Umbilical cord clamping time and maternal satisfaction.

OBJECTIVE: Clamping of the umbilical cord is part of the third stage of delivery. Delayed cord clamping (DCC) is recommended due to its contribution to prevention of anaemia. There is no evidence on the effect of DCC on maternal satisfaction. The aim of this study is to evaluate the effect of different sociodemographic and obstetric factors, including the timing of cord clamping, on maternal satisfaction with the birth experience in our healthcare system. DESIGN: Pragmatic non-drug intervention study with simple random assignment of participating mothers (Clinical Trials N°: NCT03624335). SETTING: A public, university-level hospital in Villarreal city, eastern Spain. PARTICIPANTS: Childbearing woman, gestation week between 35 and 42 weeks, with regular medical pregnancy checks, single pregnancy and vaginal delivery (N = 198, 80% of the women recruited). INTERVENTIONS: umbilical cord clamping within 60 seconds of the birth (Early cord clamping, ECC) versus umbilical cord clamping after pulsation had been ceased (Delayed cord clamping, DCC). MEASUREMENTS: Birth satisfaction was measured using the Mackey Childbirth Satisfaction Rating Scale (MCSRS). Additionally, sociodemographic data, degree of knowledge about the moment of clamping and type of breastfeeding data were recorded. The Mann-Whitney and Kruskal-Wallis tests for comparison of the mean of two, three, or more groups, respectively, and Chi-square and Spearman for comparison of two qualitative and quantitative variables, respectively, were used. To determine the weight of each factor of MCSRS, an exploratory factor analysis was carried out using the maximum likelihood method for factor extraction and the varimax method for factor rotation. The adequacy of the factor analysis was checked by mean of Kaiser-Meyer-Olkin test and Bartlett sphericity test. The level of significance was set at a p-value of < 0.05. FINDINGS: The average degree of satisfaction was 4.55/5 (SD: 0.37). No statistically significant difference was observed between mothers' satisfaction according to mother level of study or mother's place of birth, while it changed significantly with age (p = 0.0398). Within the obstetric variables, satisfaction was significantly associated with spontaneous amniorrhexis, the duration of the second stage of delivery, and the Apgar value of the newborn at the first minute of life, and was independent of the number of previous pregnancies and deliveries, use of intrapartum oxytocin, epidural analgesia, episiotomy, the weight of the child at birth and type of breastfeeding. Furthermore, there was no relationship between the time of clamping and satisfaction (p = 0.5178). KEY CONCLUSIONS: Maternal satisfaction with the birth experience varies with the age of the childbearing woman, and some intrapartum factors and the result is not influenced by the time of clamping of the umbilical cord. Therefore, this component of the physiological management of childbirth provides additional benefits for the health of the neonate, without negative consequences on the final perception of the maternal health care received. IMPLICATIONS FOR PRACTICE: If there are no reasons that justify an early umbilical cord clamping, delaying it brings benefits to the neonate, without negatively affecting the maternal assessment of the experience of childbirth.

¿Qué dicen las madres gitanas de la lactancia materna? / What gypsy mothers say about breastfeeding?

Objetivo: Conocer y profundizar en la valoración, la experiencia y la vivencia de las mujeres de etnia gitana con la lactancia materna. Método: Estudio cualitativo con un enfoque fenomenológico interpretativo, a través de la realización de un grupo focal en el que participaron 6 madres de etnia gitana usuarias del Centro de Salud de Fuente de San Luis de la ciudad de Valencia. Resultados: Las barreras descritas por estas madres en cuanto a la lactancia refieren: una falta de apoyo familiar, una asociación del amamantamiento al sacrificio y a la dependencia del bebé al pecho. De los relatos de estas madres se percibe un desinterés por la lactancia, y una falta de confianza en su propia biología que, unido a una escasa participación en las actividades de educación maternal, han supuesto las barreras que mayormente han limitado y dificultado en gran parte la lactancia en este grupo de madres. Conclusiones: Sería deseable poner en marcha acciones de mejora que prestaran mayor atención en promover, proteger y apoyar la lactancia en este colectivo.(AU)

Objective: To know and deepen in the evaluation, and experience of gypsy women with breastfeeding. Method: Qualitative study with an interpretative phenomenological approach, through a focus group with the participation of six mothers of gypsy ethnicity, users of the Fuente de San Luis Health Center in the city of Valencia. Results: The barriers described by these mothers regarding breastfeeding refer to a lack of family support, an association of breastfeeding to sacrifice and to the dependence of the baby to the breast. From the accounts of these mothers it is perceived, a disinterest in breastfeeding and a lack of confidence in their own bilogy, which together with a low participation in maternal education activities, have meant the barriers that have mostly limited and largely hindered breastfeeding in this group of mothers. Conclusions: It would be desirable to implement improvement actions that would pay more attention to promote, protect and support breastfeeding in this group.(AU)

What gypsy mothers say about breastfeeding.

OBJECTIVE: To know and deepen in the evaluation, and experience of gypsy women with breastfeeding. METHOD: Qualitative study with an interpretative phenomenological approach, through a focus group with the participation of six mothers of gypsy ethnicity, users of the Fuente de San Luis Health Center in the city of Valencia. RESULTS: The barriers described by these mothers regarding breastfeeding refer to a lack of family support, an association of breastfeeding to sacrifice and to the dependence of the baby to the breast. From the accounts of these mothers it is perceived, a disinterest in breastfeeding and a lack of confidence in their own bilogy, which together with a low participation in maternal education activities, have meant the barriers that have mostly limited and largely hindered breastfeeding in this group of mothers. CONCLUSIONS: It would be desirable to implement improvement actions that would pay more attention to promote, protect and support breastfeeding in this group.

Women's knowledge and attitudes towards cervical cancer prevention: A qualitative study in the Spanish context.

AIMS AND OBJECTIVES: To explore the knowledge, attitudes and practices related to cervical cancer and its prevention in Spain. BACKGROUND: Worldwide, women's knowledge about cervical cancer is low, and their attitudes towards its prevention are good, but they do not correlate with the screening uptake. Although the rates of Spanish women performing cervical cancer screening are mostly acceptable, their knowledge and attitudes about it have not been explored. DESIGN: Qualitative descriptive study. METHODS: Three focus groups were conducted, with 21 women aged 25 to 65 years. Participants were recruited through convenience sampling. For intragroup homogeneity, women participated in age groups. The COREQ reporting guidelines were used. RESULTS: Women expressed their knowledge about cervical cancer was low. None of the participants identified the human papillomavirus as a cause of cervical cancer, nor did they mention the vaccine as a preventive measure. They all knew about the screening existence, but not about its frequency nor target population. About the attitudes and practice, 18 women had an appropriate screening, and they were favourable to this health check, claiming an increase in its frequency. Nineteen women claimed they had not received enough information from the healthcare system and a lack of social awareness in comparison with breast cancer. They demanded from the professionals more health education, a reminder of their appointments and a report of the Pap test results. CONCLUSIONS: There was a self-perceived low level of knowledge about cervical cancer risk factors and its prevention in the participants. However, they expressed favourable attitudes towards screening, and they demanded more information about cervical cancer and its prevention measures, and they regretted its low social awareness. RELEVANCE TO CLINICAL PRACTICE: Midwives, general nurses and other nurse specialists may have a leading position in health education for cervical cancer prevention in different population levels.

Efectividad de un programa de promoción de la salud sexual y de prevención de violencia de género en adolescentes / Efectiveness of a program for the promotion of sexual health and the prevention of gender violence in adolescents

Estudio de intervención antes-después realizado en cuatro colegios, sobre una muestra de 202 estudiantes de segundo de bachillerato y ciclos formativos de grado medio. La intervención se hizo mediante sesiones educativas en grupos de 20-25 sujetos, con programación secuencial de conocimientos y actitudes. Los resultados reflejaron la eficacia del programa ya que tras su aplicación, se produjo un aumento significativo en las tasas de conocimientos y de actitudes afectivo-sexuales con independencia del sexo, tipo de colegio o de enseñanza (AU)

This paper describes a before-afterwards intervention study undertaken in four schools with a sample of 202 students from second year high school and formative cycles grades. The intervention was carried our by means of educational sessions in groups of 20-25 subjects with sequential programming of knowledge and attitudes. The results reflected the effectiveness of the program as after its application a significant increase in the rates of knowledge and of affective-sexual attitudes, with independence of he sex, type of school or teaching, took place (AU)