This is a qualitative study that explores the perspectives and experiences of a group of Mexican women who experienced institutionalized childbirth care in the first and second waves of the COVID-19 pandemic. Through a semi-structured script, nine women who experienced childbirth care were interviewed between March and October 2020 in public and private hospitals in the city of San Luis Potosí, Mexico. Under the Grounded Theory analysis proposal, it was identified that the health strategies implemented during the pandemic brought with them a setback in the guarantee of humanized childbirth. Women described themselves as distrustful of the protocols that personnel followed to attend to their births in public sector hospitals and very confident in those implemented in the private sector. The intervention of cesarean sections without a clear justification emerged as a constant, as did early dyad separation. Healthcare personnel\'s and institutions\' willingness and conviction to guarantee, protect and defend the right of women to experience childbirth free of violence remain fragile. Resistance persists to rethink childbirth care from a non-biomedicalizing paradigm.
Estudio de tipo cualitativo que explora las perspectivas y experiencias de un grupo de mujeres mexicanas que vivieron la atención institucionalizada del parto en la primera y segunda ola de la pandemia por COVID-19. A través de un guión semiestructurado se entrevistó a nueve mujeres que vivieron la experiencia de la atención del parto entre marzo y octubre de 2020, en hospitales públicos y privados de la ciudad de San Luis Potosí, en México. Bajo la propuesta de análisis de la teoría fundamentada, se identificó que las estrategias sanitarias implementadas en el marco de la pandemia, trajeron consigo un retroceso en la garantía del parto humanizado, las mujeres se narraron desconfiadas en los protocolos que siguió el personal para la atención de sus partos en los hospitales del sector público y muy confiadas en los que se implementaron en el sector privado. La realización de cesáreas sin una justificación clara emergió como una constante, igual que la separación temprana de los binomios. Continúa frágil la disposición y el convencimiento del personal sanitario y las instituciones para garantizar, proteger y defender el derecho de las mujeres a vivir el parto libre de violencia. Persisten resistencias para repensar la atención del parto desde un paradigma no biomédicalizante.

The prevalence and influence of gangs on adolescents and young adults remain a concern in Western Cape, South Africa-particularly as they have one of the largest gang presence. While less attention has been focused on young women, there is a need to elucidate the relationship between gang exposure and health behaviors, such substance use, in addition to understanding whether becoming a caregiver impacts this relationship. This study uses baseline data from 496 participants enrolled in a NIDA-funded R01 trial that recruited young women aged 16 to 19 who were out of school and reported recent alcohol or other drug use and sexual risk behavior. At enrollment, a risk behavior survey was administered, and urine drug screening was conducted. Multivariable logistic regression analyses were conducted to examine baseline associations between childbirth, a gang exposure index based on eight items, and positive drug screens of the most prevalent drugs in the Western Cape (marijuana, methaqualone, and methamphetamine). At enrollment, approximately 39% of the sample had a positive urine screen for marijuana, 17% for methaqualone, and 11% for methamphetamine. Additionally, 28% had ever given birth. While only 6% reported ever being a member of a gang, most reported exposure to gangs through their physical and social environments. For all three drugs, gang exposure was associated with statistically significantly higher odds of a positive screen. Every one-point increase in the gang exposure index was associated with a 31% increase in the odds of a positive marijuana screen (p < .001), a 26% increase for methaqualone (p = 0.005) and a 37% increase in the odds of a positive methamphetamine screen (p < .001). Ever given birth was associated with lower odds of marijuana use (adjusted odds ratio [AOR]: 0.63; 95% CI: 0.42-0.96), but it was not associated with methaqualone or methamphetamine use. The findings suggest that exposure to gangs through young women\'s social and physical environment is positively associated with drug use. Childbirth was also protective for marijuana use, indicating there may be something unique about this type of drug, such as one\'s ability to more easily stop use. Although very few young women reported gang membership, a majority reported some exposure, indicating the need to address how pervasive this exposure is and the potential risk.

暂无摘要。

In Lower-Middle-Income-Countries women are encouraged to present at a birthing facility for skilled care, but attending early can be associated with additional harm. Women admitted in latent labour are more likely to receive a cascade of unnecessary interventions compared with those attending a birthing facility during active labour. One reason that women present early is pain, with higher rates of admission among those who pain catastrophise. The aim of this study was to explore the prevalence of pain catastrophising in nulliparous women in Nepal and to identify predictors for pain catastrophising. A cross sectional study was conducted using a semi-structured survey. The survey was completed by 170 women (18-32 years) in one higher education institution in Kathmandu. The survey included the pain catastrophising scale (PCS), current and previous pain and information about period pain, sociodemographic variables of age, ethnicity, and religion. The prevalence of pain catastrophising reported at a cut off score of PCS≥20 was 55.9% and at a cut off score of PCS≥30 was 17.1%. All women with a PCS ≥30 reported having painful periods. Those with a PCS≥20 were four times [95%CI 1.93-8.42] more likely to report painful periods affecting their daily activities (p<0.001) and those with PCS≥30 three times [95%CI1.10-10.53] more likely (p<0.05). In both cases ethnicity and age were not associated. Women with higher PCS were less likely to take pain medication. A high prevalence of pain catastrophising was reported. It is important to understand how women\'s previous negative experiences of pain and pain catastrophising are perceived and if they are contributing to the rise in obstetric intervention, particularly caesarean births, in Nepal. We recommend repeating this study with a larger sample representing a more diverse population.

BACKGROUND: Birth preparedness and complication readiness is a holistic approach that empowers mothers and families with the knowledge, attitude, and resources to alleviate potential challenges during childbirth. Despite its benefits, husbands\' participation in maternal care differs significantly between countries and regions. There is a lack of previous studies that look at husbands\' responses to birth preparedness and complication readiness in the research area. Thus, the primary goal of this study is to find out how husbands who have wives with infants under 12 months old feel about birth preparation, readiness for problems, and its associated factors.
METHODS: A community-based cross-sectional study design was conducted from May 30 to July 29, 2022. Simple random sampling was employed to select 499 husbands. An interviewer-administered, structured, and pretested questionnaire was used to collect the data. Data entry and analysis were performed using Epi Data version 4.6 and SPSS version 25, respectively. We used multivariable logistic regression to find statistically significant factors. P-values less than 0.05, 95% confidence intervals, and adjusted odds ratios are used to declare statistical significance. The findings were shown in figures, tables, and text.
RESULTS: The study found that 55.9% (95% CI: 51.4 to 61.4%) of husbands responded to birth preparedness and complication readiness. This response was significantly associated with being employed (AOR = 3.7, 95% CI: 2.27-5.95), engaging in self-business (AOR = 5.3, 95% CI: 2.34-12.01), having wives who delivered in health facilities (AOR = 7.1, 95% CI: 3.92-12.86), accompanying wives for antenatal care (AOR = 2.2, 95% CI: 1.39-3.56), possessing good knowledge of danger signs during labor (AOR = 2.0, 95% CI: 1.08-3.74) and the postnatal period (AOR = 7.1, 95% CI: 3.14-16.01). Interestingly, residents living near a health facility (AOR = 0.6, 95% CI: 0.39-0.97) were less likely to respond.
CONCLUSIONS: The present study found that nearly 6 out of 10 husbands actively responded in terms of birth preparedness and complication readiness. While husbands in this study showed some involvement in birth preparedness and complications, it is good when compared to studies carried out nationally. To improve this, educating husbands by focusing on the danger signs and their role in childbirth is recommended.

In this study, the aim was to evaluate the preferences and experiences interventions among women in Turkey. A total of 347 women who gave birth vaginally participated in this analytical cross-sectional study. Data were collected using the face-to-face interview technique in the clinic rooms within the first 24 hours after delivery, when the women\'s babies were asleep, allowing the mothers to comfortably answer the questions before discharge. The arithmetic mean, standard deviation and number-percentage distributions of the data were calculated. Of them, 81% had a positive birth experience at birth. The majority of the participating women did not want to undergo non-evidence based interventions with a limited effect during the intrapartum period. While evidence-based intrapartum care is provided, women\'s preferences should be taken into account, they should be informed about evidence-based interventions and these interventions should be performed during the intrapartum period.
Dans cette étude, l\'objectif était d\'évaluer les préférences et les expériences d\'interventions chez les femmes en Turquie. 347 femmes ayant accouché par voie vaginale ont participé à cette étude analytique transversale. Les données ont été collectées à l’aide de la technique d’entretien en face-à-face dans leurs chambres de la clinique dans les 24 heures suivant l’accouchement, lorsque les bébés des femmes dormaient et que les mères pouvaient facilement répondre aux questions avant leur sortie. La moyenne arithmétique, l\'écart type et les distributions en nombre et en pourcentage des données ont été calculées.Parmi eux, 81 % ont vécu une expérience positive à la naissance. La majorité des femmes participantes ne souhaitaient pas subir d\'interventions non fondées sur des données probantes et ayant un effet limité pendant la période intrapartum. Bien que des soins intrapartum fondés sur des données probantes soient fournis, les préférences des femmes doivent être prises en compte, elles doivent être informées des interventions fondées sur des données probantes et ces interventions doivent être effectuées pendant la période intrapartum.

OBJECTIVE: to understand the process of adapting to childbirth during the COVID-19 pandemic from the perspective of a group of pregnant women.
METHODS: a qualitative, descriptive-exploratory study was conducted with 23 women. Data were collected between October and December 2021 through documentation and semi-structured interviews, which were analyzed using Minayo\'s methodology and Roy\'s Adaptation Model.
RESULTS: various types of stimuli - focal, contextual, and residual - were identified as influencing childbirth preparation. The online group was essential for facilitating pregnant women\'s adaptation, offering significant support and generating positive feedback for childbirth preparation.
CONCLUSIONS: the importance of pregnant women\'s groups as a strategy for improving adaptation to childbirth was identified, underscoring the effectiveness of this support among professionals and participants, as well as among pregnant women. This support network strengthened preparation for childbirth during a challenging period like the pandemic.

UNASSIGNED: Postpartum depression is associated with low socioeconomic status, adverse birthing processes, and life stress. Increasing evidence of mistreatment during childbirth, negative birth experiences, and poor quality of maternal care is of global concern.
UNASSIGNED: To assess the risk of experiencing depressive symptoms among postpartum women exposed to mistreatment during institutional birthing in Nepal.
UNASSIGNED: We conducted a prospective cohort study from 29 March to 19 August 2022. Of 1629 women who gave birth in a hospital in Nepal, 1222 were assessed for mistreatment during childbirth and depressive symptoms using the Edinburgh Postnatal Depression Scale. We used binomial generalized linear mixed model to examine the risk ratio of postpartum depressive symptoms in women exposed to mistreatment during childbirth.
UNASSIGNED: The prevalence of postpartum depressive symptoms was 4.4%. Women exposed to mistreatment during childbirth were almost fifty percent more likely to have postpartum depressive symptoms (cRR 1.47; 95% CI 1.14, 1.89; p = 0.003) compared with the unexposed group. Furthermore, adolescent mothers exposed to mistreatment during childbirth had a seventy percent increased risk of depressive symptoms (aRR 1.72; 95% CI 1.23, 2.41; p = 0.002). Similarly, women who gave birth to female infants were thirty percent more likely to experience postpartum depressive symptoms (aRR 1.32; 95% CI 1.01-1.74; p = 0.039).
UNASSIGNED: We observed an association between postpartum depressive symptoms and mistreatment during institutional births in Nepal. The implementation of appropriate respectful maternity care during childbirth and also routine screening for depressive symptoms is critical to improving perinatal mental health and well-being.
Main findings: Despite widespread reports of mistreatment during childbirth in health facilities, little is known about possible association with poor perinatal mental health outcomes.Added knowledge: This prospective cohort study in Nepal found an association between postpartum depressive symptoms and mistreatment during institutional childbirth.Global health impact for policy and action: Postpartum depression is a global health issue, and there is an urgent need for interventions to promote respectful maternity care.

BACKGROUND: Testing positive for COVID-19 was associated with higher rates of detrimental psycho-social and physical health outcomes. The COVID-19 pandemic caused unprecedented disruption to everyday life. This included major reconfiguration of maternal, child, and perinatal mental health and care services and provision. This study aimed to investigate the experiences of those who tested positive for COVID-19 during pregnancy, labour and birth, or the early postnatal period.
METHODS: National on-line recruitment from across the United Kingdom resulted in sixteen mothers being invited to qualitative semi-structured interviews to understand the experiences of mothers who had been infected by COVID-19 during pregnancy, labour and birth, or the early postnatal period. Interviews were conducted, recorded, and transcribed using video-conferencing software. A Grounded Theory approach was used to analyse the data gathered pertaining to women\'s experiences of their positive COVID-19 diagnosis during pregnancy, labour and birth, or the early postnatal period.
RESULTS: The theory of \'Oscillating Autonomy - Losing and Seeking to Regain Control by Striving for Agency\' was developed, comprising three main themes: \'Anxious Anticipation: The fear of infection was worse than COVID-19 itself\'; \'Fluctuating Agency: What changed when COVID-19 took control\'; and \'Reclaiming Control: Seeking reassurance during COVID-19 positivity\'. Testing positive for COVID-19 whilst pregnant, during labour or birth, or in the early postnatal period was associated with a perceived loss of control. Those who were able to regain that control felt more secure in their situation.
CONCLUSIONS: Support was paramount to manage increased vulnerability, as was reassurance achieved by information seeking and positive action including increased health monitoring and COVID-19 vaccination.

BACKGROUND: The birth experience plays a pivotal role in the mother´s mental well-being and has a crucial effect on the mother-child bond. Unanticipated medical interventions, including fundal pressure, episiotomy, assisted vaginal delivery (AVD), or unplanned cesarean section (CS) during labor, may adversely affect the birth experience. The objective of this study is to identify factors contributing to the diminished evaluation of the birth experience after assessing the prevalence of unplanned obstetrical interventions in Germany.
METHODS: For this cross-sectional analysis, 4000 mothers whose children were born 8 or 12 months before were asked about their birth experience via a paper-based questionnaire. Overall 1102 mothers participated in the study, representing a response rate of 27.6%. The revised Childbirth Experience Questionnaire (CEQ2) was used to measure the childbirth experience. In addition to descriptive and bivariate analyses using the Wilcoxon rank-sum test and Kruskal-Wallis-test, we calculated multivariate linear regression models for each dimension of the CEQ2.
RESULTS: In general, the participants evaluated their childbirth experience favorably, assigning an average rating of 3.09 on a scale ranging from 1 to 4. Women who experienced fundal pressure, an AVD, or an unplanned CS rated their birth experience significantly worse compared to women who gave birth without interventions. Unplanned CSs received the lowest ratings for \"personal capability\" and \"perceived safety,\" and an AVD resulted in lower scores for \"professional support\" and \"participation.\" However, the interventions we studied did not account for much of the variation in how the childbirth experience plays out for different individuals.
CONCLUSIONS: Obstetric interventions have a significant effect on different dimensions of the birth experience. If a high level of birth satisfaction is to be achieved, it is important to know which dimension of satisfaction is affected by the intervention so that explicit measures, like fostering communication, participation or safety can be taken to promote improvement.
UNASSIGNED: DRKS00029214, retrospectively registered (Registration Date 22.06.2023).