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Background: Peripartum antibiotics are commonly administered. Little is known of the attitudes of pregnant women toward peripartum antibiotics. Aim: We aimed to assess the awareness of and attitudes toward peripartum antibiotic use in Australian women. Materials and Methods: We surveyed post‐partum women at three hospitals over six months. Women reported if they received antibiotics 48 h either side of delivery and responded to statements assessing attitudes to peripartum antibiotic use. Administered antibiotics were recorded. We reported the proportion receiving antibiotics and the proportion aware of receiving them. Participants responded on five‐point Likert scales and selected side effects of concern. Results: Participants responding were 248 of 299 (83%, Royal Brisbane and Women's Hospital), 56 of 106 (53%, Caboolture Hospital) and 17 (Redcliffe Hospital, denominator not recorded). Of 183 (57%) receiving antibiotics, 134 (73%) received them pre‐delivery only, 18 (10%) post‐delivery only and 31 (17%) pre‐ and post‐delivery. Pre‐delivery, the most common indication was pre‐incisional prophylaxis for caesarean delivery (93 of 160 responses, 58%). Seventy‐nine (51%, 156 responses) of those receiving pre‐delivery antibiotics were aware. Of 49 women receiving post‐delivery antibiotics, 36 (73%) were aware. Most agreed they were worried that pre‐delivery antibiotics would affect their baby (198, 62%) and 160 (50%) were concerned about effects on their own microbiome. Most (204, 65%) agreed they would rather not take antibiotics while breastfeeding. Conclusion: Many women were unaware of receiving pre‐delivery antibiotics. Most had concerns about side effects. Improved communication regarding peripartum antibiotic use would improve patient‐centred care. [ABSTRACT FROM AUTHOR]

Objective: To determine the association between continued antidepressant use in pregnancy and postpartum psychiatric visits for eating (ED) or mood/anxiety disorders in women with preexisting ED. Method: Using Danish health registry data (1998–2015), we identified 3529 pregnancies in women with ED prepregnancy: (i) 564 with continued antidepressant use before and during pregnancy; (ii) 778 with discontinued antidepressants before pregnancy; (iii) 2137 unexposed. Outpatient and inpatient postpartum visits for an ED or a mood/anxiety disorder constituted the outcome measures. We estimated hazard ratios (HRs) and 95% confidence intervals (CI) using Cox regression with inverse probability of treatment weighting, and performed stratified analyses by antidepressant prescription filling in the first 3 months postpartum. Results: The weighted cumulative incidence for an ED visit at end of follow‐up was 4.5% (continued) and 4.8% (discontinued). We found no association between continued antidepressant and postpartum ED visit, relative to discontinued (HR: 0.89, 95% CI: 0.52–1.52). The HR for postpartum mood/anxiety disorder visit was 1.27 (95% CI: 0.68–2.36) with continued antidepressants versus discontinued but decreased if more than two antidepressant prescriptions were refilled. Continued antidepressant use was associated with a 57% reduced likelihood of a postpartum ED visit versus discontinued use in pregnancies with antidepressant prescription refills in the early postpartum. Conclusion: Among women with preexisting ED, there was no association between continued antidepressant use during pregnancy and the likelihood of postpartum psychiatric visits, relative to discontinued antidepressants before pregnancy. Continuation of treatment into the early postpartum is associated with reduced likelihood of postpartum ED visit. Public Significance: Based on data from the Danish registries, we identified 3529 pregnancies among women with preexisting eating disorders before pregnancy. Women with continued antidepressant treatment both before and during pregnancy did not have a lower probability of having postpartum psychiatric visits for an eating disorder or for mood/anxiety disorders (often coexisting with eating disorders), relative to those who discontinued antidepressants before pregnancy. Further continuation of antidepressant treatment into the early postpartum is associated with improved maternal postpartum outcomes. However, residual confounding by disease severity limits confidence in this conclusion. [ABSTRACT FROM AUTHOR]

Background and Aims: Health services during pregnancy, childbirth, and the postnatal period play a pivotal role in the survival of both the mother and the baby. We, therefore, analyzed maternal health service utilization and the related drivers among women of childbearing age in Ethiopia. Methods: We used secondary data from the 2019 Ethiopian mini Demographic and Health Survey. The survey was conducted in 11 regions, and 2 city administrations, in Ethiopia from March 21 to June 28, 2019. Maternal health service utilization was measured in terms of three dimensions including antenatal care (ANC), skilled delivery service, and postnatal care (PNC). Bi‐variable and multivariable logistic regression was used. We then fitted three separate models. Data were analyzed using SPSS version 25; all analysis was adjusted for cluster and sample weight. Results: A total of 2923, 3924, and 1899 women were included for ANC, delivery, and PNC utilization, respectively. The majority of 1802 (61.7%) women had a "good" antenatal care utilization, and it was explained by the level of maternal education, marital status, and wealth index. Nearly half, of 1899 (48.1%) of the women gave birth in a health facility, and it was associated with age, educational status, wealth index, the timing of first antenatal care, and the number of antenatal care contact. Finally, one third (33.7%) of them had adequate PNC utilization and it was associated with households having a television, the timing of first antenatal care, and the number of antenatal care contacts. Conclusion: Despite the due emphasis on maternal health services by the Ethiopian government, the uptake of services is not optimal. Women empowerment and timely and adequate ANC contacts will prepare women for better uptake of services. [ABSTRACT FROM AUTHOR]

Objective: To measure satisfaction with general practitioner obstetrician‐led maternity care in Western Australia and to explore perspectives of maternity service users Design: Women were recruited at antenatal visits with their general practitioner obstetrician. Participants completed a validated three‐part survey about their satisfaction with antenatal, intrapartum and postpartum care. They were all offered a semi‐structured interview. Setting: Nine general practitioner obstetrician practices located in regional Western Australia. Participants: 155 women receiving general practitioner obstetrician‐led maternity care within the South West or Great Southern regions of Western Australia. 13 of these women also participated in an interview. Main Outcome Measures: We quantified satisfaction with aspects of antenatal, intrapartum and postpartum care using a Likert scale. Descriptive variables included demographic information and birth outcomes. Qualitative data described valued aspects of maternity care. Results: 116 women completed all 3 surveys. General practitioner obstetrician‐led care resulted in high rates of satisfaction across all 3 stages of care, with 78%‐100% agreement with positively worded satisfaction statements. Thematic analysis identified four key aspects of care women valued when receiving maternity care: the woman‐centred care experience, the skills of the general practitioner obstetrician, support from the health care team and the health care environment. Conclusion: General practitioner obstetrician‐led maternity care is a highly regarded model of maternity care, valued by rural women with high rates of satisfaction. [ABSTRACT FROM AUTHOR]

Objective: Continuum of care (CoC) in maternal health is built on evidence suggesting that the integration of effective interventions across pregnancy, childbirth, and the postnatal period leads to better perinatal health outcomes. We explored gaps along the CoC in maternal health in Benin. Methods: A mixed‐methods study triangulating results from a qualitative study in southern Benin with a quantitative analysis of Benin Demographic and Health Survey (BDHS) data on the use of services along the CoC was conducted. Results: Benin Demographic and Health Survey analysis showed that although 89% of women reported at least one antenatal care (ANC) visit, only half initiated ANC in the first trimester and completed 4 or more visits. 85% reported facility‐based childbirth and 69% a postnatal check within 48 h after childbirth. Our qualitative study confirms early initiation of ANC and the transition from facility‐based childbirth to postnatal care are important gaps along the CoC and reveals late arrival at health facility for childbirth as an additional gap. These gaps interact with spiritual and alternative care practices that aim to safeguard pregnancy and prevent complications. Structural factors related to poverty and disrespectful care in health facilities compounded to limit the utilisation of formal healthcare. Conclusions: The combined use of BDHS and qualitative data contributed to highlighting critical gaps along the maternal CoC. A lack of integration of spiritual or alternative aspects of care into biomedical services, as well as structural factors, impeded access to healthcare in Benin. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to summarize cases of successful pregnancy and delivery in patients with transposition of the great arteries (TGA) after atrial switch operation (ASO), to provide management, clinical experience, and maternal and fetal outcomes. Methods: During a 16‐year period (2004–2019), we experienced 30 pregnancies in 15 patients after ASO at our institution. We retrospectively reviewed the medical records of the patients. Results: In 30 pregnancies, there were 21 (70%) live births, five (17%) miscarriages, and four (13%) artificial abortions. There were no maternal or neonatal deaths. Cardiac complications occurred in nine (43%) patients: deterioration of right ventricular (RV) function in one, symptomatic heart failure (HF) in three, supraventricular tachyarrhythmia requiring electrical cardioversion in two, sick sinus syndrome that required pacemaker implantation in two, and hemoptysis in one. Obstetric complications occurred in five (24%). Neonatal complications were premature births (delivery at <37 weeks of gestation) in 15 (71%), and birthweight <2500 g in 18 (86%). The mode of delivery consisted of vaginal delivery (VD) in five (24%), and cesarean section (CS) in 16 (76%). Conclusion: A high incidence of preterm CS and cardiac complications including deterioration of RV function was observed in patients who had undergone ASO for TGA. [ABSTRACT FROM AUTHOR]

Adequate maternal healthcare practices are crucial to both maternal and infant nutrition outcomes. The Sylhet region of Bangladesh is vulnerable and performs poorly, as maternal and child health indicators are falling behind compared to other areas. Suchana, a large‐scale intervention programme aims to improve the health and nutritional status of mothers and children in this region. The objective of the present analysis is to assess the changes in indicators related to maternal healthcare practices among Suchana beneficiaries. We obtained data from the Suchana baseline and endline evaluation survey. Descriptive statistics were employed to summarize data. The following maternal healthcare practices were considered: if a Suchana beneficiary mother received antenatal care (ANC) from skilled service providers, took day time resting during pregnancy, consumed additional diet during pregnancy, took at least 100 iron‐folic acid (IFA) tablets during pregnancy and took a vitamin A capsule after delivery. Logistic regression analysis was performed to assess the impact of the Suchana intervention on maternal healthcare practices. The prevalence of the outcome variables at endline in the intervention area were as follows: 40% of mothers received at least four ANC from skilled service providers, 50% practiced daytime resting during pregnancy, 51% consumed additional diet during pregnancy, 41% took at least 100 iron‐folic acid tablets during pregnancy, 39% received postnatal care and 30% took a vitamin A capsule after delivery. The Suchana intervention significantly, positively improved indicators related to maternal healthcare practices; these findings support future larger‐scale programmes to improve maternal healthcare practices among vulnerable people in rural Bangladesh. [ABSTRACT FROM AUTHOR]

The aim of this study is to investigate the effects of Education, Employment, Economic Status and Empowerment (introduced as the 4Es) and other explanatory socio‐demographic factors on the utilization of maternal health care services in India. This study used data from the National Family Health Survey‐4 (2015–2016). Separate logistic regression models were fitted for four or more antenatal care visits, skilled birth attendance and postnatal care to understand the effects of 4Es on the utilization of maternal health care services in India. The findings indicate positive effects of education on antenatal care, skilled birth attendance and postnatal care, the effects of higher education being even stronger in case of antenatal care. Education leads to employment, economic status and empowerment which in turn are significantly associated with the use of antenatal care and skilled birth attendance. Interestingly, in case of postnatal care, while controlling for economic status and empowerment, the effects of education vanish. Overall, education, employment, greater economic status and empowerment emerged as reliable predictors of the use of all three maternal health care services. The positive association between the 4Es and maternal health care services utilization reiterates the need for rigorous monitoring and evaluation of the existing policies and programs, coupled with efforts to change societal attitudes toward females through political advocacy and commitment which is reflected in parallel investment in girl education, job creation for poverty reduction to facilitate women empowerment. [ABSTRACT FROM AUTHOR]

Aims: To undertake a Priority Setting Partnership (PSP) to establish priorities for future research in diabetes and pregnancy, according to women with experience of pregnancy, and planning pregnancy, with any type of diabetes, their support networks and healthcare professionals. Methods: The PSP used established James Lind Alliance (JLA) methodology working with women and their support networks and healthcare professionals UK‐wide. Unanswered questions about the time before, during or after pregnancy with any type of diabetes were identified using an online survey and broad‐level literature search. A second survey identified a shortlist of questions for final prioritisation at an online consensus development workshop. Results: There were 466 responses (32% healthcare professionals) to the initial survey, with 1161 questions, which were aggregated into 60 unanswered questions. There were 614 responses (20% healthcare professionals) to the second survey and 18 questions shortlisted for ranking at the workshop. The top 10 questions were: diabetes technology, the best test for diabetes during pregnancy, diet and lifestyle interventions for diabetes management during pregnancy, emotional and well‐being needs of women with diabetes pre‐ to post‐pregnancy, safe full‐term birth, post‐natal care and support needs of women, diagnosis and management late in pregnancy, prevention of other types of diabetes in women with gestational diabetes, women's labour and birth experiences and choices and improving planning pregnancy. Conclusions: These research priorities provide guidance for research funders and researchers to target research in diabetes and pregnancy that will achieve greatest value and impact. [ABSTRACT FROM AUTHOR]

Infectious diseases can directly affect women and men differently. During the COVID-19 pandemic, higher case fatality rates have been observed in men in most countries. There is growing evidence, however, that while organisational changes to healthcare delivery have occurred to protect those vulnerable to the virus (staff and patients), these may lead to indirect, potentially harmful consequences, particularly to vulnerable groups including pregnant women. These encompass reduced access to antenatal and postnatal care, with a lack of inperson clinics impacting the ability to screen for physical, psychological and social issues such as elevated blood pressure, mental health issues and sex-based violence. Indirect consequences also encompass a lack of equity when considering the inclusion of pregnant women in COVID-19 research and their absence from vaccine trials, leading to a lack of safety data for breastfeeding and pregnant women. The risk-benefit analysis of these changes to healthcare delivery remains to be fully evaluated, but the battle against COVID-19 cannot come at the expense of losing existing quality standards in other areas of healthcare, especially formaternal health. [ABSTRACT FROM AUTHOR]

The authors offer insights into the lack of national guidelines regarding skin-to-skin contact between incarcerated women and their newborn infants in the U.S. and advocate for equitable care for pregnant women in prison. Topics mentioned include the benefits of immediate skin-to-skin contact for mothers and infants including the improvement in thermoregulation and the stimulation of breastfeeding, and the dangers of immediate separation after birth.

This is the full version of the Australasian Diabetes in Pregnancy Society (ADIPS) 2020 guideline for pre‐existing diabetes and pregnancy. The guideline encompasses the management of women with pre‐existing type 1 diabetes and type 2 diabetes in relation to pregnancy, including preconception, antepartum, intrapartum and postpartum care. The management of women with monogenic diabetes or cystic fibrosis‐related diabetes in relation to pregnancy is also discussed. [ABSTRACT FROM AUTHOR]

Context: Socially accountable health professional education (SAHPE) is committed to achieving health equity through training health professionals to meet local health needs and serve disadvantaged populations. This Philippines study investigates the impact of SAHPE students and graduates on child and maternal health services and outcomes. Methods: This is a non‐randomised, controlled study involving a researcher‐administered survey to 827 recent mothers (≥1 child aged 0–5 years). Five communities were serviced by SAHPE medical graduates or final‐year medical students (interns) in Eastern Visayas and the Zamboanga Peninsula, and five communities in the same regions were serviced by conventionally trained (non‐SAHPE) graduates. Findings: Mothers in communities serviced by SAHPE‐trained medical graduates and interns were more likely than their counterpart mothers in communities serviced by non‐SAPHE trained graduates to: have lower gross family income (p < 0.001); have laboratory results of blood and urine samples taken during pregnancy discussed (p < 0.001, respectively); have first pre‐natal check‐up before 4th month of pregnancy (p = 0.003); receive their first postnatal check‐up <7 days of birth (p < 0.001); and have a youngest child with normal (>2500 g) birthweight (p = 0.003). In addition, mothers from SAHPE‐serviced communities were more likely to have a youngest child that: was still breastfed at 6 months of age (p = 0.045); received a vitamin K injection soon after birth (p = 0.026); and was fully immunised against polio (p < 0.001), hepatitis B (p < 0.001), measles (p = 0.008) and diphtheria/pertussis/tetanus (p < 0.001). In communities serviced by conventional medical graduates, mothers from lower socio‐economic quartiles (<20 000 Php) were less likely (p < 0.05) than higher socio‐economic mothers to: report that their youngest child's delivery was assisted by a doctor; have their weight measured during pregnancy; and receive iron syrups or tablets. Conclusions: The presence of SAHPE medical graduates or interns in Philippine communities significantly strengthens many recommended core elements of child and maternal health services irrespective of existing income constraints, and is associated with positive child health outcomes. [ABSTRACT FROM AUTHOR]

Background: The objective was to determine if antenatal anemia is associated with postpartum red blood cell (RBC) transfusion.Study Design and Methods: Women who gave birth at a regional, tertiary care maternity hospital between December 1, 2015, and September 31, 2016, with a documented antenatal hemoglobin (Hb) concentration were included. Women were grouped into those who were either anemic (Hb < 11.0 g/dL) or nonanemic. The change in Hb concentration and RBC transfusion rates were compared between the anemic and nonanemic women, as well as by the mode of delivery (vaginal vs. Cesarean). To estimate the volume of blood loss in a normal delivery, the mean postpartum Hb concentration decrease for the not transfused women was calculated by subtracting the nadir postpartum Hb concentration from the antenatal Hb concentration and averaging these concentrations according to delivery route.Results: Of 8039 cases analyzed, 1562 (19%) had antenatal anemia and 6477 (81%) were nonanemic. Of the anemic women, 57 (3.6%) received an RBC transfusion compared to 49 (0.76%) of the nonanemic women (p = 0.0001; odds ratio, 4.97; 95% confidence interval, 3.38-7.31). Antenatal anemia was significantly associated with receiving an RBC transfusion regardless of mode of delivery for those who delivered vaginally (p = 0.0001) or by Cesarean (p = 0.0001) compared to those who were nonanemic. The mean postpartum Hb concentration decrease was 1.12 ± 1.12 g/dL for vaginal deliveries and 1.34 ± 0.21 g/dL for Cesarean deliveries in the not transfused women (p = 0.0001).Conclusion: Although the overall rate of transfusion was low, antenatal anemia was significantly associated with receiving a postpartum RBC transfusion. [ABSTRACT FROM AUTHOR]

Background Surveys have shown that women are highly satisfied with their maternity care. Their satisfaction has been associated with various demographic, personal, and care factors. Isolating the factors that most matter to women about their care can guide quality improvement efforts. This study aimed to identify the most significant factors associated with high ratings of care by women in the three maternity periods (antenatal, birth, and postnatal). Methods A survey was sent to 2,048 women who gave birth at seven public hospitals in New South Wales, Australia, exploring their expectations of, and experiences with maternity care. Women's overall ratings of care for the antenatal, birth, and postnatal periods were analyzed, and a number of maternal characteristics and care factors examined as potential predictors of 'Very good' ratings of care. Results Among 886 women with a completed survey, 65 percent assigned a 'Very good' rating for antenatal care, 74 percent for birth care, 58 percent for postnatal care, and 44 percent for all three periods. One factor was strongly associated with care ratings in all three maternity periods: women who were 'always or almost always' treated with kindness and understanding were 1.8-2.8 times more likely to rate their antenatal, birth, and postnatal care as 'Very good.' A limited number of other factors were significantly associated with high care ratings for one or two of the maternity periods. Conclusions Women's perceptions about the quality of their interpersonal interactions with health caregivers have a significant bearing on women's views about their maternity care journey. [ABSTRACT FROM AUTHOR]

Background Disparities exist in pregnancy and birth outcomes between Australian Aboriginal women and their non-Aboriginal counterparts. Understanding patterns of health service use by Aboriginal women is critical. This study describes the use of maternal health services by remote dwelling Aboriginal women in northern Australia during pregnancy, birth and the postpartum period and their burden of disease. Methods A retrospective cohort study of maternity care for all 412 maternity cases from two remote Aboriginal communities in the Northern Territory of Australia, 2004-2006. Primary endpoints were the number and type of maternal health-related complications and service episodes at the health centers and regional hospital during pregnancy, birth, and the first 6 months postpartum. Results Ninety-three percent of women attended antenatal care. This often commenced late in pregnancy. High levels of complications were identified and 23 percent of all women required antenatal hospitalization. Birth occurred within the regional hospital for 90 percent of women. By 6 months postpartum, 45 percent of women had documented postnatal morbidities and 8 percent required hospital admission. The majority of women accessed remote health services at least once; however, only one third had a record of a postnatal care within 2 months of giving birth. Conclusion Maternal health outcomes were poor despite frequent service use throughout pregnancy, birth, and the first 6 months postpartum suggesting quality of care rather than access issues. These findings reflect outcomes that are more aligned with the developing rather than developed world and have significant implications for future planning of maternity services that must be urgently addressed. [ABSTRACT FROM AUTHOR]

Objective This study investigates (i) rural women's needs in maternity care in Tasmania; (ii) the current rural maternity services in Tasmania; and (iii) the gap between women's needs and the services provided. Design Mixed methods study was adopted. A questionnaire explored women's views on rural maternity services from antenatal to postnatal care and also invited comments from the participants. Interviews were conducted to provide comprehensive insights into their needs in maternity care. Setting Six rural communities in Tasmania, Australia. Participants Women who have had childbirth experiences in rural areas in Tasmania. Results Two hundred ten women completed the questionnaire with a response rate of 35%. There were over 150 written comments from the survey. Twenty-two follow-up interviews were conducted. This paper reports the written comments from the survey and interviews. Five main themes emerged from the data, namely (i) access needs, (ii) safety needs, (iii) needs for rural birthing services, (iv) support needs and (v) needs for quality services. Conclusion This study has revealed a comprehensive picture of rural women's needs in maternity care throughout their pregnancy to the early postnatal period. There is a major lack of maternity services in rural areas of Tasmania. The lack of rural maternity services shifts cost and risk from the health care system to rural women and their families. Women want to have greater access to maternity services in their local community and be ensured safety for themselves and their babies. Moreover, they need more support from the health care system and they desire quality services. [ABSTRACT FROM AUTHOR]

The increasing allergy prevalence in affluent countries may be caused by reduced microbial stimulation and a decreased dietary ω-3/ω-6 long-chain polyunsaturated fatty acid ( LCPUFA) ratio, resulting in an abnormal postnatal immune maturation. The timing of allergy-preventive probiotic and ω-3 LCPUFA interventions is critical, as early-life events occurring during critical windows of immune vulnerability can have long-term impact on immune development. The maternal dietary and microbial environment during pregnancy may programme the immune development of the child. Prenatal environmental exposures may alter gene expression via epigenetic mechanisms, aiming to induce physiological adaptations to the anticipated postnatal environment, but potentially also increasing disease susceptibility in the offspring if exposures are mismatched. Although the importance of fetal programming mostly has been studied in cardiovascular and metabolic disease, this hypothesis is also very attractive in the context of environmentally influenced immune-mediated diseases. This review focuses on how prenatal, perinatal or postnatal ω-3 LCPUFA interventions regulate childhood immune and allergy development, and if synergistic effects may be obtained by simultaneous probiotic supplementation. We propose that combined pre- and postnatal preventive measures may be most efficacious. Increasing knowledge on the immunomodulatory effects of prenatal, perinatal and postnatal interventions will help to direct future strategies to combat the allergy epidemic. [ABSTRACT FROM AUTHOR]

Problem: In the Northern Territory, 64% of Indigenous births are to remote-dwelling mothers. Delivering high-quality health care in remote areas is challenging, but service improvements, informed by participative action research, are under way. Evaluation of these initiatives requires appropriate indicators. Few of the many existing maternal and infant health indicators are specifically framed for the remote context or exemplify an Indigenous consumer perspective. We aimed to identify an indicator framework with appropriate indicators to demonstrate improvements in health outcomes, determinants of health and health system performance for remote-dwelling mothers and infants from pregnancy to first birthday. Design: We reviewed existing indicators; invited input from experts; investigated existing administrative data collections and examined findings from a record audit, ethnographic work and the evaluation of the Darwin Midwifery Group Practice. Setting: Northern Territory. Process: About 660 potentially relevant indicators were identified. We adapted the Aboriginal and Torres Strait Islander Health Performance Framework and populated the resulting framework with chosen indicators. We chose the indicators best able to monitor the impact of changes to remote service delivery by eliminating duplicated or irrelevant indicators using expert opinion, triangulating data and identifying key issues for remote maternal and infant health service improvements. Lessons learnt: We propose 31 indicators to monitor service delivery to remote-dwelling Indigenous mothers and infants. Our inclusive indicator framework covers the period from pregnancy to the first year of life and includes existing indicators, but also introduces novel ones. We also attempt to highlight an Indigenous consumer. [ABSTRACT FROM AUTHOR]

Aim: To explore factors that promote or hinder skin-to-skin contact (SSC) during the first days after birth between parents and healthy fullterm infants. Methods: A total of 117 postnatal mothers and 107 fathers/partners attending two childbirth settings, where Kangaroo mother care (KMC) was implemented as a standard routine of care, one in Sweden and one in Norway, were recruited consecutively and answered questionnaires two weeks postpartum. Results: Satisfaction with support for SSC in postnatal care and being a mother in the Swedish setting was found to promote SSC during the first day postpartum; previous knowledge about SSC increased the practice also during the 2nd and 3rd days. Receiving visitors apart from partner and siblings emerged as a hindering factor. SSC was known of and practised to a larger extent in the Swedish setting, whereas parents in the Norwegian setting received more visitors and were more satisfied with the received information and support for SSC in postnatal care. Conclusions: The results highlight the need for caregivers to give parents adequate support for practising SSC with their newborn healthy fullterm infants and indicate the importance of developing information routines during the antenatal period as well as in relation to the birth of the child, to effectively introduce and implement SSC. [ABSTRACT FROM AUTHOR]

To assess utilization of antenatal care (ANC) and its determinants in a conflict-affected area in Northern Sri Lanka. Design and Sample: A cross-sectional study was conducted among pregnant mothers who had completed 36 weeks of gestation, and were admitted or referred to 2 leading hospitals in Vavuniya district. Measures: Data were collected from 392 mothers using an interviewer-administered questionnaire. Results: 55% of the respondents reported that their families were affected directly by conflict. Approximately 68% of mothers were registered by public health midwife (PHM) for ANC; 31.4% were registered before 12 weeks of gestation; 38.5% were visited at home by PHM; 37.8% had the first clinic visit before 12 weeks; and 90.1% made at least 4 clinic visits. The average number of antenatal visits to specialist clinics (5.34, 95%CI: 5.03–5.65) was significantly higher than field clinics (2.97, 95%CI: 2.69–3.25). On average, a pregnant woman was seen by PHM at home 1.47 times. ANC utilization was significantly poor in women whose families were affected by conflict, living in active conflict areas and urban regions, had a lower education level, and were not involved in decision making on ANC. Conclusion: Provision of field antenatal clinics, early entry to ANC, and domiciliary care by PHM need improvement. [ABSTRACT FROM AUTHOR]

Objective To determine the level of maternal care in Northern Nigeria. Design A cross-sectional descriptive study design was used. Setting The Study was Community based and carried out in the ten states that constitute UNICEF D zone in northeast Nigeria. Population Women who delivered in the 11 months preceding the survey and resident in the study area. Methods The WHO cluster sampling methodology was used to draw a sample of 210 eligible women in each of the 10 local government areas (LGAs). Main outcome measures Utilization of antenatal care (ANC) services, tetanous toxoid immunization, skilled attendant at delivery and postnatal care. Results Majority of the respondents, 73.2%, were between the ages 20 and 34 years. Overall, 50% of the women attended antenatal clinics during their last pregnancy, with a range of ANC coverage by LGA of 14.0–81.0%. The proportion of women who booked in the first, second and third trimesters was 22.8, 63.0 and 14.2%, respectively. The antenatal services offered ranged from 95.7% for abdominal examination to 41.2% for urine examination. Sixty percent of the women received no tetanus toxoid in their last pregnancy, 11% had one dose and 29% had at least two doses. Home delivery was still the norm throughout the zone with 1791 (85.3%) delivering at home. Up to 80.5% of the deliveries were supervised by personnel with no verifiable training in sanitary birthing techniques. Only 11.4% (233) of those who received ANC had postnatal check-up. Conclusions Maternal health care as evidenced above is far from the ideal. Likewise, the commitment of the 5th Millennium Development Goal is extremely far-reaching: to reduce the maternal mortality ratio by 75% by the year 2015 with this level of maternal care. [ABSTRACT FROM AUTHOR]

Background: Health policymakers throughout the developed world are paying close attention to factors in maternity care that may influence women's satisfaction. This paper examines some of these factors in the light of observations from previous studies of satisfaction with health services. Methods: The Scottish Birth Study, a cross-sectional questionnaire survey, sought the views of all women in Scotland delivering during a 10-day period in 1998. A total of 1,137 women completed and returned questionnaires (response rate = 69%). Results: Women were overwhelmingly satisfied with their prenatal, intrapartum, and postnatal care. As is common in this type of study, reports of dissatisfaction were relatively low. However, differences occurred in satisfaction levels between subgroups; for example, the fewer the number of caregivers the woman had during childbirth, the more likely she was to be satisfied with the care received. A range of factors appeared to influence reported satisfaction levels, such as characteristics of the care provided and the woman's psychosocial circumstances. Conclusions: In addition to the inherent limitations of satisfaction studies found in the literature, problems may arise if such surveys are used uncritically to shape the future provision of maternity services, because service users tend to value the status quo over innovations of which they have no experience. Therefore, although satisfaction surveys have a role to play, we argue that they should only be used with caution, and preferably as part of an array of tools. (BIRTH 30:2 June 2003). [ABSTRACT FROM AUTHOR]

Although the present research was exploratory in nature, the results suggest that long-range prediction of ability performance using information from prenatal, perinatal, and postnatal developmental periods was feasible. Additionally, it was found that the use of sequential prediction stages, not only allowed for more accurate classification of Ss as normal or abnormal, but also indicated some optimal interval of time beyond which increments in predictive accuracy were negligible. While the predictor variables were listed for inspection, no attempt was made to interpret which variables were good or poor predictors. Discernment of the adequacy of the predictor variables will be the major focus of a future, more elaborate study involving a much larger number of CCDP Ss. This study will require a refinement of the developmental outcome criterion to include performance on both psychological and neurological tests and a more comprehensive coverage of the wide range of available predictor variables. [ABSTRACT FROM AUTHOR]

The article presents author's comments on the improvement in the quality of care for maternal and newborn health which is an important health outcome for mothers and babies. It mentions that the Millennium Development Goals (MDGs) focused on coverage interventions including antenatal and postnatal care attendance rates and skilled birth attendance rates.

The article discusses research being done on antenatal education and postnatal support strategies for improving rates of exclusive breast feeding in Singapore. It references a study by I. I. Su et al in the 2007 issue of the "British Medical Journal." The study compares women who received pre-natal education and those who received post-natal support. The researchers conclude that there was no significant difference in the rate of exclusive breast-feeding at two weeks between the groups of women.

Looks into the practice of teaching in preparation for parenthood offered by the maternity services of hospitals in Great Britain. Problems seen on the maternity services provided; Recommendations given for preparation during the prenatal and postnatal periods; Steps to be taken by the parents for parenthood.

Background For safety reasons an in-hospital birth center was replaced by a modified form of birth center care with the same medical guidelines and equipment as in standard care. The aim of this study was to investigate women's and men's satisfaction with modified care compared with standard care. Methods Women in both groups gave birth from July 2007 to July 2008. The same medical low-risk criteria during pregnancy applied to both groups. Of those invited to the study, 547 (82.7%) women in modified birth center care and 445 (66.7%) men returned a questionnaire posted 2 months after the birth, and 786 (71.6%) women and 639 (58.2%) men in standard care. Odds ratios ( ORs) for being satisfied were calculated with 95 percent confidence intervals ( CIs) and adjusted for possible confounders. We also explored the effects of different components of care on overall satisfaction. Results Adjusted ORs for being satisfied overall were approximately doubled in the modified birth center group compared with the standard care group: antenatal care- OR: 2.1 (95% CI: 1.6-2.7) in women and OR: 2.2 (95% CI: 1.5-2.8) in men; intrapartum care- OR: 2.2 (95% CI: 1.7-2.9) in women and OR: 1.7 (95% CI: 1.3-2.4) in men; and postpartum care- OR: 1.7 in women (95% CI: 1.4-2.2) and OR: 2.1 (95% CI: 1.6-2.8) in men. Important explanations of these differences included perception of the midwife as being more supportive, the presence of a calmer environment and atmosphere (intrapartum), and the option for fathers to stay overnight (postpartum). Conclusion In-hospital birth center with medical equipment on site increased overall satisfaction with all episodes of care compared with standard care. ( BIRTH 39:2 June 2012) [ABSTRACT FROM AUTHOR]