What women say about antenatal care in St Petersburg, Russian Federation

A capacity building program for professionals in maternal and child health care in St Petersburg, Russian Federation, commenced in 1994. The program was designed to provide 12 workshops in evidence-based antenatal and intrapartum care, as well as appropriate preparation of parents for pregnancy, birth and parenthood, for health care professionals in the city. As part of this program women's observations on the quality of their maternity care services during their transition to parenthood were explored. These reports reflect maternity care practices in the former Soviet Union.     

What Women Say About Post-Partum Care and Breastfeeding in St. Petersburg,Russian Federation

A capacity-building programme for professionals in maternal and child health care in St. Petersburg, Russian Federation, was begun in 1994. The programme was designed for health care professionals in the city, and provided 12 workshops in evidence-based antenatal, intrapartum and post-partum care as well as appropriate preparation of parents for pregnancy, birth and parenthood.As part of this initiative, women’s observations on the quality of their maternity care services during their transition to parenthood were explored. This article deals with women’s knowledge of, attitudes towards and practices during post-partum care and breastfeeding in St. Petersburg. These reports describe maternity care practices in the former Soviet Union.     

The Birth of a First Child: Do Women's Reports Change Over Time?

ABSTRACT: Seventy-two women who had been interviewed three weeks postpartum in an earlier study were re-interviewed two years after the birth. There was a significant decrease over time in their ratings of each of the medical and preparation procedures they had had. Those women who had the one child or who were pregnant with a second child showed no change in overall perception of their labor and delivery after the two-year interval, while those who had had a second child were more negative than at the first interview. Women's recall of the events of their first birth was generally accurate and their pain ratings for all but the second stage labor were not significantly different at the two interviews. The results indicate that “time of interview” is an important factor to take into account in childbirth research.     

Individual Differences in Maternal,Marital, Parenting and Child Outcomes Following Perinatal Loss: A Longitudinal Study

ABSTRACT

Objective: To examine the impact of past perinatal loss on mothers and children in a community sample and to consider maternal race and adult attachment status as moderators.

Background: Prior perinatal loss has been shown to impact subsequent maternal parenting and child outcomes, but findings have been inconsistent particularly in minority mothers and samples not chosen due to perinatal loss history.

Methods: Participants were 204 first-time mothers from a longitudinal study about predictors of sensitivity. Mothers completed the Adult Attachment Interview prenatally and reported on depressive symptoms and marital satisfaction prenatally and at 6 months and 1 year postpartum. Maternal sensitivity was observed at 6 months and 1 year, and infant-mother attachment security was assessed via the Strange Situation when children were 1 year old. Mothers reported on their reproductive history and current attitudes about the target child during the preschool period.

Results: Fifty-eight (28.43%) mothers had a history of prior perinatal loss. Between group analysis revealed no differences based on perinatal loss and no moderation by maternal race or adult attachment. However, within the loss group, mothers who experienced losses later in the gestational period had less positive feelings about parenting and their children had less secure attachments to them; and mothers who had more perinatal losses had higher depressive symptoms at 1 year postpartum and less positive attitudes about parenting independent of race and SES.

Conclusion: In the circumstance of multiple and later perinatal losses maternal well-being and child outcomes may be negatively impacted.     

Risk factors for intimate partner violence against women in St. Petersburg, Russia

This exploratory study examines which risk factors are associated with intimate partner violence against women in St. Petersburg, Russia. Women attending two crisis centers and a birthing house constituted the study sample. The male partner's frequent alcohol consumption and seeing his father hit his mother in childhood were associated with an increased risk of violence, whereas living in a communal apartment reduced the risk of intimate partner violence. The importance of crisis centers in Russia is highlighted by the study, as the women who turn to them are likely to have experienced more severe forms of violence.     

Benefits and Challenges of a Nurse‐Midwife Fellowship: A Review of the Ruth B. Stifel Fellowship Program at The Midwife Center for Birth and Women's Health

New graduate nurse‐midwives are looking for a bridge between their education and clinical practice, whereas birth centers often have a difficult time recruiting midwives to hire. At the same time, women are seeking birth center and midwifery care in growing numbers. A well‐designed fellowship program helps address all of these needs in a supported, safe way. This article describes one birth center's fellowship program and the benefits and challenges of the program. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health.     

Maternal and Child Health Practices: Problems,Resources, and Methods of Delivery, 2nd Edition

Edited by Helen M. Wallace, Edwin M. Gold, and Allan C. Oglesby. New York: John Wiley and Sons, 1982. 861 pages, $30.00, hardcover. Reviewed by: Sister Nathalie Elder, C.N.M., M.S.N., Associate Professor, Director of Nurse-Midwifery Graduate Major, Saint Louis University School of Nursing, St. Louis, Missouri.     

The Maternal and Newborn Health Registry Study of the Global Network for Women's and Children's Health Research

ObjectiveTo implement a vital statistics registry system to register pregnant women and document birth outcomes in the Global Network for Women's and Children's Health Research sites in Asia, Africa, and Latin America.MethodsThe Global Network sites began a prospective population-based pregnancy registry to identify all pregnant women and record pregnancy outcomes up to 42 days post-delivery in more than 100 defined low-resource geographic areas (clusters). Pregnant women were registered during pregnancy, with 42-day maternal and neonatal follow-up recorded—including care received during the pregnancy and postpartum periods. Recorded outcomes included stillbirth, neonatal mortality, and maternal mortality rates.ResultsIn 2010, 72 848 pregnant women were enrolled and 6-week follow-up was obtained for 97.8%. Across sites, 40.7%, 24.8%, and 34.5% of births occurred in a hospital, health center, and home setting, respectively. The mean neonatal mortality rate was 23 per 1000 live births, ranging from 8.2 to 48.5 per 1000 live births. The mean stillbirth rate ranged from 13.7 to 54.4 per 1000 births.ConclusionThe registry is an ongoing study to assess the impact of interventions and trends regarding pregnancy outcomes and measures of care to inform public health.ClinicalTrial.gov Trial Registration: NCT01073475     

Home monitoring of uterine contractility. Summary of a workshop sponsored by the National Institute of Child Health and Human Development and the Bureau of Maternal and Child Health and Resources Development, Bethesda, Maryland, March 29 and 30, 1989.

At an interdisciplinary workshop on home monitoring of uterine activity, participants reviewed the basis of this technology and its use in the identification of women at high risk of preterm delivery and in the prevention of preterm birth. Although the guard-ring devices in current use appear capable of detecting uterine activity, they do not clearly distinguish between Braxton Hicks contractions and the contractions of early labor. There was agreement that women destined for preterm delivery have more uterine activity on average than do other women of comparable gestational age but that there is substantial overlap between the two groups. Thus it is uncertain whether this difference can be used effectively for screening purposes. Conferees agreed that there is considerable evidence that twice-daily monitoring of very-high-risk women, in conjunction with daily nursing support and high-quality obstetric care, may prevent preterm births. Available evidence does not clearly distinguish the contribution of tocodynamometry from that of nursing support. A number of areas were identified in which further research is needed.     

Women's Health and Hygiene Experiences During Deployment to the Iraq and Afghanistan Wars, 2003 through 2010

Introduction: The purpose of this study was to describe women's health and hygiene experiences during their deployment to Iraq and Afghanistan during the war years, 2003 through 2010. Methods: A phenomenological method described the essential structures embedded in the women's health and hygiene experiences. Colaizzi's method of data analysis was used to guide the discovery of themes. Interview data were gathered from 24 interviews with military nurses who served in the war zones. Female military nurses were specifically selected for this study because of their insight, awareness, and knowledge base. Results: Seven themes emerged from the data and captured the essence of the women's experiences: 1) bathroom trips and facilities: a walk on the wild side; 2) shower challenges: lack of privacy, water problems, and location issues; 3) menstruation: to suppress or not to suppress; 4) staying clean: a monumental task; 5) various infections: annoying distractions; 6) unintended pregnancies: wartime surprises; and 7) safety issues: enemy attacks and sexual assaults. Discussion: In the current military structure, more women are being deployed to combat zones and will endure the challenges and hardships described in this study. The health and hygiene experiences of deployed women are an important part of their daily lives in combat zones. Educational programs and clinical services need to be tailored to this cadre of women, with focused attention on preparation and anticipatory guidance prior to deployment. Access to health promotion and appropriate clinical services during deployment is critical. Finally, as these women return home as veterans, it is important for all providers to understand the contextual framework of their service and its impact on their lives.     

Effect of Previous Adverse Reproductive Health Outcomes on Young Women's Engagement in a Health Coaching Intervention to Improve Contraceptive Continuation

Study ObjectiveNonadherence in sexual risk reduction interventions might be common among adolescents. We compared intervention completion rates among adolescent and young adult women with and without a previous pregnancy or sexually transmitted infection (STI) participating in a program to improve contraceptive continuation.DesignSecondary data analysis from a feasibility study of a health-coaching intervention to improve contraceptive continuation.SettingThree urban pediatric clinics in Philadelphia.ParticipantsWomen ages 14-22 years who were English-speaking, sexually active in the past year, not desiring pregnancy in the next year, and starting a new contraceptive method.InterventionsAt baseline, participants completed a sociodemographic questionnaire and semistructured interview, followed by 5 monthly coaching sessions. Interviews and coaching sessions were audio-recorded, transcribed, and coded for thematic content.Main Outcome MeasuresIntervention completion was defined as the number of completed coaching sessions. Secondary outcomes were qualitatively explored group differences in reproductive knowledge, attitudes, and risk perception.ResultsParticipants with a previous adverse outcome (a previous STI and/or a previous pregnancy) completed fewer coaching sessions than those without such history (median: 2 vs 4; P = .03). Both groups had low HIV/STI knowledge, negative attitudes toward pregnancy, and low HIV/STI risk perception. Those with a previous adverse reproductive outcome held more negative attitudes toward condoms.ConclusionDespite similar reproductive knowledge, attitudes, and risk perception, young women who have experienced an adverse reproductive outcome might be less likely to fully engage in sexual risk reduction interventions. Future studies should confirm these findings and consider strategies to optimize the intervention's reach for vulnerable youth.