Cesarean section trends from 1992 to 2016 in Estonia and Finland: A registry-based study.

INTRODUCTION: The number of cesarean sections (CSs) has grown steadily, but the underlying factors driving this increase remain unknown. Data from Medical Birth Registries were retrieved to analyze CS trends in Estonia and Finland during the period 1992-2016. MATERIAL AND METHODS: All births in Estonia (n = 356 063) and Finland (n = 1 437 234) were included. The differences between Estonia and Finland in five-year time periods for the total CS rate, and rates in Robson 1, 2, and 5 groups (R1, R2, R5) were analyzed by logistic regression. Total CS rates were adjusted for birthweight, parity, previous CS, gestational age, singleton pregnancy, cephalic position, induction, mother's age. R1; R2; R5 rates were adjusted for birthweight and mother's age. RESULTS: In Estonia, the proportion of CSs increased from 6.5% to 21.0% and in Finland from 15.1% to 16.8% between 1992 and 2016. In 2016, Estonia and Finland remained within the target value with their R1 + 2 (Estonia 18%; Finland 16%) and R5 (Estonia 59%; Finland 42%) values. CONCLUSIONS: Comparing Robson groups in different countries can shed light on divergent CS rates and to improve the quality of perinatal and obstetric care.

Existing Health Practices in Shaping the Decision to Participate During Breast Cancer Screening Among 50-69 Years Old Women in Estonia.

Introduction: Breast cancer is easily detectable by mammography and many countries run national screening programs for women as a target group. Yet, the majority of these countries have screening participation rates below the recommended level of 70%. Objective: The aim of the present article was to examine a connection between existing health practices and a decision to participate during breast cancer screening. Methods: Methodologically, this research was a web panel and quantitative telephone survey. The survey was conducted among 1200 Estonian women in the age group 50-69 years. Statistical data analysis was performed with SPSS using a descriptive and logistic regression model. Results: The findings revealed that among different background variables, age and existing health practices significantly influenced the decision-making for participating in the screening. Results also highlighted that the possibility to participate in the screening increased with existing supportive health practices and with the increasing age. Other sociodemographic factors did not have a significant influence on the decision-making of participation. Conclusions: There is a need to educate people from an early age about the developments in health practices that could support a healthy lifestyle in terms of individual responsibility. Thus, public health campaigns should not only call for action but also focus on health education in terms of the role of preventive medicine and health practices.

Midwife students and hospital mentors satisfaction with professional practice in Estonia.

INTRODUCTION: Mentoring has played an important role in the development and support of healthcare students during the last 15 years. Constant monitoring performed by a mentor and their constructive feedback is a useful tool in professional practice. The greatest factor having a negative influence is lack of time. Mentors and midwifery students' satisfaction with practical training can be significantly affected by the clinical practice environment. This study aims to analyze the satisfaction of the mentors at women's clinics and midwifery students with the clinical practice. METHODS: The mixed methods study included midwifery mentors from the women's clinic and students who completed internships at the clinic in Estonia. The duration of the study was three years (2016-2019). Mentors were surveyed through focus group interviews. Students were surveyed through a semi-closed questionnaire. The study involved 15 midwives and 127 midwifery students. RESULTS: The mentors are aware that their responsibilities include the instruction, training, and assessment of the trainees, and they believe that a safe environment has an important role in passing the training successfully. Additionally, the most challenging aspect of providing instruction from the view of the mentors is the resultant lack of time. Students are satisfied with the mentors, co-workers, wards, and overall practical training at the women's clinic. CONCLUSIONS: The most challenging aspect of providing instruction from the view of the mentors is the resultant lack of time. Students' satisfaction with the said mentors is based on how well the students thought cooperation worked amongst mentors and co-workers. It is a problem for students from time to time that they are expected to have higher levels of skills than the knowledge they have acquired allows.