7th World Congress on Midwifery and Womens Health 2018-05-11 Osaka, Japan

Biography:

Melania E. Tudose is a midwife and an associate teacher in midwifery at Carol Davila University of Medicine and Pharmacy, Bucharest. She was an ob-gyn nurse between 1983 and 2009 when she became a licensed midwife (the valedictorian of the first promotion).  She graduated a Master’s Degree in Genetics Counseling and she is a Ph.D. student (4th year) in Medical Science (Medical Genetics). She is the first Romanian midwife accepted at a Doctoral School in Medical Science. She is the president of the Independent Midwives Association which is fighting to rehabilitate the midwifery profession and thus to increase the Romanian women’s and children’s health. In her career, she helped more than 2500 women to bring their babies into our world. She is also working as a senior midwife, coordinator of the Labor and Delivery Rooms, at Buzău Women's Hospital (near Bucharest), Romania

Abstract:

Statement of the Problem: It's widely known that pregnancy is a period with a high psycho-emotional vulnerability. Any extra emotion could bring damage hard to cope with or manage. With all technological advances of today, the only method for clarifying a suspicion of Down syndrome is still the karyotyping which uses fetal tissue obtained through invasive procedures. The suspicion itself, the invasive procedure and the waiting period for the result may disturb maternal psychological equilibrium and can associate negative psycho-emotional feelings. In most situations, the result refutes the suspicion but the harm could be already done because the psychological imbalance experienced by the mother may have already altered the fetal-maternal attachment and the psychological system of the future child. Until now, most researchers focused on the psychological aspects of the procedure, so there are few studies related to the emotional aspects associated with this period. The purpose of this study is to identify the negative emotions experienced during this period and to measure their level.  

Methodology & Theoretical Orientation: was performed an observational, descriptive and prospective study based on an applied questionnaire for knowledge and Profile Mood of States test on 40 pregnant women who performed the amniocentesis.

Findings: 62.5% experienced anxiety, 20% depression, 32.5% anger and confusion, and the total analysis showed that 15% experienced total distress. The mean of knowledge scores was too low for having an informed choice, 18.95 (SD=5,5, range 4 to 31) out of 33 possible.

Conclusion & Significance: The period between having an amniocentesis and receiving the results is a tensioned one, often animated by negative feelings. For a less intense psychological effect, providing complete information and properly emotional support are essential. This requests time and personnel with competencies and abilities in holistic monitoring and providing medical information translated and embroidered on psychological support.

Keywords: Down syndrome, amniocentesis, psychological effects, knowledge

Biography:

2015: Master of Science in Medicine (Bioethics and Health Law) (WITS University)

2012: Ph.D. (WITS)

2002: MCur in Midwifery and Neonatal Nursing (UJ, then RAU)

2000: Advanced Midwifery (RAU)

1996: BACur (Honours) (UNISA) Nursing Education

1991: BACur (UNISA)

1984: General Nursing (Ga-Rankuwa Nursing College)

1986: Diploma in Midwifery (Baragwanath Nursing College)

Currently a researcher and a Senior Lecturer at the University of South Africa. Presented 25 research papers at International and National conferences. Published 10 articles in accredited journals. Supervised 2 Doctoral and 9 Masters students to graduation. Currently mentoring 11 Doctoral and 8 Masters students.

Antenatal Care Project: 

Grant recipient for Women in Research (2017-2019). Project manager of a project on psychosocial antenatal care with a focus on holistic care in Gauteng Province, South Africa through funding granted by the University of South Africa.      

Abstract:

The aim of the antenatal psychosocial care project (2017-2019) is to raise the midwives’ awareness of psychosocial care, to improve the quality of psychosocial services and to fill the gap that exists between routine physical antenatal care and psychosocial care. The proposed project is a follow up on a pilot study that was conducted as part of a Ph.D. degree. A mixed method approach was applied to explore psychosocial risk assessment during antenatal care.

The findings from the pilot study were important in that they too, suggest that pregnant women experience psychosocial problems. The implication of the findings appeared to be that midwives are willing to incorporate the psychosocial assessment tool into routine antenatal care, however challenges including the midwifery curriculum hinders the process. The outcome of the midwifery curriculum review and the perceptions and experiences of midwifery lecturers will be shared in the conference presentation.

A long-term objective of the project is the incorporation of the psychosocial risk assessment tool as part of routine antenatal care. While the use of this antenatal psychosocial assessment tool may increase the midwives’ awareness of psychosocial risks and form a basis for further studies, a bigger sample size validation of the tool and statistical power are required to provide evidence that routine antenatal psychosocial assessment would also lead to improved outcomes for mother and/or child, which will also be addressed in this project.

Biography:

Emmanuel Chioma Blessing (Nee Ajuonuma) is a clinical instructor for midwives in active practice. Blessing’s research and practice interests are in maintaining normal childbirth and newborn care. Her research expertise is in knowledge - to -action process, narrative inquiry, mixed methods and focused groups. 

Abstract:

Background: Newborn has various needs as frequent feeding, bathing, provision of warmth, umbilical cord care, protection etc. Adequate care for them depends on the mother’s awareness, attitude, and skill. Thus maternal competence is vital. This calls for a newborn care teaching programme to increase maternal competence in newborn care.                                                                                            

Objectives: To determine the effect of newborn care programme on maternal competence and find associations between the maternal competence and selected demographic profiles among antenatal mothers.

Participants: 80 pregnant mothers attending antenatal clinic were recruited based on inclusion criteria.

Methods: Knowledge – to – action process was used. The intervention was a newborn care programme that was administered using audio-visual teaching. The experimental group (N=40) received the newborn care programme. The comparison group (N=40) did not receive any. Outcomes were measured with the Parenting Sense of Competence scale at baseline and post-intervention at 2 days after delivery.

Result: Mothers who received newborn care program had significant improvement in the maternal competence from low (pretest) to high (post-test) in satisfaction ratings. There was a significant difference (p = 0.0397, t = -2.453) in the level of maternal competence between the study and comparison group after the newborn care programme at satisfaction rating. Relationship was established (P<0.05) between the level of maternal and age (x²= 8.95, p= 0.014) and parity (x²=6.85, p = 0.0325) only but not with education, employment, and family support.

Conclusion: The newborn care program was effective in improving the maternal competence of antenatal mothers. Mother’s age and parity were identified to influence maternal competence while education, employment, and family support were not significantly related to maternal competence. 

Recent publications:

1.      Blessing C. Emmanuel, Rita C. Ramos, Udochukwu J. Ajuonuma, Mary U. Ajuonuma, Adanma J. Uzo-ngerem, Loius C. Ajonuma. (2017) The effectiveness of newborn care programme on perceived maternal competence and satisfaction of Nigerian mothers. Journal of Health, Medical, and Nursing. www.iiste.org vol.37, 41-48. ISSN2422-8419

2.      Ajuonuma, J., Jimmy, C., Ajuonuma, M., Emmanuel, B., Uzo-Ngerem, A., Ogbedeagu,  V., Chuku, C., & Ajonuma, L. (2016) Quality of Antimalarial Drugs in Malaria-Endemic Municipalities of Pangasinan, Philippines. International Journal of Malaria Research and Reviews www.resjournals.org/IJMR ISSN: 2346-7266 Vol. 4(1): 1-6.

3.      Ajonuma, L., Yusuf, A., Bamiro, A., Makonjuola, S., Ajuonuma, J., Ajuonuma, M., Emmanuel, B., Ogbedeagu, V., Chuku, C., Adabale, K., & Dosunmu, A. (2015) Sickle Cell Disease in Sub-Saharan Africa: Molecular Mechanisms Underlying Episodic Crises, Current and Emerging Therapeutic Strategies in Treatment. IMedPub Journal vol.8, 185. Doi: 10.3823/1784.

4.      Ajonuma, L., Ajuonuma, M., Ajuonuma, B., Ogbedeagu, V., Ajuonuma, J., & Chuku, C. (2011) Endocrine gland-derived vascular endothelial growth factor concentrations in follicular fluid and serum may predict ovarian hyperstimulation syndrome. Fertility and Sterility .2011.03.051 · DOI: 10.1016/j.

Ajonuma L., Ajuonuma M., Ajuonuma B., Chuku C., Ajuonuma J. (2010) Ovarian steroid hormones differentially regulate thrombospondin-1 expression. Fertility and sterility 94. E35 (IF4.167).

Biography:

Anna Marsh is a Newly Qualified Midwife working in a central London hospital, UK. Recently graduated with a BSc Midwifery from Coventry University, her interests lie in birth culture and understanding decision making to attain truly informed consent and provide the best quality individualized care.

Abstract:

Background: With a television at the centre of almost every living room across the UK, TV watching hours are at an all-time high. With childbirth the main feature of several recent programmes, what women are seeing on television could be influencing their expectations around childbirth and informing their choices. This review aims to explore the current literature to examine exactly the influences achieved and their implications. Method: A comprehensive search across a range of databases of the literature relating to childbirth on television and the influence it has on women. Results: Three themes were identified: 1) Fear, 2) Medicalisation of Childbirth and 3) Autonomy of Women. Within Fear, the subtheme Performance Anxiety was identified as well as Older Mothers within the theme Medicalisation of Childbirth. The use of increased Medicalisation for dramatization to captivate audiences gives an inaccurate portrayal of childbirth, instilling unnecessary fear in the audience. However, women are not influenced exclusively by television and utilise many other social and cultural sources of information. Conclusion: There is limited research around the effects of women being exposed to childbirth on television. From the literature, it is evident that television does influence women’s expectations and decision-making around childbirth, although the extent to which is not examined within the literatures. 

Biography:

Coming Soon

Abstract:

To highlight the neglected healthcare of women and babies during and after humanitarian crises.

 I discuss the challenges faced by both women and babies accessing healthcare in conflict zones and after natural disasters, as the theme is displacement. I also discuss the challenges faced by staff.

The presentation highlights the work of MSF, Medecins sans Frontieres/Doctors without Borders in the Democratic Republic of Congo (2015), South Sudan (2016 and 2017) and Haiti (2016) and their efforts to provide safe, effective, free and quality healthcare and also where we need to improve going forward in 2017 and beyond.

Biography:

Coming Soon

Abstract:

This report wants to put in evidence the relationship between Culture, Science, Technology, Nature, and Childbirth.

We know, from Anthropology, that there is not any population in the world, where Labor and Childbirth take place as natural and physiological events. The biological events of Labor and Birth are everywhere remolded and conditioned by social factors and dominant cultural factors of which they are expression. Physiology is universal. However, we know how there are multiple modes of approaching universal physiological events.

Birth is considered in every society as a reflection of total culture. It is culture to explain diversity and not nature.  

We should not lose sight of the fact that today we live in a Post-Modern Society where technologies have an impact on the individual greater than that produced by their meaning.

Contemporary medical obstetrics considers the use of high technology as the first element to control and dominate nature from the unpredictability of pregnancy and childbirth.  Medicine needs to control the 'risk’. In this Culture, Childbirth is a Medical event and it is not considered the fact that reproduction is not only a biological process but a complex experience that involves spirituality, psychology, ethics, rationality and relational life as expression of woman’s identity.               

Nature, Culture, and Society are the three inseparable dimensions of human reproduction and childbirth, where it cannot be ignored the existential problem of childbirth and human identity. This needs a reflection on the deepest meaning on maternity connected to women’s Conscience developed in their human biography, as a visible expression of a personal act in a synthesis of total and original intimacy.

In the Seventies, as reaction to the excess of technocratic medicine, that rigidly separates, in a Cartesian way, the body of the mind, it was felt the necessity to Humanize the Technomedicine

At present today, we are in a situation that has contradictory aspects. We can see that it has been tried to Humanize childbirth but, on the other hand, the use of Medical Technology for Childbirth has been progressively increased, as evidenced by the increase, in low-risk births, interventions in most Western countries, which have become such a routine to be considered more and more as part of births defined 'normal'

 In the Scientific Model of birth (or Physiological Model) it is believed that for healthy women with normal pregnancies, we must work to improve the quality of Birth Support by following the principles of Science, by integrating the judicious use of the best scientific evidence available, with the precise scientific knowledge of anatomy and physiology, associated with the clinical experience of the operator.  But besides this, there is the necessity to understand the patient's values, preferences, and considerations and to respect the inseparable unit of the woman with her baby. Every birth needs assistance and support.

It is therefore proposed to analyze new territorial and hospital-based birth assistants that see two parallel pathways, the physiological one entrusted to midwives with a continuity of care and that of high-risk pregnancy to doctors.

Today it is a commitment to practice Holistic Care to pregnancy and birth.

The Birth Support Model that best understands a holistic approach is that of Anglo-Saxons with the term Midwifery Model of Care and identifying in the Midwife as the appropriate operator to this type of assistance

Biography:

Howieda Fouly has her expertise in early detection of cervical lesions based on her training and decoction of cases during data collection of her doctoral thesis. I had a post-doctor scholarship at Johns Hopkins School of Nursing2017. I got Ph.D. Obstetric & Gynecologic nursing 2013.I had a Ph.D. co-scholarship 2009-2011 at the University of Pennsylvania, school of nursing USA. I joined to Assiut University, faculty of nursing as a faculty member since 2008 & I teach Obstetrics & Gynecologic nursing / theoretical & clinical curriculum 16 years ago. In addition to postgraduate teaching for Research Methods & Method of teaching since 2015.

Abstract:

Biography:

Margaux N. Yap has completed her MD at the age of 24 years from the University of Santo Tomas and had pediatric residency training at St. Luke’s Medical Center Quezon City. 

Abstract:

Objective: To determine the relationship between the knowledge, attitude, and practices of parents and the immunization status of their children aged 11 to 18 years old.

Design: Prospective cross-sectional study.

Subjects: 70 guardians of patients aged 11 to 18 years for follow up at the St. Luke’s Medical Center QC (SLMC) Pediatric Out-Patient Department (OPD). Purposive sampling was done.

Methodology: Interviewer-administered questionnaire/face to face interview and review of immunization records was conducted from December 2016 to February 2017 among parents of Adolescent patients who followed up at the Pediatric OPD of SLMC QC.

Results: Patients were most often partially or non-adherent to their recommended adolescent vaccination schedules. About 93% received at least one dose of the Hepatitis B vaccine, but none received any booster or catch-up dose. Hepatitis A and Td/Tdap vaccines were given to 17% and 10% of adolescents, respectively. The coverage rates for annual influenza (5.7%) and HPV (2.9%) were the lowest among all vaccines recorded. More than 90% of respondents correctly replied to items on the seriousness of the diseases targeted by MMR, varicella, and hepatitis A and B. In contrast, only half recognized the possibility of a serious sequelae of HPV infection. The cost of getting immunized was the leading barrier (87%) to availing of this service.

Conclusion: No significant associations were found between parents’ range of knowledge scores and the actual immunization status of their adolescent children. However, score of ≥75% appeared to be associated with increased MMR and lower hepatitis A and influenza vaccination rates. In these findings, we can conclude that availability of the vaccines in the health center can increase the adherence to adolescent immunization. The top 3 identified barriers in availing immunization were: Financial problems, Lack of knowledge and Lack of vaccines in the health center.

Biography:

Mimi M H Tiu is an Associate Professor in School of Nursing and Health Studies, The Open University of Hong Kong. Her research interest includes qualitative studies, nursing management and gerontological care.

Abstract:

As one of the unfavorable issues probably affecting reproduction, infertility affects one in six couples in Hong Kong. In the Chinese community, women were previously blamed for their inability to conceive. Infertility is a difficult experience for women. The pain and loss associated with infertility can last throughout their lifetime. Studies have also indicated that women are actually more adversely affected by infertility than men. The birth rate in Hong Kong has remained extremely low for the past decades. The encouragement of fertility can increase the workforce in society and balance out the ageing population. However, infertile women in Hong Kong are normally experiencing chronic stress, which only exacerbates the difficulty of conceiving. Thus, realizing the experiences of those suffering from infertility and scrutinizing the processes in which these experiences have been shaped by the sociocultural context is necessary. The present study aims to explore the experiences and coping strategies of infertile women. A qualitative phenomenological design was adopted, and snowball sampling method was employed. A total of 13 women diagnosed with infertility participated in the study. In depth semi structured interviews were conducted by investigators. Data were audio-typed, transcribed and then analyzed using thematic analysis. Three themes were generated from this study as follows: (1) Having no means to ventilate their feelings; (2) Evolving the relationship with their God; and (3) Receiving non-satisfactory reproductive health services. The result of this study not only enhanced understanding the life of infertile women but also the mechanisms in which health policies in Hong Kong could be refined to assist reproductive health service.

Biography:

Sumaya Joseph is currently employed by the Department of Health in the Western Cape, as an Operational Manager of a Maternal Child Health Unit in Khayelitsha. She has studied at Rand Afrikaans University, University of South Africa and recently completed a Master’s degree in Nursing at Stellenbosch University. She was identified as an expert in midwifery by the National Nursing Department and was invited to join the team of obstetricians from South Africa, at the RCOG to give input on post-partum contraceptive training manuals. She continues to advocate for women’s reproductive rights.

Abstract:

Problem: A study conducted amongst women in Soweto, South Africa attending antenatal clinics in 2002, found that 21.8% of women seeking care experienced multiple assaults by a male partner (Dunkle, Jewkes, Brown, Yoshihama, Gray, McIntyre, & Harlow, 2004:238). This study aims to develop insight into how intimate partner violence influences women’s decision making and ultimate reproductive health choices.

Methodology & Theoretical Orientation: Women were interviewed using a semi-structured interview guide. A qualitative descriptive approach was adopted with an embedded feminist perspective. Describing lived experiences has been conceptualized as an overarching philosophy on which all qualitative research draws. Descriptive qualitative research recognizes an experience as being unique to an individual. Hermeneutic descriptive qualitative research concerns with creating a rich, deep account of an experience (Burns & Grove, 2011:76).

Research Setting: All women attend a primary health care facility within the Khayelitsha Eastern substructure of the Western Cape South Africa.

Results: The lack of agency challenges women’s ability to make reproductive health choices. Adhering to social norms is of higher value than women’s rights and become an oppressive force. Intimate partner violence coupled with, fear challenges women’s agency in a society where women have a lower status than men. Women living with intimate partner violence are at risk of unwanted pregnancies, sexually transmitted infections and HIV. This is mainly because of a lack of agency. Individual stories behind statistics are powerful tools to raise awareness and steer interventions to advocate for the empowerment of women’s health care.

Biography:

Maiko Kozakura has graduated from Advanced Course in Midwifery, School of Allied Medical Sciences, Kagoshima University in 2002 and joined Kagoshima University Hospital, working at Obstetrics and Gynecology Ward, Surgical Department, NICU. She has worked at Ayase Gynecology Clinic/Postpartum Care from 2015 to 2016 and established Women’s Power Support Kozakura Maternity Hospital in 2017.

Abstract:

Oxytocin is a hormone that promotes a calm postpartum mental state. It is produced proportionally to the amount of breast milk secreted. Breast milk is part of a wonderful system that can enhance women’s sense of femininity, relaxation and promotes self-reliability. Although 98% of Japanese pregnant women wish to breastfeed, only 51.3% are actually breastfeeding at 1 month after birth. At 3 months after birth, this figure remains at 54.7%. Apparently, reasons for this figure being lower than the number of women who want to breastfeed include problems with feeding experienced by 69.6% of women (Ministry of Health, Labour and Welfare, Outline of Results of 2015 Infant Nutrition Survey). These problems include uncertainty as to whether she is producing enough breast milk, somewhat insufficient breast milk production and feeling that breastfeeding is a burden. These results suggest that Japanese women feel that breastfeeding is an everyday occurrence and good for the baby and that the nuclearization of families has meant that mothers have fewer opportunities to discuss and receive support regarding their anxieties and worries in a familiar setting. This is a disadvantage as it means that there is one less option for calming mothers in the postpartum period. Therefore, community-based midwifery centers specialized for the perinatal period play an important role.

Biography:

Yan Wang has completed her Bachelor’s degree from Nursing School, West China Hospital of Medicine, Sichuan University, China.

Abstract:

Objective: To study the influence of perinatal individualized comprehensive intervention on breastfeeding behavior of women with gestational diabetes.

Method: A randomized controlled trial was used in this study. Gestational diabetes pregnant women who stayed in a Women and Children’s Hospital in Chengdu City, Sichuan Province from July 2017 to October 2017 were randomly divided into intervention group (n=107) and control group (n=105). The intervention group adopted perinatal individualized integrated intervention, the scale was assessed at admission and individualized exercise, diet and breastfeeding measures were formulated. Breastfeeding exercises, diet guidance immediately after delivery and knowledge enhancement before discharge were examined. Researcher took one to one, face to face intervention throughout the process. The control group was given routine feeding guidance. Knowledge of breastfeeding and self-efficacy of breastfeeding were compared between the intervention group and the control group.

Result: There was no difference in baseline data between the two groups of subjects at admission (P>0.05). The pure breastfeeding rate of the intervention group (31.8%) was higher than that of the control group (13.3%) (P=0.004). The score of breastfeeding knowledge in the intervention group (111.64±9.03) was higher than that of the control group (107.39±9.21) (P=0.001) and the inner dimension, the skill dimension and the total score of the breastfeeding self-efficacy in the intervention group were all higher than the control group (P<0.01 for all).

Conclusion: The adoption of perinatal individualized comprehensive intervention can significantly improve the exclusive breastfeeding rate; improve breast feeding knowledge and breastfeeding self-efficacy in women with gestational diabetes.

Biography:

Huang Pan is a graduate student of Nursing School, West China Hospital of Medicine, Sichuan University, China.

Abstract:

Objectives: To study the effect of individualized intervention on breastfeeding behavior and evaluating the effect of behavioral intervention on maternal breastfeeding.

Methods: This study is a randomized controlled trial. Random number table was used to randomly assign the subject. For intervention group, the researchers used questionnaires to understand the subjects and analysis the existing problems at the time of admission. Meanwhile, the researchers provide personalized intervention by face to face. After delivery, the researchers targeted and personalized guide mothers to breastfeed. Researchers monthly ask for details of breast-feeding situation and existing problems and gave guidance by telephone follow-up after maternal hospital discharge to postpartum 4 months. For the control group, conventional breastfeeding education was given by the hospital staff.

Results: We recruited 352 women from August 2016 to December 2016 of whom 176 were randomized to intervention group, 176 to control group. Two groups of subjects had no statistical difference in the baseline data (P>0.05). By the chi-square test and t test, two groups of breastfeeding rate is statistically significant, the exclusive breastfeeding rate of intervention group is higher than the control group at discharge from hospital and at postpartum 4 months; Intervention group is lower in adding milk and used bottles compared with the control group, the difference is statistically significant. Related behaviors such as breastfeeding on-demand lactation, feeding times, add milk were different between the two groups (P<0.05). Compared with control group, the intervention group increased maternal satisfaction (P<0.05) and baby satisfaction (P<0.05).

Conclusion: The combination of prenatal and postnatal personalized behavior intervention can change the breastfeeding behavior and effectively improve the rate of exclusive breastfeeding. The personalized behavior intervention can enhance maternal and infant satisfaction.

Biography:

Coming Soon

Abstract:

Problem: A study conducted amongst women in Soweto, South Africa attending antenatal clinics in 2002, found that 21.8% of women seeking care experienced multiple assaults by a male partner (Dunkle, Jewkes, Brown, Yoshihama, Gray, McIntyre, & Harlow, 2004:238).

This study aims to develop insight into how intimate partner violence influences women’s decision making and ultimate reproductive health choices.

Methodology and theoretical orientation: women were interviewed using a semi-structured interview guide. A qualitative descriptive approach was adopted with an embedded feminist perspective. Describing lived experiences has been conceptualized as an overarching philosophy on which all qualitative research draws. Descriptive qualitative research recognizes an experience as being unique to an individual. Hermeneutic descriptive qualitative research concerns with creating a rich, deep account of an experience (Burns & Grove, 2011:76).

Research setting: all women attend a primary health care facility within the Khayelitsha Eastern substructure of the Western Cape South Africa.

Findings: Women have limited agency which influenced not only their reproductive and sexual health but their daily lives.

The following is a summary of themes that emerged.

Conclusion: The lack of agency challenges women’s ability to make reproductive health choices. Adhering to social norms is of higher value than women’s rights and become an oppressive force. Intimate partner violence coupled with, fear challenges women’s agency in a society where women have a lower status than men.

Women living with intimate partner violence are at risk of unwanted pregnancies, sexually transmitted infections and HIV. This is mainly because of a lack of agency.

Individual stories behind statistics are powerful tools to raise awareness and steer interventions to advocate for the empowerment of women’s health care. 

Reference list

Abrahams, N. Mathews, S. Jewkes, R. Martin, L.J. & Lombard,C. Every eight hours: Intimate femicide in South Africa 10 years later. South African medical research council research brief. August 2012:1-4.

Burns, N & Grove, S.K. 2011. Understanding Nursing Research. Building an Evidence-Based Practice. 5^th Edition. St Louis, Elsevier Publishers.

Cowley, A.D. 2013. “Let’s get drunk and have sex”: The complex relationship of alcohol, gender, and sexual victimization. Journal of interpersonal violence.11(3):1-21.

Dunkle, K.l. Jewkes, R.K. Brown, Yoshihama, M. Gray, G.E. McIntyre, J.A. & Harlow, S.D. 2004. Prevalence and patterns of gender-based and revictimization among women attending antenatal clinics in Soweto, South Africa. American journal of epidemiology.160(3):230-239.

Fikree, F.F. Jafarey, S.N. Korejo, R. Afshan, A. & Durocher, J.M. 2006. Intimate partner violence before and during pregnancy: Experiences of postpartum women in Karachi, Pakistan. Journal Pakistan medical association. 56(6)252-257.

Shamu, S. Abrahams, N. Temmerman, M. Shefer, T. & Zarowsky, C.2012. “that pregnancy can bring noise into the family”: Exploring intimate partner sexual violence during pregnancy in the context of HIV in Zimbabwe. Plos One. 7(8):1-9.

Golden, S.D. Perreira, K.M. &  Durrance, C.E. 2013. Troubled times, troubled relationships: How economic resource, gender beliefs, and neighborhood disadvantage influence intimate partner violence. interprets violence. [online]. Available. www.ncbi.nlm.nih.gov/pubmed/23300198 [2013,February 26].

Biography:

Coming Soon

Abstract:

The study aims to evaluate the perspective of health care professionals on the implementation of the Essential Newborn Care Protocol as well as the problems encountered of respondents from the 6 Rural Health Units of Eastern Pangasinan along with Governance, Service Delivery, and Regulation. A descriptive quantitative research design was employed through a survey questionnaire; total enumeration was employed with 90 respondents. Frequency count, mean, and rank was used to analyze the data. Findings revealed that there is a moderate implementation (2.91) along with Governance, and Service Delivery; and respondents stated a poor implementation (1.98) of the Essential Newborn Care Protocols. Problems encountered by health workers include time pressure due to an increased number of clients (2.72), uncooperative mothers (2.62) knowledge deficit about the protocols of the "Unang Yakap" (2.45), and lack of related seminars and training (2.32). It can be concluded that there is a poor implementation of the existing program in other areas because they lack training and knowledge regarding the Essential Newborn Care.

Biography:

Addisu has completed his MSc at the age of 26 years from Mekelle University College of Medicine and Health Sciences. He is a researcher and lecturer at Mizan Tepi University, Ethiopia. He has published more than 3 papers in reputed journals. 

Abstract:

Background

Cesarean section is a lifesaving medical intervention. Its share in decreasing maternal mortality and morbidity rates are immense, it is also an indicator of maternal health services quality of a country. However, it is associated with many complications compared with vaginal deliveries. The rising rate of CS is a global concern and it ranges between 12 and 86 % in developed and middle-income countries and between 2 and 39 % in developing countries. Unjustified prior cesarean section and decreasing trial of labor after cesarean section are among the reasons for its increment. A woman after a primary cesarean has only 10% chance of a vaginal birth for subsequent deliveries. In Ethiopia rate of cesarean section is increasing ranging from 8 to 37% in the urbanized region. However, rate and factors leading to primary caesarian section are not addressed well.

Objectives

To assess the magnitude and associated factors of primary cesarean section among mothers who gave birth between September and August 2008 E.C in Suhul general hospital, Tigray, Ethiopia.

Methodology

Retrospective cross-sectional study from September 19 to October 20, 2009, E.C was conducted at Suhul general Hospital. The data entered into EPI-Info version 7 and exported to SPSS version 20 for cleaning, editing and analyzing. Logistic (bi-variable and multi-variables) logistic regressions were used to examine associations between outcome and independent variables.

Result; The rate of primary CS in this study was 20.2%.Fetal distress 26 (32.2%), cephalopelvic disproportion 15 (17.3%). Mothers who had been augmented were 3.14 times more likely to undergone primary CS than who hadn’t been AOR(95%CI)= 3.14(1.497,6.571) and mothers who had pregnancy induced hypertension were 3.10 times more likely to undergone primary CS than those who hadn’t AOR,95%CI =3.10(1.230,7.829).

Conclusion and Recommendation

The magnitude of primary cesarean section in this study is high. Gestational age and augmentations, pregnancy-induced hypertension and birth weights were associated factors. Objective decision for non-reassuring fetal heartbeat pattern should be practiced to reduce the magnitude of primary Caesarean section.

Biography:

Coming Soon

Abstract:

Objectives  To study the effect of an individualized intervention on breastfeeding behavior. Evaluation the effect of behavioral intervention on maternal breastfeeding.

Methods  This study is a randomized controlled trial. Random number table was used to randomly assign the subject. Intervention methods: For the intervention group, the researchers used questionnaires to understand the subjects and analysis the existing problems at the time of admission. Meanwhile, the researchers provide personalized intervention by face to face. After delivery, the researchers targeted and personalized guide mothers to breastfeed. Researchers monthly ask for details of breastfeeding situation and existing problems and give guidance by telephone follow-up after maternal hospital discharge to postpartum 4 months. For the control group, conventional breastfeeding education was given by the hospital staff. Results We recruited 352 women from August 2016 to December 2016, of whom 176 were randomised to innervation group, 176 to control group. Two groups of subjects had no statistical difference in the baseline data (P > 0.05). By the chi-square test and t-test, two groups of breastfeeding rate is statistically significant, the exclusive breastfeeding rate of intervention group is higher than the control group at discharge from hospital and at postpartum 4 months; Intervention group is lower in add milk and used bottles compared with the control group, the difference is statistically significant; Related behaviors such as breastfeeding on-demand lactation, feeding times, add milk were different between the two groups (P < 0.05).  Compared with control group, the intervention group increased maternal satisfaction (P < 0.05) and baby satisfaction (P < 0.05). Conclusion  The combination of prenatal and postnatal personalized behavior intervention can change the breastfeeding behavior, and effectively improve the rate of exclusive breastfeeding. The personalized behavior intervention can enhance maternal and infant satisfaction. 

Biography:

Ntandoyenkosi is a midwife at a referral hospital in Zimbabwe. She attained BSc honors in Nursing science with MCH major in 2015. Has worked as a senior midwife in the maternity unit, midwifery clinical instructor for 6 years, ward manager in the maternity unity and is currently a clinical matron in the children’s hospital. Presented an abstract at ECSACON 2016. Currently studying for a Diploma in Child Health with the University of Sydney.

Abstract:

The intrapartum period is a critical time in women’s lives and as they seek care, they expect quality services that ensure optimal outcomes for themselves and their babies. Childbirth is the time of greatest risk for maternal deaths; avoidable deaths and morbidity continue to occur and are in part attributed to poor quality care especially during the intrapartum period.(Hulton et al 2000) Women as consumers of intrapartum care play an important role in the assessment of the quality of care rendered during this period. Maternal mortality in Zimbabwe currently stands at 614 per 100 000 live births with 11-17% of maternal deaths occurring during labor and delivery ( Unicef 2015).Poor quality of care can contribute to poor uptake of maternity services leading to high rate of maternal and perinatal mortality and severe morbidity (Thaddeus and Maine 1994)

This study describes women’s views on the quality of intrapartum care received at a referral maternity hospital in Zimbabwe.A framework for the evaluation of care in maternity services by Hulton et al (2000) guided this study.

OBJECTIVES

}  To determine women’s views on  physical care during labor at the maternity hospital

}  To explore women’s views on midwife- client relationships during labor

}  To obtain women’s perceptions about the birthing environment

METHODOLOGY

Study conducted at a-referral maternity hospital in Zimbabwe=about 700 deliveries per month.Qualitative approach using the phenomenological design was used.Data obtained from a purposive sample of 10 women relating to their opinions experiences and perceptions of the care they received during the intrapartum period.In-depth interviews lasting 15-20minutes until saturation was reached.The women were selected on the basis of their willingness to participant in the study

RESULTS

Women interviewed had mixed experiences relating to the care they received during labor. Though care was perceived as generally good, some issues which seemed to compromise the quality of care emerged during the interviews. These included staff attitudes, information giving, poor communication, and relationships.

IMPLICATIONS FOR PRACTISE

}  The findings point out to the existing gaps in midwifery practice which need to be addressed to promote competency-based intrapartum care

}   Study also forms a basis for further research on the quality of intrapartum care.

}  In-service education for midwives is required to address issues of poor attitudes and midwife-client communication

}  Educating women so that they are aware of their right to quality intrapartum care.

Biography:

Navita Rahim has completed her BSc in 2012 from Aga Khan University, School of Nursing and Midwifery, Karachi, Pakistan. She has completed her Diploma in Midwifery from Aga Khan Maternal and Child Health Center in 2004. She is the Clinical Trainer at Jhpiego, Pakistan. She has worked for more than five years in reputed organization and has been serving for maternal and child health. She has worked for four years with international Non-Government Organizations (NGOs) to improve family planning quality services in low socio-economic areas of Pakistan for the betterment of maternal life and decrease maternal mortality rate (MMR).

Abstract:

Holistic care is a comprehensive model of caring and proper guidance. Use of family planning (FP) services is still a question mark nowadays. One MWRA (Married Women of Reproductive Age) in four has an unmet need for contraception, which is the highest such rate in the region. Meeting unmet need for limiting can be accomplish by increasing the holistic approach, for family planning, three major components can be highlighted: Supply, the enabling environment and demand. Up take of family planning services can be enhanced, more successful and sustainable if multifaceted determinates included in interventions. Availability and quality of services and other supply-related issues is a major factor for not availing FP services. Improvement in family planning cannot be achieved without quality services. Quality is considered good when adequate infrastructure, supplies and equipment are in place and when well- trained, skilled, motivated and supported staffs are available. Besides that, an enabling environment for health-seeking behavior is another factor for increasing services. An enabling environment requires adequate resources, effective leadership, management and accountability. Engagement of governments, communities and other members of civil society is critical to fostering an enabling environment. Furthermore, improve knowledge of family planning and cultivate a demand for services. The demand for FP exists in different forms: Actual use and latent demand. The latter exists among those who wish to avoid pregnancy but are not currently using FP (those with an unmet need for FP) and those who might wish to avoid pregnancy. Holistic, client-centered approaches are the only way to make FP programming effective and successful ultimately supports health system.

Biography:

Affryta Nur Fauzia Analda is currently a student of Diploma Midwifery in Medical Faculty of Sebelas Maret University, Indonesia.

Abstract:

Relation between breast-feeding duration and childrens nutritional status is still a controversy. Positive as well as negative relations were shown. Exclusive breastfeeding has a high nutrient content to fulfill the nutritional needs of infants aged 0 months. The aim of this study was to describe the nutritional status of infants aged 12-24 months and to determine the relationship of exclusive breastfeeding and nutritional status of infants aged 12-24 months and support this current issue on breast feeding duration and nutritional status of children aged 12-24 months in Pusat Kesehatan Masyarakat (Puskesmas) Gajahan, Surakarta. A cross sectional study was conducted with 100 propositional stratified random coupled samples (mothers and weaned children) with inclusion criteria: Normal birth weight, full-term delivery and no physical and psychological problems. Data from children were measured using seca digital weight scale, wooden length board, while data from mothers were collected through 1×24 hours food recall form and a questionnaire on mothers knowledge. The average of breastfeeding duration was 14 months. The prevalence of malnutrition was quite low (<10%), but the prevalence of stunting was high enough (22.3%) while wasting was moderately high (10.2%). Breastfeeding duration was significantly associated to childrens nutritional status (height for age index and weight for height index). The highest correlation was found in height for age index (r=0.403). Regression model revealed that breastfeeding duration, exclusive breastfeeding, diarrhea, working mother, mothers knowledge, energy intake and protein intake were independently associated with childrens nutritional status. As this study found that the average of breastfeeding duration was 14 months and there was a significant association between exclusive breastfeeding and nutritional status of infants aged 12-24 months old, thus these findings strengthen the recommendation of WHO to continue breast feeding up to 2 years old.

Biography:

Silfana Putri Nur Azizah is a Midwifery Student in Medical Faculty of Sebelas Maret University, Indonesia.            

Abstract:

Mom’s milk is needed by a baby for a perfect growth in golden period. WHO/UNICEF recommends exclusive breastfeeding in the first six months after birth, then supplemented feeding of breastfeeding supplements up to the age of one or more years. Ironically, in an era of global rapid changes in science and technology, breast-feeding is exclusive often forgotten. Knowledge of ASI’s exclusive action is given to each nursing mother to strengthen the attitude of the mother in breastfeeding. The aim of this study was to analyze the relationship between educations with mother’s behavior in providing breast feeding to the baby. This study uses a correlative analytic design with cross-sectional approach. Its population is being all subjects that come to Gajahan, Surakarta, Central Java, Indonesia community health clinic and samples were taken with purposive sampling technique. Data collection using questionnaires and the data collected is presented in the form of a frequency distribution table and analyzed using logistic regression test. The result showed the greatest level of maternal education is secondary (high school) at 53.8% and most of that is 73.1% of behavior is not exclusive breastfeeding mother to their babies. Logistic regression analysis showed a p-value=0.067>0.05 means that H0 and H1 rejected. The results showed no relationship between level education and mother’s behavior in exclusive breastfeeding. The government should improve the comprehensive and continuous education about the importance of breastfeeding and the benefits of exclusive breastfeeding.

Biography:

Angelo Scuderi is a Surgeon Specialist in Obstetrics and Gynecology in Centro Studi per la Salute della Donna, Italy.

Abstract:

This report wants to put in evidence, the relationship between culture, science, technology, nature and childbirth. We know, from Anthropology, that there is no people in the world, where labor and childbirth take place as natural and physiological events. The biological events of labor and birth are everywhere remolded and conditioned by social factors and dominant cultural factors of which they are expression. Physiology is universal, however, we know how there are multiple modes of approaching universal physiological events. Birth is considered in every society as a reflection of total culture. It is the culture to explain diversity and not nature. We should not lose sight of the fact that today we live in a post-modern society where technologies have an impact on the individual greater than that produced by their meaning. Contemporary medical obstetrics considers the use of high technology as the first element to control and dominate nature from the unpredictability of pregnancy and childbirth. Medicine needs to control the risk. In this culture, childbirth is a medical event and it is not considered the fact that reproduction is not only a biological process, but a complex experience that involves spirituality, psychology, ethics, rationality and relational life as expression of woman’s identity. Nature, culture and society are the three inseparable dimensions of human reproduction and childbirth, where it cannot be ignored the existential problematic of childbirth and human identity. This needs a reflection on the deepest meaning on maternity connected to women’s conscience developed in their human biography, as a visible expression of a personal act in a synthesis of total and original intimacy. In the seventies, as reaction to the excess of technocratic medicine, that rigidly separates, in a Cartesian way, the body from the mind; it was felt the necessity to humanize the techno medicine. At present, we are in a situation that has contradictory aspects. We can see that it has been tried to humanize childbirth but, on the other hand, the use of medical technology for childbirth has been progressively increased, as evidenced by the increase, in low risk births, interventions in most Western countries, which have become such a routine to be considered more and more as part of births defined normal. In the scientific model of birth (or Physiological Model) it is believed that for healthy women with normal pregnancies, we must work to improve the quality of birth support by following the principles of science, by integrating the judicious use of the best scientific evidence available, with the precise scientific knowledge of anatomy and physiology, associated with the clinical experience of the operator. But besides this, there is the necessity to understand the patient's values, preferences and considerations and to respect the inseparable unit of the woman with her baby. Every birth needs assistance and support. It is therefore proposed to analyze new territorial and hospital based birth assistants that see two parallel pathways, the physiological one entrusted to midwives with a continuity of care and that of high risk pregnancy to doctors. Today it is a commitment to practice holistic care to pregnancy and birth. The birth support model that best understands a holistic approach is that of Anglo-Saxons with the term midwifery model of care and identifying in the midwife as the appropriate operator to this type of assistance

Biography:

Fernan N. Torreno, Master of Arts in Nursing Major in Administration & Teaching in Nursing at Urdaneta City University, Philippines

Abstract:

The study aims to evaluate the perspective of health care professionals on implementation of the essential new born care protocol as well as the problems encountered of respondents from 6 rural health units of Eastern Pangasinan along with governance, service delivery and regulation. A descriptive quantitative research design was employed through a survey questionnaire; total enumeration was employed with 90 respondents. Frequency count, mean and rank was used to analyze the data. Findings revealed that there is a moderate implementation (2.91) along with governance, service delivery and respondents stated a poor implementation (1.98) of the essential new born care protocols. Problems encountered by health workers include time pressure due to an increased number of clients, uncooperative mothers, knowledge deficit about the protocols of the "Unang Yakap", and lack of related seminars and training. It can be concluded that there is a poor implementation of the existing program in other areas because they lack training and knowledge regarding the essential new born care.