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Access to emergency obstetric care, including assisted vaginal birth and caesarean birth, is crucial for improving maternal and childbirth outcomes. However, although the proportion of births by caesarean section has increased during the last few decades, the use of assisted vaginal birth has declined. This is particularly the case in low- and middle-income countries, despite an assisted vaginal birth often being less risky than caesarean birth. We therefore conducted a three-step process to identify a research agenda necessary to increase the use of, or reintroduce, assisted vaginal birth: after conducting an evidence synthesis, which informed a consultation with technical experts who proposed an initial research agenda, we sought and incorporated the views of women's representatives of this agenda. This process has allowed us to identify a comprehensive research agenda, with topics categorized as: (i) the need to understand women's perceptions of assisted vaginal birth, and provide appropriate and reliable information; (ii) the importance of training health-care providers in clinical skills but also in respectful care, effective communication, shared decision-making and informed consent; and (iii) the barriers to and facilitators of implementation and sustainability. From women's feedback, we learned of the urgent need to recognize labour, childbirth and postpartum experiences as inherently physiological and dignified human processes, in which interventions should only be implemented if necessary. The promotion and/or reintroduction of assisted vaginal birth in low-resource settings requires governments, policy-makers and hospital administrators to support skilled health-care providers who can, in turn, respectfully support women in labour and childbirth. L'acces aux soins obstetriques d'urgence, y compris l'accouchement vaginal assiste et la cesarienne, est essentiel pour ameliorer les effets de la maternite et de l'accouchement. Toutefois, bien que la proportion de cesariennes ait augmente ces dernieres decennies, le recours a l'accouchement vaginal assiste a diminue. C'est particulierement le cas dans les pays a revenu faible ou intermediaire, bien que l'accouchement vaginal assiste soit souvent moins risque qu'une cesarienne. Nous avons donc mene un processus en trois etapes afin d'imaginer un programme de recherche qui permettrait d'augmenter le recours a l'accouchement vaginal assiste ou de le reintroduire. Apres avoir realise une synthese des donnees probantes, qui a servi de base a une consultation avec des experts techniques qui ont propose un programme de recherche initial, nous avons sollicite et incorpore les avis des representantes des femmes pour ce programme. Ce processus nous a permis d'imaginer un programme de recherche complet, avec des sujets classes comme suit: (i) la necessite de comprendre la perception qu'ont les femmes de l'accouchement vaginal assiste et de fournir des informations appropriees et fiables; (ii) l'importance de la formation des prestataires de soins de sante en matiere de competences cliniques, mais aussi de respect dans les soins de sante, de communication efficace, de prise de decision partagee et de consentement eclaire; ou (iii) les obstacles a la mise en reuvre et a la durabilite et les facteurs qui les facilitent. Les reactions de femmes nous ont appris qu'il etait urgent de reconnaitre que l'accouchement, la naissance et le post-partum sont des processus humains intrinsequement physiologiques et dignes au cours desquels les interventions ne devraient etre mises en reuvre qu'en cas de necessite. La promotion et/ou la reintroduction de l'accouchement vaginal assiste dans les regions a faibles ressources necessitent que les pouvoirs publics, les decideurs politiques et les administrations d'hopitaux soutiennent les prestataires de soins de sante qualifies, qui pourront a leur tour soutenir respectueusement les femmes pendant l'accouchement. El acceso a la atencion obstetrica de emergencia, incluido el parto vaginal asistido y el parto por cesarea, es crucial para mejorar los resultados de la maternidad y el parto. No obstante, aunque el porcentaje de partos por cesarea ha aumentado en las ultimas decadas, el uso del parto vaginal asistido ha disminuido. Esto ocurre especialmente en los paises de ingresos bajos y medios, a pesar de que un parto vaginal asistido suele ser menos arriesgado que un parto por cesarea. Por lo tanto, llevamos a cabo un proceso de tres pasos para identificar un programa de investigacion necesario para aumentar el uso del parto vaginal asistido o volver a incorporarlo: tras realizar una sintesis de la evidencia, que sirvio de base para una consulta con expertos tecnicos que propusieron un programa de investigacion inicial, buscamos e integramos las opiniones de las representantes de las mujeres sobre este programa. Este proceso nos ha permitido identificar un programa de investigacion exhaustivo, con temas categorizados como: (i) la necesidad de comprender las percepciones de las mujeres sobre el parto vaginal asistido, y proporcionar informacion adecuada y fiable; (ii) la importancia de formar a los profesionales sanitarios en habilidades clinicas, pero tambien en atencion respetuosa, comunicacion efectiva, toma de decisiones compartida y consentimiento informado; o (iii) las barreras y los facilitadores de la implementacion y la sostenibilidad. A partir de las opiniones de las mujeres, nos enteramos de la urgente necesidad de reconocer las experiencias del parto, el alumbramiento y el posparto como procesos humanos inherentemente fisiologicos y dignos, en los que las intervenciones solo deben aplicarse si son necesarias. La promocion o la reincoporacion del parto vaginal asistido en regiones de escasos recursos exige que los gobiernos, los responsables de formular politicas y los administradores de hospitales apoyen a los profesionales sanitarios capacitados que, a su vez, pueden ayudar a las mujeres en el trabajo de parto y el alumbramiento de manera respetuosa. [phrase omitted], Introduction Assisted vaginal birth, also known as instrumental or operative vaginal birth, refers to a vaginal birth conducted with the help of an instrument such as forceps or a vacuum [...]

Optimizing caesarean section use is a global health priority, given the maternal and perinatal morbidity and mortality associated with caesarean underuse and overuse. (1,2) Monitoring caesarean section rates is important [...]

Background/Objective: Diet is a risk factor for gestational diabetes mellitus (GDM). There are few studies on women's diet and glucose tolerance test (GTT) results during pregnancy. The objective of this study was to evaluate the relationship between one's previous diet and the number of abnormal values on the diagnostic GTT in women with GDM. We hypothesized that there would be an inverse relation between antioxidant micronutrient consumption and the number of abnormal GTT values. Methods: This cross-sectional study included 60 women diagnosed with GDM (2-h, 75 g-GTT), divided in two groups as follows: 1 abnormal glucose value and 2–3 abnormal values. Shortly after the diagnosis, participants answered a validated food frequency questionnaire to assess their food consumption in the last 6 months. The Mann–Whitney test was used to compare the dietary intake of the participants in the two groups. Results: The participant characteristics were similar. The median intake of total calories, carbohydrates, lipids, and proteins did not differ significantly between groups. Participants with 1 abnormal GTT value had significantly higher intakes of fiber (11.9 vs. 11.0 g/day p = 0.049), vitamin D (40.6 vs. 40.4 mcg/day p = 0.049), and vitamin C (180.0 vs. 151.0 mg/day p = 0.008) than those with 2–3 abnormal values. Conclusions: Our results suggest a possible association between the consumption of fiber and antioxidant micronutrients and the number of abnormal GTT values. [ABSTRACT FROM AUTHOR]