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Predictors of traumatic birth experience among a group of Iranian primipara women: a cross sectional study.

ABSTRACT: BACKGROUND:Traumatic birth experience has undesirable effects on the life of the mother, child, family, and society. The identification of predictive factors can be useful in improving birth experiences among women. This study aimed to assess the prevalence of a traumatic birth experience and identify its predictors among a group primiparous women. METHODS:A cross-sectional study was conducted among 64 health centres in Tabriz, the second largest city in Iran. Cluster sampling was used to recruit 800 eligible women at one to 4 months postpartum. The Persian version of the Childbirth Experience Questionnaire was used to measure the womens' birth experiences. Data were collected through face to face interviews and analysed mainly by multivariable logistic regression. RESULTS:The prevalence of traumatic birth experience was 37% in the study group. The independent predictors of the traumatic birth experience were related to antenatal and intrapartum factors. The antenatal predictor was the lack of exercise during pregnancy (OR?=?2.81, CI 1.40-5.63, P?=?.003) and the intrapartum predictors were the absence of pain relief during labour and birth (OR?=?4.24, CI 2.12-8.50, P?

SUBMITTER: Ghanbari-Homayi S

PROVIDER: S-EPMC6532129 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Predictors of traumatic birth experience among a group of Iranian primipara women: a cross sectional study.

Ghanbari-Homayi Solmaz S Fardiazar Zahra Z Meedya Shahla S Mohammad-Alizadeh-Charandabi Sakineh S Asghari-Jafarabadi Mohammad M Mohammadi Eesa E Mirghafourvand Mojgan M

BMC pregnancy and childbirth 20190522 1

<h4>Background</h4>Traumatic birth experience has undesirable effects on the life of the mother, child, family, and society. The identification of predictive factors can be useful in improving birth experiences among women. This study aimed to assess the prevalence of a traumatic birth experience and identify its predictors among a group primiparous women.<h4>Methods</h4>A cross-sectional study was conducted among 64 health centres in Tabriz, the second largest city in Iran. Cluster sampling was ...[more]

PMID: 31117987

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Project description:BackgroundFear of childbirth (FOC) may contribute to postpartum depression, impaired maternal-infant relation, and preference for cesarean in future pregnancies. We aimed to investigate predictors of FOC and normal vaginal birth among postpartum women who had planned for a normal vaginal birth.MethodsThis cross-sectional study was conducted in 2019 with postpartum women during the first 24 h after the birth. A sample of 662 women, selected using a convenient sampling method, filled out the questionnaire composed of socio-demographic and obstetric questions and the Wijma Delivery-Expectancy Questionnaire (W-DEQ). We used multiple logistic regression analyses to determine predictors of FOC and normal vaginal birth.ResultsThe percentage of women with mild (score ≤ 37), moderate (38-65), high (66-84), severe (85-99), and intense FOC (score ≥ 100) were 7.9, 19.5, 40.9, 21.1, and 10.6% respectively. Predictors of intense FOC were age < 30, primiparity, low maternal satisfaction with pregnancy, and a low level of perceived marital satisfaction. Overall, 21.8% of women gave birth by cesarean. Predictors of normal vaginal birth were birth weight < 4 kg, spontaneous onset of labor pain, mother's age < 30, term pregnancy, having a doula, multiparity, satisfaction with husband's support, and overall satisfaction with pregnancy. A high level of perceived marital/sexual satisfaction was a risk factor for cesarean. Mode of birth was not a predictor of postpartum FOC.ConclusionsThe rate of severe and intense FOC among this group of postpartum women is high. Our findings highlight modifiable factors for reducing FOC and increasing normal vaginal birth. In designing programs to increase the rate of normal vaginal birth, the following factors should be considered: limiting induced labor, encouraging women to recruit a doula to help them at labor, facilitate husband's attendance throughout antenatal/intrapartum, and postnatal care to support his wife, and pay attention to women's common misunderstandings about the effect of vaginal birth on marital/sexual relationship. Our findings indicate that seeking novel ways to promote marital/sexual satisfaction and helping women to have a smooth, hassle-free pregnancy may contribute to a reduction in the rate of the FOC.

Project description:Recent studies suggest that birth mode (Cesarean section [C-section] or vaginal delivery) is an important event in the initial colonization of the human microbiome and may be associated with long-term health outcomes. We sought to determine the association between a woman's birth mode and her vaginal microbiota in adulthood. We re-contacted 144 adult women from two U.S. studies and administered a brief survey. Vaginal microbiota was characterized on a single sample by amplicon sequencing of the V3-V4 hypervariable regions of the 16S rRNA gene and clustered into community state types (CSTs). We evaluated the association between birth mode and a CST with low relative abundance of Lactobacillus spp. ("molecular bacterial vaginosis" [Molecular-BV]) compared to Lactobacillus-dominated CSTs in logistic regression modeling which adjusted for body mass index, a confounder in this analysis. Twenty-seven women (19%) reported C-section. Overall, C-section showed a non-significant trend towards increased odds of Molecular-BV (aOR = 1.22, 95% CI: 0.45, 3.32), and Prevotella bivia was the strongest single taxa associated with C-section. However, because the two archived studies had different inclusion criteria (interaction p = 0.048), we stratified the analysis by study site. In the study with a larger sample size (n = 88), women born by C-section had 3-fold higher odds of Molecular-BV compared to vaginally-delivered women (aOR = 3.55, p = 0.06, 95% CI: 0.97-13.02). No association was found in the smaller study (n = 56, aOR = 0.19, p = 0.14, 95% CI: 0.02-1.71). This pilot cross-sectional study suggests a possible association between C-section and Molecular-BV in adulthood. However, the analysis is limited by small sample size and lack of comparability in participant age and other characteristics between the study sites. Future longitudinal studies could recruit larger samples of women, address the temporal dynamics of vaginal microbiota, and explore other confounders, including maternal factors, breastfeeding history, and socioeconomic status, which may affect the relationship between birth mode and vaginal microbiota.

Project description:IntroductionBirth spacing is a critical pathway to improving reproductive health. WHO recommends a minimum of 33-month interval between two consecutive births to reduce maternal, perinatal, infant morbidity and mortality. Our study evaluated factors associated with short birth intervals (SBIs) of less than 33 months between two consecutive births, in Karachi, Pakistan.MethodsWe used data from a cross-sectional study among married women of reproductive age (MWRA) who had at least one live birth in the 6 years preceding the survey (N=2394). Information regarding their sociodemographic characteristics, reproductive history, fertility preferences, family planning history and a 6-year reproductive calendar were collected. To identify factors associated with SBIs, we fitted simple and multiple Cox proportional hazards models and computed HRs with their 95% CIs.ResultsThe median birth interval was 25 months (IQR: 14-39 months), with 22.9% (833) of births occurring within 33 months of the index birth. Women's increasing age (25-30 years (aHR 0.63 (0.53 to 0.75), 30+ years (aHR 0.29, 95% CI 0.22 to 0.39) compared with 20-24 years; secondary education (aHR 0.75, 95% CI 0.63 to 0.88), intermediate education (aHR 0.62, 95% CI 0.48 to 0.80), higher education (aHR 0.69, 95% CI 0.51 to 0.92) compared with no education, and a male child of the index birth (aHR 0.81, 95% CI 0.70 to 0.94) reduced the likelihood of SBIs. Women's younger age <20 years (aHR 1.24, 95% CI 1.05 to 1.24) compared with 20-24 years, and those who did not use contraception within 9 months of the index birth had a higher likelihood for SBIs for succeeding birth compared with those who used contraception (aHR 2.23, 95% CI 1.93 to 2.58).ConclusionStudy shows that birth intervals in the study population are lower than the national average. To optimise birth intervals, programmes should target child spacing strategies and counsel MWRA on the benefits of optimal birth spacing, family planning services and contraceptive utilisation.

Project description:BACKGROUND:Psychological birth trauma (PBT), mainly due to overlooking maternal mental health, is a common and high prevalence public health problem in low-resource settings. Preventing PBT is a good indicator of the realization of human rights in healthcare. This work reports the results of a qualitative study that aimed to identify perceived strategies of PBT prevention among childbearing women in Iran. METHODS:We conducted semi-structured in-depth interviews with 22 mothers with history of traumatic childbirth, two mothers with positive childbirth experience, two spouses, and eight health professionals between April and June 2017. We used purposive sampling method to recruit traumatized mothers, while health experts were selected based on their relevant expertise and experience. Our initial literature review identified eight categories, using which we developed our interview guide and conducted the content analysis approach. RESULTS:With the maximum possible purification, we reached 50 thematic codes. The strategies to prevent PBT are generally summarized in four major themes and 13 categories: 1) skill-builder knowledge [Birth preparedness, Mothers' empowerment in maintaining mental health, Understanding the importance of mental care in maternity services], 2) responsible caregiving [Support loop, Good behavior of the caregivers, Deepening trust, Struggle with medicalization of childbirth, Labour pain relief, Special services for maternal mental health], 3) the alliance of prenatal and antenatal care [Continuity of care, Coordination of prenatal and antenatal caregivers], and 4) reconstruction of the structures [Efficient management, Rebuilding physical structures]. CONCLUSIONS:This is a comprehensive approach towards PBT prevention, which can guide future efforts to reduce PBT at the clinical level and open further avenues for future studies. We recommend policy makers to consider the integration of multilevel and multidimensional PBT prevention interventions, simultaneously within maternity care services packages for promotion of mental health.

Project description:BackgroundThe significant role of midwives in providing labor and delivery care underscores the necessity of the identification of attitudes and beliefs of these groups of maternity care providers toward physiological childbirth. The purpose of the current study was to describe midwives' attitudes and beliefs toward physiological childbirth and identify its related factors.MethodsThis cross-sectional study was carried out on 200 midwives working in the labor and delivery wards of selected hospitals in an urban area of Tehran, Iran, through the continuous sampling method from May to July 2018. The data were collected using a two-part demographic characteristic form and Midwives' Attitudes and Beliefs Questionnaire-Revised toward physiological childbirth. Data analysis was performed in SPSS software (version 25). The significance level was set at P?<?0.05.ResultsThe mean score of midwives' attitudes and beliefs toward physiological childbirth were 119.90 with a standard deviation of 9.30. Moreover, of the different domains of Midwives' Attitudes and Beliefs Questionnaire-Revised, the women's experience of birth (78.53) and the medical model conflict (51.05) obtained the highest and lowest scores, respectively. According to the multiple linear regression model analysis, the total mean score of midwives' attitudes and beliefs toward physiological childbirth was significantly correlated with the level of education and interest in the profession (P?<?0.05). Midwives with a master degree obtained higher scores (4.32) in terms of attitudes and beliefs toward physiologic childbirth, compared to those with an associate or bachelor degree. Also, there were 0.09 increases in the attitude and belief score of midwives per one score increase in their interest in the profession. It can be concluded that these two variables explained 16% of the variation in the scores of midwives' attitudes and beliefs to physiological childbirth.ConclusionThe results of this study showed that midwives with higher levels of education and more interest in their profession had more positive attitudes and beliefs toward physiological childbirth. Therefore, it is necessary to motivate midwives to obtain higher levels of education and increase their interest in the profession to promote physiological childbirth.

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Predictors of traumatic birth experience among a group of Iranian primipara women: a cross sectional study.

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Predictors of traumatic birth experience among a group of Iranian primipara women: a cross sectional study.

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