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Objectives: Optimal postpartum care promotes healthcare utilization and outcomes. This qualitative study investigated the experiences and perceived needs for postpartum care among women in rural communities in Arizona, United States. Methods: We conducted in-depth interviews with thirty childbearing women and analyzed the transcripts using reflexive thematic analysis to gauge their experiences, needs, and factors affecting postpartum healthcare utilization. Results: Experiences during childbirth and multiple structural factors, including transportation, childcare services, financial constraints, and social support, played crucial roles in postpartum care utilization for childbearing people in rural communities. Access to comprehensive health information and community-level support systems were perceived as critical for optimizing postpartum care and utilization. Conclusions for Practice: This study provides valuable insights for policymakers, healthcare providers, and community stakeholders in enhancing postpartum care services for individuals in rural communities in the United States. Significance: What is already known on this subject: Centering postpartum policies and interventions to particular population groups necessitates a comprehensive and nuanced understanding of priority needs. What this study adds: This study sheds light on the distinct experiences and challenges influencing postpartum experiences and healthcare utilization among childbearing individuals in rural communities in the United States. [ABSTRACT FROM AUTHOR]

Objective: With the increasing number of incarcerated women worldwide, the rate of women who experience pregnancy in prison, has also increased in this population. Exploring the unique experience of pregnant prisoners can contribute to understanding the complex world of this vulnerable population and, as a result, tailoring programs to promote their health status. The objective of this study was to understand the psychological experience of pregnancy in prison based on the lived experiences of incarcerated women. Methods: This was a qualitative inquiry using van Manen's approach to phenomenology. Seven pregnant and four early postpartum women, with experience of pregnancy during incarceration, were selected purposefully in a prison in Iran from 2019 to 2020. In-depth semi-structured interviews were used to collect data. To analyze data, six-step van Manen's descriptive-interpretive phenomenological approach was adopted using MAXQDA10 software. Results: The main theme of "white torture", a term used to describe the psychological and emotional distress experienced by incarcerated pregnant women, emerged from the data analysis. This theme echoes the pressure and torment of pregnancy on incarcerated women and consists of two subthemes: "captive to bitter and harsh emotions" and "suffering from psychosomatic pain and injuries." Conclusion for Practice: As an emotional trauma, pregnancy puts incarcerated women under psychological torture. Policies should be developed towards the acknowledgment and meeting of the unique psychological needs of pregnant women in prison. It is also crucial for healthcare providers to provide women in prison with training on coping strategies to address the psychological and emotional challenges of pregnancy. Significance: The women who get pregnant while incarcerated face many of emotions ranging from isolation and grief to anger and hostility. Incarcerated pregnant women are constantly tormented; a torment that may have no physical evidence but for pregnant prisoners, their bulging abdomen, leaves deep and long-term psychological impacts that seems like constant torture. This shows that the psychological needs of these women should be identified, and comprehensive executive-guaranteed mental health programs must be developed to promote their psychological and emotional health. [ABSTRACT FROM AUTHOR]

Objective Measles immunity testing, unlike that for rubella, is not currently part of prenatal screening even though immunity to both is conferred by the measles–mumps–rubella (MMR) vaccine. Although endemic transmission of measles was declared eliminated in the United States in 2001, outbreaks have continued to occur. Given the risks associated with measles infection during pregnancy, we sought to identify risk factors for measles nonimmunity (MNI) in rubella-immune (RI) pregnant individuals. Methods We performed a retrospective observational cross-sectional study of patients receiving prenatal care and delivering at two university hospitals and a county hospital in Southern California from April 1, 2019 to February 1, 2021. Inclusion criteria were pregnant individuals ≥18 years old who had serological testing for rubella and measles during pregnancy. Demographic data were extracted from electronic medical records, including results of serological testing and chronic medical conditions. All subjects were rubella immune, and we compared measles-immune (MI) with MNI groups. Results In total, 1,813 RI individuals were identified, with 1,467 (81%) MI and 346 (19%) MNI individuals. Variables associated with an increased risk of MNI included having public health insurance (adjusted relative risk [aRR]: 1.56; 95% confidence interval [CI]: 1.24, 1.97) and Hispanic ethnicity (aRR: 1.37; 95% CI: 1.06, 1.78). Black race was associated with a decreased risk of MNI (aRR: 0.52; 95% CI: 0.29, 0.91). Birth year before 1989 demonstrated a trend toward increased risk of MNI, but this did not reach statistical significance (aRR 1.23; 95% CI: 1.00, 1.52). No differences were seen between the two groups for medical comorbidities. Conclusion Our study is the first to demonstrate risk factors for measles MNI in patients with documented rubella immunity. In the absence of universal measles serological screening recommendations, the risk factors identified could help guide clinicians in selective screening for those at risk of needing postpartum MMR vaccination. Key Points The rate of measles nonimmunity is higher than previously reported. Hispanic ethnicity and use of public insurance are risk factors for measles nonimmunity. The current recommendation for history-based screening for measles immunity is likely insufficient. [ABSTRACT FROM AUTHOR]

Background This study aimed to explore the relationship between women's empowerment and utilization of maternity care for married Afghan women aged 15–49 y in Afghanistan, assessing the convergence validity of the Survey-based Women's Empowerment Index in Afghanistan (SWEI-A). Methods The study used data from the 2015 Afghanistan Demographic Health Survey to examine the association of different domains of women's empowerment with the utilization of maternity care using multilevel Poisson regression at both individual and community levels. Results The utilization of maternity services was considerably higher among women with high scores compared with those with low scores in almost all domains of the SWEI-A, except for property owning, in which women with high scores appeared to have lower rates of utilization of such services compared with those with low scores. At the community level, those communities with high participation of women in the labor force were less likely to have adequate antenatal care (ANC), institutional delivery and postnatal care (PNC). Individual-level literacy was associated with higher utilization of ANC, institutional delivery and PNC, contrary to community-level literacy. Conclusions Except for property owning, the high score in almost all other domains was associated with higher utilization of maternity care, which indicates an acceptable level of convergence validity for the developed index (i.e. the SWEI-A) in measuring women's empowerment among married Afghan women aged 15–49 y. [ABSTRACT FROM AUTHOR]

Curcuma aeruginosa (CA) rhizomes are used in traditional medicine as gastrointestinal remedies, postpartum care and uterine issues. However, its effects on gastrointestinal motility have not yet been explored. Extracts of CA rhizomes prepared using chloroform, methanol and water were evaluated for their effects on gastrointestinal contractions using isolated rat gastric fundus and ileum. Varied solvents aim for extraction of different compounds of CA rhizome. In the ileum, the 3 extracts did not significantly affect spontaneous contractions, but significantly reduced contractions induced by acetylcholine (ACh, 0.3 μM) and KCl (40 mM) in a concentration-dependent manner. The order of potency, based on ACh-induced contraction, was chloroform > methanol > water extracts, with respective IC50 values of 0.025 ± 0.001, 0.46 ± 0.02 and 2.57 ± 0.47 mg/mL. Similar potency order against KCl-induced contraction was observed, with IC50 values of 0.011 ± 0.002, 0.47 ± 0.06 and 1.18 ± 0.18 mg/mL, respectively. In the isolated gastric fundus model, both methanol and water extracts resulted in an increase in the force of contraction in the absence of stimulation. However, when ACh (0.3 μM) was introduced, the methanol and water extracts exhibited a concentration-dependent reduction in contractions, with IC50 values of 0.62 ± 0.06 and 2.30 ± 0.32 mg/mL, respectively. As for KCl (40 mM)-induced contraction, only the highest concentration of the water extract (3.75 mg/mL) significantly decreased the contraction by 41.29 ± 2.94 %. CA extract demonstrated relaxant effects on both isolated rat gastric fundus and ileal contractions induced by ACh and KCl. These findings support the use of CA in traditional medicine as a gastrointestinal remedy. These extracts have the potential to be used as antispasmodics and to treat infectious and non-infectious diarrhea, the latter of which occurs in functional gastrointestinal diseases. It might also be useful as a gastroprokinetic. [ABSTRACT FROM AUTHOR]

Aim: Crying seems to be a common trigger for abusive head trauma (AHT), which is the leading cause of fatalities from physical abuse in infants. Our objective was to evaluate knowledge of AHT, crying infants and correct behavioural measures in a general population. Methods: An online questionnaire (LimeSurvey) was created to assess the risk of shaking. The online survey contained a total of 41 questions, including a demonstration of a previously recorded video in which an infant doll is shaken. Results: A total of 319 people, 245 of them (76.8%) with own children, participated in the study. Almost all respondents (98.4%) were aware of serious injuries due to shaking, even to the point of death (98.1%). Most participants (97.5%) had heard the term 'shaking trauma' prior but did not receive any professional information, neither before nor after birth (85.2% or 86%), or during follow‐up examinations (88.5%). The majority of the participants (95%) considered that useful coping strategies in infant crying were inappropriate. Conclusion: The consequences of shaking an infant were common knowledge in a normal population, whereas there was a knowledge gap regarding the management of excessive crying infants. Prevention programmes should mainly focus on male caregivers during postnatal care. [ABSTRACT FROM AUTHOR]

Background: Due to the shortage of midwives in Germany, it is not always possible to provide comprehensive basic postnatal care for young families. Therefore, it is quite likely that general practitioners (GP), who serve as the first contact person in all health matters in our health care system, will be increasingly consulted regarding questions on postnatal care in the future. Consequently, the aim of this qualitative study was to explore central competencies for the care of families in the postnatal phase. Methods: Midwives were questioned about their postnatal activities with the help of a semistructured questionnaire. Thereafter, the interviews were evaluated using the Mayring method. Results: Interviews were conducted with 25 midwives with an average age of 45 years. Knowledge about the (patho)physiological processes of the mother and child during the postnatal phase, a supportive basic attitude, and time are important elements in the work with young postnatal families. Additionally, it is important to obtain competences in psychosocial issues. Conclusion: The acquisition of competences for the postnatal phase appears to be useful for GPs. Among other aspects, creation of a good networking structure with other health professions is important. [ABSTRACT FROM AUTHOR]

Care bundles are a promising approach to reducing postpartum hemorrhage–related morbidity and mortality. We assessed the effectiveness and safety of care bundles for postpartum hemorrhage prevention and/or treatment. We searched MEDLINE, Embase, Cochrane CENTRAL, Maternity and Infant Care Database, and Global Index Medicus (inception to June 9, 2023) and ClinicalTrials.gov and the International Clinical Trials Registry Platform (last 5 years) using a phased search strategy, combining terms for postpartum hemorrhage and care bundles. Peer-reviewed studies evaluating postpartum hemorrhage–related care bundles were included. Care bundles were defined as interventions comprising ≥3 components implemented collectively, concurrently, or in rapid succession. Randomized and nonrandomized controlled trials, interrupted time series, and before-after studies (controlled or uncontrolled) were eligible. Risk of bias was assessed using RoB 2 (randomized trials) and ROBINS-I (nonrandomized studies). For controlled studies, we reported risk ratios for dichotomous outcomes and mean differences for continuous outcomes, with certainty of evidence determined using GRADE. For uncontrolled studies, we used effect direction tables and summarized results narratively. Twenty-two studies were included for analysis. For prevention-only bundles (2 studies), low-certainty evidence suggests possible benefits in reducing blood loss, duration of hospitalization, and intensive care unit stay, and maternal well-being. For treatment-only bundles (9 studies), high-certainty evidence shows that the E-MOTIVE intervention reduced risks of composite severe morbidity (risk ratio, 0.40; 95% confidence interval, 0.32–0.50) and blood transfusion for bleeding, postpartum hemorrhage, severe postpartum hemorrhage, and mean blood loss. One nonrandomized trial and 7 uncontrolled studies suggest that other postpartum hemorrhage treatment bundles might reduce blood loss and severe postpartum hemorrhage, but this is uncertain. For combined prevention/treatment bundles (11 studies), low-certainty evidence shows that the California Maternal Quality Care Collaborative care bundle may reduce severe maternal morbidity (risk ratio, 0.64; 95% confidence interval, 0.57–0.72). Ten uncontrolled studies variably showed possible benefits, no effects, or harms for other bundle types. Nearly all uncontrolled studies did not use suitable statistical methods for single-group pretest-posttest comparisons and should thus be interpreted with caution. The E-MOTIVE intervention improves postpartum hemorrhage–related outcomes among women delivering vaginally, and the California Maternal Quality Care Collaborative bundle may reduce severe maternal morbidity. Other bundle designs warrant further effectiveness research before implementation is contemplated. [Display omitted] [ABSTRACT FROM AUTHOR]

• We identified public health guidelines on postpartum physical activity from 22 countries and on postpartum sedentary behavior from 11 countries. • Physical activity guidance focused on type, frequency, duration, and intensity, as well as progression for each of these from pregnancy to postpartum. • Half the guidelines supported physical activity while breastfeeding, while the other half did not address the topic. • Eight guidelines remarked on the impact of delivery (i.e., vaginal, caesarean section) on physical activity. • Sedentary behavior guidance included limiting long-term sitting and interrupting sitting with physical activity. The period following pregnancy is a critical time window when future habits with respect to physical activity (PA) and sedentary behavior (SB) are established; therefore, it warrants guidance. The purpose of this scoping review was to summarize public health-oriented country-specific postpartum PA and SB guidelines worldwide. To identify guidelines published since 2010, we performed a (a) systematic search of 4 databases (CINAHL, Global Health, PubMed, and SPORTDiscus), (b) structured repeatable web-based search separately for 194 countries, and (c) separate web-based search. Only the most recent guideline was included for each country. We identified 22 countries with public health-oriented postpartum guidelines for PA and 11 countries with SB guidelines. The continents with guidelines included Europe (n = 12), Asia (n = 5), Oceania (n = 2), Africa (n = 1), North America (n = 1), and South America (n = 1). The most common benefits recorded for PA included weight control/management (n = 10), reducing the risk of postpartum depression or depressive symptoms (n = 9), and improving mood/well-being (n = 8). Postpartum guidelines specified exercises to engage in, including pelvic floor exercises (n = 17); muscle strengthening, weight training, or resistance exercises (n = 13); aerobics/general aerobic activity (n = 13); walking (n = 11); cycling (n = 9); and swimming (n = 9). Eleven guidelines remarked on the interaction between PA and breastfeeding; several guidelines stated that PA did not impact breast milk quantity (n = 7), breast milk quality (n = 6), or infant growth (n = 3). For SB, suggestions included limiting long-term sitting and interrupting sitting with PA. Country-specific postpartum guidelines for PA and SB can help promote healthy behaviors using a culturally appropriate context while providing specific guidance to public health practitioners. [Display omitted] [ABSTRACT FROM AUTHOR]

The birth of a premature infant and its subsequent hospitalization in the neonatal intensive care unit are stressful experiences for mothers. Because of uncertainty concerning interactions with a premature baby, mothers often feel helpless and only hesitantly assume their maternal role. This may have a negative impact on the mother-child interaction and prevents mothers from taking an active part in the care for their child. "Creating Opportunities for Parent Empowerment" (COPE) is a 4-phase educational intervention program aiming to systematically involve parents into caring for their premature infant. In this pretest-posttest quasi-experimental study in 2 Swiss university hospitals, we focused on maternal self-efficacy. We compared self-efficacy in mothers receiving the COPE program or standard care alone at baseline and 3 months after estimated delivery date. To measure maternal self-efficacy, we used the "Tool to measure Parenting Self-Efficacy" (TOPSE).While scores for "Emotion and Affection," "Empathy and Understanding," as well as "Learning and Knowledge" increased in both groups, only "Learning and Knowledge" scores were significantly higher in the intervention group. Given the intention of improving learning and knowledge, the COPE program might be a promising intervention contributing to enhanced maternal self-efficacy. [ABSTRACT FROM AUTHOR]

Increasing incidence of prolonged oestrus reported in cross-bred dairy cows bred through artificial insemination (AI), is attributed to various causative factors and underlying mechanisms. The present study was to assess the pattern of follicular growth, oestrogen secretion, and conception on the first and second day of oestrus and to understand the influence of thermal stress as a causative factor for oestrus prolongation. The year-round study involved 52 crossbred cows intensively managed under a hot humid climate, during their second and third months postpartum. Animals were examined for the status of ovarian follicles, oestrogen level, and conception to AI on Day 0 and Day 1 of oestrus confirmation and the findings were compared across seasons. While oestrus detection rate (ODR) and conception of AI were lowest during the summer season attributable to maximum TS, better ODR (P<0.05) and more prolonged oestrus (P<0.01) occurred during the seasons of favourable climate having least TS and better green fodder availability. Besides, the occurrence of larger follicles and almost similar oestradiol levels on Day 0 and Day 1 of oestrus, better conception rate for double AI (63.16 %) than total AI (48.48 %) indicated prolonged oestrus and involvement of delayed ovulation among the causation. Comparison of the seasonal pattern of follicular growth, oestrogen level, and conception to AI between Day 0 and Day 1 further clarifies the influence of TS and increased milk production as the potential contributors to the occurrence of prolonged oestrus in cross-bred cows under the hot humid tropical climate. [ABSTRACT FROM AUTHOR]

The study aimed to evaluate suitable hormonal treatment regimen for inducing oestrus in postpartum anoestrus Vechur cows and its reproductive outcome. The efficiency of Ovsynch and Ovsynch + progesterone protocols in 12 anoestrus cows was studied. Six anoestrus cows were kept as untreated control and they were observed for a period of 180 days postpartum. Both treatment protocols resulted in a complete oestrus induction response of 100 per cent. The interval from treatment to induced oestrus was significantly lower in the Ovsynch group (50.10 ± 1.44 h) than in the Ovsynch + progesterone (54.40 ± 0.48 h) group. In comparison to the control group, treatment group animals displayed a high intensity score for oestrus. The duration of oestrus in the Ovsynch group (26.41 ± 0.53 h) was significantly longer than the control (24.45 ± 0.46 h) group and the Ovsynch + progesterone group (24.13 ± 0.42 h). The overall conception rate for three consecutive AI in Ovsynch, Ovsynch + progesterone and control group were 66.67, 83.33 and 33.33 per cent, respectively. The calving to conception intervals were significantly (p<0.001) shorter in Ovsynch (118.33 ± 9.71 d) and Ovsynch + progesterone (106.67 ± 8.12 d) groups than the control (191.5 ± 5.36 d). It is concluded that hormonal treatment is effective in inducing postpartum oestrus and reducing the calving to conception interval in Vechur cows. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the incidence of urinary incontinence (UI) during pregnancy and after delivery, perceptions of UI, effectiveness of pelvic floor muscle exercise (PFME) on UI, and risk factors for UI among pregnant women. Methods: Chinese women aged =18 years at 35 to 37 weeks of gestation were invited to participate. Perceptions of UI were assessed using a questionnaire that comprises seven statements. Urinary symptoms were assessed using the self-report six-item Urogenital Distress Inventory (UDI-6). Women were considered to have UI when they had positive scores on any of the incontinence items. Women who reported to have UI symptoms were assessed by a physiotherapist in the postnatal ward and were taught PFME. UI impact on quality of life was assessed using the self-report seven-item Incontinence Impact Questionnaire. Participants with UI during pregnancy who delivered in our hospital were followed up at 6 weeks postnatally through telephone. Their adherence to PFME was assessed in terms of the mean number of contractions performed per day. Results: Of 1134 participants, the incidence of UI was 73.0% during pregnancy and 21.9% after delivery. Predictors for UI during pregnancy were a history of UI before pregnancy (odds ratio [OR]=14.40, p<0.001), higher pre-pregnancy body mass index (OR=1.04, p=0.034), and previous vaginal delivery (OR=2.06, p=0.001), whereas predictors for UI after delivery were vaginal delivery in the index pregnancy (OR=3.86, p<0.001), older age (OR=1.12, p<0.001), a history of UI before pregnancy (OR=1.86, p=0.028), and total score of items 2 to 4 on the UDI-6 during pregnancy (OR=1.20, p=0.015). 86.4% of participants reported poor or no adherence to PFME. Adherence to postnatal PFME was not associated with UI after delivery (p=0.477). Women with higher education levels adhered more to PFME (p=0.008). Perceptions of UI were not associated with adherence to postnatal PFME. Conclusion: A history of pre-pregnancy UI is the main predictor for UI during pregnancy, whereas vaginal delivery is the main predictor for UI after delivery. The effect of postpartum PFME on UI after delivery is not significant, probably owing to the low rate of adherence to PFME. [ABSTRACT FROM AUTHOR]

Taking as its objects of study two contemporary films, Sergei Dvortsevoy's 2018 Ayka and Anastasia Borisova's 2019 film Mama, this article considers the vicissitudes of life as a female economic migrant and young mother in Moscow, with Mama representing the internal migration of its main protagonist from Sakha (known also as Yakutia) and Ayka the experience of a new mother from Kyrgyzstan. Both films engage the themes of pregnancy, childcare and racialised labour within post-Soviet Moscow, and they do so in analogous ways, each employing a documentary style that we might see as gesturing towards the 'ethnofictions' of Jean Rouch. Central to my inquiry is that both Ayka and Iye appeared at a time when pronatalist policies were actively being pursued within the Russian Federation, as part of the highly conservative agenda of V.V. Putin, and yet the dire material conditions of the films' migrant heroines leave them unable to fully 'assent' to their new maternal roles. My article considers each film's attempt to document the unequal access to postpartum care in Russia's metropolis and draws upon theories of cinematic spectatorship to ask whether 'intersectional' Russophone films can transcend the violence of voyeurism and play an active role in feminist advocacy. [ABSTRACT FROM AUTHOR]

Background & Objective: This study aimed to assess maternal and neonatal outcomes in cases of Intrauterine Growth Restriction (IUGR). Understanding these outcomes is vital for early identification of potential adverse effects and facilitating prompt intervention and management. Materials & Methods: This retrospective cohort study focused on mothers whose fetuses experienced IUGR at Imam Khomeini Hospital in Ahvaz, Iran, between March 2021 and 2022. Data on neurodevelopmental and clinical aspects were collected periodically up to 24 months’ post-birth, encompassing various parameters such as infant age, gender, developmental and motor coordination disorders, neurodevelopmental status, medical and speech disorders, and maternal health during pregnancy. Results: Over a one-year period, 80 breastfed infants were studied. At 6, 12, and 24 months after birth, 30% of children showed growth disorders. Boys had a slightly higher percentage of growth arrest (76.4% vs. 63.2%, P>0.05). Growth retardation was present in 13.16% of girls, compared to none of the boys. The most common medical outcomes were asthma and orthopedic disorders (5% each). Developmental disorders and motor disorders were the most common neurological and developmental outcomes, each affecting 11.25% of children. During pregnancy, 16.25% had gestational diabetes, 17.5% had hypertension, and 10% had hypothyroidism, which decreased to 6.25%, 11.25%, and 3.75%, respectively, after childbirth. Conclusion: The present study indicates a significant prevalence of growth and developmental disorders, as well as medical outcomes such as asthma and orthopedic issues at the age of two in infants with IUGR. Mothers of these infants also faced significant postpartum issues, such as diabetes and hypertension. [ABSTRACT FROM AUTHOR]

Background: There is a knowledge-to-practice gap regarding parent-delivered pain management, and few studies have investigated parents' and nurses' participation in and acceptance of combined parent-delivered pain-alleviating interventions such as skin-to-skin contact (SSC), breastfeeding, and parental musical presence. This study investigated parents' and nurses' perceptions of and reflections on experiencing combined parent-delivered pain management. Methods: This qualitative study applies a collaborative participatory action research design using ethnographic data collection methods such as focus groups, video observations, and video-stimulated recall interviews with parents and nurses. Results: The results concern three main categories, i.e., preparation, participation, and closeness, as well as various sub-categories. Preparations were central to enabling combined parent-delivered pain management. Participation was facilitated by parental musical presence, in which parents shifted their attention toward their infant. Closeness and presence during neonatal care helped parents become active during their infant's painful procedures. Parental lullaby singing created a calm and trusting atmosphere and after the procedure, both parents and nurses felt that they had successfully supported the infant through a potentially painful procedure. Conclusions: Mental and practical preparation is central to implementing combined parent-delivered pain management. When parents and nurses explored the interventions, they found the methods feasible, promoting self-efficacy and confidence in both parents and nurses. [ABSTRACT FROM AUTHOR]

Introduction: The corpus callosum is one of the five main cerebral commissures. It is key to combining sensory and motor functions. Its structure can be pathological (dysgenesis) or completely absent (agenesis). The corpus callosum dys- or agenesis is a rare disease (1:4000 live births), but it can have serious mental effects. Methods: In our study, we processed the data of 64 pregnant women. They attended a prenatal diagnostic center and genetic counseling from 2005 to 2019 at the Department of Obstetrics and Gynecology at Semmelweis University. Results: The pregnancies had the following outcomes: 52 ended in delivery, 1 in spontaneous abortion, and 11 in termination of pregnancy (TOP) cases (n = 64). The average time of detection with imaging tests was 25.24 gestational weeks. In 16 cases, prenatal magnetic resonance imaging (MRI) was performed. If the abnormality was detected before the 20th week, a genetic test was performed on an amniotic fluid sample obtained from a genetic amniocentesis. Karyotyping and cytogenetic tests were performed in 15 of the investigated cases. Karyotyping gave normal results in three cases (46,XX or XY). In one of these cases, postnatally chromosomal microarray (CMA) was later performed, which confirmed Aicardi syndrome (3q21.3–21.1 microdeletion). In one case, postnatally, the test found Wiedemann–Rautenstrauch syndrome. In other cases, it found X ring, Di George syndrome, 46,XY,del(13q)(q13q22) and 46,XX,del(5p)(p13) (Cri-du-chat syndrome). Edwards syndrome was diagnosed in six cases, and Patau syndrome in one case. Conclusions: We found that corpus callosum abnormalities are often linked to chromosomal problems. We recommend that a cytogenetic test be performed in all cases to rule out inherited diseases. Also, the long-term outcome does not just depend on the disease's severity and the associated other conditions, and hence proper follow-up and early development are also key. For this reason, close teamwork between neonatology, developmental neurology, and pediatric surgery is vital. [ABSTRACT FROM AUTHOR]

Background: Postpartum mental health care is a public health priority requiring interprofessional and interorganizational collaboration. Primary care physicians (PCPs) have the potential to play an essential role in facilitating access to health care and providing comprehensive and coordinated care for postpartum mental health problems. In Japan, however, there are no previous studies on the extent to which PCPs are involved in postpartum mental health care. Therefore, this study aimed to investigate the practices and experiences of Japanese PCPs in providing such care. Methods: This study presents a subset of the findings from a cross‐sectional study using an online questionnaire on postpartum care among Japanese PCPs. We employed descriptive analysis to examine their practices and experiences in providing general and postpartum mental health care. Results: We received 339 valid responses from 5811 PCPs. The median proportion of the outpatients with mental health problems that PCPs regularly saw was 15%. Approximately two out of three PCPs (68.7%) reported routinely performing screening for depression and anxiety. Seventy‐six percent of PCPs had the opportunity to provide care for postpartum women. Approximately one in two PCPs (47.8%) had managed cases of postpartum mental health problems and collaborated with various professionals and resources to provide care. Conclusions: The majority of Japanese PCP participants in the study provide mental health care and have managed cases of postpartum mental health problems, collaborating with various health professionals. [ABSTRACT FROM AUTHOR]

Background: Stunting is a frequent dietary issue that mostly affects less industrialized countries, such as Somalia. Even so, the Somali government has made some progress towards achieving the target for stunting, but still, 25.3% of children under five years old are stunted. If the annual decreasing proportion continues at this rate, Somalia will not be able to meet the established target set by the WHO in 2012, which was to reduce stunting by 40% by 2025. Therefore, this study aimed to assess the prevalence and associated factors of stunting among children aged 6-59 months in Galkaio Town, Puntland, Somalia, from 1-April 2023 to 1-May, 2023. Methods and materials: A cross-sectional study with a community focus was carried out. among 362 children aged 6-59 months matched with mothers and caregivers. Districts served as first-stage units, villages served as second-stage units, and houses served as third-stage units in the multistage sampling technique. A structured questionnaire was used, and the mothers and caregivers were interviewed. Standardized anthropometric measurements were used to measure the child's height. Version 3.1 of Epi Data was used to enter the data, and SPSS version 20 was used for analysis. Using both bivariate and multivariate logistic regression models, the factors linked to stunting were determined. Statistical significance was set at P < 0.05. Result: The overall prevalence of stunting among children between the ages of 6 and 59 months in this study was 37.3%, 95% CI (32.6-42.5). Polygamous marriage to father [AOR = 2.824; 95% CI: (1.60, 4.98)], educational status of mother [AOR = 2.502; 95% CI: (1.28, 4.90)], sex of child [AOR = 2.079; 95% CI: (1.27, 3.41)], time to initiation of breastfeeding [AOR = 3.212; 95% CI: (1.95, 5.29)], exclusive breastfeeding [AOR = 1.725; 95% CI: (1.01, 2.96)], minimum dietary diversity score [AOR = 2.579; 95% CI: (1.30, 5.28)], and postnatal care visits of mothers [AOR = 2.688; 95% CI: (1.60, 4.52)] were significantly associated with stunting. Conclusion: The prevalence of stunting among children aged 6-59 months was higher than that among the national population. The polygamous marriage of the father, educational status of the mother, sex of the child, time for initiation of breastfeeding, exclusive breastfeeding, minimum dietary diversity score, and postnatal care visits of the mother were significantly associated with stunting. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Health Sciences / Türkiye Klinikleri Sağlık Bilimleri Dergisi is the property of Turkiye Klinikleri 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.)

Research indicates gaps in postpartum care that negatively impact maternal and infant health. Prior research exploring clinicians' perspectives on these gaps is limited to those of maternal providers. We explored the views and experiences of maternal and infant health-care providers on the care of mothers and infants in the postpartum period. Qualitative analysis revealed three themes: Gaps in Infant Care Education and Preparation for Parenting, Gaps in Maternal Pregnancy and Postpartum Care and Expectations and Knowledge, and Ideas for Integrating Care, Education, and Support in the postpartum period. Results suggest a need for care models that offer improved prenatal education and expectation setting, methods to help mothers prepare their social support networks, and integrated and convenient access to postpartum care. [ABSTRACT FROM AUTHOR]

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AbstractLBTQ people have increased risks of complications during birth, risks potentially driven by minority stress and increased levels of mental illness and fear of childbirth. With the aim of exploring reproductive injustices in postpartum care for LBTQ people, we analyzed qualitative interviews where 22 LBTQ birth and non-birth parents shared their experiences of support needs during the postpartum period after births where complications had arisen. Results point to the importance of providing an LBTQ safe space, which includes the need to feel safe regarding one’s gender or sexual identity, by avoiding cisheteronormative assumptions and using inclusive language. In the context of recently experiencing birth complications, parents needed a space where they were able to focus on physical and mental healing. The results further show the need for validation of the non-birth parent and inclusive breast/chest-feeding support. Results emphasize the need for more psychosocial support around the birth experience, including better medical support and information during the whole process of childbirth. [ABSTRACT FROM AUTHOR]

Background: Poor attachment, suckling, and positioning contribute to ineffective breastfeeding techniques. Poor weight gain, stunting, and decreased immunity are caused by insufficient breast milk intake owing to ineffective breastfeeding techniques. Numerous primary studies conducted in Ethiopia have revealed negative effects of ineffective breastfeeding techniques. However, inconsistencies have been observed among these studies, and no review has been conducted to report the amalgamated magnitude and associated factors. Therefore, this review aimed to estimate the national prevalence and factors associated with ineffective breastfeeding techniques in Ethiopia. Methods: Using PRISMA standards, we systematically reviewed and meta-analyzed articles from PubMed, Cochrane Library, and Google Scholar to investigate the prevalence and associated factors of ineffective breastfeeding techniques. Q and I2 tests were used to assess heterogeneity across studies. To evaluate the national prevalence and effect size of the linked covariates, a weighted inverse variance random-effects model was used. Subgroup analysis was performed based on the region, sample size, and year of publication. Funnel plots and Egger's regression tests were used to examine publication bias. A sensitivity analysis was also performed to determine the impact of the studies. Results: The analysis included a total of eleven studies with 4,470 participants used in the analysis. The pooled prevalence of ineffective breastfeeding techniques in Ethiopia was 53.13% (45.49, 60.78) no formal education (AOR = 3.42; 95% CI:1.67–5.18; I2 = 72.2%; P = 0.0132), primipara (AOR = 2.72;95% CI:1.81–3.64; I2 = 46.7%; P = 0.131), postnatal care (PNC) (AOR = 1.84; 95% CI:1.35–2.32; I2 = 0%; P = 0.53), breastfeeding counseling (AOR = 1.93; 95% CI:1.23–2.63; I2 = 0%;P = 0.35), home delivery and having breast problem (AOR = 3.11; 95% CI:1.09–5.16; I2 = 0%;P = 0.877) and (AOR = 2.22; 95% CI:1.28–3.16; I2 = 0%;P = 0.80) respectively were significantly associated with ineffective breastfeeding techniques. Conclusion: The prevalence of ineffective breastfeeding techniques in Ethiopia remains high. Policymakers and program officials should focus on empowering women, increasing institutional delivery, and providing counseling on breastfeeding throughout the maternal continuum of care. These measures will improve breastfeeding techniques and lead to better health of both infants and women. [ABSTRACT FROM AUTHOR]

Bisphenols (BP), including BPA and "BPA-free" structural analogs, are commonly used plasticizers that are present in many plastics and are known endocrine disrupting chemicals. Prenatal exposure to BPA has been associated with negative neurodevelopmental and behavioral outcomes in children and in rodent models. Prenatal BPA exposure has also been shown to impair postnatal maternal care provisioning, which can also affect offspring neurodevelopment and behavior. However, there is limited knowledge regarding the biological effects of prenatal exposure to bisphenols other than BPA and the interplay between prenatal bisphenol exposure and postnatal maternal care on adult behavior. The purpose of the current study was to determine the interactive impact of prenatal bisphenol exposure and postnatal maternal care on neurodevelopment and behavior in rats. Our findings suggest that the effects of prenatal bisphenol exposure on eye-opening, adult attentional set shifting and anxiety-like behavior in the open field are dependent on maternal care in the first five days of life. Interestingly, maternal care might also attenuate the effects of prenatal bisphenol exposure on eye opening and adult attentional set shifting. Finally, transcriptomic profiles in male and female medial prefrontal cortex and amygdala suggest that the interactive effects of prenatal bisphenol exposure and postnatal maternal care converge on estrogen receptor signaling and are involved in biological processes related to gene expression and protein translation and synthesis. Overall, these findings indicate that postnatal maternal care plays a critical role in the expression of the effects of prenatal bisphenol exposure on neurodevelopment and adult behavior. Understanding the underlying biological mechanisms involved might allow us to identify potential avenues to mitigate the adverse effects of prenatal bisphenol exposure and improve health and well-being in human populations. [ABSTRACT FROM AUTHOR]

Background: One of the most effective ways to reduce maternal and neonatal mortality is to improve mother and newborn health via the provision of appropriate postnatal care services by qualified healthcare providers. However, there is limited information on the use of postnatal care services in Yemen. This study aimed to determine the utilisation of postnatal care services among mothers in Yemen. Methodology: A descriptive cross-sectional study was conducted in the Maeen District of Sana'a City, Yemen from December 2022 to January 2023. Convenience sampling was employed to recruit 321 participants. Semi-structured questionnaires were applied as the study tool in the face-to-face survey. Result: Less than half (45.2%) of the study participants utilised postnatal care services in this study. The mode of delivery, place of delivery, and receiving information about postnatal care during antenatal visits were significantly associated with postnatal care service utilisation. Conclusion: Less than half of the study participants were informed about postnatal care services, contributing to their low utilisation. Thus, it is vital to strengthen the provision of information, education, and communication with regard to postnatal care services among pregnant mothers visiting antenatal clinics. [ABSTRACT FROM AUTHOR]

Background: Despite research that has shown that the presence of support persons during maternity care is associated with more respectful care, support persons are frequently excluded due to facility practices or negative attitudes of providers. Little quantitative research has examined how integrating support persons in maternity care has implications for the quality of care received by women, a potential pathway for improving maternal and neonatal health outcomes. This study aimed to investigate how integrating support persons in maternity care is associated with multiple dimensions of the quality of maternity care. Methods: We used facility-based cross-sectional survey data from women (n = 1,138) who gave birth at six high-volume facilities in Nairobi and Kiambu counties in Kenya and their support persons (n = 606) present during the immediate postpartum period. Integration was measured by the Person-Centered Integration of Support Persons (PC-ISP) items. We investigated quality of care outcomes including person-centered care outcomes (i.e., Person-Centered Maternity Care (PCMC) and Satisfaction with care) and clinical outcomes (i.e., Implementation of WHO-recommended clinical practices). We used fractional regression with robust standard errors to estimate associations between PC-ISP and care outcomes. Results: Compared to low integration, high integration (≥four woman-reported PC-ISP experiences vs. <4) was associated with multiple dimensions of quality care: 3.71%-point (95% CI: 2.95%, 4.46%) higher PCMC scores, 2.76%-point higher (95% CI: 1.86%, 3.65%) satisfaction with care scores, and 4.43%-point (95% CI: 3.52%, 5.34%) higher key clinical practices, controlling for covariates. PC-ISP indicators related to communication with providers showed stronger associations with quality of care compared to other PC-ISP sub-constructs. Some support person-reported PC-ISP experiences were positively associated with women's satisfaction and key practices. Conclusions: Integrating support persons, as key advocates for women, is important for respectful maternity care. Practices to better integrate support persons, especially improving communication between support persons with providers, can potentially improve the person-centered and clinical quality of maternity care in Kenya and other low-resource settings. [ABSTRACT FROM AUTHOR]

Background: Unintended pregnancies can adversely affect maternal health, preventable through timely postpartum contraception. During the COVID-19 pandemic, family planning services were constrained by policies that curtailed outpatient visits. We investigated the prevalence of postpartum contraceptive initiation at King Chulalongkorn Memorial Hospital (KCMH) during January to June 2020, comparing with the same period in 2019, and identified factors associated with such initiation. Methods: We reviewed the medical records of 4506 postpartum women who delivered at KCMH during the study period. Logistic regression was conducted to test the association between early COVID-19 phase deliveries and post-partum long acting reversible contraception (LARC) initiation including copper intrauterine devices, levonorgestrel intrauterine systems, contraceptive implants, and progestogen-only injectable contraceptives. Results: A total of 3765 women (83.6%), of whom 1821 delivered during the pandemic and 1944 during the historical cohort period, were included in this study. The proportion of women who initiated non-permanent modern contraceptives at six weeks postpartum was comparable between the COVID-19 (73.4%) and historical cohort (75.3%) (p = 0.27) periods. The proportion of women who initiated LARC at six weeks postpartumwas comparable between the historical cohort period (22.5%) and the COVID-19 (19.7%) (p = 0.05) period. Accessing a six-week postpartum check-up was independently associated with LARC initiation, of which the adjusted odds ratio (OR) (95% confidence interval) was 3.01 (2.26 to 4.02). Conclusions: Our findings demonstrated that accessing postpartum care significantly associate with the use of LARC. The data suggest the strong influence of postpartum check-ups in facilitating the adoption of effective contraception, emphasizing the need for accessible postpartum care to sustain maternal health during health crises. Plain language summary: In this study, we looked at how often new mothers used birth control methods after giving birth during the COVID-19 pandemic in Thailand. We also wanted to find the factors that influenced their decision to use birth control. We reviewed the medical records of 4,506 women who had recently given birth at King Chulalongkorn Memorial Hospital. Out of these, 3,765 women were included in the study. Some gave birth during the pandemic, and others gave birth before the pandemic. We found that a similar number of women started using birth control about six weeks after giving birth, whether it was during the pandemic or before it. However, slightly fewer women chose very effective methods of birth control during the pandemic compared to before it. One important factor we found was that women who went for a check-up six weeks after giving birth were more likely to use highly effective birth control. This means that getting regular check-ups after childbirth can help women make better choices about birth control. In summary, our study showed that receiving postpartum care is closely linked to using LARC. This underlines how important it is for new mothers to have their check-ups after giving birth, to help them start using effective birth control if they choose. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to describe the impact of COVID-19 on maternal and child health service utilization in the Eastern part of Ethiopia. Methods: Comparative analysis was used to examine 2 years of maternal and child health service utilization. Data were extracted from client registers. A traditional Expert Modeler and one-way Analysis of Variance were used to compare service utilization before and during the COVID-19 pandemic. Results: A total of 34,576 client records were reviewed, of which 17,100 (49.5%) and 17,476 (50.5%) had visited the MCH service before and during the COVID-19 pandemic, respectively. The total client visit has shown a 2% percentage point increase. However, postnatal care and child immunization services showed a decrease. Moreover, there was a significant difference between service visits before and during COVID-19 (f = 4.6, p < 0.04). Conclusion: Mothers and children have missed or unattended facility appointments due to protective impositions or fear of getting infected with COVID-19, which might suggest a higher proportion of MCH issues were not addressed during the pandemic. The health system should therefore improve its resilience and strengthen its access at the lowest health care inlets. [ABSTRACT FROM AUTHOR]

The article focuses on evaluating the effectiveness of a program aimed at preventing Sudden Unexpected Postnatal Collapse (SUPC) through Proper Infant Positioning (PIP) training for mothers. Topics include the methodology involving anonymous surveys among postpartum mothers to assess their confidence and skills after receiving PIP training, revealing positive outcomes.

A designated psychologist in the Neonatal Intensive Care Unit (NICU) may seem like an obvious choice, given psychologists' expertise in trauma, attachment, neurodevelopment, mental health, and grief; however, few NICUs have a psychologist on staff. As National Network of NICU Psychologists members, we hope to increase access to psychology services as a routine part of care in NICUs. US News and World Reports (USNWR) ranks NICUs annually on multiple criteria, including having a "designated psychologist or psychiatrist" for consultations with families. We evaluated the psychology services provided by several NICUs of hospitals ranked in the top 50 by USNWR between 2015 and 2019. Many of these respondents had a designated NICU psychologist at varying capacities across the division of Neonatology. This indication should motivate other NICUs to hire a NICU psychologist as the standard of care for families and increase their overall USNWR score. [ABSTRACT FROM AUTHOR]

Introduction and Hypothesis: This study was carried out to investigate the effect of low-frequency pulsed electrotherapy combined with acupoint massage on postpartum urinary retention (PUR). Methods: The patients were divided into control group, intervention group 1, and intervention group 2 according to the nursing method. The control group received conventional postpartum care, intervention group 1 received conventional postpartum care and low frequency pulsed electrotherapy, and intervention group 2 received conventional postpartum care, low-frequency pulsed electrotherapy, and Shuidao point massage. The bladder function, comfort score, and quality of life score before and after intervention were compared among the three groups. Results: The bladder function, comfort level, and quality of life of intervention group 1 and intervention group 2 after nursing were significantly better than those of the control group. In addition, intervention group 2 had better bladder function than intervention group 1, with lower residual urine volume and higher bladder compliance. In the Kolcaba score, the mental dimension of intervention group 2 was significantly higher than that of intervention group 1. In terms of QOL scores, the social function, physical function, and state of material life scores of intervention group 2 were significantly higher than those of intervention group 1. Conclusions: Low-frequency pulsed electrotherapy combined with acupoint massage can significantly improve the bladder function, comfort, and quality of life of patients with PUR. [ABSTRACT FROM AUTHOR]

Quantify and compare reported breastfeeding support practices in the Baby-Friendly Hospital Initiative (BFHI) and non-BFHI facilities. Cross-sectional survey. Regions across the US. Two hundred and eighty-six facilities (110 BFHI and 176 non-BFHI) selected by a stratified (by hospital size) random sample of 50% BFHI and 50% non-BFHI facilities. Emailed survey Fall 2019 through Spring 2020. Reported adherence to the 10 Steps to Successful Breastfeeding. Wilcoxon rank sum test with continuity correction, Pearson chi-square test of independence, and Fisher's exact test. Baby-Friendly Hospital Initiative facilities were more likely to report adherence to the 10 Steps to Successful Breastfeeding. Only 2 of the reported steps were not significantly different: immediate postnatal care and responsive feeding. This research supports breastfeeding support interventions within hospitals as both BFHI and non-BFHI facilities have room for improvement. Interventions targeting non-BFHI facilities are an opportunity to close the disparity in breastfeeding care. [ABSTRACT FROM AUTHOR]

Background: There is limited data on use of electroconvulsive therapy (ECT) for management of psychiatric disorders during the postpartum period from India. Aim: We aimed to assess the demographic and clinical profile of patients receiving ECT during the postpartum period for various psychiatric disorders using a retrospective study design. Methods: ECT register of the department was reviewed for the period of January 2019 to December 2023 to identify the patients who received ECT during the postpartum period. The treatment records of these patients were evaluated to extract the demographic and clinical profile. Results: During the study period, 10 patients received ECT during the postpartum period. The mean age of the study sample was 27 (standard deviation [SD]: 2.9) years. Majority of the patients were inpatients (70%) at the time of receiving ECT. Five patients were diagnosed with first-episode depression with postpartum onset, and two patients had postpartum-onset psychotic disorder. One patient was diagnosed with recurrent depressive episode and one with bipolar disorder, current episode mania with psychotic symptom, at the time of receiving ECT. The mean number of ECTs during the ECT course was 6.7 (SD: 3.09). Nine out of the 10 patients showed good response to ECT. Conclusion: Although ECT is less frequently used for management of postpartum psychiatric disorders, its use is associated with significant clinical improvement. [ABSTRACT FROM AUTHOR]

The utilization of medicinal plants has been a longstanding tradition -- providing natural remedies with cultural and therapeutic significance, especially in the context of postpartum care. Thus, this study aims to document the usage of medicinal plants in postpartum recuperation, specifically in herbal steaming and bathing in the upland community of Leon, Iloilo, the Philippines. Semi-structured interviews were conducted with 34 key informants using a snowball sampling method from October--November 2022 and in March 2024, thereby resulting in the documentation of 70 medicinal plant species distributed in 64 genera and 35 families. The Fabaceae family was most represented with seven species, followed by Poaceae with six species, and Lamiaceae with five species. Most of the documented species are non-native (51%) and cosmopolitan, categorized as "least concern" (50%) in the IUCN Red List of Endangered Species. A variety of medicinal plants were documented -- including trees (57%), herbs (20%), shrubs (17%), and climbers (6%). Roots (64%) and leaves (24%) were the plant parts used most often, and decoction was the primary form of preparation. These medicinal plants can be found growing within the community's vicinity, with most of them (51%) found in forested areas and the rest (49%) being cultivated. The use value (UV) and family use value (FUV) indices were calculated to evaluate the plant's importance. Pittosporum pentandrum (Blanco) Merr. had the highest (0.91) UV, followed by Citrus maxima (Burm.) Merr. and Justicia gendarussa Burm.f. (0.88), and Bambusa spinosa Roxb. (0.85). Pittosporaceae (0.91) and Hypericaceae (0.62) had the highest FUVs. The findings of this study will provide a foundation for additional scientific validation of the biological properties of the documented plants, specifically focusing on the most valued species, and raise awareness for the preservation of cultural practices and beliefs regarding postpartum care for women. [ABSTRACT FROM AUTHOR]

Objective: Responding to the National Institutes of Health Working Group's call for research on the psychological impact of stillbirth, we compared coping-related behaviors by outcome of an index birth (surviving live birth or perinatal loss – stillbirth or neonatal death) and, among individuals with loss, characterized coping strategies and their association with depressive symptoms 6–36 months postpartum. Methods: We used data from the Stillbirth Collaborative Research Network follow-up study (2006–2008) of 285 individuals who experienced a stillbirth, 691 a livebirth, and 49 a neonatal death. We conducted a thematic analysis of coping strategies individuals recommended following their loss. We fit logistic regression models, accounting for sampling and inverse probability of follow-up weights to estimate associations between pregnancy outcomes and coping-related behaviors and, separately, coping strategies and probable depression (Edinburgh Postnatal Depression Scale > 12) for those with loss. Results: Compared to those with a surviving live birth and adjusting for pre-pregnancy drinking and smoking, history of stillbirth, and age, individuals who experienced a loss were more likely to report increased drinking or smoking in the two months postpartum (adjusted OR: 2.7, 95% CI = 1.4–5.4). Those who smoked or drank more had greater odds of probable depression at 6 to 36 months postpartum (adjusted OR 6.4, 95% CI = 2.5–16.4). Among those with loss, recommended coping strategies commonly included communication, support groups, memorializing the loss, and spirituality. Discussion: Access to a variety of evidence-based and culturally-appropriate positive coping strategies may help individuals experiencing perinatal loss avoid adverse health consequences. Significance: What Is Already Known on this Subject?: Experiencing a perinatal loss (stillbirth or neonatal death) is a traumatic event with potential long term psychologic consequences. Effective coping strategies can prevent complicated grief; yet little is known about current practices and preferences among parents who experience perinatal loss. What this Study Adds?: In a population-based study, individuals who experienced perinatal loss reported higher maladaptive coping (increased smoking and drinking) compared to those with healthy live birth. Individuals who experienced perinatal loss recommended a wide range of coping including communication, memorializing the loss, spirituality, and support groups. [ABSTRACT FROM AUTHOR]

Background: Breastfeeding is an important issue to the whole community not only for mothers and infants. The WHO recommends exclusive breastfeeding (EBF) for the first six months of life. So mothers' knowledge of breastfeeding is a critical issue. Objective: to assess mothers' knowledge and practice toward exclusive breastfeeding. Methods: This is a cross sectional study conducted on 261 mothers attending Awlad saqr family health center and units from November 2022 till September 2023. Data was collected by using semi semi-structured questionnaire. The mothers included in the study were in the third trimester till three months postnatal coming for breastfeeding counseling service or other health care services e.g. (vaccination, family planning, and antenatal and postnatal visits). Results: The study revealed that mothers practiced exclusive breast feeding was 191 (73.2%) mothers. Sufficient knowledge level was reported in 45.2% of participants. Mothers' intention for exclusive breastfeeding at 6 months was 86.2%. Being a housewife, receiving high education, and counseling in previous and current pregnancies are significant predictors for sufficient knowledge detected by logistic multivariate analysis. They significantly increase the opportunity for sufficient knowledge by 2.31, 18.67, 2.04, and 6.3 respectively. Conclusion: Although the percentage of participants who reported exclusive breastfeeding was high, there was an inadequacy of knowledge about breastfeeding in general and about correct feeding practices. Educated mothers, frequent antenatal care (ANC) visits, and counseling sessions are associated with good knowledge and intention. Counseling sessions for mothers about EBF need to be enhanced to improve counseling services during antenatal and postnatal care visits. [ABSTRACT FROM AUTHOR]

Repeated visits to clinical trial sites inflict hardships on study participants, especially pregnant women. A newer trend is community-based follow-up for measurements, dosage, or monitoring, through technology or physical visits. We conducted a methodological experiment of performing "community-based physical follow-up" of participants of a trial, receiving facility-based diagnosis and pathogen-specific antibiotics for asymptomatic bacteriuria, guided by an optical-sensor-based rapid point-of-care test. We were able to retain 95.8% participants in the study. Here we describe challenges faced and socio-economic and gender issues encountered in this approach in a low-resource Indian scenario, to guide researchers world-wide for designing mother-friendly clinical trials. [ABSTRACT FROM AUTHOR]

Kangaroo care (KC), skin-to-skin contact between infants and caregivers, is encouraged in neonatal intensive care units (NICUs) to support health through improved weight, growth, and infant–maternal attachment while reducing the incidence of sepsis and infant pain. However, the optimal duration and frequency of KC to maximize health outcomes is unknown. Given parents' time stressors, identifying optimal KC time is critical. A literature review was undertaken on May 28, 2021 via querying the PubMed database from January 1, 1995, to May 28, 2021, regarding KC and NICUs with 442 results. Eleven studies met the eligibility criteria of (1) comparative KC between infants and adult caregivers in NICUs as a randomized controlled trial, (2) peer-reviewed articles in English, (3) study subjects ≥5, (4) health outcomes, and (5) KC sessions >1. Infant physical growth parameters, infant neurodevelopment, infant stress via salivary cortisol levels, and breastfeeding outcomes appear to increase with KC as compared with standard care (SC) without KC. Improvements were observed with longer KC duration, 2 h/d as compared with 1 h/d, for neurodevelopment and breastfeeding outcomes, but no greater improvement with longer KC duration was shown for reducing infant stress through salivary cortisol levels. Regarding maternal stress, the influence of KC duration showed mixed Parental Stressor Score: NICU scores. Further study on the impact of KC duration and frequency on health outcomes and dose–response relationship would help determine how much and how frequent KC is needed to improve specific health outcomes for infants and their mothers. Key Points Data on kangaroo care duration's health impacts is lacking. Establishing dose–response for kangaroo care is needed. Kangaroo care for longer improves some but not all outcomes. [ABSTRACT FROM AUTHOR]

Background: Cesarean birth has been associated with increased risks of short‐term mental health problems. Little is known about whether these associations persist in the long term. This study aimed to estimate the associations between mode of birth and maternal mental health in midlife while considering mental health before and during pregnancy. Methods: Cohort study among mothers in the Danish National Birth Cohort. Birth mode for each woman's entire reproductive history was obtained from Danish national registries. Symptoms of depression and stress in midlife were self‐reported using validated scales. Log binomial regression was used to calculate risk ratios (RR) with 95% confidence intervals (CI) for the association between birth mode and depressive symptoms. Linear regression was used to calculate mean difference in stress score by birth mode. Results: Among 42,872 women, 15.5% reported depressive symptoms at follow‐up, where they were, on average, 43.9 years and 11.2 years after their last birth. Compared with women who only ever had spontaneous vaginal births, women who only had cesarean births, or had both cesarean and vaginal births with the last birth by cesarean, reported slightly more symptoms of depression (RR 1.10, 95% CI 1.01;1.20) and stress (mean difference 0.68 on a 100‐point scale, 95% CI 0.10;1.26). Conclusion: Whether due to the birth experience or underlying factors, depression and stress in midlife were more frequent in women with only cesarean births or whose last birth was by cesarean compared with women with vaginal births. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic led to changes in the provision of pregnancy and postpartum care. The purpose of this study was to describe changes in access to prenatal and postpartum care over time, from early in the pandemic (July 2020) to mid‐pandemic (January 2021) and to explore socioeconomic and COVID‐19‐related economic factors associated with experiencing barriers to care. Methods: We recruited two cross sections of women and birthing people in the US in July 2020 (N = 4645) and January 2021 (N = 3343) using Facebook and Instagram Ads. Results: Three out of four women in the prenatal period and four out of five women in the postpartum period reported barriers to scheduling a visit. The likelihood of not having a visit (OR = 4.44, 95% CI 2.67–7.40), being unable to schedule a visit (OR = 2.73, 95% CI 1.71–4.35), and not being offered visits (OR = 4.26, 95% CI 2.32–7.81) increased over time. Participants were more likely to report barriers attending scheduled prenatal or postpartum appointments over time (OR = 2.72, 95% CI 2.14–3.45). Women who experienced more economic impacts from COVID‐19 were older, less educated, and were Black, Indigenous, or a person of color, and were more likely to have barriers to attending appointments. Conclusions: Certain subgroups are more at risk during COVID‐19, and around 9 months into the pandemic, women were not only still facing barriers to care, but these had been amplified. Additional research using other data sources is needed to identify and ameliorate barriers and inequalities in access to prenatal and postpartum care that appear to have persisted throughout the pandemic. [ABSTRACT FROM AUTHOR]

Kidney transplant recipients are at risk of complications in late pregnancy, with increased rates of pre-eclampsia, intrauterine growth restriction and preterm birth. It is recommended that these women receive more intensive monitoring after 20 weeks' gestation, ideally provided by a multidisciplinary team in a tertiary centre. This review focuses on the management of late pregnancy in kidney transplant recipients, from the perspective of different members of the multidisciplinary team. This includes evidence and guidance to inform the nephrologist, obstetrician, obstetric anaesthetist, transplant surgeon, midwife, and a summary of the woman's perspective. The review outlines a late pregnancy and early postnatal care pathway as a common algorithm to be used by the whole multidisciplinary team. [ABSTRACT FROM AUTHOR]

Purpose: Factors increasing the risk of maternal critical illness are rising in prevalence in maternity populations. Studies of general critical care populations highlight that severe illness is associated with longer-term physical and psychological morbidity. We aimed to compare short- and longer-term outcomes between women who required critical care admission during pregnancy/puerperium and those who did not. Methods: This is a cohort study including all women delivering in Scottish hospitals between 01/01/2005 and 31/12/2018, using national healthcare databases. The primary exposure was intensive care unit (ICU) admission, while secondary exposures included high dependency unit admission. Outcomes included hospital readmission (1-year post-hospital discharge, 1-year mortality, psychiatric hospital admission, stillbirth, and neonatal critical care admission). Multivariable Cox and logistic regression were used to report hazard ratios (HR) and odds ratios (OR) of association between ICU admission and outcomes. Results: Of 762,918 deliveries, 1449 (0.18%) women were admitted to ICU, most commonly due to post-partum hemorrhage (225, 15.5%) followed by eclampsia/pre-eclampsia (133, 9.2%). Over-half (53.8%) required mechanical ventilation. One-year hospital readmission was more frequent in women admitted to ICU compared with non-ICU populations [24.5% (n = 299) vs 8.9% (n = 68,029)]. This association persisted after confounder adjustment (HR 1.93, 95% confidence interval [CI] 1.33, 2.81, p < 0.001). Furthermore, maternal ICU admission was associated with increased 1-year mortality (HR 40.06, 95% CI 24.04, 66.76, p < 0.001), stillbirth (OR 12.31, 95% CI 7.95,19.08, p < 0.001) and neonatal critical care admission (OR 6.99, 95% CI 5.64,8.67, p < 0.001) after confounder adjustment. Conclusion: Critical care admission increases the risk of adverse short-term and long-term maternal, pregnancy and neonatal outcomes. Optimizing long-term post-partum care may benefit maternal critical illness survivors. [ABSTRACT FROM AUTHOR]

Aims: To synthesize the available evidence to better understand the effectiveness of interventions to prevent or delay hyperglycaemia and Type 2 diabetes mellitus (T2DM) postnatally in women with current or previous gestational diabetes mellitus (GDM). Methods: We searched five databases up to December 2020 for primary peer‐reviewed articles reporting postpartum glycaemic outcomes in women with (previous) GDM following pharmacological or lifestyle intervention. Outcomes were relative risk of T2DM or continuous measures of glycaemia, change or at follow‐up. A minimum of two studies evaluating the same intervention‐outcome combination were needed to conduct meta‐analyses, otherwise studies were described narratively. Meta‐regression was used to evaluate whether associations varied by additional variables. We assessed risk of bias using the Critical Appraisal Skills Programme checklist. PROSPERO record CRD42018102380. Results: We included 31 studies in the review with a total sample size of 8624 participants, and 26 studies in meta‐analyses. Two‐thirds of studies followed up participants at 1 year or less. Pharmacological interventions were associated with reduced risk of T2DM (0.80 [95% CI 0.64–1.00], n = 6 studies), as were lifestyle interventions albeit with a smaller effect size (0.88 [95% CI 0.76–1.01], n = 12 studies). Dietary and physical activity interventions were associated with a small reduction in fasting plasma glucose, particularly in longer interventions, but inconsistent effects were seen for other continuous outcomes. Conclusions: Although possibly due to chance, interventions to reduce hyperglycaemia after GDM may be effective. Future research should improve understanding of how interventions affect glucose control and how to optimise interventions for this population. [ABSTRACT FROM AUTHOR]

Purpose: Social support is essential for postpartum well-being, but little is known about the postpnatal social support preferred by primiparous women. This study aimed to comprehensively understand and describe the meaning of postnatal social support experience in primiparous women. Methods: The participants were seven primiparous women who were within 1 year after childbirth, recruited through purposive and snowball sampling from an online parenting community. The data were collected through in-depth interviews from November 14 to 28, 2022. Participants were interviewed face-to-face or via phone or online platform, according to their choice. Colaizzi's phenomenological qualitative research method was applied to analyze the meaning of the participants' experience. Results: Five theme clusters and fourteen themes were identified from the data. The five theme clusters are as follows: (1) Shortcomings of the childbirth and postpartum care system I learned through my experience; (2) Government policies focusing on childbirth and child-rearing rather than postpartum recovery; (3) Driving force of postpartum recovery: Shared childbirth process; (4) Childcare on my own; and (5) Conflicted between being a stay-at-home mom and a working mom under inadequate maternity protection policies. Conclusion: Despite postpartum support from the government that was perceived as inadequate, first-time mothers regained confidence and motivation for parenting with the help of family, peers, and social networks. First-time mothers need support from professionals and reliable online communities for postpartum recovery and parenting. [ABSTRACT FROM AUTHOR]

Background: The neonatal phase is vital for child survival, with a substantial portion of deaths occurring in the first month. Neonatal mortality rates differ significantly between Vietnam (10.52/1000 live births) and the United States (3.27/1000). In response to these challenges, interventions such as the Helping Babies Breathe (HBB) program have emerged, aiming to enhance the quality of care provided during childbirth, and the postpartum period in low-resource settings. Purpose: The purpose of this study was to explore stakeholder perceptions of the HBB program in Vietnam postpandemic, aiming to identify requisites for resuming training. Methods: Utilizing qualitative content analysis, 19 in-person semistructured interviews were conducted with diverse stakeholders in 2 provinces of Central Vietnam. Results: The content analysis revealed following 5 main themes: (1) the pandemic's impact on HBB training; (2) resource needs for scaling up HBB training as the pandemic abates; (3) participants' perceptions of the pandemic's effect on HBB skills and knowledge; (4) the pandemic's influence on a skilled neonatal resuscitation workforce; and (5) future prospects and challenges for HBB training in a postpandemic era. Implications for Practice and Research: This research highlights the importance of sustainable post-HBB training competencies, including skill assessment, innovative knowledge retention strategies, community-based initiatives, and evidencebased interventions for improved healthcare decision-making and patient outcomes. Healthcare institutions should prioritize skill assessments, refresher training, and collaborative efforts among hospitals, authorities, non-government organizations, and community organizations for evidence-based education and HBB implementation. [ABSTRACT FROM AUTHOR]

Background: Skin-to-skin contact (SSC) is widely implemented in the neonatal intensive care unit (NICU) due to its established role in reducing mortality and morbidity. However, the impact of SSC on diaphragmatic electrical activity (Edi) in premature infants undergoing noninvasive pressure control (NIV-PC) for respiratory management remains insufficiently explored. Purpose: To assess the effects of SSC on Edi and vital signs in preterm infants managed with NIV-PC. Methods: A prospective, observational, crossover study was conducted, involving preterm infants admitted to a level III NICU between May 2020 and August 2021, who were receiving respiratory support with NIV-PC. Data were collected at 3 distinct time points: before SSC (pre-SSC period), during SSC (SSC period), and after SSC (post-SSC period). Thirty-minute periods of stable data were extracted for analysis. Results: A total of 21 SSC sessions were performed on 14 preterm infants, with a median age at the initiation of SSC of 62 days. The median (interquartile range) Edi peak (in microvolts) before, during, and after SSC was 7.1 (5.8-10.8), 6.8 (4.3-8.8), and 7.1 (5.5-8.8), respectively. No statistically significant differences were observed in Edi peak or minimum values during SSC, when compared with the periods before and after the SSC procedure. Likewise, no significant changes were noted in respiratory rate, oxygen saturation, heart rate, or the incidence of apnea. Implications for Practice and Research: SSC in preterm infants undergoing NIV-PC does not exacerbate their clinical condition. Further investigations involving diverse patient cohorts are warranted. [ABSTRACT FROM AUTHOR]

Midwifery practices are defined as the level of midwifery care in which midwives use their expertise, management, and clinical leadership to provide personalized, evidence-based care to women independently and autonomously. Midwifery care includes antepartum, intrapartum, and postpartum care, which are defined by the WHO as the care provided by skilled healthcare professionals to pregnant women and adolescent girls to ensure the best health conditions for the mother and baby during the antepartum, intrapartum and postpartum period. The aim of this study was to evaluate midwifery practices among registered midwives in selected hospitals in Limpopo Province, South Africa. The quantitative, descriptive, and cross-sectional research design was used to assess and describe midwifery practices among registered midwives in selected hospitals in Limpopo Province, South Africa. The population size was 100 registered midwives in the selected hospitals. The sample size of 80 registered midwives was determined using the Slovin formula. Simple random sampling was used to select the sample. A self-developed questionnaire was tested and validated prior to conducting the main study. The findings of the pilot study were used to refine the questionnaire before being used for the main study. Reliability and validity were ensured. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 27 with the assistance of a statistician. The study revealed inadequate provision of midwifery care during antepartum, intrapartum, and postpartum periods due to lack of resources and equipment. The shortage of midwives and the shorter experience in the clinical setting within the midwifery environment were overwhelming. The study concluded that the practices of registered midwives were inadequate due to some challenges they faced during the provision of midwifery care. Inadequate midwifery practices have serious implications for the health and well-being of mothers and newborns. These practices were influenced by various factors, such as inadequate material and human resources and lack and malfunctioning of available equipment. The study recommended that women have access to a variety of pain relief options during labor, including both pharmacological and non-pharmacological methods. In addition, the study recommended implementation of the presence of doulas during labor and childbirth. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Understand and explore the childbirth experiences of pregnant women living with HIV (PWLWHIV). With the advent of several measures to decrease the intrapartum HIV infection and a strong emphasis on the humanization of childbirth, there is a growing focus on providing positive childbirth experiences for pregnant women. Indeed, a positive childbirth experience is even more important in the group of pregnant women living with HIV (PWLWHIV) as it plays a pivotal role in enhancing the mother's adherence to her postpartum treatment and the newborn's engagement in Infectious Disease services. METHODOLOGY: A scoping review was conducted. Searches were performed on databases, such as MEDLINE, PUBMED, WEB OF SCIENCE and Cochrane Library, using the following keywords: childbirth, birth, parturition, HIV, humaniz*, perceived safety, experience, maternal satisfaction, healthcare professional and midwi*. Articles meeting pre-established criteria were selected within the timeframe of 2013 to 2023 for inclusion in the review. RESULTS: Out of a total of 2,340,391 articles, 4 were chosen based on our defined criteria. Three primary themes emerged from the selected articles: the assessment of childbirth experience quality, vulnerability and autonomy. CONCLUSIONS: The four studies identified had a small sample size and were not adequately conducted with a specific focus on studying the childbirth experience of pregnant women living with HIV (PWLWHIV). This scoping review revealed a gap in the existing literature, indicating a need for further research and clarification in the identified area. [ABSTRACT FROM AUTHOR]