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1.
Midwifery ; 92: 102877, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33157497

RESUMO

AIM: This study aims to examine pregnancy and birth planning during COVID-19 and the effects of a tele-education offered to pregnant women for this planning process on prenatal distress and pregnancy-related anxiety. METHOD: The population of this quasi-experimental study was composed of pregnant women who applied for the antenatal education class of a public hospital in the east of Turkey during their past prenatal follow-ups and wrote their contact details in the registration book to participate in group trainings. The sample of the study consisted of a total of 96 pregnant women, including 48 in the experiment and 48 in the control groups, who were selected using power analysis and non-probability random sampling method. The data were collected between April 22 and May 13, 2020 using a "Personal Information Form", the "Revised Prenatal Distress Questionnaire (NuPDQ)" and the "Pregnancy Related Anxiety Questionnaire-Revised 2 (PRAQ-R2)". An individual tele-education (interactive education and consultancy provided by phone calls, text message and digital education booklet) was provided to the pregnant women in the experiment group for one week. No intervention was administered to those in the control group. The data were statistically analyzed using descriptive statistics (frequency, percentage, mean, standard deviation, min-max values) and t-test in dependent and independent groups. RESULTS: The posttest NuPDQ total mean scores of pregnant women in the experiment and control groups were 8.75±5.10 and 11.50±4.91, respectively, whereby the difference between the groups was statistically significant (t=-2.689, p=0.008). Additionally, the difference between their mean scores on both PRAQ-R2 and its subscales of "fear of giving birth" and "worries of bearing a physically or mentally handicapped child" was statistically significant (p<0.05), where those in the experiment group had lower anxiety, fear of giving birth and worries of bearing a physically or mentally handicapped child. CONCLUSION: The tele-education offered to the pregnant women for pregnancy and birth planning during COVID-19 decreased their prenatal distress and pregnancy-related anxiety.


Assuntos
Ansiedade/psicologia , Parto/psicologia , Complicações na Gravidez/psicologia , Gestantes/psicologia , Telemedicina/métodos , Adulto , Ansiedade/prevenção & controle , Estudos de Casos e Controles , Feminino , Humanos , Gravidez , Complicações na Gravidez/prevenção & controle , Inquéritos e Questionários , Turquia
2.
Int J Gynaecol Obstet ; 153(1): 83-88, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33368216

RESUMO

OBJECTIVE: To understand how giving birth during the coronavirus disease 2019 (COVID-19) pandemic affected women based on birth parameters (gestational age, type of birth and body weight at birth), satisfaction with childbirth, and development of postpartum depression. METHODS: This is a cross-sectional study of 162 Spanish women. They were divided into two groups: those who gave birth before the pandemic (n = 82; from September 1, 2019 to March 1, 2020) and during the pandemic (n = 75; from April 1, 2020 to July 1, 2020). They were assessed using psychological instruments for postpartum childbirth satisfaction and postpartum depression. RESULTS: It was found that women who gave birth during the pandemic suffered higher levels of stress during childbirth (U = 2652.50; P = 0.040) and gave a worse rating of the quality of care received (U = 2703.50; P = 0.041). In addition, the percentage of postpartum depression was much higher in women who gave birth during the pandemic (χ2  = 4.31; P  = 0.038). CONCLUSION: Giving birth during the COVID-19 pandemic could have an impact on greater dissatisfaction with childbirth, as well as increasing the risk of postpartum depression.


Assuntos
Parto Obstétrico , Depressão Pós-Parto , Parto/psicologia , Estresse Psicológico , Adulto , /prevenção & controle , Estudos Transversais , Parto Obstétrico/métodos , Parto Obstétrico/psicologia , Parto Obstétrico/estatística & dados numéricos , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/epidemiologia , Feminino , Idade Gestacional , Humanos , Satisfação Pessoal , Período Pós-Parto/psicologia , Gravidez , Espanha/epidemiologia , Estresse Psicológico/epidemiologia , Estresse Psicológico/etiologia
3.
PLoS One ; 15(12): e0244310, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33378372

RESUMO

Although strong evidence exists about the effectiveness of basic childbirth services in reducing maternal and newborn mortality, these services are not provided in every childbirth, even those at health facilities. The WHO Safe Childbirth Checklist (SCC) was developed as a job aide to remind health workers of evidenced-based practices to be provided at specific points in the childbirth process. The Zambian government requested context-specific evidence on the feasibility and outcomes associated with introducing the checklist and related mentorship. A study was conducted on use of the SCC in four facilities in Nchelenge District of Zambia. Observations of childbirth services were conducted just before and six months after the introduction of the intervention. Observers used a structured tool to record adherence to essential services indicated on the checklist. The primary outcome of interest was the change in the average proportion of essential childbirth practices completed. Feedback questionnaires were administered to health workers before and six months after the intervention. At baseline and endline, 108 and 148 pause points were observed, respectively. There was an increase from 57% to 76% of tasks performed (p = 0.04). Considering only these cases where necessary supplies were available, health workers completed 60% of associated tasks at baseline compared to 84% at endline (p<0.01). Some tasks, such as taking an infant's temperature and hand washing, were never or rarely performed at baseline. Feedback from the health workers indicated that nearly all health workers agreed or strongly agreed with positive statements about the intervention. The performance of health workers in Zambia in completing essential practices in childbirth was low at baseline but improvements were observed with the introduction of the SCC and mentorship. Our results suggest that such interventions could improve quality of care for facility-based childbirth. However, national-level commitment to ensuring availability of trained staff and supplies is essential for success. Trial registration Clinical Trials.gov (NCT03263182) Registered August 28, 2017 This study adheres to CONSORT guidelines.


Assuntos
Lista de Checagem/métodos , Fidelidade a Diretrizes/estatística & dados numéricos , Educação Pré-Natal/métodos , Adulto , Lista de Checagem/estatística & dados numéricos , Parto Obstétrico/normas , Parto Obstétrico/estatística & dados numéricos , Parto Obstétrico/tendências , Feminino , Instalações de Saúde/estatística & dados numéricos , Pessoal de Saúde , Humanos , Masculino , Serviços de Saúde Materna/normas , Serviços de Saúde Materna/estatística & dados numéricos , Serviços de Saúde Materna/tendências , Pessoa de Meia-Idade , Parto/psicologia , Gravidez , Melhoria de Qualidade , Inquéritos e Questionários , Organização Mundial da Saúde , Zâmbia/epidemiologia
5.
Rev Bras Enferm ; 73(Suppl 2): e20200551, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33206819

RESUMO

OBJECTIVE: Reflect on how the new coronavirus pandemic triggered or accentuated the fear of childbirth in pregnant women and affected childbirth care practices. METHODS: Reflective analysis of women's pregnancy and childbirth experiences during the current pandemic, supported by the latest scientific evidence and recommendations on the topic. RESULTS: Pregnancy and childbirth are life-changing events for women, but during the new coronavirus pandemic, fear and uncertainty have taken on an unprecedented dimension in the negative way that many pregnant women have anticipated and experienced childbirth. FINAL CONSIDERATIONS: The current period has accentuated a chronic problem: a paternalistic system of health institutions in the approach to childbirth, dense with additional levels of fear in pregnant women. In this context, addressing the fear of childbirth means not giving up the promotion of safe and positive birth experiences for women.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Medo/psicologia , Parto/psicologia , Pneumonia Viral/epidemiologia , Gestantes/psicologia , Infecções por Coronavirus/psicologia , Feminino , Humanos , Tocologia , Obstetrícia , Pandemias , Pneumonia Viral/psicologia , Gravidez
6.
BMC Pregnancy Childbirth ; 20(1): 703, 2020 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-33208115

RESUMO

BACKGROUND: Trauma, natural and man-made catastrophic events can be predictors of postpartum psychological distress. In a public health response due to coronavirus disease 2019 outbreak, the Italian government imposed a lockdown from March 9 to May 3. This extraordinary situation may have been challenging for maternal psychological health. The aim of this study was to investigate the prevalence of depressive and post-traumatic stress symptoms in women giving birth during the Covid-19 pandemic and its associations with quarantine measures, obstetrical factors, and relational attachment style. METHODS: Women who gave birth in a high-volume obstetric/gynaecological medical centre located in an epidemic area during the Covid-19 pandemic (March 8 to June 15) were asked to complete an online survey about their childbirth experience and the perceived effect of the pandemic. The Edinburgh Postnatal Depression Scale (EPDS), the Impact of Event Scale-Revised (IES-R), and the Relationship Questionnaire (RQ) were administered to assess levels of postpartum depressive and post-traumatic stress symptoms (PTSS) and relational style of attachment, respectively. Multivariate analysis was applied to identify associations between quarantine measures, childbirth experience, attachment style, and EPDS and IES-R scores. RESULTS: The survey was completed by 163 women (response rate 60.8%). The prevalence of depressive symptoms was 44.2% (EPDS cut-off score ≥ 11) and the PTSS rate was 42.9% (IES-R cut-off score ≥ 24). Dismissive and fearful avoidant attachment styles were significantly associated with the risk of depression and PTSS, respectively. Perceived pain during birth was a risk factor for postpartum depression. Perceived support provided by healthcare staff was a protective factor against depression and PTSS. Another protective factor against PTSS was quiet on the ward due to the absence of hospital visitors. CONCLUSION: This study reports a high prevalence of postpartum depressive and PTSS in women who gave birth during the Covid-19 pandemic. Postnatal psychological distress seemed to be associated more with the prenatal experience and other individual factors than with the pandemic hospital restrictions. Early detection during pregnancy of an insecure attachment style is fundamental to provide targeted preventive and therapeutic psychological interventions.


Assuntos
Infecções por Coronavirus/psicologia , Depressão Pós-Parto , Pneumonia Viral/psicologia , Período Pós-Parto/psicologia , Gestantes/psicologia , Angústia Psicológica , Quarentena/psicologia , Adulto , Betacoronavirus , Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Estudos Transversais , Depressão Pós-Parto/epidemiologia , Depressão Pós-Parto/etiologia , Depressão Pós-Parto/prevenção & controle , Feminino , Humanos , Itália/epidemiologia , Pandemias/prevenção & controle , Parto/psicologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Gravidez , Prevalência , Psicologia , Sistemas de Apoio Psicossocial , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/etiologia , Transtornos de Estresse Pós-Traumáticos/prevenção & controle
7.
Niger J Clin Pract ; 23(10): 1456-1461, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33047706

RESUMO

Background: Birth preparedness and complication readiness (BPCR) is a strategy with specific interventions to reduce pregnancy related morbidity and mortality. Aim: The study assessed the predictors of optimal birth preparedness and complication readiness among parturient in a tertiary health institution in Nigeria. Subject and Methods: This descriptive cross-sectional study was conducted among parturient at the labor and post-natal wards of University of Nigeria Teaching Hospital Enugu over a 6 months period. Demographic information and predictors of BPCR were analyzed by descriptive statistics and logistic regression respectively with P value of < 0.05 considered statistically significant. Results: Of the 420 parturient, 330 (78.6%) and 90 (21.4%) were booked and unbooked respectively. Majority (74.2%) of the booked and about half of the unbooked parturient were knowledgeable about BPCR. Most (92.4%) of the booked parturient were optimally birth prepared at delivery as against 22.2% of the unbooked. Higher parity (adj OR = 3.79; 95% CI = 1.46-9.82, P = 0.01), tertiary educational level (adj OR = 2.98; 95% CI = 1.23-7.20, P = 0.02), regular antenatal visit (adj OR = 2.68; 95% CI = 1.06-6.76, P = 0.04), information received on birth preparedness before delivery (adj OR = 0.21; 95% CI = 0.07-0.61, P = <0.01), and booked status (adj OR = 0.02; 95% CI = 0.01-0.05, P = <0.001) where significant predictors of optimal BPCR. Conclusion: Encouraging female education, regular antenatal visits, and participation in health talk is advocated to improve BPCR and ultimately reduce maternal and perinatal mortality/morbidity among women in southeast Nigeria.


Assuntos
Parto Obstétrico/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Trabalho de Parto/psicologia , Complicações do Trabalho de Parto/psicologia , Parto/psicologia , Complicações na Gravidez/psicologia , Gestantes/psicologia , Cuidado Pré-Natal/métodos , Adulto , Estudos Transversais , Feminino , Hospitais de Ensino , Humanos , Modelos Logísticos , Nigéria , Paridade , Mortalidade Perinatal , Gravidez , Adulto Jovem
8.
PLoS One ; 15(8): e0236722, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32756586

RESUMO

In 2014, the EU funded a four-year European Cooperation in Science and Technology (COST) Action to address the topic of childbirth. The COST Birth Action was a cross-European network, that brought together over 120 scientists, practitioners, activists and policy makers from 34 countries to work on intrapartum care. The central aim was to advance the state of research and practice in a specific area of great clinical and social importance, intrapartum care. The Action used inter and trans-disciplinary approaches to address birth from multiple perspectives and drew on complexity theory and the concept of salutogenesis (wellbeing). This special collection presents six papers produced from the Action and gives a sense of the range and depth of the work conducted. The Collection illustrates the knowledge that can be generated when a diverse group of people come together with a similar goals and perspectives.


Assuntos
União Europeia , Parto/psicologia , Senso de Coerência , Humanos
9.
Br J Clin Psychol ; 59(4): 480-502, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32808684

RESUMO

OBJECTIVES: To investigate whether levels of perfectionism, organization, and intolerance of uncertainty predispose women to more negative birth experiences and post-partum post-traumatic stress symptoms (PTSS). Birth experience was also examined as a potential moderator of the relationship between levels of the personality traits and post-natal PTSS. DESIGN: Prospective survey. METHOD: First-time expectant mothers (N = 10,000) were contacted via Emma's Diary during the perinatal period. At 32-42 weeks' gestation, participants completed measures examining the three personality traits and prenatal mood. At 6-12 weeks' post-partum, instruments assessing childbirth experience, birth trauma, PTSS, and post-natal mood were completed. Data from 418 women were analysed. RESULTS: Higher perfectionism and intolerance of uncertainty were associated with more negative birth appraisals and PTSS. Organization was unrelated to birth experience or PTSS. In a regression, higher intolerance of uncertainty and perfectionism statistically predicted more negative birth appraisals. Only perfectionism predicted PTSS. Birth experience did not moderate the relationship between perfectionism or intolerance of uncertainty and PTSS. CONCLUSIONS: Personality risk factors for negative birth experiences and post-natal PTSS are identifiable prenatally. Maternity care providers could educate women about the unique roles of high perfectionism and intolerance of uncertainty during antenatal birth preparation. PRACTITIONER POINTS: Women who expect themselves to be more perfect or who find it more difficult to cope with uncertainty had more negative experiences of childbirth. Women with higher levels of perfectionism were more likely to experience more symptoms of post-traumatic stress during the early post-natal period. Being more perfectionistic continued to have a more negative effect on women's well-being after birth, regardless of whether they had a positive or negative experience of birth. Integrating these findings into antenatal discussion around birth preferences would increase women's awareness of predisposing and obstetric risk factors that partially explain experiences of unsatisfactory births and post-partum post-traumatic stress.


Assuntos
Ansiedade/psicologia , Parto Obstétrico/psicologia , Serviços de Saúde Materna/organização & administração , Parto/psicologia , Personalidade , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Estresse Psicológico/complicações , Incerteza , Adulto , Parto Obstétrico/efeitos adversos , Parto Obstétrico/normas , Depressão/psicologia , Depressão Pós-Parto/psicologia , Feminino , Humanos , Gravidez , Estudos Prospectivos , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/etiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Estresse Psicológico/psicologia , Inquéritos e Questionários
10.
J Med Internet Res ; 22(9): e22002, 2020 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-32857707

RESUMO

BACKGROUND: The COVID-19 global pandemic has impacted the whole of society, requiring rapid implementation of individual-, population-, and system-level public health responses to contain and reduce the spread of infection. Women in the perinatal period (pregnant, birthing, and postpartum) have unique and timely needs for directives on health, safety, and risk aversion during periods of isolation and physical distancing for themselves, their child or children, and other family members. In addition, they are a vulnerable group at increased risk of psychological distress that may be exacerbated in the context of social support deprivation and a high-risk external environment. OBJECTIVE: The aim of this study is to examine the public discourse of a perinatal cohort to understand unmet health information and support needs, and the impacts on mothering identity and social dynamics in the context of COVID-19. METHODS: A leading Australian online support forum for women pre- through to postbirth was used to interrogate all posts related to COVID-19 from January 27 to May 12, 2020, inclusive. Key search terms included "COVID," "corona," and "pandemic." A three-phase analysis was conducted, including thematic analysis, sentiment analysis, and word frequency calculations. RESULTS: The search yielded 960 posts, of which 831 were included in our analysis. The qualitative thematic analysis demonstrated reasonable understanding, interpretation, and application of relevant restrictions in place, with five emerging themes identified. These were (1) heightened distress related to a high-risk external environment; (2) despair and anticipatory grief due to deprivation of social and family support, and bonding rituals; (3) altered family and support relationships; (4) guilt-tampered happiness; and (5) family future postponed. Sentiment analysis revealed that the content was predominantly negative (very negative: n=537 and moderately negative: n=443 compared to very positive: n=236 and moderately positive: n=340). Negative words were frequently used in the 831 posts with associated derivatives including "worried" (n=165, 19.9%), "risk" (n=143, 17.2%), "anxiety" (n=98, 11.8%), "concerns" (n=74, 8.8%), and "stress" (n=69, 8.3%). CONCLUSIONS: Women in the perinatal period are uniquely impacted by the current pandemic. General information on COVID-19 safe behaviors did not meet the particular needs of this cohort. The lack of nuanced and timely information may exacerbate the risk of psychological and psychosocial distress in this vulnerable, high-risk group. State and federal public health departments need to provide a central repository of information that is targeted, consistent, accessible, timely, and reassuring. Compensatory social and emotional support should be considered, using alternative measures to mitigate the risk of mental health disorders in this cohort.


Assuntos
Infecções por Coronavirus/epidemiologia , Internet , Saúde Mental/estatística & dados numéricos , Mães/psicologia , Poder Familiar/psicologia , Pneumonia Viral/epidemiologia , Período Pós-Parto/psicologia , Gravidez/psicologia , Estresse Psicológico/epidemiologia , Adulto , Ansiedade/epidemiologia , Austrália/epidemiologia , Criança , Infecções por Coronavirus/prevenção & controle , Feminino , Humanos , Pandemias/prevenção & controle , Parto/psicologia , Pneumonia Viral/prevenção & controle , Complicações Infecciosas na Gravidez/prevenção & controle , Complicações Infecciosas na Gravidez/psicologia , Apoio Social
11.
Artigo em Inglês | MEDLINE | ID: mdl-32858960

RESUMO

Postpartum depression (PPD) has detrimental effects on the health of the mother, child and family. Socio-demographic variables can influence PPD. Sense of coherence (SOC) is a personal resource that mitigates the experience of stressful events. We hypothesized that SOC would have a protective effect against PPD over time. The aim was to investigate the effects of socio-demographic factors and SOC on PPD at birth (T1) and nine months postpartum (T2). A longitudinal study of primiparous women (n = 114; age range 18-47 years) measured PPD, SOC and socio-demographics at T1 and T2. The majority were married, had no economic difficulties and were employed before birth. Results showed that PPD at T1 (15.8%) declined to 6.2% (T2). Job status was positively associated with SOC at T1. The structured equation model accounted for 27% of the variance in PPD (T2). In the first pathway, job status was linked to PPD (T2) via SOC at T1 and T2. In the second, SOC and PPD (T1) and SOC (T2) mediated the link between job status and PPD (T2). Results and clinical implications are discussed in the context of the theory of conservation of resources. An intervention for enhancing SOC is recommended for woman at risk of PPD.


Assuntos
Depressão Pós-Parto/psicologia , Emprego/psicologia , Parto/psicologia , Qualidade de Vida/psicologia , Senso de Coerência , Adolescente , Adulto , Criança , Depressão Pós-Parto/epidemiologia , Depressão Pós-Parto/etiologia , Feminino , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , Gravidez , Fatores de Risco , Adulto Jovem
12.
PLoS One ; 15(7): e0236008, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32726359

RESUMO

OBJECTIVES: To reach nuanced understanding of the perinatal experiences of ethnic minority women from Turkish and Moroccan descent giving birth in maternity wards in Belgium thereby gaining insight into the underlying challenges of providing intercultural care for ethnic minority persons in a hospital setting. METHODS: A qualitative study design was used by conducting In-depth interviews with 24 women from Turkish and Moroccan descent who gave birth during the past three years in maternity wards in Flanders, Belgium. The interviews were analysed using a Grounded Theory Approach. RESULTS: This study shows that the women's care experiences were shaped by the care interactions with their caregivers, more specifically on the attention that was given by the caregivers towards two essential dimensions of the care relationship, viz. Ereignis (attention to what happens) and Erlebnis (attention to how it happens). These two dimensions were interrelated in four different ways, which defined the women's care experiences as being either 'uncaring', 'protocolized', 'embraced' or 'ambiguous'. Moreover, these experiences were fundamentally embedded within the women's cultural context, which has to be understood as a relational process in which an emotional and moral meaning was given to the women's care expectations, interactions and interpretations of care. CONCLUSIONS: The findings reveal that the quality of intercultural care depends on the nature and quality of care interactions between ethnic minority patients and caregivers much more than on the way in which cultural questions and tensions are being handled or dealt with in a practical way. As such, the importance of establishing a meaningful care relationship should be the priority when providing intercultural care. In this, a shift in perspective on 'culture' from being an 'individual culture-in-isolation' towards an understanding of culture as being inter-relational and emerging from within these care relationships is necessary.


Assuntos
Cuidadores/normas , Assistência à Saúde/normas , Grupos Étnicos/psicologia , Hospitais/normas , Islamismo , Serviços de Saúde Materna/normas , Parto/psicologia , Bélgica , Criança , Pré-Escolar , Barreiras de Comunicação , Emigrantes e Imigrantes , Grupos Étnicos/estatística & dados numéricos , Feminino , Humanos , Lactente , Marrocos , Satisfação do Paciente , Gravidez , Pesquisa Qualitativa , Turquia
13.
PLoS One ; 15(7): e0230992, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32722725

RESUMO

BACKGROUND: Psychological aspects of labor and birth have received little attention within maternity care service planning or clinical practice. The aim of this paper is to propose a model demonstrating how neurohormonal processes, in particular oxytocinergic mechanisms, not only control the physiological aspects of labor and birth, but also contribute to the subjective psychological experiences of birth. In addition, sensory information from the uterus as well as the external environment might influence these neurohormonal processes thereby influencing the progress of labor and the experience of birth. METHODOLOGY: In this new model of childbirth, we integrated the findings from two previous systematic reviews, one on maternal plasma levels of oxytocin during physiological childbirth and one meta-synthesis of women´s subjective experiences of physiological childbirth. FINDINGS: The neurobiological processes induced by the release of endogenous oxytocin during birth influence maternal behaviour and feelings in connection with birth in order to facilitate birth. The psychological experiences during birth may promote an optimal transition to motherhood. The spontaneous altered state of consciousness, that some women experience, may well be a hallmark of physiological childbirth in humans. The data also highlights the crucial role of one-to-one support during labor and birth. The physiological importance of social support to reduce labor stress and pain necessitates a reconsideration of many aspects of modern maternity care. CONCLUSION: By listening to women's experiences and by observing women during childbirth, factors that contribute to an optimized process of labor, such as the mothers' wellbeing and feelings of safety, may be identified. These observations support the integrative role of endogenous oxytocin in coordinating the neuroendocrine, psychological and physiological aspects of labor and birth, including oxytocin mediated. decrease of pain, fear and stress, support the need for midwifery one-to-one support in labour as well as the need for maternity care that optimizes the function of these neuroendocrine processes even when birth interventions are used. Women and their partners would benefit from understanding the crucial role that endogenous oxytocin plays in the psychological and neuroendocrinological process of labor.


Assuntos
Trabalho de Parto/fisiologia , Trabalho de Parto/psicologia , Ocitocina/sangue , Parto/fisiologia , Parto/psicologia , Feminino , Humanos , Comportamento Materno , Serviços de Saúde Materna , Tocologia , Modelos Biológicos , Período Pós-Parto/fisiologia , Período Pós-Parto/psicologia , Gravidez , Apoio Social , Estresse Fisiológico
15.
Complement Ther Clin Pract ; 39: 101099, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32379641

RESUMO

BACKGROUND AND PURPOSE: Considering that pregnancy triggers profound transformations in the life experience of women, among them the need to adapt to a body in a constant process of physiological, psychic, social and emotional change, it is important to identify to what extent yoga can contribute to this process. For this reason, the present study aimed to comprehend the meanings and perceptions of women regarding the practice of yoga during pregnancy. MATERIALS AND METHODS: A qualitative and descriptive study was carried out with nine women at different gestational ages who were practicing yoga in places with alternative and integrative therapies for pregnant women located in São Paulo, Brazil. Data collection was performed through semi-structured interviews and the women's statements were transcribed, analysed and grouped into three thematic categories. RESULTS: The analysis of the interviews allowed the identification of three categories 'Benefits of practicing yoga', 'Self-knowledge, autonomy and self-care' and 'Empowerment for the moment of the birth'. These findings allowed us to understand how the women perceived the practice of yoga in the pregnancy and considered it fundamental to the recognition that they were competent and skilled to manage and control their bodies during childbirth. CONCLUSION: It was concluded that the practice of yoga provided physical and psychosocial benefits for the women of this study, including strengthening of the pelvic floor, pain relief, improvement of breathing, reduction of stress and anxiety, and strengthening of self-confidence, self-esteem and autonomy in the management of the pregnancy and in caring for themselves.


Assuntos
Atitude , Gestantes , Autocuidado , Ioga , Adulto , Ansiedade/prevenção & controle , Brasil , Feminino , Humanos , Manejo da Dor , Parto/psicologia , Pelve , Gravidez , Gestantes/psicologia , Pesquisa Qualitativa , Respiração , Autoeficácia , Inquéritos e Questionários , Ioga/psicologia , Adulto Jovem
18.
BMC Psychol ; 8(1): 41, 2020 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-32345375

RESUMO

BACKGROUND: Maternal mental well-being and social circumstances during pregnancy and early childhood impact the child's well-being and development. Supportive and sensitive parenting is one of the strongest predictors of positive emotional, social and behavioral outcomes for the child. Knowledge is needed about how to detect and support vulnerable families already during pregnancy and in the postnatal period. The aim of this study is to assemble and evaluate an interdisciplinary cross-sectoral intervention to promote maternal sensitivity among women with psychological or social vulnerabilities. METHODS/DESIGN: This randomized controlled trial tests the efficacy of an intervention program in the perinatal period compared to care as usual in enhancing maternal sensitivity in a group of psychologically or socially vulnerable women in the Capital Region of Denmark. The intervention consists of four components: 1) detecting symptoms of mental illness in vulnerable pregnant women and initiating treatment if indicated, 2) strengthening parenting skills using the Circle of Security Parenting program, 3) supporting breastfeeding, and 4) sharing knowledge and organizing treatment pathways for families across sectors. Seventy-six families will be randomly assigned to the intervention or care-as-usual. Data will be obtained at study inclusion at 3-5 months of pregnancy, eight weeks after childbirth, and nine months after childbirth. The primary outcome is maternal sensitivity. Secondary outcomes include infant's socio-emotional development, parents' mentalization, parental stress, depressive symptoms, and parental wellbeing. Qualitative data will provide insight into the implementation process. DISCUSSION: This paper presents the rational and background for developing the intervention. Furthermore, the design and protocol of the randomized controlled trial. It is hypothesized that the intervention will be associated with positive changes in primary and secondary outcomes. If effective, the intervention will provide insights into prenatal risk profiles among an identified group of psychosocial vulnerable women important for early screening and point to effective preventive interventions that can support women in the perinatal period, increase maternal sensitivity and promote positive child development -starting before the child is born. TRIAL REGISTRATION: ClinicalTrials.gov: ID: NCT03190707. Registered June 16, 2017.


Assuntos
Serviços de Saúde Materna , Poder Familiar/psicologia , Complicações na Gravidez/psicologia , Adulto , Aleitamento Materno/psicologia , Desenvolvimento Infantil , Dinamarca , Emoções , Feminino , Humanos , Lactente , Parto/psicologia , Assistência Perinatal , Gravidez
19.
PLoS One ; 15(4): e0231557, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32287303

RESUMO

BACKGROUND: Information on repeat adolescent birth remains scarce in sub-Sahara Africa. We investigated the prevalence and time trends in repeat adolescent birth in Uganda, and associated factors. METHODS: We analyzed Uganda Demographic and Health Survey data of women age 20-24 years collected on 6 surveys (1988/89-2016) to estimate repeat adolescent birth (first live birth <18 years of age followed by another live birth(s) <20 years). Further, we estimated the wantedness of the second order birth and the prevalence of short birth intervals birth (<13 months) between the first and second such birth. On the 2016 survey, we examined factors associated with repeat adolescent birth using bivariate and multivariate modified Poisson regression. RESULTS: At the 1988/89 survey, 58.9% of women with first birth <18 years reported a repeat adolescent birth. This percentage increased to 66.8% in 2006 (+7.9 percentage points [pp], p = 0.010) and thereafter declined to 55.6% by 2016 (-11.2 pp, p<0.001), nevertheless, no change occurred between 1988/89 and 2016 (-3.3pp, p = 0.251). Among women with repeat adolescent births, the mean number of live births by exact age 20 years (2.2 births) and prevalence of short birth intervals (3.5% in 1988/89, 5.4% in 2016) (+1.9pp, p = 0.245) did not change. Increasingly more women with repeat adolescent births preferred to have had the second child later, 22.5% in 1995 and 43.1% in 2016 (+20.6pp, p = <0.001). On the 2016 survey, women from poorer households and those of younger age at first birth were significantly more likely to report repeat adolescent birth. CONCLUSION: Following a first birth <18 years, more than half of the women report a repeat adolescent birth (<20 years), with no decline observed in 30 years. Increasingly more women wanted the second adolescent pregnancy later, highlighting the need to support adolescents with improved family planning services at each contact.


Assuntos
Paridade , Gravidez na Adolescência/estatística & dados numéricos , Adolescente , Adulto , Ordem de Nascimento/psicologia , Coeficiente de Natalidade/tendências , Serviços de Planejamento Familiar/tendências , Feminino , Inquéritos Epidemiológicos , Humanos , Idade Materna , Parto/psicologia , Gravidez , Uganda/epidemiologia , Adulto Jovem
20.
PLoS One ; 15(4): e0230407, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32240176

RESUMO

BACKGROUND: Choosing where to give birth can be a matter of life and death for both mother and child. Migrants, registered or unregistered, may face different choices and challenges than non-migrants. Despite this, previous research on the factors migrant women consider when deciding where to give birth is very limited. This paper addresses this gap by examining women's decision making in a respective border and urban locale in Thailand. METHODS: We held focus group discussions [13] with 72 non-Thai pregnant migrant women at non-government clinics in a rural border area and at two hospitals in Chiang Mai, a large city in Northern Thailand in 2018. We asked women where they will go to give birth and to explain the factors that influenced their decision. RESULTS: Women identified getting the relevant documentation necessary to register their child's birth, safe birth and medical advice/quality care, as the top three factors that influenced their care seeking decision making. Language of service, free or low cost care, language of services, proximity to home, and limited alternate options for care were also identified as important considerations. CONCLUSION: Understanding factors that migrant women value when choosing where to deliver can help health care providers to create services that are responsive to migrants' preferences and encourage provision of relevant information which may influence patient decision making. The desire to obtain birth documentation for their child appears to be important for migrants who understand the importance of personal documentation for the lives of their children. Healthcare institutions may wish to introduce processes to facilitate obtaining documentation for pregnant migrant women and their newborns.


Assuntos
Comportamento de Escolha , Tomada de Decisões , Acesso aos Serviços de Saúde , Parto/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Gestantes/psicologia , Migrantes/psicologia , Feminino , Humanos , Pesquisa Qualitativa , Tailândia
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