scholarly journals A decade of inequality in maternity care: antenatal care, professional attendance at delivery, and caesarean section in Bangladesh (1991–2004)

2007 ◽  
Vol 6 (1) ◽  
Author(s):  
Simon M Collin ◽  
Iqbal Anwar ◽  
Carine Ronsmans
Keyword(s):  
Caesarean Section ◽  
Antenatal Care ◽  
Maternity Care

scholarly journals Outcome of induced labour in pregnancies at 41 weeks gestation and over in Saudi Arabia

2021 ◽  
Vol 9 (3) ◽  
pp. 316-323
Author(s):  
A. A. Sobande ◽  
H. M. Al Bar
Keyword(s):  
Clinical Trial ◽  
Saudi Arabia ◽  
Cohort Study ◽  
Caesarean Section ◽  
Antenatal Care ◽  
Pregnancy Outcomes ◽  
Caesarean Section Rate ◽  
Military Hospital ◽  
Perinatal Morbidity ◽  
Perinatal Complications

A retrospective, descriptive cohort study was conducted at King Faisal Military Hospital, Saudi Arabia, to compare pregnancy outcomes in patients induced with prostagl and in E2 from 41 weeks gestation. A total of 450 women whose antenatal care and delivery were conducted at the hospital during 1995-99 were studied. The main outcome measures used were caesarean section rate and perinatal morbidity and mortality. In otherwise normal pregnancies, the caesarean section rate was not significantly increased when induction of labour was carried out at 41 weeks gestation compared with >/=42 weeks. Although more perinatal complications occurred when induction was carried out at 42 weeks, the results were not statistically significant. A large prospective clinical trial is indicated

Design and Development of BACIS Program

2021 ◽  
pp. 90-103
Keyword(s):  
South Africa ◽  
Information System ◽  
Maternal Health ◽  
Antenatal Care ◽  
Maternity Care ◽  
Rule Base ◽  
Domain Expert ◽  
Knowledge Engineer ◽  
Improve Compliance ◽  
Technical Architecture

The name BACIS combines the names basic antenatal care checklist and information systems. This is to highlight the fact that the BACIS program is an information system that implements the guidelines for maternity care in South Africa and the basic antenatal care checklist process. The BACIS program was conceptualised by the author and the study obstetrician as a tool that could be used at primary healthcare level to improve compliance to maternal health protocols and the BANC checklist. The author's role was that of knowledge engineer and software developer with the study obstetrician acting as the medical domain expert. This chapter presents the technical architecture of the BACIS program. This includes the technology used in creating the system's rule base, as well as the system's data model and software classes and its interface.

scholarly journals Workshop: The Danish MAMAACT trial as an example for discussing evaluation methods in complex interventions

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
Keyword(s):  
Antenatal Care ◽  
Vulnerable Populations ◽  
Infant Death ◽  
Maternity Care ◽  
Sociological Theory ◽  
Immigrant Women ◽  
Complex Interventions ◽  
Ethnic Disparities ◽  
Care Systems ◽  
The Impact

Abstract Over recent years, immigration to Europe has risen significantly. This development has led to increasing birth rates by non-Western immigrant women. Maternity care systems are not yet adapted to this increased diversity of women. In Denmark, 13 % of all children are currently born by women originating from non-Western countries. Despite a publically funded antenatal care, non-Western immigrant women have lower utilization of Danish antenatal care compared to other women giving birth. Many non-Western immigrant women have an increased prevalence of severe maternal morbidity and higher risks of maternal death, stillbirth and infant death compared to the majority populations. Poor health status at birth can impair the cognitive, sensory and motor development and lead to learning disabilities during school age, and thus reduce equality in life chances. Suboptimal care is a contributing factor to these ethnic disparities. Provision of appropriate antenatal care is pivotal to reduce these serious disparities and challenges to public health, however little is known about models of care, which can overcome these barriers. The MAMAACT intervention was developed to increase response to symptoms of pregnancy complications among maternity care providers as well as non-Western immigrant women. The intervention consisted of postgraduate training of midwives in intercultural communication and health education materials (leaflet and an app) for non-Western immigrant women describing how to respond to warning signs during pregnancy in six different languages, The intervention was implemented at 10 out of 20 Danish maternity wards as part of a national trial from the year 2018 to 2019, potentially reaching 25.000 pregnant women, including 2500 of non-Western origin. This workshop shares insight into innovative ways of providing antenatal care for non-Western immigrant women and will focus on methodological aspects of scientific evaluation of complex interventions for vulnerable populations. The workshop includes an introduction, three presentations, and a discussion with the audience. Using quantitative data, the first presentation will give an overview of ethnic disparities in stillbirth and infant death in Denmark. The second presentation will present qualitative data from the implementation evaluation of the MAMAACT intervention with a focus on the interventions program theory, methodological considerations and evaluation results. Finally, the third presentation will illuminate how the concepts of Health Literacy and cultural health capital contribute to an understanding of mechanisms leading to ethnic disparities and how they can be used for evaluating the impact of the MAMAACT intervention. The final discussion will stimulate knowledge sharing between the participants on how to combine quantitative and qualitative insights in trials, how to build partnerships and recruit vulnerable populations in evaluations, and how to use sociological theory in evaluations. Key messages Reducing ethnic disparity in reproductive health requires maternity care systems to rethink their antenatal care services so they are better equipped to support non-Western immigrant women’s needs. Sharing knowledge on the use of mixed methods, recruitment of vulnerable populations, and the use of sociological theory can contribute to future approaches to evaluate complex interventions.

scholarly journals Rationale, development and feasibility of group antenatal care for immigrant women in Sweden: a study protocol for the Hooyo Project

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e030314 ◽  
Author(s):  
Ulrika Byrskog ◽  
Malin Ahrne ◽  
Rhonda Small ◽  
Ewa Andersson ◽  
Birgitta Essen ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Maternity Care ◽  
Immigrant Women ◽  
Care Delivery ◽  
Depression Scale ◽  
Well Being ◽  
Phase Iii ◽  
Ethical Review ◽  
Study Phase ◽  
Childbearing Age

IntroductionSomali-born women comprise a large group of immigrant women of childbearing age in Sweden, with increased risks for perinatal morbidity and mortality and poor experiences of care, despite the goal of providing equitable healthcare for the entire population. Rethinking how care is provided may help to improve outcomes.Overall aimTo develop and test the acceptability, feasibility and immediate impacts of group antenatal care for Somali-born immigrant women, in an effort to improve experiences of antenatal care, knowledge about childbearing and the Swedish healthcare system, emotional well-being and ultimately, pregnancy outcomes. This protocol describes the rationale, planning and development of the study.Methods and analysisAn intervention development and feasibility study. Phase I includes needs assessment and development of contextual understanding using focus group discussions. In phase II, the intervention and evaluation tools, based on core values for quality care and person-centred care, are developed. Phase III includes the historically controlled evaluation in which relevant outcome measures are compared for women receiving individual care (2016–2018) and women receiving group antenatal care (2018–2019): care satisfaction (Migrant Friendly Maternity Care Questionnaire), emotional well-being (Edinburgh Postnatal Depression Scale), social support, childbirth fear, knowledge of Swedish maternity care, delivery outcomes. Phase IV includes the process evaluation, investigate process, feasibility and mechanisms of impact using field notes, observations, interviews and questionnaires. All phases are conducted in collaboration with a stakeholder reference group.Ethics and disseminationThe study is approved by the Regional Ethical Review Board, Stockholm, Sweden. Participants receive information about the study and their right to decline/withdraw without consequences. Consent is given prior to enrolment. Findings will be disseminated at antenatal care units, national/international conferences, through publications in peer-reviewed journals, seminars involving stakeholders, practitioners, community and via the project website. Participating women will receive a summary of results in their language.

scholarly journals Antenatal Care and Couples’ HIV Testing in Rural Northern Uganda: A Gender Relations Analysis

2015 ◽  
Vol 11 (4) ◽  
pp. 811-822 ◽  
Author(s):  
Sarah Rudrum ◽  
John L. Oliffe ◽  
Helen Brown
Keyword(s):  
Antenatal Care ◽  
Hiv Testing ◽  
Maternity Care ◽  
Gender Relations ◽  
Power Dynamics ◽  
Northern Uganda ◽  
Heterosexual Couples ◽  
Male Partners ◽  
Institutional Structures

HIV rates continue to increase among heterosexual couples in many countries including Uganda. This article examines approaches to antenatal care and heterosexual partners’ HIV testing in Amuru subcounty, northern Uganda, drawing on findings derived from fieldwork and interviews. The study findings reveal how institutional structures influence the uptake of HIV testing amid power dynamics, wherein many male partners refuse to be tested. Discussed are the coercive approaches to HIV testing in which couples’ participation in HIV testing is leveraged by connecting testing to future maternity care. This article advances understandings about how heterosexual gender relations at the local, regional, and global levels affect the health of women, men, and families in Amuru subcounty.

COVID-19 and clinical outcomes of pregnancy: a comparative study

2021 ◽  
Vol 29 (11) ◽  
pp. 642-647
Author(s):  
Valerie Smith ◽  
Sunita Panda ◽  
Deirdre O'Malley ◽  
Nora Vallejo ◽  
Paula Barry
Keyword(s):  
Caesarean Section ◽  
Comparative Study ◽  
Clinical Outcomes ◽  
Maternity Care ◽  
Maternity Hospital ◽  
Emergency Caesarean Section ◽  
Care Provision ◽  
Health And Wellbeing ◽  
Multiparous Women ◽  
The Impact

Background A series of changes in maternity care provision were implemented internationally in response to the COVID-19 pandemic. This study aimed to assess the impact of COVID-19 on maternal clinical outcomes, resulting from these changes to care provision. Methods A before and during comparative study of maternal pregnancy, childbirth, and postpartum clinical outcomes was conducted at a maternity hospital in Ireland. Inferential statistics were used to compare datasets with significance set at P<0.05. Results Overall, no difference in caesarean section rates between the two study periods was observed, although more caesarean sections were observed in multiparous women during the pandemic (30% vs 35%, P=0.01). The rate of elective compared to emergency caesarean section was also higher during the pandemic, from a proportionate difference of 3.6% pre-pandemic to 13.6% during the pandemic. Rates of induction of labour for post-dates (post-maturity induction) were also increased during the pandemic. Conclusions The changes to maternity care because of the COVID-19 pandemic appear to have affected some maternal clinical outcomes, and thus, potentially, women's overall intrapartum and postnatal health and wellbeing.

scholarly journals Prevalence and predictors of timely initiation of breastfeeding in Ghana: an analysis of 2017–2018 multiple indicator cluster survey

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Paschal Awingura Apanga ◽  
Maxwell Tii Kumbeni
Keyword(s):  
Caesarean Section ◽  
Antenatal Care ◽  
Skilled Attendant ◽  
Timely Initiation ◽  
Cluster Survey ◽  
Factors Associated ◽  
Multiple Indicator Cluster Survey ◽  
Multiple Indicator ◽  
Timely Initiation Of Breastfeeding ◽  
Initiation Of Breastfeeding

Abstract Background Timely initiation of breastfeeding is putting the newborn to the breast within 1 h of birth. Its practice can prevent neonatal and under-5 mortality. This study aims to assess the prevalence and factors associated with timely initiation of breastfeeding among mothers in Ghana. Methods We used data from the 2017–2018 Ghana multiple indicator cluster survey and our analysis was restricted to 15,305 mothers who had a live birth within 2 years. Multivariable logistic regression was used to estimate the factors associated with timely initiation of breastfeeding whilst adjusting for potential confounders, and accounted for clustering, stratification, and sample weights. Results The prevalence of timely initiation of breastfeeding was 51.3% (95% CI 48.1, 54.6%). Mothers who received antenatal care were twice as likely to timely initiate breastfeeding compared to mothers who did not receive antenatal care (Adjusted prevalence odds ratios [aPOR] 2.01, 95% CI 1.03, 3.95). Mothers who were assisted by a skilled attendant at birth had 90% higher odds of timely initiation of breastfeeding compared to mothers who were not assisted by a skilled attendant (aPOR 1.90, 95% CI 1.41, 2.55). Mothers who delivered by caesarean section had 76% lower odds of timely initiation of breastfeeding compared to mothers who had a vaginal delivery (aPOR 0.24, 95, 95% CI 0.16, 0.36). Mothers who had planned their pregnancy had 45% higher odds of timely initiation of breastfeeding compared to mothers who had an unplanned pregnancy (aPOR 1.45, 95% CI 1.09, 1.92). There were also 84% and 55% higher odds of timely initiation of breastfeeding among mothers who perceived their baby was large (aPOR 1.84, 95% CI 1.32, 2.58), and of average size (aPOR 1.55, 95% CI 1.11, 2.17) at birth respectively, compared to mothers who perceived their baby was small. Conclusions Interventions to increase timely initiation of breastfeeding should provide breastfeeding support to mothers who have had a caesarean section or small sized babies, prevent unplanned pregnancies, and promote antenatal care attendance among pregnant women.

scholarly journals Health system factors and caesarean sections in Kosovo: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e026702 ◽  
Author(s):  
Ilir Hoxha ◽  
Alban Fejza ◽  
Mrika Aliu ◽  
Peter Jüni ◽  
David C Goodman
Keyword(s):  
Health Insurance ◽  
Caesarean Section ◽  
Antenatal Care ◽  
Health System ◽  
Insurance Coverage ◽  
Public Hospitals ◽  
Low Risk ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
System Characteristics

ObjectiveTo investigate the association of caesarean section rates with the health system characteristics in the public hospitals of Kosovo.DesignCross-sectional survey.SettingFive largest public hospitals in Kosovo.Participants859 women with low-risk deliveries who delivered from April to May 2015 in five public hospitals in Kosovo.Outcome measuresThe prespecified outcomes were the crude and adjusted OR of births delivered with caesarean section by health system characteristics such as delivery by the physician who provided antenatal care, health insurance status and other. Additional prespecified outcomes were caesarean section rates and crude ORs for delivery with caesarean in each public hospital.ResultsWomen with personal monthly income had increased odds for caesarean (OR 1.55, 95% CI 1.06 to 2.27), as did women with private health insurance coverage (OR 3.44, 95% CI 1.20 to 9.85). Women instructed by a midwife on preparation for delivery had decreasing odds (OR 0.32, 95% CI 0.19 to 0.51) while women having preference for a caesarean had increasing odds for delivery with caesarean (OR 3.84, 95% CI 1.96 to 7.51). The odds for caesarean increased also in the case of delivery by a physician who provided antenatal care (OR 2.06, 95% CI 1.16 to 3.67) and delivery during office hours (OR 2.36, 95% CI 1.37 to 4.05), while delivery at the University Clinical Centre of Kosovo decreased the odds for caesarean (OR 0.46, 95% CI 0.24 to 0.90).ConclusionsWe found that several health system characteristics are associated with the increase of caesarean sections in a low-risk population of delivering women in public hospitals of Kosovo. These findings should be explored further and addressed via policy measures that would tackle provision of unnecessary caesareans. The study findings could assist Kosovo to develop corrective policies in addressing overuse of caesareans and may provide useful information for other middle-income countries.

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