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Background: The COVID-19 pandemic has significantly impacted pregnant and breastfeeding women. Both low- and high-risk groups adopted preventive approaches such as mask-wearing and handwashing to slow down and prevent viral transmission during critical periods that may affect mother-child interactions. Methods: A longitudinal observational study was conducted with primiparous women recruited using convenience sampling from the postpartum care ward of Afzalipour Teaching Hospital in Kerman from August 1, 2020 to March 30, 2021. The research questionnaires included demographic information, preventive behaviors, breastfeeding intention and practices, postpartum distress, and Edinburgh Postpartum Depression Scale. All the questionnaires were self-reported online in three stages: before discharge from the postpartum ward, the first month after delivery, and the third month after delivery. Results: A Total of 160 primiparous women were included. The results showed significant changes in preventive behaviors and postpartum distress levels during the study. Breastfeeding intention and practices were negatively affected by postpartum distress (P = 0.034), unwanted pregnancies (P = 0.009), and cesarean delivery (P < 0.001). Postpartum distress was directly affected by the presence of depression (P < 0.001). Preventive behaviors at discharge were significantly associated with postpartum distress three months after delivery (P = 0.013). The study also found an association between women's and partner's education, unwanted pregnancy, and cesarean delivery that determined postpartum distress. Conclusions: Pandemic restrictions did not affect breastfeeding intentions or practices, possibly due to sufficient social and family support during the pandemic. However, robust guidelines are required to increase enable women's access to specializede care to cope with future pandemics, particularly during the first few weeks after childbirth. Significance: • Sufficient social and family support can overcome such concerns to promote breastfeeding. • Maternal support services are vital during the current and future pandemic periods to promote breastfeeding. • Pandemics like COVID-19 will become more common in the future. The outcome of this study provides a useful perspective for the future. [ABSTRACT FROM AUTHOR]

This study aimed to develop and validate a labor induction nomogram for nulliparous and multiparous women who were 38 weeks pregnant or more and had their labor induced by an unfavorable cervix. This prospective study was conducted on 300 individuals (200 for nomogram development and 100 for nomogram validation). Height, body mass index at delivery, parity, gestational age, adjusted bishop score, and cesarean section risk assessment were all recorded on a checklist. Participants were followed until they gave birth, and the type of delivery was noted in the checklist. Out of 300 labor inductions, 80 (26.7%) underwent a cesarean section. Cesarean risk estimation was the only predictor of delivery type based on multivariate logistic regression. The AUC (Area Under the Curve) in development group was 0.68 and in validation group was 0.71. The developed nomogram for predicting of cesarean section risk following labor induction has a relatively good predictive value among women. [ABSTRACT FROM AUTHOR]

Introduction: One of the most common complications of spinal anesthesia in elective cesarean is a headache, known commonly as post-dural-puncture headache (PDPH). Various methods are mainly recommended such as resting and the use of non-opioid analgesics, caffeine, and codeine, but none of them has been fully effective in its treatment. Hence, this study was conducted to evaluate the effect of magnesium sulfate on the prevention of postdural- puncture headache in the elective cesarean. Method: a total of 68 patients candidate for elective cesarean and admitted to Kamali Hospital were selected using convenient sampling and they were randomly divided into two groups. One group received magnesium and other group received saline. Subjects of case group received magnesium at the dose of 50 mg / kg as bolus and the subjects of control group received normal saline at the same dose as bolus. The incidence of headache and its severity 12, 24, 36, 48, 60 and 72 hours after surgery were measured in both case and control groups. Results: The mean age of patients in the magnesium sulfate group was 27.94 years with a standard deviation of 5.18 and the mean age of patients in the normal saline group was 29.35 years with a standard deviation of 5.97. The mean body mass index (BMI) in the magnesium sulfate group was 26.34 with a standard deviation of 4.03 and the mean body mass index (BMI) in the normal saline group was 27.15 with a standard deviation of 2.47. Postdural- puncture headache severity was lower in the case group than that in the control group at all times (P <0.05). Conclusion: The results of this study revealed that intravenous administration of magnesium sulfate before elective cesarean in patients undergoing spinal anesthesia significantly decreases the severity of post-duralpuncture headache (PDPH). [ABSTRACT FROM AUTHOR]

Background: Child birth is one of the most important events in a mother's life. Different factors influence whether a child is delivered by cesarean or normal vaginal delivery. Despite the complications of cesarean, demand for this type of delivery is increasing. The purpose of this study was to examine the influence of personal traits on the choice of the delivery method based on HEXACO personality model.Methods: Two hundred and ten pregnant women in some health centers in Tehran volunteered to participate in this research. To identify their personality dimensions, the pregnant women first filled out HEXACO personality forms. Then, the received data were analyzed through multivariate analysis of variance using a software package called SPSS-23.Results: 104 women selected cesarean and 106 other women preferred normal vaginal delivery. The results of the multivariate analysis of variance showed that there is a significant difference between the two groups of women for six personality factors in HEXACO (P = 0.001). The linear combination of personality characteristics of pregnant women has a significant effect on the choice of delivery method (P < 0.05).Conclusions: Personality differences of pregnant women can be considered in psychological interventions and antenatal counseling to overcome psychological resistance to vaginal delivery and increase its choice. [ABSTRACT FROM AUTHOR]

Background: The rate of Cesarean Section (CS) is high in Iran. A successful Vaginal Birth After Cesarean (VBAC) section can protect mothers against the risk of having multiple CS. This study aimed to evaluate the success rate of VBAC, related factors, and the causes of failure. Materials and Methods: This cross-sectional study was conducted on 150 pregnant women who were candidates for VBAC and admitted at maternity hospitals in Qom from 2016 to 2018. The required data were collected from the patients' records and entered into the checklist. Then, the success rate of VBAC was estimated, and related factors together with the causes of failure were determined by t-test, Chi-square, and independent-samples t-tests in SPSS v. 18 software. Results: The mean (SD) maternal age was 32 (5.20) years and ranged from 21 to 45 years old. The success rate of VBAC was estimated to be 85.33%, and 14.67% of the patients had to repeat a CS after failure in vaginal delivery. The mean time between previous CS and present delivery was statistically significant between successful and failure groups (t125 = 2.32, p = 0.002). The results also revealed that the most important causes of VBAC failure were prolonged labor [odds ratio (OR) = 4.70)], full arrest (OR = 2.70), and decline fetal heart (OR = 5.31). Conclusions: The success rate of VBAC in our study was high. However, VBAC was more successful when the interval between inter-deliveries was long, and lower complications were reported when the interval was 2–4 years. [ABSTRACT FROM AUTHOR]

Background: In‐hospital feeding practices have been shown negatively to affect breastfeeding exclusivity and duration. The purpose of this study was to report the prevalence and determinants of delayed breastfeeding, provision of traditional prelacteal foods, and use of infant formula in hospital. Methods: Between June 2014 and March 2015, 700 women were recruited from three public and two private maternity hospitals in Shiraz, Iran. Data were collected at recruitment via face‐to‐face interviews and extracted from medical records. Multivariable logistic regression was used to explore the association of feeding practices with a variety of maternal characteristics and hospital practices. Results: Only 32.2% of infants were breastfed within 1 hour of birth, with 40.8% receiving a traditional prelacteal food, and 34.9% given formula during their hospital stay. Compared with infants delivered vaginally, those delivered by cesarean were more likely to have experienced delayed breastfeeding and received formula, but less likely to have received traditional prelacteal foods. Infants who did not experience skin‐to‐skin contact were more likely to have experienced delayed breastfeeding and received traditional prelacteal foods and formula in hospital. Conclusions: Although four out of the five hospitals were designated as Baby‐Friendly, several of the 10 Steps to Successful Breastfeeding were not adhered to. The high rate of cesarean delivery was a barrier to the early initiation of breastfeeding and the majority of infants did not experience early skin‐to‐skin contact. Maternity care practices should be reviewed and include a clear breastfeeding care plan for women who undergo a cesarean delivery. [ABSTRACT FROM AUTHOR]

Background: Cesarean birth (CB) rates have increased over recent years with concerns over differences between these rates in migrant communities compared with the rates among women in their receiving country. This review aimed at summarizing the available literature regarding the incidence of CB among migrants in Europe., Methods: A systematic search of four electronic databases was carried out, including CINAHL, MEDLINE, Scopus, and Maternity and Infant Care. Identified studies were screened and their quality assessed. Meta-analysis was undertaken using Rev Man 5.4 where sufficient data were available. Otherwise, data were synthesized narratively., Results: From the 435 records identified in searches, 21 papers were included. Analysis shows that overall CB rates were significantly lower for Syrian refugee women compared with women in their receiving country (Turkey) and higher for Iranian migrants than women in their host country. Emergency CB rates were significantly higher for migrant women from "Sub Saharan Africa" and the "South East Asia, Asia and Pacific" region than rates in the receiving country. Statistical significance was not found between other populations., Conclusions: This review highlights differences between CB rates in certain migrant groups in comparison with women native to their host country, which merits further investigation for potential explanations. We also identified a need to standardize definitions and population groupings to enable more meaningful analysis. This review also highlights a substantial lack of data on CB rates between different population groups that could negatively impact the provision of care., (© 2023 The Authors. Birth published by Wiley Periodicals LLC.)

Background: Uncontrolled increase of C-section is one of the major problems in Iranian health system, such that C-section is the most common surgical procedure in the entire country's hospitals in Obstetrics and Gynecology sections. A variety of complications also come along with cesarean. Objective: The aim of this study was to evaluate the prevalence, causes, and complications of cesarean in Iran. Materials and Methods: forty-one articles were considered with respect to certain criteria and were included in a systematic review to perform a meta-analysis study. The systematic review's search was conducted on SID, Iranmedx, Magiran, Medlib, PubMed, and Science Direct databases published between1999-2016. The weight of each included study was calculated according to its sample size and the reported prevalence of binomial distribution. A random-effects model using R and STATA (Version 11.2) software was utilized for analyzing data. Results: The total number of the sample was 197514 pregnant women with a mean age of 26.72 yr. The prevalence of cesarean in Iran was estimated at 48%. The main reasons for the prevalence of cesarean in this study were mothers' higher education, previous cesarean, and doctor recommendation. The most frequent complication in women undergoing cesarean was the muscular pain, and the most common fetal complications in newborns by caesarean delivery was transient tachypnea. Conclusion: The prevalence of C-section in Iran is much higher than what WHO recommends. It is essential, to decrease such a phenomenon, making the mothers aware of the risks of cesarean delivery, and establishing counselling sessions as well to eliminate the mothers' fear of vaginal delivery. [ABSTRACT FROM AUTHOR]

Objective: Cesarean rates in recent decades have been increasing and a number of studies have shown that cesarean increases maternal morbidities. The aim of this study is to compare the quality of life after cesarean and vaginal delivery. Methods: This prospective study was carried out on 356 pregnant women visiting urban health centers in Shahroud City, Northeast Iran, in 2011. The subjects completed the quality of life questionnaire in the third trimester of pregnancy and at 8 weeks postpartum. Results: In primiparas, the mean global QOL scores for the cesarean and vaginal delivery groups were 67.65±12.7 and 72.12±11.8, respectively. Also, the scores for the physical, psychological and social domains of QOL as well as the global score of QOL were higher in the vaginal delivery group than the cesarean group (p<0.05). In the case of primiparas, multiple regression analysis revealed that after adjusting for education, desirability of pregnancy and the General Health Questionnaire score, the delivery type remained as a predictor of the scores for the physical (R2=1.7%; B=-3.826; p=0.031; CI [-7.301, -.350]) and social (R2=2.5%; B=-5.708; p=0.017; CI [-10.392, -1.023]) domains of QOL and the global QOL score (R2=2.6%; B=-4.065; p=0.006; CI [-6.964, -1.164]). While multiparas, there was no relationship between QOL and type of delivery. Conclusion: In this sample of low-risk women, cesarean negatively affected the QOL of primiparas. More studies with larger sample sizes should be conducted to examine the effects of cesarean on QOL in both primiparas and multiparas within a shorter period after delivery. [ABSTRACT FROM AUTHOR]

Background: Considering the increasing number of cesarean cases and to identify the effective factors in choosing such surgery, this study was performed to evaluate the attitudes of medical specialists and gynecological assistants toward the type of delivery and the reasons for increasing rates of cesarean. Materials and Methods: Data were gathered through a semi-structured interview and analyzed using a content-analysis method. Finally, 11 physicians and assistants were participated in the study. The participants were selected through purposeful sampling. The first two participants were selected through accessible sampling, while the others by previous participants to consider the variety of physicians' experiences and attitudes. Data were analyzed using the Cheevakumjon method. After reviewing the data, key sentences and concepts were derived and finally categorized. Results: Fear of the delivery pain was one of the most important reasons that made women to select the cesarean, while having a good delivery experience was one of the most important reasons for choosing the vaginal delivery. Four categories of factors, some facilitators for choosing the cesarean and the others for vaginal delivery, affecting the choice of delivery were related to patient, culture, delivery conditions and also the outcomes. Conclusion: Several factors should be considered in choosing a delivery method. Furthermore, preparing a woman for a painless and pleasant delivery and also changing the attitudes toward the type of delivery are very important. [ABSTRACT FROM AUTHOR]

Background: Mother and newborn's health is one of the important indexes in health services of every country and one of its main assessment indexes is the number of normal deliveries in each country. Identifying the effective factors in labor helps the right selection of patients the process of delivery. The main goal of this study was to assess the association between fetal sex and unsuccessful labor process which result in cesarean section. Materials and Methods: This observational cross-sectional study was conducted on 1537 pregnant women admitted for delivery to Taleghani Hospital of Arak during 6 months. Data were catch through a check list consisting of obstetric history, physical examination, labor process, and lab tests coupled with interview and observation. The results were analyzed through Chi2, chance ration analysis, and t-test. Results: Of the 1537 pregnant women, 74% had normal delivery and 26% underwent cesarean section. Of all infants, 35.1% of those delivered by normal vaginal delivery and 13.4% of those delivered by cesarean section were male sex while 38.9% of the infants in the normal delivery group and 12.6% of those in the cesarean group were female. These results did not show any association between fetal sex and type of delivery. Overall, 36.5% of the deliveries done through cesarean section were due to dystosia (18.1% male and 18.4% female) (P=0.934). Also,14.3% of the newborns delivered through cesarean sction due to fetal distress were male and 10.8% of them were female (P=0.162) while 10.5% of newborns delivered through cesarean section due to meconium were male and 8.5% of them were male (P=0.359). Conclusion: It appears there is no association between fetal sex and labor disorders which result in cesarean section. [ABSTRACT FROM AUTHOR]

Background: Cesarean is one of the most common surgeries. Pain is on of it`s side effect which bothers mothers. Opioids are the most common pain relief which used as Intra muscular, Intra venues, sub cotaneous or new methods such as patient control analgesia (PCA). As it is new method, research decided to compare efficacy of these 2 methods. Methods: This is a prospective clinical trial study which has done on primi parous with full term, single pregnancy who were candidate for elective cesarean in Sepahan shahr hospital of Isfahan in year 2010. Excluding criteria was using another drugs, essential disease, not to permit, dizziness, coma. Number of cases was 44 in each group which had been selected simple. In recovery and surgery ward patients were evaluated about vital signs- drugs side effects in 1, 2, 4, 8, 12 hours after surgery. Pain score evaluated by visual analog scale (VAS) by patients. Satisfaction of pain relief asked from patients. Findings: Petidin was significantly more effective for pain relief than PCA in1, 8, 12 hours after surgery (P < 0.05). Mean of pain was less in 2,4hours after surgery in Petidin Im group than PCA but not meaningful. Total Petidin was more effective than PCA for pain relief (P < 0.02). Conclusion: This study showed although PCA is new method for pain relief but it is doesn't have efficacy such as old methods such as Intra muscular petidine. Also patient`s satisfaction was less in PCA method .It may because of expensive and it`s side effect such as nausea and vomiting. [ABSTRACT FROM AUTHOR]

Objective: Determining the effect of discharge time after elective cesarean section on maternal outcomes., Methods: This study is a randomized clinical trial that performed on 294 women who undergo elective cesarean section. The patients were randomized in two groups by simple randomization method: Group A (discharge 24 h after cesarean) and group B (discharge for 48 h after cesarean). In both groups, during the first 24 h, they received intravenous antibiotic (cefazolin as routine order) and pethidine at the time of pain. The patients were discharged with the hematinic and mefenamic acid. The main outcome variables were satisfaction of the patient, surgical site infection, separation of incision, endometritis, urinary tract infection, gastrointestinal complications, rehospitalization, secondary postpartum hemorrhage and pain of the patient on discharge day, one and six weeks after cesarean., Results: Satisfaction scores and pain score at discharge day, one and six weeks after discharge were not significant different in the study groups (P > 0.05). Another key finding of this paper was no significant difference in the incidence of surgical site infection, separation of incision, endometritis, urinary tract infection, gastrointestinal complications, rehospitalization, secondary postpartum hemorrhage at one and six weeks after discharge in the study groups(P > 0.05)., Conclusion: The time of discharge can be reduced to 24 h after surgery if the mother to be at good general condition, the vital signs are stable, the patient has no underlying problem and disease, and it is financed for the patient and the health system.

Background: Fear of childbirth (FOC) may contribute to postpartum depression, impaired maternal-infant relation, and preference for cesarean in future pregnancies. We aimed to investigate predictors of FOC and normal vaginal birth among postpartum women who had planned for a normal vaginal birth., Methods: This cross-sectional study was conducted in 2019 with postpartum women during the first 24 h after the birth. A sample of 662 women, selected using a convenient sampling method, filled out the questionnaire composed of socio-demographic and obstetric questions and the Wijma Delivery-Expectancy Questionnaire (W-DEQ). We used multiple logistic regression analyses to determine predictors of FOC and normal vaginal birth., Results: The percentage of women with mild (score ≤ 37), moderate (38-65), high (66-84), severe (85-99), and intense FOC (score ≥ 100) were 7.9, 19.5, 40.9, 21.1, and 10.6% respectively. Predictors of intense FOC were age < 30, primiparity, low maternal satisfaction with pregnancy, and a low level of perceived marital satisfaction. Overall, 21.8% of women gave birth by cesarean. Predictors of normal vaginal birth were birth weight < 4 kg, spontaneous onset of labor pain, mother's age < 30, term pregnancy, having a doula, multiparity, satisfaction with husband's support, and overall satisfaction with pregnancy. A high level of perceived marital/sexual satisfaction was a risk factor for cesarean. Mode of birth was not a predictor of postpartum FOC., Conclusions: The rate of severe and intense FOC among this group of postpartum women is high. Our findings highlight modifiable factors for reducing FOC and increasing normal vaginal birth. In designing programs to increase the rate of normal vaginal birth, the following factors should be considered: limiting induced labor, encouraging women to recruit a doula to help them at labor, facilitate husband's attendance throughout antenatal/intrapartum, and postnatal care to support his wife, and pay attention to women's common misunderstandings about the effect of vaginal birth on marital/sexual relationship. Our findings indicate that seeking novel ways to promote marital/sexual satisfaction and helping women to have a smooth, hassle-free pregnancy may contribute to a reduction in the rate of the FOC.