COVID-19 Pandemic and Maternal Psychological Wellbeing During the Malaysian Movement Control Order: A Cross-Sectional Study

Background: COVID-19 pandemic had resulted in nationwide lockdown as a disease control measure. Potential harm to self and baby due to COVID-19 infection as well as uncertainties about delivery are among contributors to maternal anxiety. We aimed to assess the prevalence of psychological distress among pregnant women during the Malaysian Movement Control Order (MCO).Methods: A cross-sectional study was conducted between May and June 2020 in a teaching hospital in Kuala Lumpur, Malaysia. A self-administered electronic questionnaire was distributed which included the following; (1) Depression, Anxiety and Stress Scale-21 (DASS 21), (2) Short Warwick Edinburgh Mental Wellbeing Scale (SWEMWBS), (3) MCO effect questionnaire, and (4) newly designed COVID-19 pregnancy-related anxiety. Chi-square test and logistic regression were performed to determine significant associations whilst mean scores comparison were conducted through Mann-Whitney-U-test.Results: Four hundred and fifteen women were included in the final analysis. The prevalence of psychological distress among our cohort was 14.7%; with a two-fold increase of risk among the non-Malays (AOR 1.98, 95% CI 1.00–3.89) whilst a greater number of social support showed a protective effect (AOR 0.51, 95%CI 0.28–0.92). Malay ethnicity (p < 0.001) alongside greater household income (p = 0.014) were positive predictors of a higher sense of maternal wellbeing. Multiparous women and those of higher economic status experienced the more negative effect of the MCO. Around 88% of our women reported a higher level of COVID-19 pregnancy-related anxiety. Younger (p = 0.017) and first-time mothers (p = 0.039) were more likely to be anxious. Although adequate maternal knowledge on COVID-19 was associated with a greater sense of maternal wellbeing (p = 0.028), it was also linked to a higher level of COVID-19 related anxiety (AOR 3.54, 95% 1.29–9.70).Conclusion: There was a relatively low prevalence of psychological distress among expectant mothers in Malaysia during the first wave of the COVID-19 pandemic. Expectant mothers should receive accurate and reliable information on the effect of COVID-19 on pregnancy to relieve some maternal anxiety. Maternal health screening is important to identify individuals who would benefit from extra support and mental health intervention, especially in prolonged lockdown.

PREGNANCY CARE IN COVID19 THROUGH AYURVEDA

The coronavirus disease 2019 (COVID-19) is a highly transmittable and pathogenic viral infection caused by se- vere acute respiratory syndrome coronavirus 2 (SARS COV-2) and Garbha-Kala is one of the most crucial and responsible stages in women's life. COVID-19 can produce a devastating effect on maternal wellbeing. Ayurveda has mentioned the pandemic situation under the term Janapadodhwamsa which spread through Vayu, Jala, Desha and Kala. The outbreak of Covid-19 is severely affecting the world. It is an infectious disease caused by severe acute respiratory syndrome coronavirus 2. It has mainly respiratory and systemic manifestations. People having diabetes, chronic diseases, pregnant women are more prone to this infection as they are more susceptible to path- ogens and the development of severe conditions like pneumonia. Due to the physiological changes during preg- nancy, pregnant women are the most vulnerable group in this pandemic situation because infection during preg- nancy can result in adverse outcomes. Much research is still in continuation because we are not sure of much evi- dence till now. Many preventive protocols suggested by Ayurveda can prevent the prevalence of disease up to some extent. Keywords: Ayurveda, Covid-19, Janapadodhwamsa, Pandemic, Pregnancy

Tika Tonu: Young Māori Mothers' Experiences of Wellbeing Surrounding the Birth of their First Tamaiti

<p>The wellbeing experiences of young Māori mothers’ (ngā māmā) surrounding the birth of their first tamaiti and the impact of those experiences, often determine outcomes for wāhine Māori, their tamariki and whānau. A greater understanding and nurturing of young Māori mothers has far reaching implications that encompass hapū, iwi, community, Aotearoa and the health experiences and outcomes of Indigenous and other subjugated people in the global community. However, there is little exploration and information about the wellbeing experiences of young Māori mothers, and therefore little is known about their stories, thoughts, and feelings from their experiences. This thesis explores the experiences of young Māori mothers from their perspective, regarding pregnancy, birth and motherhood. Historical misrepresentation, western notions of gender and sexuality, negative statistics and reports have portrayed young Māori mothers as the least capable, least desired and deficient. Dominant western ideologies of motherhood and hegemonic perceptions fail to recognise the essence of wellbeing for young Māori mothers, and instead marginalise and render their aspirations invisible and irrelevant. This thesis brings to the fore the elements that ngā māmā signal as vital to their wellbeing. By utilising a kaupapa Māori approach to methodology, and a theoretical framework of kaupapa Māori and mana wahine, this thesis explores what matters to ngā māmā and their wellbeing, and how te ao Māori is an intrinsic part of those experiences. An integrated kaupapa Māori analytical framework is presented, which was developed for the thesis as a legitimate and authentic approach to research method and design to help make sense of and assemble the codes, symbolism and themes of the data. The findings of this thesis signify the power of the female to influence the wellbeing of ngā māmā through stability, guidance and empowerment. The thesis captures the tamaiti as ‘tohu aroha’, and explicates the journey of ngā māmā to greater rangatiratanga and identity. Furthermore, the vitality and balance of te ao Māori within the lives of ngā māmā contributes to what is significant to their experiences of wellbeing. The thesis emancipates ngā māmā from entrenched stereotypes by epitomising their experiences and thus denouncing deficit discourses, and advances the aspirations of ngā māmā and the lives of their tamariki and whānau. This thesis makes an original and complementary contribution to the growing knowledge around Māori maternal wellbeing, kaupapa Māori methodology and research.</p>

Tika Tonu: Young Māori Mothers' Experiences of Wellbeing Surrounding the Birth of their First Tamaiti

<p>The wellbeing experiences of young Māori mothers’ (ngā māmā) surrounding the birth of their first tamaiti and the impact of those experiences, often determine outcomes for wāhine Māori, their tamariki and whānau. A greater understanding and nurturing of young Māori mothers has far reaching implications that encompass hapū, iwi, community, Aotearoa and the health experiences and outcomes of Indigenous and other subjugated people in the global community. However, there is little exploration and information about the wellbeing experiences of young Māori mothers, and therefore little is known about their stories, thoughts, and feelings from their experiences. This thesis explores the experiences of young Māori mothers from their perspective, regarding pregnancy, birth and motherhood. Historical misrepresentation, western notions of gender and sexuality, negative statistics and reports have portrayed young Māori mothers as the least capable, least desired and deficient. Dominant western ideologies of motherhood and hegemonic perceptions fail to recognise the essence of wellbeing for young Māori mothers, and instead marginalise and render their aspirations invisible and irrelevant. This thesis brings to the fore the elements that ngā māmā signal as vital to their wellbeing. By utilising a kaupapa Māori approach to methodology, and a theoretical framework of kaupapa Māori and mana wahine, this thesis explores what matters to ngā māmā and their wellbeing, and how te ao Māori is an intrinsic part of those experiences. An integrated kaupapa Māori analytical framework is presented, which was developed for the thesis as a legitimate and authentic approach to research method and design to help make sense of and assemble the codes, symbolism and themes of the data. The findings of this thesis signify the power of the female to influence the wellbeing of ngā māmā through stability, guidance and empowerment. The thesis captures the tamaiti as ‘tohu aroha’, and explicates the journey of ngā māmā to greater rangatiratanga and identity. Furthermore, the vitality and balance of te ao Māori within the lives of ngā māmā contributes to what is significant to their experiences of wellbeing. The thesis emancipates ngā māmā from entrenched stereotypes by epitomising their experiences and thus denouncing deficit discourses, and advances the aspirations of ngā māmā and the lives of their tamariki and whānau. This thesis makes an original and complementary contribution to the growing knowledge around Māori maternal wellbeing, kaupapa Māori methodology and research.</p>

Exploring the lived experiences of mothers who identify with ‘gender disappointment’

In a western context, little is known about the term ‘gender disappointment’, which describes feelings of despair around not having a child of the desired sex. This study aimed to explore the lived experiences of British women who identify with the concept. Six mothers with only sons, who also desired a daughter, participated in a semi-structured interview via an online platform. An interpretative phenomenological analysis identified themes related to pity, societal expectations of unfulfillment, and concerns relating to the future mother-son relationship, feelings of guilt and shame, barriers to seeking help and the benefits of talking. The study concludes that there is a need for greater awareness of gender disappointment and the negative impact it has on maternal wellbeing. In addition, mothers who identify with gender disappointment would benefit from support from health visitors to enable them to access the help they need.

Association of Maternal Observation and Motivation (MOM) Program with M-Health Support on Maternal and Newborn Health

Maternal and child nutrition has been a critical component of health, sustainable development, and progress in low- and middle-income countries (LMIC). While a decrement in maternal mortality is an important indicator, simply surviving pregnancy and childbirth does not imply better maternal health. One of the fundamental obligations of nations under international human rights law is to enable mothers and teenage girls to endure pregnancy and delivery as an aspect of their enjoyment of reproductive and sexual health and rights and live a dignified life. The aim of this study was to discover the correlation between the Maternal Observation and Motivation (MOM) program and m-Health support for maternal and newborn health. A Comparative study was done among 109 pregnant mothers (study group-94; control group-102 mothers) with not less than 20 weeks of gestation. Maternal outcomes such as Hb, weight gain and newborn results like birth weight and crown- heel length was obtained on the baseline, 28 and 36 weeks of gestation. Other secondary data collected were abortion, stillbirth, low birth weight, major congenital malformations, twin or triplet pregnancies, physical activity and maternal wellbeing. The MOM intervention included initial face to face education, three in-person visits and eight virtual health coaching by WhatsApp. The baseline data on Hb of the mothers show that 31(32.98%) vs 27(28.72%) of the study and control group had anaemia, which improved to 27.66% and 14.98% among study group mothers at 28 and 36 weeks of gestation (p&lt;0.001). The weight gain (p&lt; 0.001), level of physical activity (p&lt; 0.001), and maternal wellbeing (p&lt; 0.01) also had significant differences after the Intervention. Even after controlling for potentially confounding variables, the maternal food practices regression model revealed that birth weight was directly correlated with consumption of milk (p 0.001), fruits (p 0.01), and green vegetables (p 0.05).As per the physical activity and maternal wellbeing regression model, the birth weight and crown heel length were strongly related with the physical activity and maternal wellbeing of mothers at 36 weeks of gestation (p &lt;0.05). Combining the MOM intervention with standard antenatal care is a safe and effective way to improve maternal welfare while upholding pregnant mothers' human rights.

PROM and it’s maternal outcome: a retrospective study in a rural medical college of India

Background: Premature rupture of membrane is the unconstrained break of layer before the beginning of labor and can happen any gestational age even at 42 weeks of growth. Around 2-30 % of all pregnancy will encounter PROM and prompts 33% of preterm birth. The analysis of PROM is to a great extent clinical and is normally proposed by a history of watery vaginal discharge and affirmed on sterile speculum assessment. This examination was led to decide the occurrence, to discover the age, equality dispersion, gestational age dissemination, presentation of PROM and plan the line of the management.Methods: The cases selected in this study were those who had spontaneous rupture of membrane after 28 weeks of gestation but before the onset of labor pain. The study period was of one year from 1st January 2019 to 31st December 2019. The study was conducted in the labor room complex of Coochbehar Govt. Medical College and Hospital, WB India. The patients were admitted in the labor room through emergency. All datas were collected from labor room log book.Results: Total no. of deliveries were 10900 and total no of PROM were 545.Incidence of PROM is 5% in the present study. Maximum no of cases were in the age group between 20-29yr (63%). PROM mainly occurs in primigravida (50.45%). And low rupture of membrane was 91.8%. Cephalic is the commonest presentation (85%) in PROM and the incidence of caesarean section is 24.95%.Conclusions: PROM is the obstetric emergency and once the PROM is diagnosed it is important to weigh the risk of PROM and prematurity and make the right choice of conservative management and active management. If there is chance of maternal morbidity pregnancy should be terminated considering the maternal wellbeing first and then that of the fetus.

Understanding and Approach towards Breast Feeding (A Study of Rural Nursing Mothers)

A well-known saying "your health will depend on the type of food you eat". A solid eating regimen comprises of an even eating routine made out of exceedingly significant supplements in right extent. It forestalls lack of healthy sustenance and beginning of illnesses like weight, diabetes, heart ailments, disease and stroke to give some examples. Newborn child and little youngster taking care of practices are of prime significance to keep up the dietary status of kids between 0-24 months of age and are frequently affected by conventional practices. Baby and small kid taking care of practices, lack of healthy sustenance and kid endurance rates in the nation are interlinked. Accentuation on improving these practices is a basic advance for better advancement and wellbeing of children. Contamination and ailing health during the pinnacle time of advancement in the initial two years of life influence the development capability of kids. Breastfeeding is an essential human action, crucial to newborn child and maternal wellbeing also, of monstrous financial incentive to families and societies. To survey the healthful information and demeanor towards breast feeding among rural nursing moms, present investigation was led. The example was 200 lactating moms. Purposive Random examining strategy was utilized to gather the data. The information was gathered legitimately from moms by utilizing organized survey to evaluate the dietary information and attitude of nursing mother. After the information assortment, information will be coded efficiently and organized under various heads. Coding was done on the basis of knowledge and attitude. After this, content and statistical analysis was done using percentage.

Validating social support and prioritizing maternal wellbeing: beyond intensive mothering and maternal responsibility

In this piece, I reflect on the current model of motherhood that prevails in Western countries, often termed ‘intensive mothering'. I will briefly trace the history of this approach, focusing in particular on how theory from developmental psychology has, to some extent, functioned to reinforce it by foregrounding the mother–child dyad and emphasizing the importance of maternal practices for children's developmental outcomes. I will then consider the particular implications of this cultural approach to motherhood for women's experiences of motherhood and maternal wellbeing. Finally, I reiterate that we need to continue to challenge this western-centric model of motherhood, which risks both isolating and overburdening women, by highlighting the ways in which both women and children benefit from wider social support systems, yet also by making it permissible for women to access social support without compromising a ‘good mother' identity. This article is part of the theme issue ‘Multidisciplinary perspectives on social support and maternal–child health'.