by more comprehensive and long-term health policy efforts and appropriate research to determine the most effective ways of prevention and nonsurgical alternatives to treat obesity and type 2 diabetes.

  17. Perioperatory antibiotic prophylaxis in Pediatric Surgery (Part II: non-abdominal surgery.

    Directory of Open Access Journals (Sweden)

    Sergio Luis González López

    2005-12-01

    Full Text Available The surgical wound infection is the biggest cause of infectious morbility in surgical patients. It is an important cause of morbility that causes lincreased hospital demurrages, increased cost of medical attention and serious inconveniences to the patients and their familiies. 25% of all nosocomial infections are surgical wound infection. One of the big advances of the surgery in the last three decades is an introduction of antibiotic prophylaxis in the surgical practice. Is considered that it has saved more lives than any other novel procedure in surgery in the last 20 years. We presented the Good Clinical Practices Guideline for Antibiotic prophylaxis in no-abdominal surgery, approved by consensus in the 1st National Good Clinical Practices Workshop in Pediatric Surgery (Cienfuegos, Cuba, March 7 – 9, 2002.

  18. Development of plastic surgery

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    Pećanac Marija Đ.

    2015-01-01

    Full Text Available Introduction. Plastic surgery is a medical specialty dealing with corrections of defects, improvements in appearance and restoration of lost function. Ancient Times. The first recorded account of reconstructive plastic surgery was found in ancient Indian Sanskrit texts, which described reconstructive surgeries of the nose and ears. In ancient Greece and Rome, many medicine men performed simple plastic cosmetic surgeries to repair damaged parts of the body caused by war mutilation, punishment or humiliation. In the Middle Ages, the development of all medical braches, including plastic surgery was hindered. New age. The interest in surgical reconstruction of mutilated body parts was renewed in the XVIII century by a great number of enthusiastic and charismatic surgeons, who mastered surgical disciplines and became true artists that created new forms. Modern Era. In the XX century, plastic surgery developed as a modern branch in medicine including many types of reconstructive surgery, hand, head and neck surgery, microsurgery and replantation, treatment of burns and their sequelae, and esthetic surgery. Contemporary and future plastic surgery will continue to evolve and improve with regenerative medicine and tissue engineering resulting in a lot of benefits to be gained by patients in reconstruction after body trauma, oncology amputation, and for congenital disfigurement and dysfunction.

  19. Telesurgery: remote knowledge translation in clinical surgery.

    Science.gov (United States)

    Anvari, Mehran

    2007-08-01

    Dissemination of new surgical knowledge, skills, and techniques across the wide spectrum of practicing surgeons in the community is often difficult and slow. This is even more problematic in countries such as Canada, where geographic distances separate a large portion of community surgeons from the large teaching centers. As an example, the penetration of advanced minimally invasive techniques in Canada has been severely hampered by the inability to provide adequate training opportunities and support for community surgeons, many of whom live in remote regions of the country. In an attempt to overcome the barriers that exist, the Centre for Minimal Access Surgery (CMAS) at McMaster University has been using broadband Internet and telecommunication systems to provide distance training and mentoring to community surgeons living in remote northern communities of Canada. This article describes our experience with telementoring and robot-assisted remote telepresence surgery and assisting, between a teaching hospital in Hamilton and two community hospitals in northern Ontario and Quebec.

  20. Understanding the process of living as signified by myocardial revascularization surgery patients Comprendiendo el proceso de vivir significado por pacientes sometidos a la cirugía de revascularización del miocardio Compreendendo o processo de viver significado por pacientes submetidos a cirurgia de revascularização do miocárdio

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    Alacoque Lorenzini Erdmann

    2013-02-01

    Full Text Available OBJECTIVE: To understand the meanings for the process of living, for patients undergoing myocardial revascularization surgery, and to construct an explanatory theoretical model. METHOD: Grounded Theory was used, with data collection undertaken between October 2010 and May 2012, in a health institution which specializes in cardiac surgery, located in the south of Brazil. Thirty-three subjects were interviewed (patients, health care professionals and family members, distributed in four sample groups. Result: The explanatory theoretical model was comprised of 11 categories and the central phenomenon. The specialized service and the cardiac rehabilitation program formed the context, the discovery of the cardiac disease and the feelings experienced during the perioperative period were the cause and intervening conditions in the process of experiencing the myocardial revascularization surgery. The strategies were relying on the family's support, having faith and hope, and participating in the rehabilitation program. This process's main consequences were the confrontation of the changes and the resulting limitations, difficulties and adaptations to the new lifestyle after surgery. CONCLUSION: The process of experiencing the myocardial revascularization surgery constitutes an opportunity for maintaining the patient's life associated with the needs for confronting the significant changes in lifestyle.OBJETIVO: Comprender los significados sobre el proceso de vivir para pacientes sometidos a la cirugía de Revascularización do Miocardio, y construir un modelo teorético explicativo. MÉTODO: se utilizó la Teoría Fundamentada en los datos con colecta realizada de octubre/2010 a la mayo/2012, en una institución de salud referencia en cirugía cardíaca localizada al sur de Brasil. Se entrevistó 33 sujetos (pacientes, profesionales de salud y familiares, distribuidos en 4 grupos de la muestra. RESULTADO: El modelo teorético explicativo fue constituido