Maternal-Child Health Outcomes from Pre- to Post-Implementation of a Trauma-Informed Care Initiative in the Prenatal Care Setting: A Retrospective Study

Background: There has been an increase in use of trauma-informed care (TIC) approaches, which can include screening for maternal Adverse Childhood Experiences (ACEs) during prenatal care. However, there is a paucity of research showing that TIC approaches are associated with improvements in maternal or offspring health outcomes. Using retrospective file review, the current study evaluated whether differences in pregnancy health and infant birth outcomes were observed from before to after the implementation of a TIC approach in a low-risk maternity clinic, serving women of low medical risk. Methods: Demographic and health data were extracted from the medical records of 601 women (n = 338 TIC care, n = 263 pre-TIC initiative) who received prenatal care at a low-risk maternity clinic. Cumulative risk scores for maternal pregnancy health and infant birth outcomes were completed by health professionals. Results: Using independent chi-squared tests, the proportion of women without pregnancy health risks did not differ for women from before to after the implementation of TIC, χ2 (2, 601) = 3.75, p = 0.15. Infants of mothers who received TIC were less likely to have a health risk at birth, χ2 (2, 519) = 6.17, p = 0.046. Conclusion: A TIC approach conveyed modest benefits for infant outcomes, but not maternal health in pregnancy. Future research examining other potential benefits of TIC approaches are needed including among women of high socio-demographic and medical risk.

MASASE MENGURANGI NYERI PERSALINAN PADA IBU BERSALIN

Introduction: Labor pain management can be implemented both non pharmacologically and pharmacologically. It can be done non pharmacologically without using drugs such as relaxation, massage, acupressure, acupuncture, hot or cold compresses and aromatherapy, while pharmacologically through the use of drugs. Non-pharmacological pain management is more secure, simpler, no bad side effect and reffering to mother caring than pharmacological pain management that potentially have adverse effect.Purpose: To identify the effect of massage on mothers’ pain during first stage labor. Method: This is an analytical survey study with cross sectional method. It was taken place in Hadijah Maternity Clinic which is located in Medan. It was conducted from January to July 2021. The populations were 38 mothers who gave birth physiologically, that complained pain during first stage labor in Hadijah Maternity Clinic. The samples were part of the number and characteristics possessed by the population. There were 38 women chosen as the sample of the study that devided into 2 groups; control group and intervention group.Results: The rate of pain intensity in intervention group before the massage was about 7,26 and after the massage was 4,74 with the value p=0,000. Whereas in control group, the rate of pain intensity before the massage was 7,00 and after the massage 6,16 with value p=0,007. So that the comparison after the massage which was carried out in the intervention and control groups obtained value p=0,001Conclusion: There is a significant effect of the massage on the reduction of mothers’ labor pain during first stage labor. Suggestion clinics and hospitals to use the massage method as an intervention in reducing labor pain in the active phase of the first stage Key words: Massage, Labor Pain, First Stage Labor ABSTRAKPendahuluan : Manajemen nyeri persalinan dapat diterapkan secara non farmakologis dan farmakologis. Pendekatan secara non farmakologis tanpa penggunaan obat-obatan seperti relaksasi, masase, akupresur, akupunktur, kompres panas atau dingin dan aromaterapi, sedangkan secara farmakologis melalui penggunaan obat-obatan. Manajemen nyeri non farmakologis lebih aman, sederhana dan tidak menimbulkan efek merugikan serta mengacu kepada asuhan sayang ibu, dibandingkan dengan metode farmakologi yang berpotensi mempunyai efek yang merugikanTujuan : Mengidentifikasi pengaruh metode masase terhadap nyeri persalinan pada ibu inpartu kala I fase aktif. Metode : Jenis penelitian kuantitatif pendekatan quasy ekspreimen Lokasi penelitian di RB Hadijah yang terletak di Kota Medan. Penelitian dilakukan sejak bulan Januari sampai dengan bulan Juli 2021. Populasi penelitian adalah semua Ibu Bersalin Fisiologis yang mempunyai keluhan nyeri persalinan dengan partus pervaginam di RB Hadijah sebanyak 38 orang. Sampel adalah bagian dari jumlah dan karakteristik yang dimiliki oleh populasi. Sampel dalam penelitian ini sesuai dengan kriteria adalah sebanyak 38 orang dibagi menjadi 2 yaitu kelompok control dan kelompok intervensiHasil : Intensitas nyeri responden pada kelompok intervensi rata-rata skala nyeri sebelum dilakukan metode masase adalah 7,26 dan sesudah dilakukan metode masase adalah 4,74 diperoleh nilai p=0,000. Pada kelompok kontrol rata-rata skala nyeri sebelum dilakukan metode masase adalah 7,00 dan sesudah dilakukan metode masase pada kelompok kontrol 6,16 diperoleh nilai p=0,007. Sehingga perbandingan sesudah dilakukan metode masase pada kelompok intervensi dan kontrol diperoleh nilai p=0,001Kesimpulan : ada pengaruh yang signifikan metode masase terhadap pengurangan nyeri persalinan pada ibu inpartu kala I fase aktif.Saran klinik maupun rumah sakit supaya menggunakan metode masase sebagai salah satu intervensi dalam mengurangi nyeri persalinan kala I fase aktif Kata Kunci : Metode masase, Nyeri Persalinan, Inpartu Kala I

Neonatal rebound hyperkalemia associated with ritodrine alone: a case report

Background Betamimetics have been used for tocolysis extensively in the past, and one of them, ritodrine is widely used in Japan. Various adverse events have been reported for this agent, including newborn hypoglycemia and hypokalemia, as well as maternal hypokalemia and rebound hyperkalemia; however, cases of neonatal rebound hyperkalemia are not described in the literature. Case presentation A male infant born at 36 weeks of gestation by cesarean section at a local maternity clinic suddenly entered cardiopulmonary arrest with ventricular tachycardia and fibrillation due to hyperkalemia (K+, 8.7 mmol/L). No monitoring, examination of blood electrolyte levels, or infusions had been performed prior to this event. Maternal infusion of ritodrine (maximum dose, 170 μg/min) had been performed for 7 weeks prior to cesarean section. After resuscitation combined with calcium gluconate, the infant died at 4 months old due to serious respiratory failure accompanied by acute lung injury following shock. No cause of hyperkalemia other than rebound hyperkalemia associated with ritodrine was identified. Conclusions This case report serves as a warning regarding the potential risk of neonatal rebound hyperkalemia in association with maternal long-term ritodrine administration.

Midwifery Care for Pregnant Women With Back Pain Discomfort in Trimester III Pregnancy at the Karunia Birth Clinic, Sidoarjo.

Pregnancy is a process that begins with the unification of spermatozoa with ovum called fertilization and then continued with implantation. Normal pregnancies generally last for 9 months, and are divided into the first 3 trimesters 1-12 weeks, the second trimester 13-27 weeks, the third trimester 28-40 weeks. Various complaints felt by pregnant women, one of which is back pain that causes pregnant women discomfort. This aerikel was written taken from the place of Maternity Clinic Karunia Sidoarjo on January 05, 2020. The way of data collection is by means of anamnesa, examination of analysis, data then documenting by comparing between the data that has been obtained with existing theories. Mrs. .m 40 weeks gestational age, with complaints of physiological back pain with good maternal and fetal conditions.

“I came to escort someone”: Men’s experiences of antenatal care services in urban Ghana—a qualitative study

Background Male involvement in maternal healthcare has been widely recognized as essential for positive health outcomes for expectant mothers and their unborn babies. However, few studies have explored men’s experiences of maternal health services. The purpose of this paper is to explore men’s involvement in antenatal care in urban Ghana and to discuss how men navigate their roles in a space that has been constructed as feminine. The study draws upon theories of space, place, and gender. Methods A qualitative exploratory study using semistructured interviews, focus group discussion, and observation was conducted in Accra, Ghana. Expectant fathers and health workers were interviewed, and observation was conducted at a selected public hospital in Accra. Results The findings suggest that the few men who attend antenatal care with their expecting partners become involved to a limited extent in the clinic’s activities. Beyond a few who take an active role, most men stay on the outskirts of the hospital grounds and rarely participate in consultations with their partner and midwife. Men still view their presence as necessary to acquire knowledge and as sources of emotional, financial, and physical support for their partners. On the health workers’ side, the study found no clear agenda for engaging men at the clinic, and nurses/midwives felt there was a lack of staff who could engage more directly with the men. Conclusion The study indicates that most expecting fathers feel too shy and uncomfortable to locate themselves in the female space that makes up antenatal care/maternity wards. Health workers do not feel they have the necessary resources to involve men fruitfully. Thus, men do not engage in the activity as hoped but rather remain on the outskirts of the maternity clinic. However, if men continue to negotiate their involvement at the clinic and become more assertive in their roles, the maternity clinic as a female space could, with time, be transformed into a space in which both expecting mothers and fathers can actively participate and be engaged to the benefit of all.

KEEFEKTIFAN DAUN KOL DALAM MENGHAMBAT BENDUNGAN ASI PADA IBU MENYUSUI DI KLINIK BERSALIN BESNAWATI Br. SEMBIRING TAHUN 2019

Dams of breast milk in the mother's breast develop fever, pain, and inflammation. If not treated immediately, mastitis may occur. Mastitis in the mother's breast to the baby is not well nourished. The aim of this study was to minimize pain in the mother's breast against breast milk dams by using cabbage leaves in the Maternity Clinic of Besnawati Br. Sembiring and it is hoped that the mother will be able to face the postpartum period and the breastfeeding process well. This type of research is analytic with cross sectional study approach, namely by measuring several variables at once. The data analysis used in this research is qualitative and quantitative analysis. Quantitative analysis using the Chi-square statistical test. Types of data analysis were performed using the Statistical Package for the Social Science (SPSS) program computer, with a total sample of 30 people. Researchers are interested in finding a method that is more comfortable, can be done independently, and does not hurt the mother in overcoming breast engorgement, namely cabbage leaves, which have been shown to reduce swelling (ASI dam) in areas of the body that experience swelling, so it can be concluded that cabbage leaves can minimize pain in the mother's breast against breast milk dams by using cabbage leaves at the Maternity Clinic Besnawati Br. Sembiring and it is hoped that the mother will be able to face the postpartum period and the breastfeeding process well.

Antimicrobial susceptibility of H. pylori isolated from suspected patient using stool sample at Malali Hospital and Maternity Clinic Kaduna, Kaduna State – Nigeria

The antimicrobial susceptibility of Helicobacter pylori isolated from suspected patient using stool sample at Beijing greatest college of health sciences and technology, Kaduna, demonstration clinic. The analyses were carried out to further understand the intestinal environment condition of the sample sites. As it has been noted that: it is difficult of growing Helicobacter pylori in a broth, hence, no specific enrichment has been proposed. Note: As everything present in the stomach would be found in the stools, hence there is no doubt that Helicobacter pylori can be eliminated via this route and successful culturing of Helicobacter pylori from the stool sample had been achieved. [4]. The stool was diluted to a 20% w/v solution of in phosphate buffered saline (PBS) and the suspension was sieved through a 250 um strainer before plating onto the selective media. The sample was passed through a series of dilution techniques and centrifugation before finally plating on to the deoxycholate citrate agar (selective) and incubates at 37oC under the microacrobic atmospheric oxygen concentration of 7 – 12% (O2) for four (4) days. Across the cultured, the cultured plate there was marked abundant of bacterial cells with some colonies having the characteristics of Helicobacter pylori which later sub-cultured and isolated for antimicrobial test.

Guests and Hosts in an Athens Public Hospital: Hospitality as Lens for Analyzing Migrants’ Health Care

Based on six months of ethnographic research in the maternity clinic of a major Athens public hospital in 2017, this chapter employs the conceptual lens of “hospitality” to analyze relationships that formed around the care of pregnant migrants arriving in Greece since 2015. Permanent health-care personnel, mostly midwives, are the hosts; guests include migrant women, NGO workers that accompany them to the hospital, Greek Roma maternity patients, obstetrics residents, and the native ethnographer herself. The focus is on pregnant migrants; the other guests provide comparative fodder to flesh out the subjectivity of the hosts. Through an ethnographic reconstruction of the microcosm of the clinic as a space of care, sovereignty, and everyday life, the chapter takes on two theoretical issues: the problem of scale and the argument that the hierarchical character of hospitality is incompatible with a rights-based framework. Critiques to the use of the host-guest trope as a frame for the analysis of relations between migrants and receiving states and societies are well heeded. Yet I demonstrate that guest-host dynamics are very much operative in the interaction between state-employed, permanent health-care personnel and migrants. My analysis highlights the limits and capacities of hospitality’s scalar transpositions, as well as the critical potential of hospitality as a lens that elucidates how legally guaranteed migrants’ rights are accessed and granted in practice; hospitality and rights thus emerge as complementary rather than opposing structural and explanatory frameworks.

“I came to escort someone”: Men’s experiences of antenatal care services in Urban Ghana. A qualitative study

BackgroundMale involvement in maternal healthcare has been widely recognized as important for positive health outcomes for expectant mothers and their unborn babies, but few studies have explored men’s experiences of maternal health services. The purpose of this paper is to explore men’s involvement in antenatal care in urban Ghana and to discuss how men navigate their roles in a space that has been constructed as feminine. The study draws upon theories of gender, place and space.MethodsA qualitative exploratory study using semi-structured interviews, focus group discussion and observation was conducted in Accra, Ghana. Expectant fathers and health workers were interviewed and observation was conducted at a selected public hospital in Accra. ResultsThe findings suggest that the few men who attend antenatal care with their expecting partners get involved to a limited extent in activities at the clinic. Beyond a few who take an active role, most men stay on the outskirts of the hospital grounds, and rarely participate in the consultation with their partner and nurse-midwife. Men still view their presence as important, both to acquire knowledge, and as a source of emotional, financial and physical support for their partners. On the health workers’ side, the study found that there was no clear agenda for engaging men at the clinic, and nurses / midwives felt the lack of staff who could engage more directly with the men. ConclusionThe study indicates that most expecting fathers feel too shy and uncomfortable to locate themselves in the female space that makes up antenatal care / maternity wards. Health workers do not feel they have the necessary resources to involve men in a fruitful way. Thus, men do not engage in the activity as hoped but remain on the outskirts of the maternity clinic. However, if men continue to negotiate their involvement at the clinic and become more assertive in their roles, the maternity clinic as a female space could, with time, be transformed into a space where both expecting mothers and fathers can be active and engaged to the benefit of all.