Effect of Educational Guideline on Nurses Performance Regarding Postnatal Care of Mothers and Neonates

Background Postnatal periods are very sensitive periods for both the mother and the neonates where morbidity and mortality are high. Post natal care knowledge has significant role in reducing such complications. The research aimed to determine the educational guideline's effect on nurses’ performance regarding mothers and neonates’ postnatal care. Design A quasi-experimental design was decided to fulfil the aim of this study. Setting The study was conducted in the obstetric skill lab of faculty of nursing, Benha university. Sample A purposive sample was used to recruit 140 maternity nurses from Maternal and child health centres at kalioubia governorate. data collection: Two tools were used: Tool (I) Structured Questionnaire sheet. It is composed of these parts: Part I: Socio-demographic characteristics and Part II: nurses’ knowledge about postpartum care. Tool (II) postpartum care observation checklist. Results knowledge and practices about postpartum care showed highly statistically significant differences between pre and post- implementation phases, and total knowledge score regarding post-partum care were improved from 34.52% pre implementation to 45.65% after implementation with (t = 8.11 and p <0.01**) and total practice were improved from 38.52% pre implementation to 54.21% after implementation with highly significant difference (t = 12.75 and p < 0.01**). Conclusion Nurses’ knowledge and practice show a significant improvement post-implementation of health educational guideline regarding the care of postnatal mothers and neonates compared to pre-implementation.

Article 24: The Right to Health

Article 24 reflects the perspective of the drafters that the right to health cannot be understood in narrow bio-medical terms or limited to the delivery of health services. Rather, in its reference, for example, to food, water, sanitation, and environmental dangers, it recognises the wider social and economic factors that influence and impact on the child’s state of health. Thus, the text of Article 24 sets out: a broad right to health for all children combined with a right of access to health services a priority focus on measures to address infant and child mortality, the provision of primary health care, nutritious food and clean drinking water, pre-natal and post-natal care, and preventive health care, including family planning the need for effective measures to abolish traditional practices harmful to children’s health a specific obligation on States Parties to cooperate internationally towards the realisation of the child’s right to health everywhere, having particular regard to the needs of developing countries. The right to health is a prime example of the interelatedness of child rights as it is contingent upon and informed by the realization of so many other rights guaranteed to children under the convention. This chapter analyses the child’s right to health in relation to four essential attributes. The first attribute of the child’s right to the highest attainable standard of health emphasizes what an exacting standard this human rights norm contains. Taking a social determinants of health perspective the right entails not just access to health services but programmatic supports in sanitation, transportation, education and other fields to guarantee the enjoyment of health. The second attribute focuses on the Basic minimum criteria of the right to health as reflected in Article 24(2). A third attribute is the insistence upon child health accountability mechanisms using the Availability, Accessibility, Acceptability and Quality Accountability Framework. Finally, given the wide discrepancies in enjoyment of children’s right to health across the globe, a fourth attribute focuses upon international cooperation to ensure equal access to the right to health.

Hubungan Kepuasan Klien Post Natal Care Terhadap Kualitas Pelayanan Bidan Di Puskesmas

Introduction; How to reduce maternal mortality, there is a need for quality services that are needed by every client because good service can foster client confidence in services. Purpose; to determine the relationship of Post Natal Care Client Satisfaction to the quality of Midwife services. Method; analytic descriptive research with cross-sectional approach. Results; show that there is a relationship between the midwife's response to post-natal care client satisfaction and there is a relationship between the midwife's attention and post-natal care client satisfaction. Conclusion: that there is a relationship between midwifery services to postpartum mother satisfaction.

The association between midwifery staffing levels and the experiences of mothers on postnatal wards: cross sectional analysis of routine data

Background Women have consistently reported lower satisfaction with postnatal care compared with antenatal and labour care. The aim of this research was to examine whether women's experience of inpatient postnatal care in England is associated with variation in midwifery staffing levels. Methods Analysis of data from the National Maternity Survey in 2018 including 17,611 women from 129 organisations. This was linked to hospital midwifery staffing numbers from the National Health Service (NHS) Workforce Statistics and the number of births from Hospital Episode Statistics. A two-level logistic regression model was created to examine the association of midwifery staffing levels and experiences in post-natal care. Results The median full time equivalent midwives per 100 births was 3.55 (interquartile range 3.26 to 3.78). Higher staffing levels were associated with less likelihood of women reporting delay in discharge (adjusted odds ratio [aOR] 0.849, 95% CI 0.753 to 0.959, p=0.008), increased chances of women reporting that staff always helped in a reasonable time aOR1.200 (95% CI 1.052, 1.369, p=0.007) and that they always had the information or explanations they needed aOR 1.150 (95% CI 1.040, 1.271, p=0.006). Women were more likely to report being treated with kindness and understanding with higher staffing, but the difference was small and not statistically significant aOR 1.059 (0.949, 1.181, p=0.306). Conclusions Negative experiences for women on postnatal wards were more likely to occur in trusts with fewer midwives. Low staffing could be contributing to discharge delays and lack of support and information, which may in turn have implications for longer term outcomes for maternal and infant wellbeing.

Mothers front-load their investment to the egg stage when helped in a wild cooperative bird

In many cooperative societies, including our own, helpers assist with the post-natal care of breeders' young, and may thereby benefit the post-natal development of offspring. Here we present evidence of a novel mechanism by which such post-natal helping could also have hitherto unexplored beneficial effects on pre-natal development: by lightening post-natal maternal workloads, helpers may allow mothers to increase their pre-natal investment per offspring. We present the findings of a decade-long study of cooperatively breeding white-browed sparrow weaver, Plocepasser mahali, societies. Within each social group, reproduction is monopolized by a dominant breeding pair, and non-breeding helpers assist with nestling feeding. Using a within-mother reaction norm approach to formally identify maternal plasticity, we demonstrate that when mothers have more female helpers they decrease their own post-natal investment per offspring (feed their nestlings at lower rates) but increase their pre-natal investment per offspring (lay larger eggs, which yield heavier hatchlings). That these plastic maternal responses are predicted by female helper number, and not male helper number, implicates the availability of post-natal helping per se as the likely driver (rather than correlated effects of group size), because female helpers feed nestlings at substantially higher rates than males. We term this novel maternal strategy 'maternal front-loading' and hypothesize that the expected availability of post-natal help allows helped mothers to focus maternal investment on the pre-natal phase, to which helpers cannot contribute directly. Such cryptic maternally mediated helper effects on pre-natal development may markedly complicate attempts to identify and quantify the fitness consequences of helping.

Childbirth patterns after previous caesarean birth in sub-Saharan Africa: a retrospective analytical study in two referral hospitals in a semi-urban setting in Cameroon

Background: Rising rates of caesarean section (CS) predispose to uterine rupture (UR) during subsequent childbirths. Childbirth after previous CS has poorly been studied in rural Africa. Objective was to describe and analyse the patterns of childbirths after previous CS.Methods: A retrospective analytical study of facility-based deliveries after previous caesarean birth from January 1, 2019 to April 30, 2021 in Bafoussam, Cameroon. We included 416 files of women with previous CS for term singleton pregnancies. Statistics were computed with SPSS®.Results: Mean age and mean parity were 29.9±5.6 years and 3.2±1.4 respectively. Almost half of participants [199 (47.8%)] had had a previous vaginal birth. Antenatal care (ANC) providers were nurses/midwives and general practitioners for 232 (55.8%) and 77 (18.5%) women respectively. The route of delivery wasn’t chosen during ANC for 312 (75.0%) women and 99 (23.8%) of participants were referred during labour. Elective repeat CS was done for 92 (22.1%) women and 324 (77.9%) underwent trial of labour after CS (TOLAC) of whom 131 (40.4%) gave birth by vaginal route. Onset of labour was spontaneous in 304 (93.8%) cases. UR complicated 13 (4.0%) cases of TOLAC. Previous vaginal birth predicted successful TOLAC and referred parturients had higher risk of UR. There were 28 (8.6%) perinatal deaths and 1 (0.3%) maternal death.Conclusions: In our semi urban setting, deliveries after previous caesarean births are unplanned. The success rate of TOLAC is low with a high rate of complications. There is need to improve quality of ANC, birth care and post-natal care for women with previous CS.

Filhos da (in)justiça

The following article presents statements by pregnant or breastfeeding women to have been through custody hearings and criminal proceedings while released on bail, illustrating institutional responses to prenatal, childbirth, and post-natal care outside the prison environment. The aim was to document the possibilities for and difficulties of applying release measures, according to the women’s own narratives of violence. The qualitative research is based on an analysis of content and is organized according to thematic modules with an exploration of the material collected in interviews and field data. Several obstacles faced in the empirical study have been highlighted, as have the experiences of the women inside and outside the prisons, in terms of the exercise of motherhood, life with the child, the lack of state assistance, and the consequences of the imprisonment. The report from mothers to have been released on bail or placed under house arrest due to pregnancy demonstrates adequate pre-natal care and the children’s healthy development, although difficulties were still experienced during childbirth. The adoption of measures to release the women allowed for better access to healthcare, in line with the human right to safe motherhood. The satisfaction of being able to care for their children and live alongside family stood out as a positive factor. Situations of institutional violence still persist, given the insufficiency or absence of state protection.

Assessment of Indications, Risk Factors, & Materno-foetal Outcomes of LSCS (Emergency & Planned) in a Tertiary Care Rural Hospital of Wardha District, India

Background: Occurrence of elective Caesarean Section (CS) is prevalent in the advanced age group, i.e. 26-30 years while higher incidence of emergency CS is seen in 20-25 years, the younger age group. Emergency caesarean delivery analogous with substantially greater maternal and foetal delivery complications in contrast to elective caesarean sections regardless of its growing acceptance as a preferable alternative to vaginal delivery. The study attempts to determine risk factors for emergency and scheduled caesarean surgeries, along with indications of LSCS and maternal-foetal outcomes. Method: Prospective observational study will be carried out on post-natal care women who have undergone LSCS in the past 1 week in the rural tertiary care hospital, Wardha. Study participants will be approached in the OBGY Post Natal Care Ward 1or 2 days post-delivery after assuring their comfort. A predesigned & pre-structured questionnaire containing socio-demographic profile, maternal details, and reasons for planned/emergency C-section, neonatal details etc. Results: From the baseline study, the average number of caesarean-sections was 55-60 %. Proportion of elective and emergency caesarean was 41.40 % and 58.60% respectively. Emergency group is expected to show all of the complications significantly higher in terms of both maternal and fetal outcome. Conclusion: Previous c-section, foetal distress and misrepresentation of the foetus (Breech and Transverse Lie) were recorded as a most important indicator of caesarean section along with obstructed labour. Higher incidence of emergency CS was 20-25 years, while the incidence of elective C-Section was prevalent. in the age group of 26-30 years; Modifiable risk factors for the Caesarean Section, such as early marriage with its associated inadequate pelvic growth and unnecessary avoidance of hospital delivery due to fear of CS, should be discouraged.

Faktor–Faktor yang Mempengaruhi Kunjungan Nifas Lengkap di Indonesia: Analisis Lanjut Data Riskesdas 2018

Abstrak Latar Belakang: Perawatan nifas dibutuhkan pada periode setelah persalinan untuk mendeteksi dini masalah atau mengobati penyakit pascapersalinan. Lebih dari 65% kematian ibu terjadi selama 42 hari pertama pascapersalinan. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang mempengaruhi kunjungan nifas lengkap di Indonesia. Metode: Penelitian menggunakan data Riset Kesehatan Dasar (Riskesdas) 2018. Unit analisis penelitian ini adalah ibu yang melahirkan anak terakhir dalam kurun 2013 sampai wawancara Riskesdas 2018. Hasil: Berdasarkan hasil regresi logistik, faktor predisposisi yang memiliki peluang untuk mempengaruhi kunjungan nifas lengkap adalah umur ibu 20-35 tahun (OR 0,885), pendidikan tinggi (OR 1,167), paritas ≤ 2(OR 1,090), persalinan secara sesar/vacuum/forceps, dll (OR 1,491), persalinan di fasilitas kesehatan (OR 1,489), pemeriksaan kehamilan lengkap (OR 1,613), dan regional Sumatera (OR 0,510). Faktor pemungkin yang memiliki peluang untuk mempengaruhi kunjungan nifas lengkap adalah status tidak bekerja (OR 0,954) dan memiliki jaminan kesehatan (OR 1,141). Faktor kebutuhan yang memiliki peluang untuk mempengaruhi kunjungan nifas lengkap adalah memiliki riwayat komplikasi kehamilan (OR 0,948). Kesimpulan: Faktor-faktor yang mempengaruhi kunjungan nifas lengkap adalah umur ibu, pendidikan, paritas, metode persalinan, tempat persalinan, pemeriksaan kehamilan, regional tempat tinggal, status pekerjaan, kepemilikan jaminan kesehatan, dan riwayat komplikasi kehamilan. The Determinants of Fully Postpartum Visit in Indonesia: Further Analysis of Riskesdas 2018 Abstract Background: Post-natal care is needed during postpartum for early detection or to cure disease or any problem of postpartum. More than 60% of maternal mortality happens during 42 days of postpartum. This research is intended to analyse the determinant factors of fully postpartum visit in Indonesia. Method: This research uses the data from Riskesdas 2018. The unit of analytic research is mothers having last birth happened from 2013 until Riskesdas interview on 2018. Result: Based on the result of logistic regression, predisposition factors that have chance to affect the fully postpartum visit are mothers on age 20-35 years old (OR 0,885), advance education (OR 1,167), parity ≤2 (OR 1,090), laboring through caesar, vacuum, forceps et all (OR 1,491), labor using medical facility (OR 1,489), fully pregnancy checkup (OR 1,613) and region Sumatera (OR 0,510). Enabling factors that have chance to affect the fully postpartum visit are unemployment (OR 0,954) and owning health insurance (OR 1,141). Need factor that has chance to affect fully postpartum visit is having history of pregnancy complications (OR 0,948). Conclusion: The factors affecting fully postpartum visit are age, education, parity, labor method, place of labor, pregnancy checkup and region of province, job status, health insurance ownership and history of pregnancy complication.

Unintended pregnancy: its proportion and associated factors among rural women in Bench Maji zone south west Ethiopia: Community based cross sectional study

Background: Globally, unintended pregnancy affects life of thousands of women annually. It harms the health of both the mother and baby. By avoiding unwanted pregnancies, it is possible to save thousands of mothers from premature pregnancy-related deaths. Objectives: to assess level of unintended pregnancy and associated factors among rural women in Bench Maji zone south west Ethiopia.Methods: A community-based cross-sectional study was conducted among 829 pregnant women from March to June 2018 in the Bench Maji Zone, southwest Ethiopia. A multistage sampling technique was used to select study participants. The data were collected by trained data collectors using a structured and pre-tested questionnaire. Data were entered into the epi data manager version 4.0.2.101, and then exported to SPSS version 21 for analysis. Multivariable binary logistic regression was done and variables with a p-value < 0.05 were factors associated with unintended pregnancy. Results: Of the 829 interviewed women, 109 (13.1%) of them became pregnant without their intention. Factors associated with unintended pregnancy were having exposure to media (radio) [AOR=5.06: 95% CI: 1.89-13.53], having 3 and more children [AOR=2.34: 95CI:1.19-4.64], place of recent delivery [AOR=2.07, 95%CI: 1.12-3.84], and having post-natal care utilization for recent delivery AOR=4.03, 95% CI: 2.09-7.79].Conclusion: The magnitude of unintended pregnancy was significant in number in the study area. Interventions have to take based on exposure to media (radio), number of born children, place of recent delivery, and post-natal care utilization for recent delivery of the women.