Journal of Midwifery & Reproductive health
Volume:8 Issue: 4, Oct 2020

Forensic midwifery is a new major which has been established in response to the need of endangered women for forensic services and also the lack of service provision in this domain. However, there are ambiguities in the definition of this major and its scope of practice. The present study was conducted to investigate the scope of practice in forensic midwifery.

In this integrative review, the articles related to the subject of interest were searched in several database including PubMed, Scopus, CINHAL and Google Scholar. All kinds of publications including reviews and standards, qualitative, quantitative, or mixed methods studies were included in the review regardless of the publication date. The data related to the scope of practice in forensic midwifery were extracted using a wide and in-depth analysis, in addition to using an expert panel for validation. To do the analysis, every concept representing scope of practice was coded and similar codes were classified into themes.

The search process resulted in retrieval of 43 articles. Based on the reviewed papers, the scope of practice in forensic midwifery divided into four categories including the practices related to reproductive issues, violence, malpractice in obstetrics and gynecology profession, and the improvement of the professionalism in midwifery domain.

Considering the potentials of forensic midwifery, the graduates of this major could have an important role in the protection of women’s rights in forensic situations.

Due to the development of major complications after cesarean section (C-section), surgical site infection and delayed wound healing was of great concern to gynecologists since a long time ago. It is especially the case for mothers susceptible to post-cesarean wound infection who need special care. The present study therefore aimed to investigate the effect of Recove ointment on wound healing in women susceptible to C-section wound infection.

In this triple-blind randomized clinical trial, which was conducted on the women who underwent C-section in Ommolbanin Hospital, Mashhad, in 2019, using a two-group design, a number of 80  eligible women with C-section were assigned into intervention and placebo groups. Intervention group received Recove ointment for a maximum of 10 days. The wound recovery was assessed using Reeda scale before intervention and 3, 5, and 10 days after C-section. Data were analyzed using T test and Mann-Whitey, Chi-square as well as Fisher's exact test.

The score of wound healing was significantly different in intervention and control group 5 days after cesarean section (P=0.008). But no significant difference was seen between two groups on days 3 and 10 post cesarean (P=0.69). Also there was significant difference between wound healing score before and after intervention in both intervention (P=0.001) and placebo groups (P=0.001).

Although the effectiveness of the ingredients of Recove ointment was indicated in several studies, this ointment was revealed to be effective for wounds healing just 5 days after cesarean section. Further research with larger sample size is required to investigate the effect of this ointment.

Women experience many physical and emotional changes during pregnancy. Simultaneously, they experience dramatic alterations in their family structure and function including changes in the spousal role of couple. Due to the scarcity of studies in this regard, the present study aimed to provide an account of women's experiences of spousal role during pregnancy.

In this ethnophenomenological exploration, 25 pregnant women referred to health centers, prenatal clinics of hospitals, and private offices of obstetricians, were included in the study. Participants were selected using purposive sampling with a maximum variation strategy between October 2016 and March 2017. Data were collected using semi-structured in-depth individual interviews, vignette interviews, and participant observations. The data were analyzed adopting Van Manen's descriptive-interpretive phenomenological approach (1997) using MAXQDA software (version 10).

The main theme of "attempt to preserve spousal role" was emerged. This theme was derived from four themes of "mother's effort to manage marital issues", "couples' interactions", "husband physical and mental care of wife" and "mother's conflicts with the rights and duties attached to the spousal role".

Pregnant women consider the spousal role to be one of their main duties and regarded it as their central responsibility. Therefore, they meticulously play their spousal role to provide constructive interactions with their spouses. The inclusion of gender-sensitive programs and services, including providing prenatal care, is of utmost importance to pregnant women in order to meet their needs to play their spousal role, appropriately.

Exclusive breastfeeding (EBF) is an essential need for the development and survival of the neonates, particularly in low-income countries. Therefore, the purpose of this survey was to determine the prevalence of EBF practice and its associated factors among mothers with children of 6-23 months in Dire Dawa Administration, eastern Ethiopia.

This community-based cross-sectional survey was conducted on 704 participants in 15 kebeles in the Dire Dawa Administration using multistage sampling in 2018. The data were collected using a pretested interviewer-administered questionnaire. Binary logistic regression was used to identify the factors associated with EBF.

The magnitude of EBF practice was 81.1% (95% CI: 78.0-83.8). In the multivariate logistic analysis, the odds of EBF practice were significantly higher among unemployed mothers (AOR: 1.93; 95% CI: 1.17-3.20), antenatal care (ANC) users (AOR: 1.69; 95% CI: 1.05-2.72), as well as the young mothers within the age ranges of 15-25 (AOR: 4.41; 95% CI: 1.90-10.20) and 26-35 (AOR: 2.16; 95% CI: 1.12-4.18) years. However, the subjects with bottle-feeding practice had lower odds (AOR: 0.55; 95% CI: 0.35-0.87), compared to those reported with EBF practice.

The magnitude of EBF practice was almost as high as the recommended level. The unemployment status, ANC visit, maternal age, and bottle-feeding practice were the factors associated with EBF. Therefore, employed mothers should be provided with a special room in their workplace to breastfeed their children, daycare facilities, and/or six-month maternity leave. Also, healthcare workers should give attention to the encouragement of mothers to receive ANC.

Despite the importance of motivation for having a child in the process of infertility treatment, there are few studies in this field. This study aimed to investigate the childbearingmotivations of infertile women and comparing the results with those of fertile women.

This descriptive cross-sectional study was conducted on 308 women, including 96 infertile women referring to Milad Infertility Center of Mashhad, Iran, in 2015 selected by convenient sampling technique and 212 fertile women of reproductive ages selected from different healthcare settings. The childbearing motivations of participants was gathered through the Childbearing Motivation Questionnaire in two groups and compared using Mann-Whitney U test, and independent t-test. Data analysis was performed applying SPSS (version 16).

The mean scores of positive childbearingmotivations (PCM) in infertile and fertile women were 99.5±9.7 and 93.61±14.05 out of 112, respectively. The mean of all subscales of PCM, with the exception of “instrumental values of children,” of infertile women were significantly higher than fertile women (p=0.000). Also, The mean scores of negative childbearingmotivations (NCM) in infertile and fertile women were 44.7±10.1 and 52.80±9.26 out of 84, respectively. The mean of all subscales of NCM scores of infertile women were significantly lower than fertile women (p=0.000).

The findings showed that infertile women had high PCM and low NCM and the experience of parenthood was very important for the infertile couples. It is suggested to offer the appropriate duration and type of treatment based on clients’ needs and their childbearing motivation in the counselling and treatment of infertile couples.

In 2016, 28% of Syrian women residing in Amman experienced at least one unplanned pregnancy, and 17% did not access antenatal care for pregnancy.  This study aimed to elucidate the imminent need for greater accessibility to comprehensive sexual and reproductive healthcare among Syrian refuges residing in Jordan.

This ethnographic case study was conducted in 2017 in order to understand the reproductive health experiences of 21 male and female Syrian refugees residing in Amman. Participants were selected based on purposive sampling. Study interviews examined the experiences of participants regarding their pregnancy outcomes, influencing factors for their reproductive decisions, and gaps in sexual and reproductive healthcare in Amman.

Participants indicated great SRH need specifically related to the education on contraceptive methods. Participants confirmed that reproductive health services in Syria were more accessible, affordable, and comprehensive compared to health services in Jordan. The greatest contributors to gaps in care for participants were financial constraints and apathy regarding refugee welfare among providers in Jordanian public facilities. All study participants placed great value on family and reproduction. The most commonly used methods of contraception among participants were the oral contraceptive pill (OCP) and coitus interruptus. Over 75% of participants began trying to conceive right after marriage.

Increases in access to comprehensive sexual and reproductive healthcare among refugees in low-resource, humanitarian settings is a healthcare priority. The findings can influence the policies affecting family planning and reproductive health mechanisms provided for migrants in Jordan in both public and private hospitals.

In a lower-middle income country, such as Ghana, maternal death still occurs even in case of providing skilled perinatal care. The impact of maternal death on the family, community, and society has been largely studied. However, its implications for midwifery practice in Ghana has not been extensively investigated. The purpose of this study was to explore the experiences of midwives whose clients died during the peripartum period and unearth the influence of their experiences on their personal lives and practices as midwife.

The present study adopted a descriptive exploratory approach. Purposive and snowball sampling were employed to recruit six midwives attending the women who died during the peripartum period. The experiences of midwives were uncovered using in-depth interviews. Data analysis was conducted using Colaizzi’s phenomenological method as a frame of reference. Rigor was maintained through member checking and prolonged engagement.

Four main themes emerged from the data, including conceptualizing maternal death, midwives initial reaction to maternal death, perceived preparedness to manage maternal death, and building resilience (blurring the memory). There was minimal institutional support for the midwives when maternal death occurred. The participants used various coping strategies to rebuild their self-confidence and professional confidence.

Midwives attending women who die during the peripartum period suffer emotionally and psychologically. The implications of these experiences in the midwifery profession are enormous. Supportive strategies should be institutionalized to achieve the complete recovery of attending midwives and provide experiential training of the entire midwifery staff.

In addition to the benefits of frozen embryo transfer (FET), the key question is whether freezing or melting embryos can cause fetal harm and prenatal complications. This study aimed to assess pregnancy and neonatal outcomes after FET and fresh embryo transfer (ET).

This retrospective cohort study investigated the pregnancy outcomes of infertile women undergoing intracytoplasmic sperm injection with FET and ET in Kowsar Infertility Center of Motahary hospital in Urmia, Iran between March 2014 and March 2016. A questionnaire was completed based on the hospital records of pregnancy or neonatal outcomes. To assess the continuation of pregnancy and delivery, the questionnaires were completed through phone call. The pregnancy and neonatal outcomes were compared between FET (n=96) and fresh ET (n=93) using Student’s t-test, Chi-square, Fisher’s exact tests and multiple logistic regression using SPSS software (version 21.0).

The rate of ongoing pregnancy were reported as 60.2% and 76% in the FET and fresh ET groups, respectively. The rate of multiple pregnancy and ongoing pregnancy were lower in FET, compared to those reported for fresh ET (OR=0.38, 95% CI: 0.18-0.79, P=0.01; OR=0.48, 95% CI: 0.25-0.85, P=0.02). The frequency of spontaneous abortion was not different between two groups (P=0.07). The FET and fresh ET increased the odds of lower neonatal weight; however, it was not statistically significant.

In this study, a lower rate of ongoing pregnancy was reported in the FET group. It seems that FET can cause damage to the embryo during freezing and melting.

Ministry of Health in Turkey has launched a mother-friendly hospital (MFH) initiative to reduce cesarean section rate, support evidence-based practices, and improve mother-baby friendly maternity care. This study aimed to investigate the views of the obstetricians and midwives using the MFH initiative and measure their job satisfaction levels.

A cross-sectional descriptive design was employed. The data were collected through a questionnaire distributed among 16 obstetricians and 61 midwives working in delivery rooms at four hospitals using the MFH initiative in Turkey. This questionnaire consisted of eight items to elicit participants’ characteristics, and another eight items were used to investigate participants’ views regarding the MFH setting. The participants' suggestions to MFH initiative, job satisfaction levels and the intention to leave were also measured.

The majority of the participants reported that the MFH initiative increase the quality of the maternal services (90.9%) and contributed to their profession (90.9%). Moreover, they stated that their colleagues (84.4%) and pregnant women (94.8%) are satisfied with the MFH. Also, 54.5% of them reported concerns about the MFH initiatives. The mean job satisfaction score was 7.92 (SE=0.26). Significant differences were noted among the participants' job satisfaction in terms of their workload perception, intention to leave, and the workplace (p <0.05).

The participants had positive attitudes towards the MFH initiativse and higher levels of job satisfaction. The results suggest that the MFH initiatives are successfully implemented and contributed to maternal services.

Iranian policymakers have recently shifted away from a birth control towards a pro-fertility policies. In this regard, it is indispensable to recognize the determinants of childbearing willingness to evaluate the influence of these policies on certain target groups. With this background in mind, the present study aimed to find determinants of childbearing willingness in employed women.

In this cross-sectional study, 140 married females, holding non-professional job positions in Iran University of Medical Sciences (IUMS), Tehran, Iran, completed a self-administered questionnaire about demographic characteristics, actual and ideal number of children, own and spouse’s willingness to have another child, in addition to perceived incentives and barriers of childbearing. Chi-square test and logistic regression analysis were applied for data analysis.

The mean age of participants was reported as 39.48±6.915. The actual and ideal number of participants’ children were obtained at 1.32±0.77 and 2.3±1.06, respectively (P-value<0.001). 50 (35.7%) of all respondents were willing to bear a child, including 37(74%) of cases who had at least one child at the time of study and 13 (26%) of those with no children (P=0.016). “The pleasure of having a baby” was their strongest explanation for childbearing desire, while “challenges of raising children” was regarded as the strongest obstacle in the group of participants who were reluctant to have children. On the other hand, in the group of cases who were willing to have a (another) child, "flexible work hours" and " job security during and after maternity leave" were the most important suggested interventions to raise children.

“The pleasure of having a baby” and “challenges of raising children” were the most important incentive and obstacle for childbearing, respectively.

Hot flashes and night sweats are the most common consequences of menopause. This study aimed to compare the effects of Cimifugol and Salvigol capsules on night sweat in postmenopausal women.

This randomized clinical trial was carried out on 80 postmenopausal women who were assigned to two groups of Cimifugol (n=40) and Salvigol (n=40). The participants of each group were requested to take Cimifugol (6.5 mg) and Salvigol (100 mg) three times a day for two months. Wiklund vasomotor symptom scale was used to record the intensity and frequency of night sweats. The two groups completed this questionnaire before the intervention and then every week until the end of the intervention period (8 weeks). The data were analyzed in SPSS software (version 20) using through independent t-test, Chi-square, analysis of covariance, repeated measure ANOVA and repeated measure ANCOVA tests.

The mean±SD values of the number of sweats as well as its duration in the Salvigol group were 8.93±6.350 and 6.15±4.394 before the intervention, respectively. However, the corresponding values were 2.53±1.132 and 195±1.108, respectively after the intervention (at the end of the eighth week). Salvigol reduced the frequency of night sweats in different weeks (p <0.001). No significant difference was observed before and after the intervention in the Cimifugol group regarding the frequency and duration of night sweat (P>0.05).

Based on the results, it is recommended to use Salvigol in the treatment of menopausal sweating.

Gestational diabetes mellitus (GDM) is the most commonly observed metabolic disorder in pregnancy. Self-care and self-efficacy are recognized as contributing factors to the control of this disease. Nonetheless, these factors might be affected by such issues as one's knowledge and attitude. The present study aimed to assess how attitude towards GDM could predict diabetic women's self-care and self-efficacy during pregnancy. This predictive correlational study was conducted on 400 women with GDM referring to health centers and maternity clinics in Mashhad, Iran. Data were collected using a demographic and midwifery questionnaire, a diabetes attitude scale, a self-efficacy questionnaire, and a self-care questionnaire retrieved from the Summary of Diabetes Self-Care Activities (SDSCA) questionnaire. The data were analyzed in SPSS software (version22) using Spearman and Pearson correlation coefficients, as well as multiple liner regression and general linear regression models. A direct linear relationship was observed between the attitude and self-efficacy (p <0/0001; r=0/23). However, no significant relationship was found between attitude and self-care (P=0.365; r=0.45). Based on the results of the general linear regression model, attitude could predict self-efficacy (p <0.0001; F=27.798; β=0.334). There was also a significant direct relationship between self-efficacy and self-care. It can be concluded that midwives could tailor interventions to improve the attitude of women towards GDM to enhance their sense of self-efficacy in order to execute diabetes self-care activities to manage their disease, effectively.

High health literacy enhances informed decision-making for cervical cancer screening (i.e., a Pap smear) among women. The present study aimed to determine the health literacy related to cervical cancer in women referring to health centers of Yazd, Iran.

This cross-sectional study was conducted on a total of 800 women in 2018. The study participants were selected using systematic random sampling. To collect data a valid and reliable health literacy questionnaire was used to address different aspects of cervical cancer health literacy (i.e., accessibility, reading, understanding, appraising, and decision-making). Data analysis was carried out using Pearson's correlation, independent samples t-test, and multivariate analysis of variance with SPSS software (version 20).

The mean age of the participants was 35.85±7.99 years. The mean score of the overall health literacy was reported as 67.46±15.59 and the mean score of the subscales of accessibility, reading, understanding, appraising, and decision-making were 13.34±4.25, 13.29±3.06, 11.25±3.56, 12.72±13, and 16.84±6.16, respectively. Also, there was a significant relationship between health literacy with age, employment status, income level, and daily consumption of fruits and vegetables (p <0.001).

The present study indicated that women's level of health literacy in terms of cervical cancer was low in Yazd; therefore, health care providers should pay special attention to women using modern educational methods as well as appropriate educational technologies in order to enhance women's health literacy regarding cervical cancer.

Colostrum feeding has a significant health benefit for neonates and infants, particularly in low-income countries, such as Ethiopia which has greater magnitudes of child starvation and mortality. However, colostrum is not given to newborns in the area under study for a various socio-cultural reasons and misconceptions. Therefore, the present study aimed to determine the determinant of colostrum avoidance among postpartum mothers in Ethiopia.

This hospital-based cross-sectional study was performed in Debre Tabor General Hospital, Debre Tabor, Ethiopia, from January 2 to June 28, 2019. A total of 437 postpartum mothers who had a child ≤ 6 weeks of age were included in this study. A systematic random sampling method was applied, and an interviewer administered the structured questionnaires to collect the data. Data analysis was performed in SPSS software (version 23) using bivariate and multivariable logistic regression.

The prevalence rate of colostrum avoidance was found to be 10.5%. According to the results, the determinants of colostrum avoidance were postpartum mothers with non-formal educational status [AOR=3.1, 95%C1=1.51-6.32], rural residency [AOR =5.2, 95%Cl =2.60-10.40], primiparity [AOR =5.1, 95%Cl =2.30-11.57], and lack of receiving counseling about breastfeeding during antenatal care [AOR =2.6, 95%Cl =1.32-5.47].

The prevalence rate of colostrum avoidance was low in Debre Tabor General Hospital, compared to the results of other studies. Nevertheless, it is recommended to give routine and detailed counseling about breastfeeding during antennal care to decrease colostrum avoidance.

Abdominal compartment syndrome (ACS) after cesarean section (CS) is a rare event which is associated with an increased risk of morbidity and mortality. This complication may arise as a result of musculoskeletal trauma and fluid accumulation. The present report aimed to introduce a case of ACS after the cesarean section.

We present the case of a 32-year old woman who developed abdominal compartment syndrome 4 days after the cesarean section. The patient's symptoms included severe abdominal distension, fever, decreased haemoglobin level despite normal blood pressure, and decreased urine output. Nasogastric/colonic decompression was not effective. Computed tomography (CT) scan demonstrated partial bowel obstruction. After an emergency decompressive laparotomy due to increased intra-abdominal pressure, the patient was diagnosed with ACS and rescued by supportive conservative treatment.

ACS is a rare complication of CS; nonetheless, delayed diagnosis and intervention can cause irreversible damages. The physicians and midwives should be cautious about post caesarean signs and symptoms, including massive abdominal distention, pain, fever, difficulty breathing, and decreased urine output. Conservative therapeutic strategy and decompressive laparotomy is the gold standard treatment for this disease.