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Backgrounds: Risk factors related to the built environment have been associated with women's mental health and preventive care. This study sought to identify built environment factors that are associated with variations in prenatal care and subsequent pregnancy-related outcomes in an urban setting.Methods: In a retrospective observational study, we characterized the types and frequency of prenatal care events that are associated with the various built environment factors of the patients' residing neighborhoods. In comparison to women living in higher-quality built environments, we hypothesize that women who reside in lower-quality built environments experience different patterns of clinical events that may increase the risk for adverse outcomes. Using machine learning, we performed pattern detection to characterize the variability in prenatal care concerning encounter types, clinical problems, and medication prescriptions. Structural equation modeling was used to test the associations among built environment, prenatal care variation, and pregnancy outcome. The main outcome is postpartum depression (PPD) diagnosis within 1 year following childbirth. The exposures were the quality of the built environment in the patients' residing neighborhoods. Electronic health records (EHR) data of pregnant women (n = 8,949) who had live delivery at an urban academic medical center from 2015 to 2017 were included in the study.Results: We discovered prenatal care patterns that were summarized into three common types. Women who experienced the prenatal care pattern with the highest rates of PPD were more likely to reside in neighborhoods with homogeneous land use, lower walkability, lower air pollutant concentration, and lower retail floor ratios after adjusting for age, neighborhood average education level, marital status, and income inequality.Conclusions: In an urban setting, multi-purpose and walkable communities were found to be associated with a lower risk of PPD. Findings may inform urban design policies and provide awareness for care providers on the association of patients' residing neighborhoods and healthy pregnancy. [ABSTRACT FROM AUTHOR]

Background Women with untreated phenylketonuria (PKU) are at an increased risk to have offspring with multiple abnormalities due to teratogenic effects of hyperphenylalaninaemia. Treatment goals include blood phenylalanine concentrations between 120 and 360 µmol/L, however, there are limited pieces of evidence for the practical management of pregnant PKU patient and prediction of phenylalanine tolerance changes during a course of pregnancy. Case We report the case of a mother with classical PKU (p.R408W/p.R408W) and the course of her two pregnancies with low phenylalanine tolerance increase (347mg and 227mg) despite the rewarding collaboration with a nutritionist. Conclusion This case report does not confirm the observation that a very low phenylalanine tolerance increase in pregnancy of PKU patient is a marker of coexisting PKU-affection in fetus.

BACKGROUND: Globally, many mothers and their babies die during pregnancy and childbirth. A key element of optimizing outcomes is high-quality antenatal care. The Government of Nepal has significantly improved antenatal care and health outcomes through high-level commitment and investment; however, only 69% of patients attend the 4 recommended antenatal appointments. OBJECTIVE: This study aimed to evaluate the quality and perceptions of antenatal care in Nepal to understand compliance with the Nepalese standards. STUDY DESIGN: This cross-sectional study was conducted at a tertiary referral and private hospital in Kathmandu and a secondary hospital in Makwanpur, Nepal. The study recruited 538 female inpatients on postnatal wards during the 2-week data collection period from May 2019 to June 2019. A review of case notes and verbal survey of women to understand the pregnancy information they received and their satisfaction with antenatal care were performed. We created a summary score of the completeness of antenatal care services received ranging from 0 to 50 (50 indicating complete conformity with standards) and investigated the determinants of attending 4 antenatal care visits and patient satisfaction. RESULTS: The median antenatal care attendance was 4 visits at the secondary and referral hospitals and 8 visits at the private hospital. However, 24% of the patients attended

Background: Health insurance ownership is one indicator of the readiness of pregnant women for the delivery process. The study aimed to analyze the determinants of health insurance ownership among pregnant women in Indonesia.Methods: The study population was pregnant women in Indonesia. The study involved 2542 pregnant women in Indonesia. The variables analyzed included type of place of residence, age group, education level, employment status, marital status, parity, wealth status, and know the danger signs of pregnancy. In the final step, the study employed binary logistic regression to explain the relationship between health insurance ownership and predictor variables.Results: The results show that pregnant women with higher education were 3.349 times more likely than no education pregnant women to have health insurance. Pregnant women with wealth status in the middle category were 0.679 times the poorest pregnant women to have health insurance. Meanwhile, the richest pregnant women had 1.358 times more chances than the poorest pregnant women to have health insurance. Grande multiparous pregnant women were 1.544 times more likely than primiparous pregnant women to have health insurance. Pregnant women who know the danger signs of pregnancy were 1.416 times more likely than pregnant women who don't see the danger signs of pregnancy to have health insurance.Conclusions: The study concluded that four variables, including education level, wealth status, parity, and knowledge of the danger signs of pregnancy, were significant determinants of health insurance ownership in Indonesia. [ABSTRACT FROM AUTHOR]

Copyright of Magyar Nőorvosok Lapja is the property of Hungarian Society of Obsterics & Gynaecology 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.)

Abstract Cesarean deliveries are widely used in many high- and middle-income countries. This overuse both increases costs and lowers quality of care and is thus a major concern in the healthcare industry. The study first examines the impact of prenatal care utilization on cesarean delivery rates. It then determines whether socioeconomic status affects the use of prenatal care and thereby influences the cesarean delivery decision. Using exclusive French delivery data over the 2008–2014 period, with multilevel logit models, and controlling for relevant patient and hospital characteristics, we show that women who do not participate in prenatal education have an increased probability of a cesarean delivery compared to those who do. The study further indicates that attendance at prenatal education varies according to socioeconomic status. Low socioeconomic women are more likely to have cesarean deliveries and less likely to participate in prenatal education. This result emphasizes the importance of focusing on pregnancy health education, particularly for low-income women, as a potential way to limit unnecessary cesarean deliveries. Future studies would ideally investigate the effect of interventions promoting such as care participation on cesarean delivery rates.

Background: Routine third‐trimester ultrasound is frequently offered to pregnant women to identify fetuses with abnormal growth. Infrequently, a congenital anomaly is incidentally detected. Objective: To establish the prevalence and type of fetal anomalies detected during routine third‐trimester scans using a systematic review and meta‐analysis. Search strategy: Electronic databases (MEDLINE, Embase and the Cochrane library) from inception until August 2019. Selection criteria: Population‐based studies (randomised control trials, prospective and retrospective cohorts) reporting abnormalities detected at the routine third‐trimester ultrasound performed in unselected populations with prior screening. Case reports, case series, case‐control studies and reviews without original data were excluded. Data collection and analysis: Prevalence and type of anomalies detected in the third trimester. We calculated pooled prevalence as the number of anomalies per 1000 scans with 95% confidence intervals. Publication bias was assessed. Main results: The literature search identified 9594 citations: 13 studies were eligible representing 141 717 women; 643 were diagnosed with an unexpected abnormality. The pooled prevalence of a new abnormality diagnosed was 3.68 per 1000 women scanned (95% CI 2.72–4.78). The largest groups of abnormalities were urogenital (55%), central nervous system abnormalities (18%) and cardiac abnormalities (14%). Conclusion: Combining data from 13 studies and over 140 000 women, we show that during routine third‐trimester ultrasound, an incidental fetal anomaly will be found in about 1 in 300 scanned women. This information should be taken into account when taking consent from women for third‐trimester ultrasound and when designing and assessing cost of third‐trimester ultrasound screening programmes. One in 300 women attending a third‐trimester scan will have a finding of a fetal abnormality. One in 300 women attending a third‐trimester scan will have a finding of a fetal abnormality. [ABSTRACT FROM AUTHOR]

Despite having carried out maternity care in healthcare facilities, neonatal deaths still occur. A study was conducted to analyze the effect of antenatal care (ANC) on neonatal death incidence in healthcare facilities in Indonesia. The study used the 2017 IDHS data. With stratification and multistage random sampling, 13.104 women aged 15-49 years with live births in the last 5 years, who performed maternity care in the healthcare facility, were sampled. Apart from ANC, other independent variables analyzed were a type of place, age, education, wealth, employment, parity, and complication during pregnancy. The final stage employed a binary logistic regression test. The analysis found that women who made complete ANC visits during pregnancy (≥4 times) were 0.486 times more likely than women who did not complete ANC visits (<4 times) (OR 0.486; 95% CI 0.266-0.887). The results of this analysis inform that carrying out a complete ANC visit is a protective factor for women who perform maternity care in healthcare facilities in Indonesia from neonatal death incidence. Apart from ANC, 2 variables were also found to have a significant effect on neonatal death incidence in healthcare facilities in Indonesia. These two variables are the age group and complications during pregnancy. Meanwhile, education level, wealth status, employment status, and parity proved insignificant. It was concluded that ANC is a determinant of neonatal death incidence in the healthcare facility in Indonesia. Complete ANC visits are a protective factor for women who perform maternity care in healthcare facilities in Indonesia from neonatal death incidence. [ABSTRACT FROM AUTHOR]

Health systems and society are facing the growing problem of obesity and its accompanying comorbidities. New approaches to reduce these problems must be oriented to population groups in which long-lasting effects of interventions may occur. Biological processes occurring during the first 1000 days of life, which may be modulated by environmental modifications and result in phenotypes with differential risk for noncommunicable chronic disease, constitute an opportunity for interventions. The nutritional and general health conditions of pregnant women and the fetus, as well as toddlers, can be improved with interventions during the first 1000 days, offering pregnancy care, promoting breastfeeding, instructing on the use of complementary foods, and educating on the adequacy of the family dietary patterns for children. Evidence that interventions during this period result in promotion of children's growth and development, influencing the risk for development of obesity in infancy, is available. In this article, an ongoing program in Mexico City directed to offer continuum of care during the first 1000 days is described. [ABSTRACT FROM AUTHOR]

Objective: To determine the impact of roster reorganization on ensuring uninterrupted services while providing necessary relief to healthcare workers (HCW) in the obstetrics department of a tertiary care center amid the COVID‐19 outbreak. Methods: The COVID‐19 rostering response began in April 2020 and evolved in two phases: (1) development of new areas for screening and managing suspected/positive cases of COVID‐19; and (2) team segregation according to area of work. The impact of these changes on HCWs and patients was assessed 3 months later. Results: Developing separate areas helped to minimize the risk of exposure of patients and HCWs to those with COVID‐19. Residents and consultants worked intensively in clinical areas for 1 week followed by 1–2 weeks of non‐clinical or standby assignments, providing adequate opportunity for isolation. Frequent re‐evaluation of the roster was nevertheless required as the pandemic progressed. Segregating teams vertically significantly reduced the number of contacts identified on contact tracing and quarantine leaves, while maintaining patient satisfaction with no increase in adverse events. Residents found the roster to be "smart" and "pandemic‐appropriate." Conclusion: The "COVID emergency roster" helped ensure quality care with minimum risk of exposure and sufficient breaks for physical and psychological recovery of HCWs. Synopsis: A team‐based roster in response to COVID‐19 outbreak ensured continuity of optimum patient care with minimum exposure and physical and psychological well‐being of healthcare workers. [ABSTRACT FROM AUTHOR]

Background and Aim: Pregnancy due to physiological and psychological changes can affect the mental health of mothers. This study aims to investigate the Approach of acceptance and commitment based on the fear of delivery pain. Materials and Methods: This study was a randomized educational trial with a commitment-based treatment approach that was performed on pregnant women in Arak in 2016-2017. After obtaining written consent forms, 42 subjects were selected through the available sampling method. Subjects were grouped in the intervention group (ACT) and in the control group. Eight 90-minute sessions were held for 8 consecutive weeks of counseling Fear of delivery pain at 10 and one month after the intervention was measured in 2 groups by the Likert scale of pain (1-7) score. Data analysis was performed through repeated measure ANOVA by using SPSS (Version 18). Results: Results showed that the mean pain immediately after the intervention was 2.52±2.20 in the intervention group and 4.66±1.80 in the control group. Which is a month later in the intervention group compared to the control group had a significant decrease (3.52±1.81 vs. 4.52±2.30) (P=0.001). Conclusion: In this study, counseling with the approach of acceptance and commitment reduction the fear of delivery pain, which is the most important reason for choosing cesarean section in women, Therefore, it seems that empowering midwives to counseling approaches can be useful to improve maternal care during pregnancy, especially in the administration of delivery preparation classes. [ABSTRACT FROM AUTHOR]

Background: This study aims to explore the potential association between unintended pregnancy and maternal health complications. Secondarily, we test whether antenatal care (ANC) and community health worker (CHW) visits moderate the observed association between unintended pregnancy and maternal health complications.Methods: Cross sectional data were collected using a multistage sampling design to identify women who had a live birth in the last 12 months across 25 highest risk districts of Uttar Pradesh (N = 3659). Participants were surveyed on demographics, unintendedness of last pregnancy, receipt of ANC clinical visits and community outreach during pregnancy, and maternal complications. Regression models described the relations between unintended pregnancy and maternal complications. To determine if receipt of ANC and CHW visits in pregnancy moderated associations between unintended pregnancy and maternal complications, we used the Mantel-Haenzel risk estimation test and stratified logistic models testing interactions of unintended pregnancy and receipt of health services to predict maternal complications.Results: Around one-fifth of the women (16.9%) reported that their previous pregnancy was unintended. Logistic regression analyses revealed that unintended pregnancy was significantly associated with maternal complications- pre-eclampsia (AOR:2.06; 95% CI:1.57-2.72), postpartum hemorrhage (AOR:1.46; 95% CI: 1.01-2.13) and postpartum pre-eclampsia (AOR:2.34; 95% CI:1.47-3.72). Results from the Mantel Haenszel test indicated that both ANC and CHW home visit in pregnancy significantly affect the association between unintended pregnancy and postpartum hemorrhage (p < 0.001).Conclusion: Unintended pregnancy is associated with increased risk for maternal health complications, but provision of ANC clinical visits and CHW home visits in pregnancy may be able to reduce potential effects of unintended pregnancy on maternal health. [ABSTRACT FROM AUTHOR]

Abstract Background Gestational diabetes mellitus (GDM) is an increasingly common condition of pregnancy. It is associated with adverse fetal, infant and maternal outcomes, as well as an increased risk of GDM in future pregnancies and type 2 diabetes for both mother and offspring. Previous studies have shown that GDM can result in an emotionally distressing pregnancy, but there is little research on the patient experience of GDM care, especially of a demographically diverse UK population. The aim of this research was to explore the experiences of GDM and GDM care for a group of women attending a large diabetes pregnancy unit in southeast London, UK, in order to improve care. Methods Framework analysis was used to support an integrated analysis of data from six focus groups with 35 women and semi-structured interviews with 15 women, held in 2015. Participants were purposively sampled and were representative of the population being studied in terms of ethnicity, age, deprivation score and body mass index (BMI). Results We identified seven themes: the disrupted pregnancy, projected anxiety, reproductive asceticism, women as baby machines, perceived stigma, lack of shared understanding and postpartum abandonment. These themes highlight the often distressing experience of GDM. While most women were grateful for the intensive support they received during pregnancy, the costs to their personal autonomy were high. Women described feeling valued solely as a means to produce a healthy infant, and felt chastised if they failed to adhere to the behaviours required to achieve this. This sometimes had an enduring impact to the potential detriment of women’s long-term psychological and physical health. Conclusions This study reveals the experiences of a demographically diverse group of patients with GDM, reflecting findings from previous studies globally and extending analysis to the context of improving care. Healthcare delivery may need to be reoriented to improve the pregnancy experience and help ensure women are engaged and attentive to their own health, particularly after birth, without compromising clinical pregnancy outcomes. Areas for consideration in GDM healthcare include: improved management of emotional responses to GDM; a more motivational approach; rethinking the medicalisation of care; and improved postpartum care.

Background: Pregnant women need information, skills and social support for the effectiveness of pregnancy care. Health education patterns play a major role in educational needs assessment in designing and implementing educational interventions. Objectives: The present study aimed to investigate the pregnancy care behaviors, based on the health belief and social support model among pregnant women. Methods: This cross-sectional study was conducted in 2016 with the participation of 215 pregnant women under the control of faculty of Iranshahr Medical Sciences who were selected by multi-stage sampling method. The data were collected through a questionnaire based on the structures of the health belief and social support model, knowledge, behavior and demographic information. Data were analyzed by descriptive, Pearson correlation and multivariate regression tests in SPSS ver19 software. Results: The highest rate of education among pregnant women (35.8%) was high school. The mean score of mothers' performance was 12.31 out of 22, and among the structures the perceived sensitivity score was the strongest, and the social support score was the weakest. Based on regression analysis, self-efficacy, perceived benefits, and social support were predictive behaviors which generally predict 27.5% of behavioral changes. Conclusion: Based on the results, the structures of self-efficacy, perceived benefits and social support should be considered as the most important predictor of pregnancy care behaviors in designing educational interventions.

Introduction: Now-a-days, pregnancy care is considered as one of the main public health focus. Pregnancy care plays an important role in the health of the mother, the newborn and the family. Therefore, efforts to evaluate the quality of care are necessary for encouraging the policymakers to create an effective program for improving the quality of health services. Aim: To determine the quality of pregnancy care from the perspective of service recipients using the SERVQUAL model in comprehensive health centers of Sanandaj of, Iran in 2018. Materials and Methods: This descriptive-analytic study was conducted on 384 pregnant women who were referred to the comprehensive health centers of Sanandaj for receiving pregnancy care. Population sampling was done based on the classification method. Data collection was performed by the standard SERVQUAL questionnaire, which measures the quality gap in five dimensions of the service (sensibility, reliability, assurance, responsibility, and empathy) using 22 questions. Data were analysed by SPSS-23 software using descriptive statistics, ANOVA, and t-tests. Results: In all five dimensions of the quality of services provided (sensibility, reliability, responsibility, assurance, and empathy), there was a negative quality gap. The highest mean quality gap was in the reliability dimension (-1.84) and the lowest mean gap was seen in the empathy dimension (-1.49). Conclusion: Data analysis showed that in all five dimensions of the quality of services, the expectation level of service recipients was beyond the level of their perceptions, and the quality improvement in the various aspects seems to be necessary.

Background: A significant number of women die from pregnancy and childbirth complications globally, particularly in low- and middle-income countries (LMICs). Receiving at least four antenatal care (ANC) visits may be important in reducing maternal and perinatal deaths. This study investigates factors associated with attending ≥ 4 ANC visits in Sarlahi district of southern Nepal., Methods: A secondary analysis was conducted on data from the Nepal Oil Massage Study (NOMS), a cluster-randomized, community-based longitudinal pregnancy cohort study encompassing 34 Village Development Committees. We quantified the association between receipt/attendance of ≥ 4 ANC visits and socioeconomic, demographic, morbidity, and pregnancy history factors using logistic regression; Generalized Estimating Equations were used to account for multiple pregnancies per woman., Results: All pregnancies resulting in a live birth (n=31,867) were included in the model and 31.4% of those pregnancies received 4+ ANC visits. Significant positive associations include socioeconomic factors such as participation in non-farming occupations for women (OR=1.52, 95% CI: 1.19, 1.93), higher education (OR=1.79, 95% CI: 1.66, 1.93) and wealth quintile OR=1.44, 95% CI: 1.31, 1.59), nutritional status such as non-short stature (OR=1.17, 95% CI: 1.07, 1.27), obstetric history such as adequate interpregnancy interval (OR=1.31, 95% CI: 1.19, 1.45) and prior pregnancy but no live birth (OR=2.14, 95% CI: 1.57, 2.92), symptoms such as vaginal bleeding (OR=1.35, 95% CI:1.11, 1.65) and awareness of the government's conditional cash transfer ANC program (OR=2.26, 95% CI: 2.01, 2.54). Conversely, belonging to the lower Shudra caste (OR=0.56, 95% CI: 0.47, 0.67), maternal age below 18 or above 35 (OR=0.81, 95% CI:0.74, 0.88; OR=0.77, 95% CI: 0.62, 0.96)), preterm birth (OR=0.41, 95% CI: 0.35, 0.49), parity ≥ 1 (OR=0.66, 95% CI: 0.61, 0.72), and the presence of hypertension during pregnancy (OR=0.79, 95% CI: 0.69, 0.90) were associated with decreased likelihood of attending ≥ 4 ANC visits., Conclusions: These findings underscore the importance of continuing and promoting the government's program and increasing awareness among women. Moreover, understanding these factors can guide interventions aimed at encouraging ANC uptake in the most vulnerable groups, subsequently reducing maternal-related adverse outcomes in LMICs., Trial Registration: The clinicaltrial.gov trial registration number for NOMS was #NCT01177111. Registration date was August 6 th , 2010., Competing Interests: Competing interests The authors declare that they have no competing interests.

We propose a framework for guiding research on perinatal health in people with intellectual disability (ID). We developed this framework based on the perinatal health framework for people with physical disabilities, American Association on Intellectual and Developmental Disabilities conceptual framework of human functioning, disability reproductive justice framework, trauma-informed care, and socio-ecological model. The framework reflects health outcomes of birthing people with ID and their infants that result from interactions of factors across the life course at policy (health, social, and disability policies), community (attitudes, social and physical environment), institutional (health care delivery-related factors, access to information/resources), interpersonal (social determinants of health/histories of trauma, social support, interactions with service-providers), and individual levels (demographics, intellectual functioning, adaptive behavior, health conditions, genetic factors, psychosocial factors, health behaviors). This framework will facilitate research to identify factors leading to perinatal health disparities in people with ID and development and evaluation of resources to address them., Competing Interests: Declaration of competing interest The authors report no conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

The purpose of this article is to establish a body of literature exploring the emergent topic of Indigenous doulas, in relation to Indigenous communities in remote locations, where women are routinely evacuated and no longer supported to give birth. In doing so the article will synthesise and critique key concepts in the literature and identify gaps for prioritisation in future research. The methodology is influenced by Indigenous, decolonising and feminist theoretical standpoints. A combined methodological approach of an integrative and scoping literature review was undertaken. Only published research, grey literature and grey data written in English and created between the years 2000 and 2018 was included. The search engines used were CINAHL plus, MEDLINE full text, Informat, Cochrane, Google Scholar and Google Search. Resources originating from only Canada and America identified and despite regional similarities, no literature from Australia or Greenland was sourced. Of the entirety of identified resources two author's Indigenous identity was readily identifiable; and in the research articles there was a total of 191 research participants identified as Indigenous. Much of the grey literature and grey data included quotations from Indigenous women. N/A. Key concepts about the role and practice of Indigenous doulas were identified: reclaiming and supporting cultural practices; sovereignty over lands and bodies; strengthening families, training, work models and defiance of evacuation policies on the pathway to returning birth. Critique of these concepts suggests that Indigenous doulas have a unique role and practice scope in Western maternity care, which is readily distinguished from standard doula practice. Research gaps worthy of future research prioritisation include: Indigenous women's perspectives as recipients of Indigenous doula care, Indigenous doulas as a pathway into midwifery, escort policy and impacts on Indigenous doula provision; evaluation and alternative research settings. The role and practice of Indigenous doulas offers a promising approach to redressing the colonisation of Indigenous childbirth while contributing to improving Indigenous maternal and infant outcomes. Indigenous doula practice shares many best-practice characteristics with Indigenous Healing Programs and as such is also likely to also promote inter-generational healing. Most of the resources located were descriptive, but this emergent topic is worthy of further applied research. [ABSTRACT FROM AUTHOR]

Pregnancy is a major concern of the world in current health issues. The maternal mortality rate (MMR) is still quite large in almost all countries in the world due to pregnancy complications. Pregnancy complications can be prevented by improving the health status of pregnant women. However, the lack of knowledge of pregnant women about pregnancy care and inadequate pregnancy care practices causes mothers to be less aware of what is experienced so that there are delays in decision making to seek help, delays in getting transportation to bring to health facilities, and delay in getting help from officers health. The highest number of cellular phone users to access the internet comes from internet users from Java and Bali (92 percent). The purpose of using the internet is 68.7 percent to search for information and browsing. The purpose of the research is to create a pregnancy guide application for the expectant mother to get the information and knowledge about pregnancy care. The method is used in the research is SDLC (System Development Life Circle) method is the method that describes the system development life cycle in the design and development of information system. The results of the research showed that application has been completed design and has been tested by taking a sample of 55 pregnant women, which is named Pregnancy Care Application Mobile Android Based. Based on the Function Point relationship, this application gets a score of 9,638 (scale 1-10) which shows the usability of use to the user. Thus, this application is very feasible to use because all the features that are prepared are things that are really needed by pregnant women in the care of daily pregnancy. [ABSTRACT FROM AUTHOR]

Background: Prenatal care is one way to prevent complications of pregnancy, and educational approach is the best approach to improve the knowledge of mothers about prenatal care. Aim: This study aimed to determine the influence of education on knowledge, attitude, and behavior of pregnancy care in Kendari, Indonesia Methods: This was Quasi Experimental study with pre-post design. There were 4 groups involved in this study, which were: 1) The group that received educational intervention using a modification module from the MHC book of the Department of Health, 2) The group that received educational intervention using MHC book of the Department of Health, 3) The group that only used modification modules from MHC book of the Department of Health, and 4) The group that only used the MHC book of Department of Health. The intervention was given for 6 months. Seventy eight of 4-months pregnant women were selected by purposive sampling. Data were collected by asking the respondents to fulfill the questionnaires, which adopted from the questionnaire of Faculty of Public Health, Hasanuddin University to measure knowledge (15 items), attitude (18 items), and behaviors (15 items) of respondents. Data were analyzed by using Wilcoxon test and Kruskal Wallis test. Results: Results showed thre was an influence of education on knowledge, attitude, and behavior of pregnancy care. Improvement in knowledge, attitudes, and behavior of pregnancy care was higher in the group of pregnant women using a modification module Conclusion: Education through the class of pregnant woman has an impact to increase knowledge, attitude, and behavior of care of pregnant woman. It is therefore the efforts to maintain educational approach is necessary.

Background: Energy metabolism speeds up during pregnancy that requires pregnant women to have extra amount of nutritions. Provision of education on nutrition during pregnancy is an effort to prevent and tackle malnutrition. Aim: This study aimed to determine the effect of education using modification module towards nutritional intake during pregnancy in Kendari, Indonesia Methods: This was Quasi Experimental study with pre-post design. There were 4 groups in this study, which were: 1) The group that received educational intervention using a modification module from the MHC book of the Department of Health, 2) The group that received educational intervention using MHC book of the Department of Health, 3) The group that only used modification modules from MHC book of the Department of Health, and 4) The group that only used the MHC book of Department of Health. The intervention was given for 6 months. Seventy eight of 4-months pregnant women were selected in this study. Data were collected by using 24 hours food recall instrument, and questionnaire adopted from Child and Maternal Nutrition Survey's Questionnaire of Faculty of Public Health, Hasanuddin University. Data were analyzed by using Wilcoxon test and Kruskal Wallis test. Results: Results showed there was an effect of education by using the module modifications to the intake of nutritions during pregnancy. Increased nutrient intake was higher in pregnant women using a module class modifications. Conclusion: Education affects nutritional intake of pregnant women. Changes in nutritional intake was higher in group 1 (education modules with modifications), compared with the education group MCH handbook. It is suggested that mothers should improve the nutrition during pregnancy for the better growth of the fetus, composition and metabolic changes in the mother's body.

Women of refugee background experience poorer perinatal outcomes when compared to their local-born counterparts. Women of refugee background have often experienced trauma and are likely to encounter barriers to accessing health services in host countries which can exacerbate their recovery from trauma and contribute to poor health outcomes. Trauma- and violence-informed approaches to care offer opportunities to address barriers to pregnancy care which may, in turn, improve these poor outcomes. Trauma- and violence-informed care is a framework that acknowledges a person's experiences of trauma, recognises its impact and symptoms, and works toward resisting re-traumatisation by integrating knowledge into practice. Despite this, trauma- and violence-informed care in maternity care settings has rarely been explored from the perspectives of women of refugee background. This study aimed to explore trauma- and violence-informed pregnancy care from the perspectives of Karen women of refugee background using Community-Based Participatory Research methods. The lead researcher is a Karen-Australian woman with lived refugee experience. A Community Advisory Group was formed to support the study. Semi-structured interviews were conducted with seven Karen women of refugee background who had recently had a baby in Western metropolitan Melbourne, Australia. The data were analysed using Reflexive Thematic Analysis. Karen women shared what they considered to be important elements of trauma- and violence-informed pregnancy care. Three major elements were identified: (1) care design and accessibility; (2) promoting choice and control; and (3) trauma-informed interpreting. The critical importance of the interpreter-mediated setting was highlighted as women reported that they may not experience trauma- and violence-informed maternity care if they cannot access an interpreter or their relationship with the interpreter is unsafe. This study offers critical insights regarding the elements of trauma- and violence-informed pregnancy care that are important to Karen women of refugee background.

Copyright of Magyar Nőorvosok Lapja is the property of Hungarian Society of Obsterics & Gynaecology 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.)

Background and Objectives : Technical quality of health care, compared with whatever is presented on the basis of scientific evidence as a standard service, is an important aspect of the quality in health services and everything that customer receives. The purpose of this study was to assess the technical quality of prenatal care according to the standards of the Ministry of Health from the perspective of pregnant women at Shahid Chamran Health Centers in Tabriz. Material and Methods : This was a cross-sectional study based on CQMH model. Forty pregnant women were selected randomly from the women who referred to Shahid Chamran Health Centers. We used standard questionnaire for collecting data which its validity has been tested and its reliability was confirmed. (Cronbach's alpha, .952) Results: The findings of the study showed that the highest level of compliance with the standard was the examining of women and listening to fetal heartbeat (16.7%) in the clinical examination. Regarding the prenatal care standard, the highest level of compliance was in oral health education (6.8%) which is 80% lower than the standard and 13.3% higher than the standard. These findings also indicated that education about bleeding and spotting is 90% lower than standard. Prescribing pharmaceutical supplements was higher than standard. In part of paraclinical services, the highest level of compliance with standard was the number of blood tests (50%) that was 6.7% lower than standard and 43.3% higher than standard. Conclusion : A significant proportion of pregnant women statements indicated the underuse and overuse of the standard which leads to a need for indispensable changes in order to improve the quality of prenatal care according to the standards of the Ministry of Health. Standards were in poor condition at the clinical examinations and prenatal care educations fields which require appropriate intervention based on the results of this study. ​

Antenatal care (ANC) is provided by skilled healthcare professionals to pregnant women to ensure the best health conditions for both mother and baby during pregnancy. It includes risk identification, prevention, management of pregnancy-related diseases, health education, and health promotion. Antenatal care has a great effect on vital health indicators such as maternal and neonatal mortality by identifying and treating pregnancy-related complications. Political instability and armed conflict have seriously affected the health system, which has catastrophic implications for pregnant women's health. This review aimed to summarize the literature on ANC in Sudan before and during political instability and war by highlighting its effect on maternal mortality, coverage, care providers, quality of care, accessibility, and utilization. Other aspects of this review are the ANC components and service provision during the war. In addition, the author tried to identify the gaps and point out the future research needs in Sudan. A total of 58 articles about ANC in Sudan have been reviewed through PubMed, Google Scholar, ResearchGate databases, and other search tools. The keywords used were "antenatal care", "coverage", "service providers", "service quality", "accessibility and utilization", "components", and "ANC during the war". All the keywords were followed by "Sudan" to confine the search. According to the reviewed data, ANC services in Sudan, even during normal political situations, were not sufficient and of poor quality in most of the reviewed regions. The political instability and armed conflicts worsened the situation, and it became catastrophic. To improve the accessibility and quality of ANC services, we will need the collaboration of all stakeholders to address the health needs of vulnerable groups, people in remote rural areas, and nomadic communities towards providing the required health services in general and ANC in particular. On the other hand, an important aspect of this development is the availability of skilled healthcare providers and the adoption, revision, and updating of working procedure guidelines to match the needs of the local communities. The main shareholders are the local communities; they must be empowered and involved by raising their awareness. Then, effective, punctual, and applicable contingency plans should be ready for any unfortunate crises., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Abdelmola et al.)

Abstract Problem Post-traumatic stress disorder and post-traumatic stress symptoms following birth occur amongst a small proportion of women but can lead to poor maternal mental health, impairment in mother-infant bonding and relationship stress. This integrative review aims to examine the associated risk factors and women's own experiences of postnatal post-traumatic stress in order to better understand this phenomenon. Method Fifty three articles were included and critically reviewed using the relevant Critical Appraisal Skills Program checklists or Strengthening the Reporting of Observational studies in Epidemiology assessment tool. Findings Risk factors for postnatal post-traumatic stress symptoms and disorder include factors arising before pregnancy, during the antenatal period, in labour and birth and in the postnatal period. Potential protective factors against postnatal post-traumatic stress have been identified in a few studies. The development of postnatal post-traumatic stress can lead to negative outcomes for women, infants and families. Discussion Risk factors for post-traumatic stress symptoms and disorder are potentially identifiable pre-pregnancy and during the antenatal, intrapartum and postnatal periods. Potential protective factors have been identified however they are presently under researched. Predictive models for postnatal post-traumatic stress disorder development have been proposed, however further investigation is required to test such models in a variety of settings. Conclusions Postnatal post-traumatic stress symptoms and disorder have been shown to negatively impact the lives of childbearing women. Further investigation into methods and models for identifying women at risk of developing postnatal post-traumatic stress following childbirth is required in order to improve outcomes for this population of women. [ABSTRACT FROM AUTHOR]

The recent demonstration of the effectiveness of low-dose aspirin administered from the first trimester in the prevention of preeclampsia will probably lead to establishing and radicating the "inverted pyramid" screening model for preeclampsia. Such a multiparametric approach for the screening of preeclampsia in the first trimester, albeit highly sensitive in identifying early-onset disease, is poor at screening the forms of preeclampsia occurring close to term. Late-onset preeclampsia is 3 to 6 times more common than early-onset preeclampsia and currently represents the major determinant of maternal morbidity related to hypertensive disorders of the pregnancy. On this ground, we discuss our idea to construct a second "screening checkpoint" in the third trimester with the aim of reassessing the risk of preeclampsia of those women who screened negative in the first trimester. If implemented, the sequential screening model we propose would convert the "inverted pyramid model" into an "arrow model" for the antenatal care of preeclampsia. [ABSTRACT FROM AUTHOR]

Objectives Healthcare systems in developed countries may differ in financing and organisation. Maternity services and delivery are particularly influenced by culture and habits. In this study, we compared the pregnancy care quality and efficiency of the German, French and Japanese healthcare systems. Study design Comparative healthcare data analysis. Methods In an international comparison based mainly on Organisation for Economic Co-operation and Development (OECD) indicators, we analysed the health resources significantly affecting pregnancy care and quantified its quality using structural equation modelling. Pregnancy care efficiency was studied using data envelopment analysis. Pregnancy output was quantified overall or separately using indicators based on perinatal, neonatal or maternal mortality. Results The density of obstetricians, midwives, paediatricians and the average annual doctor's consultations were positively and the caesarean delivery rate negatively associated with pregnancy outcome. In the international comparison at an aggregate level, Japan ranked first for pregnancy care quality, whereas Germany and France were positioned in the second part of the ranking. Similarly, at an aggregate level, the Japanese system showed pure technical efficiency, whereas Germany and France revealed mediocre efficiency results. Perinatal, neonatal and maternal care quality and efficiency taken separately were quite similar and mediocre in Germany and France. In Japan, there was a marked difference between a highly effective and efficient care of the unborn and newborn baby, and a rather mediocre quality and efficiency of maternal care. Conclusion Germany, France, and Japan have to struggle with quality and efficiency issues that are nevertheless different: in Germany and France, disappointing pregnancy care quality does not correspond to the high health care expenditures and lead to low technical efficiency. The Japanese system shows a high variability in outcomes and technical efficiency. Maternal care quality during delivery seems to be a particular issue that could possibly be addressed by legally implementing quality assurance systems with stricter rules for reimbursement in obstetrics. [ABSTRACT FROM AUTHOR]

Pregnancy and childbirth provide ideal conditions for spiritual enrichment. This study aimed to investigate the spiritual health care experiences of mothers during pregnancy in Iran. In this qualitative content analysis study, 48 semi-structured and in-depth interviews were conducted with 36 women who were pregnant or had recent experience of successful pregnancy. Subjects were selected by purposive sampling and data accuracy and trustworthiness were checked using Lincoln and Guba's criteria. For data analysis, a conventional content analysis approach was used. One theme and four categories were found in this study. Mothers were shown to be attentive about spiritual health care during pregnancy through caring for the spiritual growth of the self, the child, the family, and the community. The mothers' experiences during pregnancy can serve as a guide for healthcare planners to develop a proper spiritual health promotion programme. [ABSTRACT FROM AUTHOR]

Introduction: While reports from individual hospitals have helped to provide insights into the causes of maternal mortality in low-income countries, they are often limited for policymaking at national and subnational levels. This multisite study was designed to determine maternal mortality ratios (MMRs) and identify the risk factors for maternal deaths in referral health facilities in Nigeria. Methods: A pretested study protocol was used over a 6-month period (January 1-June 30, 2014) to obtain clinical data on pregnancies, births, and maternal deaths in eight referral hospitals across eight states and four geopolitical zones of Nigeria. Data were analyzed centrally using univariate, bivariate, and multivariate statistics. Results: The results show an MMR of 2,085 per 100,000 live births in the hospitals (range: 877-4,210 per 100,000 births). Several covariates were identified as increasing the odds for maternal mortality; however, after adjustment for confounding, five factors remained significant in the logistic regression model. These include delivery in a secondary health facility as opposed to delivery in a tertiary hospital, non-booking for antenatal and delivery care, referral as obstetric emergency from nonhospital sources of care, previous experience by women of early pregnancy complications, and grandmultiparity. Conclusion: MMR remains high in referral health facilities in Nigeria due to institutional and patient-related factors. Efforts to reduce MMR in these health facilities should include the improvement of emergency obstetric care, public health education so that women can seek appropriate and immediate evidence-based pregnancy care, the socioeconomic empowerment of women, and the strengthening of the health care system. [ABSTRACT FROM AUTHOR]

Background: Gestational diabetes mellitus (GDM) is an increasingly common condition of pregnancy. It is associated with adverse fetal, infant and maternal outcomes, as well as an increased risk of GDM in future pregnancies and type 2 diabetes for both mother and offspring. Previous studies have shown that GDM can result in an emotionally distressing pregnancy, but there is little research on the patient experience of GDM care, especially of a demographically diverse UK population. The aim of this research was to explore the experiences of GDM and GDM care for a group of women attending a large diabetes pregnancy unit in southeast London, UK, in order to improve care.Methods: Framework analysis was used to support an integrated analysis of data from six focus groups with 35 women and semi-structured interviews with 15 women, held in 2015. Participants were purposively sampled and were representative of the population being studied in terms of ethnicity, age, deprivation score and body mass index (BMI).Results: We identified seven themes: the disrupted pregnancy, projected anxiety, reproductive asceticism, women as baby machines, perceived stigma, lack of shared understanding and postpartum abandonment. These themes highlight the often distressing experience of GDM. While most women were grateful for the intensive support they received during pregnancy, the costs to their personal autonomy were high. Women described feeling valued solely as a means to produce a healthy infant, and felt chastised if they failed to adhere to the behaviours required to achieve this. This sometimes had an enduring impact to the potential detriment of women's long-term psychological and physical health.Conclusions: This study reveals the experiences of a demographically diverse group of patients with GDM, reflecting findings from previous studies globally and extending analysis to the context of improving care. Healthcare delivery may need to be reoriented to improve the pregnancy experience and help ensure women are engaged and attentive to their own health, particularly after birth, without compromising clinical pregnancy outcomes. Areas for consideration in GDM healthcare include: improved management of emotional responses to GDM; a more motivational approach; rethinking the medicalisation of care; and improved postpartum care. [ABSTRACT FROM AUTHOR]

All pregnant women need easy access to pregnancy-related personalized information, on-time quality healthcare services and effective communication links with healthcare providers. Smartphone-based devices, communication systems and eHealth applications can play an important role in facilitating some of these services to pregnant women in a fast and efficient way and can thus prevent most of the pregnancy-related complications. The objective of this work is to propose and design a pregnancy care network for pregnant women and healthcare providers. The network model, an eHealth application based on smartphone-based devices and communication systems, is designed to strengthen communication links between health professionals and pregnant women and increase education, awareness and quality of care during pregnancy and childbirth. [ABSTRACT FROM AUTHOR]

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