Journal of Midwifery & Reproductive health
Volume:6 Issue: 1, Jan 2018

Population control has remained an issue of concern to many developing nations. Many women have unmet needs for contraception. Despite the available options for abortion, unwanted pregnancies account for a high maternal mortality rate. Regarding this, the present study aimed to investigate the choices, satisfaction, and compliance with contraceptive use among the women living in Ibadan, Nigeria.
This cross-sectional study was conducted on 290 women attending the pediatric welfare clinics in four hospitals in 2015. The study population was selected through purposive sampling technique. The data were collected using a self-administered questionnaire. The data were analyzed using descriptive statistics and Chi-square test through SPPS, version 16.
According to the results, 95% of the participants were aware of the contraceptive methods, and 72.1% of them had used these methods. Partner’s refusal was the major reason for non-use of contraceptives. The birth control methods, which were commonly utilized, were natural family planning (36.5%) and oral contraceptives (30.8%). Furthermore, up to 60% of the subjects were satisfied with the method they used, and 70% of them adhered to the chosen methods. Additionally, compliance with contraceptive methods had a significant association with partners’ approval (P=0.038) and satisfaction with contraceptive methods (P=0.04).
As the findings of the present study revealed, partners’ approval of contraceptives had a significant role in the use of the birth control methods. Furthermore, some women were not satisfied with the methods they used. Regarding the findings of the study, the partners should be involved and well informed about contraceptives in order to enhance their use of contraceptives. Moreover, the women should be provided with appropriate information to be able to make an informed decision for choosing the suitable contraceptive methods.

Childbirth is a stressful event in women’s lives, and if a mother perceives it as an unpleasant event, it can influence her postpartum mental health. Depression is a common mental disorder, which can has serious consequences depending on its severity. Therefore, this study aimed to investigate the effect of debriefing and brief cognitive-behavioral therapy on postpartum depression in traumatic childbirth.
This clinical trial was performed on 179 mothers who experienced a traumatic childbirth and were admitted in postnatal ward of Nohom Dey Hospital in Torbat-e Heydarieh, North East of Iran in 2016. The subjects were randomly allocated into three groups, including two intervention groups of debriefing and brief cognitive-behavioral counseling and a control group. The intervention groups received appropriate counseling for 40-60 minutes in the first 48 postpartum hours and the control group received the routine postpartum care. Edinburgh Postnatal Depression Scale was used to evaluate postpartum depression 4-6 weeks and also three months after the intervention. Post-traumatic stress symptoms in were compared in three groups using t-test, chi-square test, and repeated measures analysis of variance.
No significant differences were observed between the mean depression scores of the two intervention groups and that of the control group 4-6 weeks after childbirth. However, three months after delivery, the mean depression scores of the two intervention groups was lower than the control group (P Both methods of debriefing and brief cognitive-behavioral therapy could significantly reduce mean postpartum depression score in high-risk mothers. Thus, these methods could be employed for early identification of depression, which in turn, lowers the rate of postpartum depression.

Marital satisfaction during pregnancy is one of the factors affecting marital affectional bond. This study was performed to evaluate the effect of paternal-fetal attachment training on marital satisfaction during pregnancy.
This clinical trial was conducted on 60 couples referring to two health centers of Mashhad, Iran, in 2015. The couples were randomly divided into intervention and control groups (n=30 couples in each group). The fathers in the intervention group participated in three 120-minute sessions of paternal-fetal attachment training and the mothers in both groups (intervention and control) received the routine prenatal care. Both groups were evaluated using Marital Satisfaction questionnaire of Nathan H Azarin before and three weeks after the intervention. To analyze the data, descriptive statistics, t-test, Chi-square test, Wilcoxon, Mann-Whitney U test, and analysis of covariance were performed using SPSS, version 22.
The mean score of marital satisfaction in men was significantly higher in the intervention group than the control group (P=0.003). The mean score of women's marital satisfaction in the intervention group increased after training from 62.63±2.58 to 66.50±2.43. However, there was no significant difference between two groups in terms of women’s mean score of marital satisfaction (P=0.083).
Paternal-fetal attachment training promoted marital satisfaction in men during pregnancy, so it is suggested to hold training programs for couples during pregnancy to enhance their marital satisfaction.

Care provision is one of the most important factors in preventing and reducing mortality among pregnant mothers. Despite availability, the uptake of health services in health centers is undesirable. This study aimed to investigate the factors influencing the behavior of pregnant women towards using prenatal care services based on health belief model in healthcare centers of Tuyserkan, Hamadan Province, Iran.
In this descriptive, analytical, cross-sectional study, 165 mothers visiting the health care centers of Tuyserkan, Hamadan Province, Iran, 1-15 days postpartum were chosen using the convenient sampling method during 2015. A self-structured questionnaire comprising items on demographics, knowledge, and health belief model constructs was employed for data collection. The data were analyzed using Pearson correlation coefficient, independent t-test, and logistic regression.
The study revealed that 72.1% of the pregnant women had regular visits, while 27.9% had irregular visits. Logistic regression reflected that knowledge (OR=0.929) and self-efficacy (OR= 0.976) were effective variables on regular prenatal visits.
Considering pregnant women's physiological and anatomical conditions, prenatal care and regular visits are essential; thus, effective interventions in this area should be planned and implemented.

Pain is the most common complaint of mothers after episiotomy. Various medications are used for the alleviation of this pain. The aim of this study was to evaluate the effect of alpha ointment on the relief of pain caused by episiotomy.
This double-blind clinical trial was conducted on 70 primiparous women in Ommolbanin Hospital in Mashhad, Iran. The participants were divided into two groups of control and intervention. The intervention group received one fingertip unit of Alpha ointment following washing the wound with normal saline and drying, 48 hour after delivery, once a day, until the tenth day. The control group received a placebo in the same manner. Pain intensity was evaluated using the shortened from of McGill Pain Questionnaire on the first, fifth, and tenth days post-delivery. Data analysis was carried out in SPSS (version 16) using the Mann-Whitney U test, t-test, Chi-square test, and Fisher's exact test.
There was no statistically significant difference between the two groups in terms of the mean pain score on the first, fifth, and tenth days of the study (P=0.73, P=0.098, and P=0.464, respectively).
As the finding of the present study showed, Alpha ointment had no effect on the perineal pain after episiotomy.

Maternal health literacy is defined as the cognitive and social skills determining the ability to get access to, understand, and use information to promote mothers’ health and that of their children. This study aimed to investigate maternal health literacy in pregnant women referred to the healthcare centers of Mashhad, Iran.
This cross-sectional study was conducted on 185 randomly selected pregnant women referred to the healthcare centers of Mashhad, Iran, in 2015. Data were collected using demographic and maternal health literacy questionnaire. Data analysis was performed using one-way analysis of variance (ANOVA), independent t-test, and Pearson's correlation coefficient test in SPSS, version 16.0.
The mean score of maternal health literacy was 42.7±5.6 (out of 56). There was a significant relationship between maternal health literacy score and women’s educational level (P The mean score of maternal health literacy is not desirable in Iran. Regarding the significant relationship between the score of maternal health literacy and women’s and their spouses’ educational level and family income, it is essential to promote maternal health literacy, especially in low-income and lower-educated population.

Emotional intelligence (EQ) is one of the factors influencing post-abortion grief and bereavement. This study aimed to determine the relationship between the level of EQ and post-abortion grief and bereavement in women referred to the hospitals affiliated to Mashhad University of Medical Sciences.
This correlational study was conducted on 60 women with spontaneous abortion admitted in Department of Obstetrics and Gynecology of Imam Reza, Ghaem, and Omolbanin hospitals, Mashhad, Iran in 2016. The subjects were selected through convenience sampling and data were collected using a self-structured questionnaire, Bar-On model of socio-emotional intelligence, grief intensity scale, and perinatal Grief and Bereavement Scale. Data analysis was performed using descriptive statistics, simple linear regression, and Pearson correlation coefficient in SPSS software version 11.5.
The subjects’ mean age was 28.6±5.7 years old and 73.3% (n=44) of them were housewives. The mean scores of post-abortion grief, bereavement, and EQ were 126.5±26.7, 42.7±9.4, and 188.4±17.9, respectively. According to the results of linear regression analysis, the EQ adversely and significantly predicts the post-abortion grief (P=0.001, β=-43.22) and bereavement (P Considering the effect of EQ on post-abortion grief and bereavement, it is recommended to provide an educational program to promote the level of EQ in women.

Midwives, as a part of the healthcare team, have a remarkable role in providing health to families and societies. Midwives have a prominent role in the family physician program (FPP); therefore, the lack of proper attention to their challenges results in a decline in their efficiency and quality of care. Therefore, this study was performed to explore the midwives’ perceptions and experiences about the challenges of working in the FPP.
This qualitative study was conducted on 23 midwives recruited in the healthcare centers of Mashhad, Iran, in 2015. The study population was selected using the purposive sampling technique. Data collection was performed through semi-structured in-depth interviews. The interviews were transcribed verbatim and analyzed using conventional content analysis approach. The trustworthiness of the research findings was checked by the criteria recommended by Lincoln and Guba (1985).
The analysis of the data led to the identification of two themes including 1) professional struggles and 2) internal reflections, each of which was further divided into several categories. Professional struggles included categories of professional autonomy, professional role ambiguity and professional commitment. Two categories of internal challenges and internal satisfaction were subsumed under the main theme of internal reflections.
Listening to the voices of midwives working in family physician program could provide valuable messages for policy makers to recognize the challenges of midwives in the FPP and to find the best solutions for their organizational problems and consequently enhance their efficiency in fulfillment of organizational goals.

Maternal mortality is defined as the death during pregnancy or up to 42 days postpartum. This study sought to determine the trend of maternal mortality ratio (MMR) and its associated factors in Khorasan Razavi province, Iran.
This retrospective cross-sectional study was conducted in Khorasan Razavi Province, North East of Iran, during 2010 to 2014. Data was collected from the reports of Maternal Mortality Committee of Mashhad University of Medical Sciences, Mashhad, Iran. The MMR was calculated for each period, and its trend was estimated. Chi-square test was used to find the relationship between mode of delivery and direct or indirect causes of maternal death.
According to the results, 94 maternal deaths occurred during 2010 to 2014. The total MMR was 17.68 (95%CI: 13.59-21.77) per 100,000 live births. The mean maternal age was 30.7±6.1 years old. Most of the deaths (75.6%) occurred during postpartum period, from which 81% happened following a high-risk pregnancy. In addition, 50% of the mothers had proper numbers of visits during pregnancy. The most direct and indirect causes of maternal death were maternal hemorrhage (24.5%) and cardiovascular diseases (12.8%), respectively. The relative risk of maternal mortality associated with cesarean section was 1.3 in comparison to normal vaginal delivery.
The estimation of MMR is essential for decision-making and resource allocation. To reach this goal, a good registration system is needed to register all deaths and their exact causes.

Job satisfaction is one of the important factors enhancing organizational efficiency and employee's performance. This study aimed to evaluate job satisfaction among midwives working in hospitals.
This cross-sectional study included all midwives (N=100) working in hospitals affiliated to Abadan School of Medical Sciences, Abadan, Iran in 2016. To obtain data, we used a demographic as well as Herzberg's Job Satisfaction Questionnaire with α=0.96 in Iran. To analyze the data, independent t-test, Chi-square test, and Pearson correlation coefficient were run in SPSS, version 22.
The mean age and work experience of the subjects were 35.37±7.3 and 11.23±7.8 years, respectively. The mean job satisfaction score of the midwives was 302.41±19. The results showed that the subjects had moderate job satisfaction in the eight domains of occupational nature and position (48%), job security (46%), salary and benefits (61%), occupational and environmental conditions (90%), relationship with colleagues (87%), supervision (91%), management policy-making (80%), and personal relationships (85%). There was a significant correlation between work experience and job satisfaction, while there was no significant relationship between job satisfaction and other demographic variables.
Considering the moderate level of job satisfaction among the midwives working in the hospitals affiliated to Abadan School of Medical Sciences, authorities should take effective steps to address job dissatisfaction by promoting occupational security, creating professional standards, and using midwives’ capabilities in building appropriate relationships with colleagues.

Maternal-fetal attachment has an important effect on mother's identity as well as maternal and fetal health. Moreover, this concept is considered as a crucial issue for the improvement of children emotional development. Regarding the Islamic recommendations on maternal-fetal attachment and its correlation with maternal affection, this study was conducted to review the importance of maternal-fetal attachment according to the Islamic recommendations.
This review was conducted on the religious texts, which covered the subject of interest and were published within 2000-2017. Various databases including Medline, PubMed, Google, IranMedex, SID, and Magiran as well as the websites of Muslim authorities (i.e., the section responding to religious questions) were searched. The searching was carried out using keywords as: “Islamic religious teachings”, “pregnant women and Fatwa of the Islamic jurists”, and “aspects of maternal fetal attachment in Islam”.
According to the results of the reviewed texts, the mutual readiness of mother and fetus leads to the improvement of their affection. The maternal factors affecting the maternal-neonatal attachment included personality traits, marriage, selection of partner, post-marriage issues, pregnancy, as well as physical and psychological characteristics. There were also some effective factors on the newborn’s innate readiness for the development of attachment, such as fetal appearance, family and social support, maternal nutrition during pregnancy, and neonatal mood.
According to the Holy Quran versus and hadiths, maternal-fetal attachment and its promotion are affected by both maternal and fetal factors. Moreover, following the factors affecting attachment will lead to their role functioning. Therefore, it is intensively recommended to incorporate a glance of Islamic instruction into the pregnancy education to improve the maternal-fetal attachment.