Determinants of antenatal care utilization – contacts and screenings – in Sao Tome & Principe: a hospital-based cross-sectional study
Alexandra VasconcelosSwasilanne SousaNelson BandeiraMarta AlvesAna Luísa PapoilaFilomena PereiraMaria do Céu Machado
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Sao Tome & Principe (STP) has a high peri-neonatal mortality rate and access to high-quality care before childbirth has been described as one of the most effective means of reducing it. The country has a gap in the coverage-content of antenatal care (ANC) services that must be addressed to better allocate resources to ultimately improve maternal and neonatal health. Therefore, this study aimed to identify the determinants for adequate ANC utilization considering the number and timing of ANC contacts and screening completion.A hospital based cross-sectional study was undertaken among women admitted for delivery at Hospital Dr. Ayres de Menezes (HAM). Data were abstracted from ANC pregnancy cards and from a structured face-to-face interviewer-administered questionnaire. ANC utilization was classified as partial vs adequate. Adequate ANC utilization was defined as having ANC 4 or more contacts, first trimester enrolment plus one or more hemoglobin tests, urine, and ultrasound. The collected data were entered into QuickTapSurvey and exported to SPSS version 25 for analysis. Multivariable logistic regression was used to identify determinants of adequate ANC utilization at P-value < 0.05.A total of 445 mothers were included with a mean age of 26.6 ± 7.1, an adequate ANC utilization was identified in 213 (47.9%; 95% CI: 43.3-52.5) and a partial ANC utilization in 232 (52.1%; 95% CI: 47.5-56.7). Age 20-34 [AOR 2.27 (95% CI: 1.28-4.04), p = 0.005] and age above 35 [AOR 2.5 (95% CI: 1.21-5.20), p = 0.013] when comparing with women aged 14-19 years, urban residence [AOR 1.98 (95% CI: 1.28-3.06), p < 0.002], and planned pregnancy [AOR 2.67 (95% CI: 1.6-4.2), p < 0.001] were the determinants of adequate ANC utilization.Less than half of the pregnant women had adequate ANC utilization. Maternal age, residence and type of pregnancy planning were the determinants for adequate ANC utilization. Stakeholders should focus on raising awareness of the importance of ANC screening and engaging more vulnerable women in earlier utilization of family planning services and choosing a pregnancy plan, as a key strategy to improve neonatal health outcomes in STP.Keywords:
Cross-sectional study
In this study, we estimate the effects of childbirth on female labour supply by using Japanese data. The novel contributions of our study are twofold. Firstly, we include the effects of unobserved preferences on female labour supply. Secondly, we apply a dynamic version of the sequential matching approach to analyse the causal effects of childbirth on female labour market outcomes. The estimated results show that childbirth decreases current employment outcomes (participation in regular and non-regular work) and that this decrease is larger for regular employees than for non-regular employees. On the timing of childbirth, while the negative effects of childbirth on regular work increase by delaying the age at childbirth, these negative effects on non-regular employment slightly decrease by delaying the age at childbirth. On future employment outcomes, childbirth does not affect the probability of choosing non-regular work in the next period regardless of childbearing age. By contrast, delayed childbirth decreases the probability of choosing regular work in the next period significantly.
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Background: The research on fear of childbirth and childbirth self-efficacy of pregnant women in China mainly concentrates on the late pregnancy, and there is a lack of research on the psychology of women during labor. This study aimed to investigate the correlation between fear of childbirth and childbirth self-efficacy during labor. Methods: 378 pregnant women in labor were selected by convenience sampling. They were investigated using a self-designed questionnaire, the Chinese version of Childbirth Attitudes Questionnaire, and the Childbirth Self-Efficacy Inventory. Results: The total score of fear of childbirth during labor was 31.95 ± 9.01, and the total score of childbirth self-efficacy was 212.03 ± 59.64. The total score of fear of childbirth and the score of each dimension were significantly negatively correlated with those of childbirth self-efficacy (R2 = –0.354 to –0.155, p < 0.01). Conclusions: Fear of childbirth during labor should arouse attention of medical staffs. It is necessary to enhance psychological support and childbirth self-efficacy during labor to reduce the fear of childbirth.
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Abstract A negative childbirth experience may have long term negative effects on maternal health. New international guidelines allow a slower progress of labor in the early active phase, however a longer time in labor may influence the childbirth experience. In this population-based cohort study including 26,429 women, who gave birth between Jan 2016 to March 2020, the association between duration of the different phases of active labor and childbirth experience was studied. The women assessed their childbirth experience by visual analogue scale (VAS) score. Data including VAS score and labor time estimates were obtained from electronic medical records and adjusted odds ratios (aOR) were calculated.The prevalence of negative childbirth experience (VAS 1-3) was 4,9%. A significant association between longer duration of all phases of active labor and a negative childbirth experience (VAS 1-3) was found for primi- and multipara. The aOR for negative childbirth experience and longer time in active labor in primipara was 1.88, 95% CI (1.59-2.22) and for multipara aOR 1.90, 95% CI (1.59-2.28).It is of great importance to identify and optimize the clinical care of women with prolonged labor to reduce the risk of negative childbirth experience and associated adverse long-term effects.
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This study estimates the effects of childbirth on female labour supply using Japanese data. The original contributions of our study are twofold. First, we include the preference for having children as a time-varying confounding variable in the effects of childbirth on female labour supply. Second, we apply a dynamic version of the sequential matching approach to analyse the causal effects of childbirth on female labour market outcomes. The results show that childbirth decreases current employment outcomes (participation as regular and non-regular workers) and that this decrease is more pronounced among regular workers than non-regular workers. At the time of childbirth, while the negative effects of childbirth on choosing regular work increase when childbirth age is delayed, the negative effects on choosing non-regular work are slightly decreased by delaying the age of childbirth. Regarding future employment outcomes, childbirth does not affect the probability of choosing non-regular work in the next period, regardless of childbirth age. In contrast, delayed childbirth decreases the probability of choosing regular work in the next period significantly.
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This quasi-experimental study aimed to investigate the effect of childbirth preparation model on childbirth experience for primipara and their supporters. The samples, 37 pregnant women and their supporters, were recruited by purposive sampling from an antenatal clinic in the tertiary care hospital, Southern Thailand. The participants in treatment group (18 pairs) were received the childbirth preparation model, such as briefly anatomy and mechanism of labor, sign and symptoms of childbirth, physical exercises and relaxed practices, caring for birth assist and risk of operative obstetrics, and visiting the labor room. The supporters were received the same knowledge as pregnant women and were learnt about their roles during the first stage of labor and the recovery stage as well. The participants in control group were received the standard care of antenatal clinic and labor room. The data were collected after child delivery giving birth within 48 hours, using primipara’s experience and supporters’ experience of childbirth questionnaires. Both questionnaires were tested the reliability, with the tests range of 0.74 - 0.84. Mean primipara’s experience and supporters’ experience of childbirth scores in treatment group were higher than the control group’s (p < 0.05). These indicated pregnant women and their supporters who were prepared for childbirth were more likely to have positive experience about childbirth. The findings from this study suggest that the childbirth preparation model should be used for promoting childbirth experience of primipara and their supporters.
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Self-efficacy for labor and childbirth fears in nulliparous pregnant women. Journal of Psychosomatic Obstetrics and Childbirth 2000;21(4).
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Objectives: This study was conducted to determine factors related to childbirth satisfaction in women who experienced psychological traumatic childbirth. Materials and Methods: This cross-sectional study was conducted to examine 375 postpartum women who had experienced psychological traumatic childbirth according to criterion A of the fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5 [A]). Data-gathering tools were the demographic and obstetric characteristics questionnaire and Mackey childbirth satisfaction questionnaire. The data were analyzed using SPSS (version 24.0), and independent t test, ANOVA, Pearson correlation coefficient, as well as multivariate linear regression test were used to perform data analysis. Results: The mean (standard deviation) of the delivery satisfaction score was 120.09 (27.11) out of 170. The predictors of satisfaction with delivery in women who had experienced psychological traumatic childbirth included type of delivery (P < 0.001), accordance of the delivery with the desired delivery (P = 0.013), and analgesia (P = 0.02). Conclusions: It seems that with continuous training and counseling about the type of delivery, the mother’s participation in delivery decisions, and also providing a variety of analgesia methods during delivery can increase childbirth satisfaction and reduce psychological traumatic childbirth.
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Effective support during childbirth reduces the need for intervention during childbirth and therefore increases women's chances of experiencing normal births. Two theoretical explanations have been suggested for these positive effects: one is that effective support during childbirth aids the passage of the fetus through the pelvic and soft tissues; the other is that it decreases the stress response to childbirth. This article reviews the literature surrounding effective support in childbirth.
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