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Purpose This study aimed to clarify the components related to midwifery care for pregnant women's continued self-care for relieving "hiesho" (sensitivity to cold) at birth centers. Methods In total, 129 midwives working at birth centers for at least five years, handling deliveries across the country, and who provided support for pregnant women's self-care for relieving hiesho at prenatal checkups were selected for this study. An anonymous self-administered questionnaire survey was conducted. The main method of analysis was an exploratory factor analysis of midwifery care for pregnant women's continued self-care to relieve hiesho. This study was approved by the Ethical Review Committee of Yokohama City University and followed all relevant ethical considerations (approval number: F221000004). Results In total, 95 valid questionnaire survey responses were received (valid response rate 92.2%). The two items that were "always implemented" (response rate of >95%) for midwifery care of pregnant women's continued self-care for relieving hiesho were "Interacting with pregnant women to be aware of the presence of the fetus" and "Interacting with pregnant women so that they can have the desire to give birth on their own." The four components of midwifery care were as follows: (1) Promoting awareness while understanding pregnant women's thoughts of continuing self-care for hiesho, (2) Motivating pregnant women to start with self-care for hiesho that they can do, (3) Creating opportunities for pregnant women to access information about self-care for hiesho themselves, and (4) Sharing information among midwives that leads to promote self-care for hiesho with respect for the individuality of pregnant women. Conclusion It was deemed important, in the context of midwifery care for pregnant women's continued self-care for relieving hiesho, to increase the intrinsic motivation of pregnant women for self-care, and related efforts were implemented at a high frequency. The four components of midwifery care extracted in this study encouraged pregnant women to continue self-care for relieving hiesho by motivating them to change their behavior, increasing their self-efficacy for self-care, creating opportunities for them to actively access information about self-care for hiesho, and implementing care that respects their individuality. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Japan Academy of Midwifery is the property of Japan Academy of Midwifery and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Japan Academy of Midwifery is the property of Japan Academy of Midwifery and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Japan Academy of Midwifery is the property of Japan Academy of Midwifery and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Japan Academy of Midwifery is the property of Japan Academy of Midwifery and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Japan Academy of Midwifery is the property of Japan Academy of Midwifery and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose The purpose of this research is to investigate the Marital Adjustment Test and factors related to marital adjustment in couples during pregnancy in Japan. Methods A Questionnaire was conducted on 206 pregnant women undergoing health checkups for pregnant women on an outpatient basis at the department of obstetrics and gynecology and their husbands with the objective of elucidating marital relationships during pregnancy as well as related factors. Results The results of the Marital Adjustment Test showed that 73.3% had a favorable marital relationship during pregnancy. Based on the results of the marital relationship awareness scale and the Marital Adjustment Test, the following five factors were identified as being related to marital adjustment during pregnancy: "acceptance of spouse", "wealth of life", "husband's trust and support", "favorable interpersonal relationship", and "expectations toward childbirth and child-rearing". Conclusion These findings suggest that establishment of a smooth relationship of trust between husband and wife is important for enabling marital adjustment that is favorable during pregnancy to remain favorable during child-rearing. [ABSTRACT FROM AUTHOR]

Objective The aim of the present study was to clarify how midwives recognize and implement care for women leaving an island to give birth on the mainland. Subjects and Methods Using an ethnographic approach, participant observation and interviews were conducted on 6 primary informants, who were midwives working at an obstetrics department on an isolated island, and 38 secondary informants, who comprised women leaving the island to give birth and their family members, an obstetrician working at a hospital on the island, an occupational health nurse, women engaged in child-raising with experience of leaving the island to give birth, midwives working at a mainland birthing hospital and staff at a mainland accommodation facility used by the majority of women leaving the island to give birth. Results It was found that antenatal care was performed with consideration given to the period that would be spent on the mainland, while postnatal care was conducted divorced from the circumstances surrounding mainland delivery. During antenatal care, midwives recognized that women leaving the island to give birth would be forced to lead solitary lifestyles on the mainland and thus were susceptible to increased anxiety and fears regarding childbirth. They also recognized the difficulties of nutrition management due to the change in environment. Against this background, it was found that midwives aimed to provide care that would engender the physical and mental state required for women giving other women the strength for childbirth. In addition, with the inevitable break in the continuity of care between pregnancy and the postpartum period, midwives recognized that the postpartum care provided to women returning home after leaving the island to give birth was not as complete as that provided to women who delivered on the island. However, despite this incompleteness of care, midwives were still able to establish connections with postpartum women. Conclusion In order for mothers and infants transferring between mainland and island environments to transition from pregnancy to child-raising safely and without worry, the following three points were found to be necessary for care coordination. 1) Care that recognizes the susceptibility for increased anxiety and fears regarding childbirth. 2) Care that responds to the difference in environment provided by mainland lifestyles. 3) Care that recognizes that child-raising begins in a place far from the help of experts in the case of puerperal women who have returned to the local area. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this study was to develop a "Women-Centered Care (WCC)" pregnancy questionnaire (WCCpreg questionnaire) that measured women's perceptions of care they received during pregnancy and to test its validity and reliability. Methods Participants were women who had a single-child birth and were hospitalized at the participating settings. The WCC-preg questionnaire is a self-administered questionnaire, which was developed based on interviews and substantive studies. This instrument originally contained 60 questions focused on their perceptions of womencentered care they received during pregnancy. Women were asked if they agreed or disagreed using a 5-point Likert-type scale. The higher the points, the more women felt that they received WCC. To examine criterion-related validity, the following scales were used; the Maternal Attachment Questionnaire (MAQ), the Labour Agentry Scale (LAS), and the 10-point Likert-type Care Satisfaction Scale. To test validity and internal consistency, 591 women from 13 settings were recruited. Among these women, 500 responded and 482 were included in the analysis. To test stability using test-retest, questionnaires were distributed to 100 women at one setting. Among these women, 60 responded and all were included in the analysis. Results In testing face validity, the WCC-preg questionnaire ended up to be a 50-item questionnaire. To test the construct validity, factor analysis was conducted. Eventually six factors emerged: "feelings of encouragement", "being respected", "trusting the caregiver", "effective interaction", "help in decision-making", and "non-threatening manner". These were found to be suitable components of WCC. The correlation with WCC-preg questionnaire and MAQ showed low correlation (r=0.22, p=0.00) while LAS showed moderate correlation (r=0.48, p=0.00) and the Care Satisfaction Scale showed high correlation (r=0.79, p=0.00) thus confirming the WCC-preg questionnaire's criterionrelated validity. Cronbach's alpha was 0.98 indicating high internal consistency. However, the correlation of the test-retest was 0.55 and therefore stability remains an issue. Conclusion This study developed a questionnaire to measure women's perception of WCC during pregnancy and tested its validity and reliability. As a result, the validity of the WCC-preg questionnaire was confirmed. Although there remained an issue concerning stability, the internal consistency was high. [ABSTRACT FROM AUTHOR]

Purpose To examine traditional birth attendants (TBAs) and their care in the Republic of Madagascar through an analysis of care and perceptions from TBAs and women who receive their care. Method The researcher spent two months in the village of A on the outskirts of the city of Antsirabe in the Republic of Madagascar. Four TBAs and 11 women who received TBA care currently and in the past participated in semistructured interviews. Interviews covered care and perceptions of TBAs and the evaluations of women receiving their care. In addition, a TBA accompanied the researcher while observations at a TBA care site were conducted. Data were qualitatively analyzed, sorted, and discussed. Results TBA activities included physical examinations during pregnancy, care during delivery, and home visits following birth. Fundamental objectives at the core of TBA care were to check the position of the child, promote labor progression, and regulate body temperature of the mother. Women who received care reported that TBAs relieved fatigue, served as a source of childbirth knowledge, and provided strength during delivery. In contrast, the women felt that TBAs did very little following the birth. Perspectives on TBA care from the women who received care agreed with that of TBAs themselves close to 50% of the time. Differences in perspectives may have arisen from the fact that the women did not remember the care they received during delivery, and because the guidance was provided based on experience and traditions and thus lacked detailed substance. Conclusion Results showed that TBAs need to supplement their knowledge in addition to fulfilling their valued role as doulas in order to meet women's needs. To this end, effective training practices are needed in conjunction with initiative to overcome barriers such as tribal status and pride as medical workers. Performance of practical actions to enhance their understanding of TBA care will enable them to fulfill their valuable support role more effectively. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Japan Academy of Midwifery is the property of Japan Academy of Midwifery and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Japan Academy of Midwifery is the property of Japan Academy of Midwifery and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Women with epilepsy are exposed to social stigma, and they have anxiety and lose self-confidence in their social role as a woman. Psychiatrists, especially female psychiatrists, are able to support them. Important considerations are: 1) Pre-pregnant counseling; Physicians give appropriate advice and guidance. We need to provide the latest information on the teratogenicity of AEDs, and replace them with a safer combination of AEDs BEFORE pregnancy. Folate supplementation is also recommended. 2) Management during pregnancy: Patients are advised to adhere to taking AEDs as instructed, which prevents not only seizures during pregnancy but also reduces the risk of miscarriage and premature delivery. Doses of AED are to be increased after the second trimester. 3) Collaborating with obstetricians at delivery: Obstetricians are also nervous when faced with women with epilepsy. Basically, patients can deliver spontaneously, and the correct way to deal with unexpected seizures during labor should be fully understood. 4) Parental care: women with epilepsy can breastfeed. Physicians advise other family members on how to bottle feed at night to help mothers avoid a lack of sleep due to breastfeeding. Childcare is one of the most precious experiences in life. Patients with epilepsy, especially women, have a lower self-esteem; however, once they experience delivery, they act positively and become even-tempered. Physicians should be aware that childcare fosters a profound insight into their lives, allowing them to mature as a person.

Objectives: Midwives are actively involved in providing dietary advice to pregnant women. In order to describe the current status of prenatal dietary advice provided by midwives, we conducted a questionnaire survey inquiring about their knowledge and usage of the "Dietary Guidelines for Pregnant and Lactating Women" (Guidelines) issued by the Ministry of Health, Labour, and Welfare in 2006., Methods: In total, 2000 members of the Japanese Midwives' Association were randomly selected for administration of the questionnaire. The recovery rate was 42.1%, and 785 responses were eligible for analyses. The questionnaire collected information on the respondent's age, years of work experience, current involvement in delivery practice, number of deliveries per year in the current affiliation, provision of dietary advice to pregnant women, and knowledge and usage of the Guidelines., Results: The proportion of respondents in their 20 s was low (1.8%). About half of the respondents were practicing delivery. Further, 66.1% (519 midwives) reported they had knowledge of the Guidelines. Among those who had knowledge of the Guidelines and were currently providing dietary advice (426 midwives), 88.0% were using the Guidelines. The most frequently used item in the Guidelines was "Diet for preventing anemia" (75.8%). The least used item was "Shoku-iku (diet and nutrition education) for pregnant and lactating women" (58.5%). Midwives who were practicing delivery showed a significantly lower usage of the Guidelines than those who were not (84.9% vs. 92.6%, P = 0.02). Among midwives practicing delivery, the most common reason for not using the Guidelines was "using original educational material produced by oneself or the facility.", Conclusion: Providing dietary advice to pregnant women constituted a large fraction of midwives' duties as well as delivery practice. About 90% of the midwives, who had knowledge of the Guidelines and provided dietary advice, were using the Guidelines. In order to increase the usage of individual items of the Guidelines, ready-to-use brochures should be developed for midwives.

Folic acid plays an important role in proliferating cells and tissues of the fetus. A randomized control trial demonstrated in 1991 that 4 mg of folic acid supplements successfully prevented 72% of recurrence of neural tube defects (NTDs) in women who had had afflicted pregnancy. In 2000, the Japanese Government recommended women of childbearing age to take 400 microgram of folate supplements per day from 4 weeks prior to and 12 weeks after conception. A questionnaire study was performed in pregnant women by post on their awareness of the role folic acid plays, their life style, and folate intake by dietary consumption. Thirty-five percent of 1,251 pregnant women were aware of the important role of folic acid in the critical stage of fetal development and 31% actually took the supplement. Information on folic acid was obtained through mass media in 47% of the women, through the internet in 17%, through healthcare providers in 13% and so forth. The food record analysis revealed that the dietary intake of folic acid averaged 341 microg/day that was 60 microg less than what was recommended by the Government and that 33 of 86 women took the supplement. Overall, a half of pregnant women are required to take 400 microg folate supplement per day. It is to be stressed that primary prevention of NTDs by periconceptional intake of folic acid is a major public health opportunity and that prevention is more important than cure in the management of NTDs.

Depression is the most common complication in perinatal period, affecting approximately 10% of women. Studies were also examined for data related to the predictors/risk factors, effects on the fetus and newborn, and treatment of depression during these periods. Psychopharmacological treatment in pregnant or breastfeeding women with depression will result primarily from a careful evaluation of their psychopathological condition. Maternal depression is associated with adverse effects on fetal and infant development. Prevention and psychological intervention is also useful for detecting mother with postnatal depression, using the EPDS. Controlled psychological trials for postnatal depression have shown the benefit of involving health professionals. Multidisciplinary specialist teams in mother and baby units have been an important role in perinatal psychiatric care.

As part of prenatal care, vaginal gram-stained smear was evaluated on 318 pregnant women at our hospital. Nugent's scoring was done by Gram staining, and in comparison with normal score group and high score group, the incidence of perinatal abnormalities was higher to the latter group. Therefore, routine examination of vaginal gram-stained smear is recommended in pregnant woman.

Purpose: We evaluated the effects of home visitation by nurses around one month after delivery, focusing on mother's anxiety and awareness of child rearing problems., Method: We selected mothers who had a normal first child, and assigned them to the intervention (n = 131) or control (n = 100) groups. For the former, home visits were made by nurses, and for the controls, the usual care was provided. Outcome measurements were conducted before the intervention (Time I) and two months after (Time II). Usual care (neonatal home visiting service) was commonly provided by city health department, but not all subjects received a visit. We excepted the subjects who were provided with this usual care, analyzing the remaining subjects in the two groups., Results: The eligible subjects of the intervention group were 64 mothers (48.9%) and in the control group were 66 mothers (66%). There were no significant difference in terms of Time I demographic characteristics and outcome measures between two groups. However, there were significant differences in outcomes (mother's anxiety and awareness) between the two groups by ANCOVA, the intervention group showed decline of anxiety (P = 0.04) and improved enjoyment of child rearing (P = 0.02). Almost all mothers of the intervention group expressed the opinion that home visits by nurses were useful for themselves., Conclusion: We suggest that nurse home visitation around one month after delivery is useful to provide formal support for mother childcare.

At the opening of lectures in 1995 on the Science of maternity Nursing in the Special Subjects of Nursing, a problem-based learning was tried as a new educating method in the unit of "Prenatal Nursing." In the present paper, reviewing the introduction/implementation of the method, subjects in the future are described. This process contained two major flows, one was the training of tutors in problem-based learning, including participating the workshop held at McMaster University, and the other was the preparation for the class at the introduction of the new educational method, such as the overall subject composition and the development of teaching materials of prenatal nursing and resources, etc. according to the procedures of the problem-based learning. As the results of the actual implementation, various different reactions in comparison with the lecture method were observed both in tutors and students. As the subjects hereafter, the following three points have been clearly elucidated, that is, in order to proceed the problem-based learning under the present condition that it is not in the comprehensive curriculum, to prevent the overload and conflict in the student learning, considering and adjusting the relationship with contents and methods of concurrent subjects and units, to establish the system for tutorial assessment and evaluation, and to insure tutors and fulfill their training system.

To explore possible associations of maternal working status with birthweight, a cohort study was conducted from July, 1989 to June, 1991 in 8 general hospitals in the Tokai district. Using a self-administered questionnaire, data on job employment were collected mostly in the first or second trimester. Information on delivery outcome was recorded by doctors, midwives or nurses after child birth. Included in this analysis were 1,360 pregnants who delivered a live singleton without major malformations at gestation of 37 weeks or more. The following major findings emerged. (1) No significant difference in mean birthweight was detected between working and non-working pregnants. (2) Working pregnants were at greater risk of delivering a low birthweight (< 2,500g) baby. (3) Delivery of a low birthweight baby was more frequent in multiparous than nulliparous mothers. (4) The risks of delivering a low birthweight baby significantly differed according to the maternal working status. (5) These results suggest that not only the maternal working factor itself but the working status should be deliberately taken into consideration in order to provide proper prenatal care.