JOURNAL OF MIDWIFERY & REPRODUCTIVE HEALTH
Year:2020 | Volume:8 | Issue:3|Papers Count:16

Currently, the novel coronavirus disease (COVID-19) outbreak is considered as a global public health emergency by the World Health Organization. This emerging contagious disease spreads through infected respiratory droplets and could create clinical symptoms including cough, fever and shortness of breath, which can results in ARDS, pneumonia, as well as multi-organ failure (1). Pregnant women are among special groups in this outbreak, which deserve more attention due to the physiological and immunological changes during pregnancy that put them at greater risk and more susceptibility to morbidity and mortality of COVID-19. . . .

Background & aim: Despite the growing popularity of electronic health interventions and their cost-effectiveness in the provision of care services and expansion of services to remote areas, its effectiveness in pregnancy and postpartum care has not been investigated. Therefore, this systematic review was conducted to review the effect of electronic interventions on the health of Iranian mothers. Methods: The English databases including PubMed, Scopus, Web of Science, and Google Scholar as well as the Iranian databases of SID, Magiran, and Irandoc were searched within 2013-2019 using related keywords in order to obtain the Persian and English articles. Finally, six articles entered the study after the exclusion of duplicate, unrelated, and low-quality papers. Results: In total, 124 articles were retrieved and finally 6 articles remained. Two were pre/post and four were randomized trial studies. The studies have been conducted on a variety of topics, including awareness of the risks of pregnancy and postpartum health, transtheoretical model structures, care satisfaction, and breastfeeding self-efficacy. Different methods were used in these studies including Telegram, SMS, and Multimedia software. In total, all studies reported an increase in care quality Conclusion: Electronic learning interventions can effectively help to improve prenatal and postpartum care; however, there is no sufficient evidence to show the associated long-term effects.

Background & aim: Warm compression is an effective method preferred in relieving pain. It enables procedures to be completed in a shorter time, and with less pain due to increasing blood flow in the area. This study aimed to investigate the effects of warm compress applied before heel lance on the procedure time, level of pain, and comfort level of healthy term newborns. Methods: This randomized controlled clinical was conducted on 80 neonates who were randomly divided into experimental and control groups. The data were collected using demographic questionnaire, observation checklist for procedure, Neonatal Infant Pain Scale (NIPS), and The Comfort Behaviour Scale (TCBS). The experimental group was subjected to local dry mild-warm compression to the heel before the heel lance procedure. The control group received routine heel lance procedure. Body temperature, peak heart rate, and oxygen saturation levels before, during, and after the procedure were recorded in both groups. Data were analyzed in SPSS software (version 16) using the Chi-square test and Mann-Whitney U test. Results: The results of the study showed shorter procedure time in the experimental group compared to the control group (P<0. 05). Moreover, the mean NIPS and TCBS total scores were lower in the experimental group compared to control group, and this was found to be statistically significant (P<0. 05). Conclusion: It was found that warm compression applied before heel lance decrease the length of the procedure and is effective in decreasing pain and providing comfort in newborns.

Background & aim: The practice of institutional delivery services utilization is reported to be very low in Ethiopian pastoral community. In this regard, health programmers should gain an insight into factors influencing the utilization of institutional delivery to improve health facility delivery among these women. Methods: A qualitative study was conducted in pastoralist communities of Bench-Maji zone, southwest Ethiopia within September-October 2017. The data were collected through in-depth interviews and focus-group discussions with women, health extension workers, traditional birth attendants, and supervisors of health extension workers. After transcription and translation, the data were thematically analyzed using Open Code software (version 3. 6). Results: As evidenced by the results of the current study, poor risk awareness, inadequate infrastructure and transport, poor quality of care, and lack of financial independence hinder easy access to obstetric care. In this regard, readily available traditional birth attendants become the best alternative to the non-responsive health system. These communities were also marginalized since they receive less health education due to their long distances to healthcare facilities. Consequently, they are encouraged to deliver at home in the belief that only complications require medical attention. Conclusion: In order to design interventions to support pastoral women’ s use of obstetric services, existing barriers need to be addressed together since they jointly hinder women’ s access to institutional delivery.

Background & aim: One of the most important professional duties of midwives is writing the reports, which considered as legal documents. Incomplete reports can resulted in misunderstanding and even lead to filing charges against midwives by the legal authorities. Therefore, this study aimed to investigate the effects of onthe-job training (OJT) and workshop training methods on the report-writing performance of the midwives working in the teaching hospitals. Methods: This quasi-experimental study was conducted on 70 midwives working in Imam Reza and Ghaem hospitals, Mashhad, Iran, in 2018, who randomly allocated to two OJT (N=35) and workshop group (N=35). Following obtaining an informed consent, a pre-test examination was performed before the intervention. The OJT group received the required trainings before and at the patients’ bedside during their work shifts. Workshop training group received lectures and practical works as the comparison group. The performance scores of the midwives were compared in both groups in three stages of pre-intervention, during the intervention, and one month post-intervention. All the data were analyzed by Mann-Whitney U test and Friedman test using SPSS software (version 24). Results: Our findings showed no significant different in terms of pre-intervention performance score (P=0. 539). However, the scores of performance in the OJT group were significantly higher than those in the workshop group during the training program and one month post-intervention (P ˂ 0. 05). Conclusion: We argue that the OJT method can be considered an effective intervention in improving the report-writing performance of midwives.

Background & aim: Lifestyle is a way of living, which has effects on people's health. Health-promoting lifestyle (HPL) is a component of health promotion and includes six dimensions. This study aimed to assess the different dimensions of health-promoting lifestyle in female students. Methods: This cross-sectional study was carried out on 133 female students of Islamic Azad University, Iran. Who were selected using a multi-stage random sampling. Data was collected through a demographic as well as Walker's lifestyle questionnaire regarding the six dimensions of HPL. The collected data were analyzed in SPSS software (version 24) using descriptive statistics, independent ttest, and Friedman nonparametric test. Results: The mean lifestyle score of students was 50± 3. 7 (%), which was considered as a moderate level of lifestyle. Mean score of nutrition (54. 9± 8. 8%) and exercise (53. 6± 8. 6%) was at the highest level. The score of other dimensions included self-actualization (51. 5± 7. 5%), health responsibility (46. 6± 6%), interpersonal support (46. 9± 5%), and stress management (43. 4± 6. 9%) was on a moderate level. In this study, the total score of lifestyle correlated significantly with the housing status of students, smoking, and coffee consumption (P<0. 05). Conclusion: The total score of lifestyle was on a moderate level. The score of stress management, interpersonal support, and health responsibility dimensions was on the lowest level. Accordingly, it is of utmost importance to provide the students with the education and social support programs, thereby improving their lifestyle with an emphasis on these dimensions.

Background & aim: Nausea and vomiting are among the most common complaints during pregnancy observed in patients with severe pregnancy outcomes. The purpose of this study was to investigate the relationship of nausea and vomiting during pregnancy (NVP) with some pregnancy complications. Methods: This cross-sectional study was conducted on 778 mothers within the age range of 18-35 years who werew experiencing their first to third pregnancy and had single fetuses born from April to September 2017 in Shahroud Teaching Hospital, Shahroud, Iran. The study population was selected using the census method. The data were collected using a questionnaire included demographic characteristics as well as pregnancy complications. A visual analogue scale (VAS) was also used to assess nausea and vomiting. The data were analyzed in SPSS software (version 18) using the Chi-square test and Spearman correlation coefficient. Results: In this study, 72. 75% of the mothers reported to have some degrees of nausea and vomiting. In this regard, based on the VAS, the mean score of NVP was obtained as 4. 29± 3. 41. As the results indicated, NVP had a significant relationship with preterm labor (P=0. 002), hypertension (P=0. 003), anemia (P=0. 002), and cesarean section (P=0. 009). However, there was no association between nausea and vomiting with the medical illnesses during pregnancy, gestational diabetes, hypothyroidism, (P=0. 12), and bleeding/ spotting. Conclusion: According to the results, NVP was associated with pregnancy complications including preterm delivery, hypertension, anemia, and cesarean section.

Background & aim: Based on the previous reports, treatment with 17 α-Hydroxyprogesterone caproate (17-OHPC) decreased the risk of preterm labor (PTL). However, some studies indicated contrasting results. This study aimed to investigate the effect of 17-OHPC on the prevention of PTL. Methods: This randomized controlled trial was performed on singleton pregnant women with a history of PTL referring to Imam Khomeini Hospital, Sari, Iran. The experimental group was subjected to an intramuscular weekly injection of 250 milligrams of 17-OHPC from week 16 to 37 of gestational age (n=50). The control group received routine prenatal care. Data were collected using a self-structured checklist, and analyzed using SPSS software (version 18) through independent Ttest, Mann-Whitney U test, and the Chi-square test. Results: The mean age of the experimental and control groups were 24. 4± 2. 6 and 25± 2. 38 years, respectively. According to the results, there were no significant differences between the groups regarding the risk of PTL less than 35 and 37 completed weeks (P=0. 21, P=0. 23). Furthermore, a significant relationship was observed between the use of 17-OHPC and birth weight (P<0. 05). The frequency of birth weight less than 2500 g in the experimental group was significantly lower than that in the control group (RR: 1. 56, 95% CI: 1. 6-2. 29, P=0. 023). Conclusion: The results of the outcome analysis based on the separation of gestational age and birth weight in the case and control groups showed no significant differences between the groups regarding the risk of PTL less than 35 and 37 completed weeks.

Background & aim: A supportive program during normal childbirth with a holistic approach could reduce the cesarean section rate and make childbirth a positive experience. Therefore, the present study aimed to develop a supportive care plan for labor using the logic model. Methods: The data generated through a grounded theory study were used to develop a program for supporting women during labor based on the logic model. A total of 25 mothers who referred to hospitals for labor as well as eight professionals were recruited through the purposive sampling in Mashhad, Iran during March 2014 to December 2016. The problems and needs of mothers, as well as the viewpoints and recommended strategies of professionals to meet those needs, were elicited through the semi-structured interviews. The stages of supportive program development included identifying the problems, defining the inputs, activities and outputs s well as identifying program outcomes. Results: In the developed care plan five areas of 'infrastructure', 'equipment', 'facilities', 'training', and 'processes' were classified in the inputs. Three areas of 'designing interventions', 'implementing interventions' and 'following ethical considerations' were categorized under the category of activities. Statements related to assessment were nominated as output. The short-term and long-term results related to the program’ s intervention were labeled as outcomes. Conclusion: The developed supportive care plan as a holistic program could be implemented instead of the existing programs. It will be a guide for both decisionmakers and practitioners in terms of managing and supervising women in labour through providing support.

Background & aim: Sexual self-concept is a cognitive perspective of humans towards their sexual aspects, which reflects their thoughts, feelings, and functions about themselves as sexual creatures and could be a predictor of sexual outcomes. This study aimed to investigate the predictive role of sexual self-concept about marital satisfaction and sexual function in reproductive-aged women. Methods: This correlational study was conducted on 707 married women (aged 15-49 years) in Sari, North of Iran, in 2016. The subjects were selected by systematic sampling. The data were collected using Snell Multidimensional Sexual Self-concept Questionnaire, ENRICH Marital Satisfaction Scale, and Rosen Female Sexual Function Index. Data analysis was performed using Pearson correlation coefficient, independent t-test, ANOVA, and linear regression tests in SPSS software (version 16. 0). Results: The positive domain of sexual self-concept had the maximum mean score (130. 38± 19. 71). In this domain, the maximum score belonged to motivation to avoid risky sex. The negative domain of sexual self-concept (9. 10± 9. 16) had the minimum score, with sexual monitoring having the maximum score. The results of the linear regression model showed that sexual self-concept could predict 43% and 36% variances of marital satisfaction and female sexual function, respectively. Conclusion: This study facilitates the conceptualization of sexual health issues. Based on the findings, it is recommended to pay attention to the transactional correlation of sexual self-concept with marital satisfaction and sexual function in primary healthcare settings.

Background & aim: Current evidence clearly shows that the mistreatment of women during labor and childbirth in health facilities is on the rise all over the world. This kind of disrespectful treatment deters women from seeking care. In spite of this, little attention has been devoted to this critical issue both in practice and research. With this background in mind, the current study aimed to investigate the prevalence of mistreatment and its associated factors among women during labor and childbirth in public hospitals of Silte Town, Southern Ethiopia. Methods: This hospital-based cross-sectional study was carried out on 409 participants using the systematic sampling method within March 1-30, 2018. The data collection was performed using a structured instrument. The data were entered into EpiData software (version 3. 1) and analyzed in SPSS software (version 23). Binary logistic regression analyses were computed to identify the associated factors at 95% CI. Results: The overall prevalence of mistreatment was observed to be 67. 7%. The factors which were significantly associated with the mistreatment included complicated labor (AOR=2. 6; 95%CI: 1. 07-6. 06) and a longer stay at a health facility (AOR=2. 6; 95% CI: 1. 34-5. 18). On the other hand, having antenatal care visits (AOR=0. 5; 95% CI: 0. 4-0. 79) and the existence of birth companion during childbirth (AOR=0. 35; 95% CI: 0. 21-0. 57) were found to be protective factors of mistreatment. Conclusion: Mistreatment during childbirth and labor is still a serious public concern in the study area. Therefore, all the responsible bodies must develop efficient methods for the prevention and elimination of mistreatment. To this end, they need to strengthen the continuous provision of antenatal care education and counseling, allow for the presence of birth companions, and minimize unnecessarily long health facility stays after childbirth.

Background & aim: Premarital counseling is the best opportunity to provide childbirth counseling for young people on the verge of marriage. Given the lack of data on the most effective way to deliver such information during this period, the present study aimed to compare the effects of integrated and group counseling on the attitude towards childbearing in women on the verge of marriage. Methods: This experimental study was carried out on 162 women receiving premarital counseling in the healthcare centers of Mashhad, Iran, during 2015-2016. The subjects were divided into three groups, who received the integrated, group, and routine counseling services. The integrated group received two sessions of group and one session of individual counseling. The group counseling received three sessions of 2-h counseling with one week interval. The control group received only the routine counseling. Data were collected using a demographic and childbirth attitude questionnaire and analyzed using one-way ANOVA, Kruskal-Wallis, paired sample t-test, and Wilcoxon tests. Results: After the intervention, the attitude towards childbearing underwent a significant change in participants of integrated (P<0. 001) and group (P=0. 03) counseling, compared to that of the control group. However, there was no significant difference between two intervention groups in terms of their attitude. Conclusion: Both integrated and group counseling methods are recommended for providing a favorable attitude towards childbearing in young people. Therefore, enough time must be spent on childbearing counseling for women on the verge of marriage attending premarital counseling clinics.

Background & aim: Self-medication as a global challenge for mother and baby is a potential threat and it is common not only in developing countries but also in developed countries. Various factors affect drug use. This study aimed to determine the rate of practicing self-medication and its related factors in pregnant women. Methods: This cross-sectional study was conducted on 598 pregnant women referring to Al-Zahra Teaching Hospital and comprehensive health centers located in Rasht, Iran. The subjects were selected using random sampling method. The data were collected by a self-structured questionnaire on self-medication and analyzed using chi square test, logistic regression. Furthermore, a logistic regression model was applied to determine the factors associated with the rate of self-medication. Results: Practice of self-medication during pregnancy was reported by 8. 7% of the mothers. The most commonly used medications were analgesics (50. 9%), herbal medicines (24. 5%), and cold/ flu medications (17%). The most common causes of self-medication among mothers included availability of medications (67. 9%), previous use (60. 4%), and treatments (47. 2%). The majority of participants had an arbitrary use due to headache (34%), common cold (22. 6%), and digestive diseases (22. 6%). Also, 86. 1% of the mothers had a moderate level of awareness about self-medication, which had no significant relationship with self-medication (P=0. 872). The spousal age (OR=0. 931, 95% CI=0. 87-0. 98; P=0. 02), gravidity (OR=1. 34, 95% CI=1. 03-1. 74; P=0. 028), comorbid diseases, (OR=2. 36, 95% CI=1. 29-4. 32; P=0. 005), and uncertainty about the effect of drugs (OR=0. 189, 95% CI=0. 04-0. 805; P=0. 024) were found to be the predictors of self-medication. Conclusion: As the findings indicated, the arbitrary use of medications during pregnancy increased with age and gravidity. Therefore, it is recommended that the Ministry of Health consider policies for the education and provision of the necessary information in this regard for the target population.

Background & aim: Scientifically, cesarean section (C-section) should be performed in case of emergency; however, the frequency of C-sections that are elective and without medical indication is high. This study aimed to compare the early postoperative maternal complications of elective and emergency C-sections. Methods: This descriptive study was carried out on a total of 120 patients undergoing elective and emergency C-sections at Fatemieh Hospital in Hamadan, Iran, between May to July 2019. The study participants were selected through convenient sampling from two groups of elective (N=60) and emergency C-sections (N=60). The data were collected using self-structured questionnaire on early maternal complications and were analyzed by SPSS software (version 23) using Chi-square and independent t-test. Results: A significant difference was observed between the two groups regarding the mean amount of intraoperative bleeding (P<0. 05). During 24 h after the surgery, the emergency cesarean group received significantly more analgesics than the elective cesarean group (P<0. 05). However, the two groups were not significantly different in terms of operative time, ileus, pain 6 h after surgery, and incidence of infection (P>0. 05). Conclusion: The incidence rates of some maternal complications were relatively higher in the emergency C-section than those reported for elective C-section. Therefore, in order to prevent postoperative complications related to emergency C-section, gynecologists should be encouraged to decide timely for cesarean section if there is a particular indication. Also, it is required to provide considerable care to decrease the rate of maternal morbidity and mortality in these cases.

SARS-CoV-2 (Covid-19) is an infectious disease that results in mild to severe respiratory system illness caused by coronavirus. In December 2019, a group of patients with respiratory syndrome, who were epidemiologically linked to a seafood wholesale market in Wuhan, China (1, 2) were admitted to hospitals. These patients developed mild symptoms such as fever, dry cough and angina. However, most of the cases improved spontaneously; but some developed various severe complications including acute respiratory distress syndrome, pulmonary edema, organ failure and shock. On 30th January 2020, the World Health Organization (WHO) announced the Chinese crisis of COVID-19 to be a health emergency for countries. . . .

Background: The osteitis pubis is an inflammatory-noninfectious disease of the pubic symphysis, which is rarely reported in the postpartum period after normal vaginal delivery. Misdiagnosis of this disease can leave the patient disabled with a poor quality of life Case report: The case in the present study was a 35-year-old woman, admitted two days after giving birth, due to severe pain in the hypogastric and groin regions. Movement aggravated the pain in a way that disabled the patient. The pelvic radiograph showed pubic symphysis dislocation, and osteitis pubis was clinically diagnosed. Therefore, conservative treatment was prescribed for her, including relative bed rest, nonsteroidal anti-inflammatory drugs (PRN, maximum TDS), physiotherapy, and pelvic binder, for two weeks. After this period, her pain decreased gradually and in the next follow-up, which was one month later, she had no limitation of motion. Conclusion: Though it seems to be a simple disease, osteitis pubis can cause profound motion disability. Early diagnosis and treatment can prevent complications, such as joint stiffness and chronic pain.