Toward sustainable development goals in gender inequality: an analysis of gender preferences among urban pregnant women in a Southeast Asian country.

BACKGROUND: Gender-biased discrimination and preferences are global phenomena, particularly son preferences. However, updated evidence about this issue in Vietnam has not yet been provided. Therefore, this study aimed to examine the gender preferences among pregnant women and identify associated factors of such preferences. METHODS: A cross-sectional survey was conducted in two hospitals in Vietnam with 732 pregnant women. Gender preferences for their child were asked, along with socio-demographic (e.g., education, occupation) and pregnancy characteristics (e.g., pressure to have a son, gender of first child, the importance to have a son of family members, and information sources on pregnancy care) by using face-to-face interviews and a structured questionnaire. Multinomial logistic regression was performed to determine factors associated with gender preferences. RESULTS: About 51.9% of the participants had no gender preference, while, among those who had a gender preference, 26.5% preferred sons, and 21.6% preferred daughters. Only 6.2% had pressure to have a son. Having the first child who was female (OR = 4.16, 95%CI = 1.54-11.25), having the pressure to have a son (OR = 6.77, 95%CI = 2.06-22.26), and higher self-perceived importance to have a son (OR = 3.05, 95%CI = 1.85-5.02) were positively associated with son preference. Otherwise, women having partners with high school education or above (OR = 2.04, 95%CI = 1.06-3.91), living with parents-in-law (OR = 2.33; 95%CI = 1.25-4.34), the higher number of pregnancies, and a higher degree of importance in having a son regarding parents-in-law (OR = 2.15, 95%CI = 1.38-3.35) associated with higher odds of preferring daughter. CONCLUSION: This study showed that gender preference was common among pregnant women, but the pressure to have a son was low. Further education programs and legal institutions should be implemented to improve gender inequality and gender preference in society.

Women's holistic self-care behaviors during pregnancy and associations with psychological well-being: implications for maternal care facilities.

BACKGROUND: Self-care behaviors during pregnancy significantly impacts mother and children's health. This study aimed to explore the self-care behaviors and the associations of these behaviors with the psychological well-being of women during pregnancy, as well as the mediating effects of different social support with these associations. METHODS: A cross-sectional data of 562 pregnant women at Hanoi Obstetrics & Gynecology Hospital and Ca Mau Obstetrics & Pediatrics in Vietnam were analyzed. Questions about self-care behaviors, pregnancy characteristics, social support, and psychological well-being were asked. Multivariate regression models were performed. Structural Equation Modeling (SEM) was employed to test the mediating effects of different social support with the association between self-care behaviors and psychological well-being. FINDINGS: Only 13% of pregnant women often or always did physical exercise at least three times a week, and 40% consumed enough fiber and five servings of vegetables a day. Only 78.7% always avoided alcohol drinking, and 53.9% of pregnant women avoided being exposed to second-hand smoking and 71,7% avoided using traditional medicine without physicians' prescriptions. Around 66% of pregnant women always or often had prenatal care checkups as scheduled. Information sources, social support and childbirth expectation were major drivers for self-care practices. SEM model showed that social support mediated the relationship between maternal health behaviors and mental well-being. CONCLUSION: This study highlighted the remarkable gaps in self-care practices among our pregnant women, which were significantly associated with their mental well-being. Social support-oriented consultancy and interventions should be warranted for improving behaviors and the mental well-being of pregnant women in Vietnam.

COVID-19 and delayed antenatal care impaired pregnant women's quality of life and psychological well-being: What supports should be provided? Evidence from Vietnam.

BACKGROUND: This study explored the associations between different structural and functional supports with the quality of life (QOL) and mental well-being of pregnant women whose antenatal care was delayed due to the COVID-19 pandemic in Vietnam. METHODS: A multi-center cross-sectional study was performed on 868 pregnant women. The pregnant women's quality of life questionnaire (QOL-GRAV), the Edinburgh Postnatal Depression Scale (EPDS), and the Perinatal Infant Care Social Support (PICSS) instruments were employed. The satisfaction with care from different sources was measured. Multivariate Tobit Regression models were used. RESULTS: Seventy pregnant women (8.1%) reported that their antenatal care was influenced by the COVID-19. In this group, a higher level of satisfaction with the care of parents-in-law and a higher score of emotional support were associated with a better "Physical and Emotional changes" domain, while a higher level of appraisal support was related to poorer "Physical and Emotional changes" domain. A higher level of satisfaction with relatives' care and a higher score of emotional support were correlated with a better "Life Satisfaction" domain. EPDS score was negatively correlated with satisfaction with parents-in-law care and appraisal support. CONCLUSIONS: Our study highlighted that intervention programs to improve the QOL and psychological well-being of pregnant women in epidemics such as COVID-19 or other diseases in the future should involve other family members such as parents-in-law and relatives as sources of support. LIMITATIONS: The cross-sectional design was unable to draw causal relationships. Recall bias might occur. The convenient sampling method might limit the generalizability of findings.

Acceptance and willingness to pay for COVID-19 vaccines among pregnant women in Vietnam.

OBJECTIVES: The aim of this study was to assess acceptance of COVID-19 vaccination and the willingness to pay (WTP) for it, and investigate associated factors among pregnant women in Vietnam. METHODS: Cross-sectional survey of pregnant women in two obstetric hospitals in Hanoi and Ca Mau provinces, Vietnam. Data on acceptance and WTP for COVID-19, demographic characteristics, maternal characteristics, and risk perceptions toward COVID-19 were collected. Multivariate logistic and linear regression models were performed to identify factors associated with the acceptance and WTP for the vaccine. RESULTS: Of 651 pregnant women, 60.4% accepted to receive the vaccine, and 82.6% of the total pregnant women were willing to pay for a COVID-19 vaccine with the mean amount of WTP of USD 15.2 (SD ± 27.4). The most common reason for refusing vaccination was "Worry about the safety of the vaccine" (66.9%) in Hanoi and "The preventive effect of COVID-19 is low" (45.2%) in Ca Mau. A higher income, having children, self-perceived risk of COVID-19 infection, and perceived risk to friends were associated with a higher likelihood of acceptance and WTP for the vaccine. CONCLUSIONS: Implementing COVID-19 vaccination and resource mobilisation among pregnant women in Vietnam is feasible, although communication programmes to improve risk perception and awareness about vaccine should be developed for facilitating acceptance of the vaccine.

Fear of Childbirth and Preferences for Prevention Services among Urban Pregnant Women in a Developing Country: A Multicenter, Cross-Sectional Study.

This study aimed to examine fear of childbirth and willingness to pay for fear-prevention services in pregnant women. A multicenter, cross-sectional study was conducted on pregnant women in two obstetric hospitals in Vietnam. The Fear of Birth Scale was utilized to evaluate fear of childbirth. Multivariable, generalized linear regression and logistic regression models were performed to identify associated factors with fear of childbirth, demand, and willingness to pay for prevention services. Of 900 pregnant women, fear of childbirth was moderately high with a mean score of 18.1 (SD = 2.3). Age of partner; ever having complications of pregnancy; attitudes toward different aspects of childbirth delivery; satisfactions with friends, parents, and siblings' care; and information support were associated with fear of childbirth. Only 33.8% participants had a demand for the prevention service, and 43.7% were willing to pay for this service with an average amount of $US 10.0 per month (SD = 72.0). Our study suggested that individualized psychological counseling and information-seeking guidance should be provided appropriately and differently for multiparous and nulliparous women for reducing fear and improving the acceptability of the prevention services.