Fear of childbirth, anxiety and depression in three groups of primiparous pregnant women not attending, irregularly attending and regularly attending childbirth preparation classes

BACKGROUND: Lack of knowledge and fear of the unknown during pregnancy and childbirth make mothers fearful, worried, and anxious. Maternal fear and anxiety can lead to problems such as preterm childbirth and low birth weight. Increasing women\u27s knowledge through prenatal education can prepare them for childbirth and improve their health. The present study was conducted to compare fear of childbirth, anxiety and depression during pregnancy in three groups of primiparous pregnant women who were either not attending, irregularly attending, or regularly attending childbirth preparation classes. METHODS: A total of 204 primiparous pregnant women attending health centers in Tabriz, Iran, were selected by cluster sampling and assigned to the following three groups: Not attending, irregularly attending (attending one to three sessions of classes) and regularly attending (attending four to eight sessions of classes). Childbirth fear, pregnancy anxiety and depression questionnaires were completed for them through interviews. The general linear model was used to compare their fear of childbirth and prenatal anxiety and depression. RESULTS: According to the general linear model, the scores of fear of childbirth (p \u3c  0.001), anxiety (p \u3c  0.001) and depression (p = 0.006) were significantly lower in the group of pregnant women regularly attending the classes compared to the non-attending group of women. No significant differences were observed between the regularly-attending and irregularly-attending groups in terms of fear of childbirth (p = 0.066), anxiety (p = 0.078), and depression (p = 0.128). CONCLUSION: Prenatal training can reduce fear, anxiety and depression in primiparous women. Incorporating such training into prenatal care helps improve maternal health

Psychometric properties of satisfaction with the childbirth education class questionnaire for Iranian population

Background: Childbirth preparation classes can reduce pregnant women's anxiety and fear for their childbirth. However, to evaluate women's feedback and their satisfaction with these classes, there is a need for a standard instrument that is suitable for Iranian context. This study is aimed to translate and conduct a psychometric analysis of the Satisfaction with the Childbirth Education Class Questionnaire (SCECQ) for Iranian population. Methods: The questionnaire was translated from English into Persian through the forward-backward translation method. The cluster sampling method was employed to select 205 pregnant women with gestational age of 35-37 weeks from all health complexes of Tabriz, Iran. The face, content, and construct validity of the research instrument were assessed through exploratory and confirmatory factor analyses. Internal consistency and test-retest reliability were measured to evaluate the overall reliability of the questionnaire. Results: The impact scores of all items were above 1.5. The content validity index (CVI) and content validity ratio (CVR) of the questionnaire were 0.88 and 0.94, respectively. The convergent construct validity of the whole questionnaire and those of its three subscales were confirmed through the exploratory factor analysis (EFA). The factor loadings of no items were below 0.3, and the X2/df ratio was smaller than 5. The overall model validity was confirmed by having the Root Mean Square Error of Approximation (RMSEA) smaller than 0.08. Cronbach's alpha and intraclass correlation coefficient (ICC) were 0.93 and 0.96, respectively, indicating the acceptable reliability of the questionnaire. Conclusion: The Persian version of this questionnaire, entitled SCECQ is a valid and reliable instrument for measuring Iranian women's satisfaction with childbirth education classes

Comparison of Continuation Rates and Reasons of Discontinuation for Cyclofem and Depot -medroxyprogesterone acetate in Rural Areas of East Azerbaijan Province, Iran

Objective: In this study continuation rate and reasons for discontinuation of Depot-medroxyprogestrone acetate (DMPA)and Cyclofem have been compared. Materials and methods: A retrospective cohort study was conducted with 422 women (202 Cyclofemand 220 DMPA users)who had started using the methods 12-24 months before the study in East Azerbaijan health houses. Data were collected by reviewing the records and interview with the clients and analysed using Kaplan-Meier and Cox Regression. Results: The 3, 6, 9, 12 months continuation rate were 56%, 37%, 30%, 27% respectively for Cyclofem versus 75%, 59.5%, 48%, 42.5% for DMPA. Menstrual changes were reported significantly more by the DMPA users than the Cyclofem users (85% vs. 73%, P=0.008) as the main reason for the discontinuation, the difference mainly reflected of amenorrhea (50% vs. 23%, P=0.003). None of DMPA users and 11% of Cyclofem users claimed frequency of visits and lack of method supplies as their main discontinuation reason. Conclusion: Discontinuation rate was high for the both methods but it was higher for Cyclofem.The common side effects mentioned as the main reasons for discontinuation of the both methods are not health threatening. Therefore, health care providers may help to improve their continuation rate by appropriate consultation

Treatment of ureteral stones: A prospective randomized controlled trial on comparison of Ho:YAG laser and pneumatic lithotripsy

Objectives: To study the treatment of ureteric stones by HO:YAG laser lithotripsy and pneumatic lithotripsy and to evaluate the results of the two treatment modalities to assess effectiveness and complications. Materials and Methods: Over 1-year period, a total of 79 patients with 82 ureteral stones were randomized into two groups. In group 1 (39 cases with 41 ureteral stones) ureteroscopic HO:YAG laser lithotripsy was performed using a rigid 8 Fr-ureteroscope (LL group). In group 2 (40 cases with 41 ureteral stones) pneumatic lithotripsy was performed in like manner. Efficacy safety and complications in both groups were analyzed. Results: A total of 79 patients with 82 calculi were treated. Two cases in LL group and one in PL group had bilateral ureteral stones. Mean stone size was 12.07 mm in LL group and 10.2 mm in PL group. Stones located in lower ureter in 30 cases on LL group and 29 cases in PL group. Proximal migration of stone occurred in 1 case on LL group and in 3 cases on PL group. Successful fragmentation occurred in 37 cases on LL group and in 30 cases on PL group. Stone-free rate after 1 month in the base of Kidney Ureter Bladder (KUB) and sonography was 95% in LL group and 80.5% in PL group. Ureteral perforation, urinoma, and urosepsis were not seen in both groups. Conclusion: HO:YAG laser has advantages over PL in high efficacy of stone fragmentation and a low-retrograde migration of ureteral stone treatment. Other complication of ureteral stone treatment with LL and PL are the same and very rare

Effects of Acupuncture on Anxiety in Infertile Women: A Systematic Review of the Literature

Background & aim: Stress and anxiety due to waiting for treatment results and uncertainty of treatment success are common problems in infertile women. Acupuncture has been suggested as an effective strategy to relieve anxiety. This study aimed to review the available evidence on the effects of acupuncture on anxiety in infertile women. Methods: This systematic review was conducted via searching in databases such as MEDLINE, PubMed, Cochrane Library, and PsycINFO, as well as clinical trial registries and reference lists of the retrieved articles. Selected articles included the studies published since the initiation of each database until March 2015. All randomized controlled trials regarding the effects of acupuncture on the anxiety of infertile women were reviewed in this study. Moreover, methodological qualities of the selected studies were examined based on the checklist of Oxford Center for Evidence-Based Medicine by two independent investigators. Results: Literature search yielded 193 relevant titles and abstracts, which were narrowed down to four randomized controlled trials involving 595 women.The majority of the reviewed articles showed that use of acupuncture could decrease anxiety in infertile women. Conclusion: According to the results of this systematic review, acupuncture is an effective technique in controlling the anxiety of infertile women. However, it is recommended that future studies with more appropriate design and methodology be conducted in this regard

Assessment of childbirth preparation classes: A parallel convergent mixed study

Background: Women\u27s fear from childbirth has been associated with increased medical interventions and traumatized birth experience. Although antenatal education is a crucial factor to empower and prepare women for their birth journey, it is not clear how Iranian childbirth classes can influence women\u27s fear and prepare them positively towards childbirth. This research is designed to evaluate childbirth preparation classes and their impact on women\u27s perception on their childbirth experiences. Methods/design: This mixed method study with the parallel convergent design has two phases. The first phase will be a quantitative cohort study with 204 primiparous pregnant women at the gestational age of 35-37 weeks. The participants will be divided into three groups based on the number of their attendance into the childbirth preparation classes: A) regular participation (4 to 8 sessions), b) irregular participation (1 to 3 sessions), and c) no-participation. Participant will be followed-up to 1 month after birth. Antenatal data will be collected by using a demographic survey questionnaire, the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ, version A), the Van den Bergh Pregnancy-Related Anxiety Questionnaire, the Satisfaction with Childbirth Preparation Classes Questionnaire, the Edinburgh Postpartum Depression Scale (EPDS) and Knowledge regarding pregnancy and childbirth Questionnaire. Postnatal data will be collected by using an Obstetric and Labor Characteristics Questionnaire, EPDS, and Childbirth experience questionnaire (CEQ). The quantitative data will be analyzed using one-way ANOVA and the multivariate linear regression. The second phase of the study will be a qualitative study that will explore the women\u27s perceptions on the impact of participation in childbirth preparation classes on their childbirth experience. The sampling in this phase will be purposeful and the participants will be studied individually by using in-depth, semi-structured interviews. The qualitative data will be analyzed through content analysis with conventional approach. Discussion: Assessing the impact of childbirth preparation classes on women\u27s childbirth experience in Iran will lead to developing recommendations about the content and quality of the childbirth classes that can improve women\u27s\u27 preparation towards positive childbirth

Psychometric properties of satisfaction with the childbirth education class questionnaire for Iranian population

2020, The Author(s). Background: Childbirth preparation classes can reduce pregnant women\u27s anxiety and fear for their childbirth. However, to evaluate women\u27s feedback and their satisfaction with these classes, there is a need for a standard instrument that is suitable for Iranian context. This study is aimed to translate and conduct a psychometric analysis of the Satisfaction with the Childbirth Education Class Questionnaire (SCECQ) for Iranian population. Methods: The questionnaire was translated from English into Persian through the forward-backward translation method. The cluster sampling method was employed to select 205 pregnant women with gestational age of 35-37 weeks from all health complexes of Tabriz, Iran. The face, content, and construct validity of the research instrument were assessed through exploratory and confirmatory factor analyses. Internal consistency and test-retest reliability were measured to evaluate the overall reliability of the questionnaire. Results: The impact scores of all items were above 1.5. The content validity index (CVI) and content validity ratio (CVR) of the questionnaire were 0.88 and 0.94, respectively. The convergent construct validity of the whole questionnaire and those of its three subscales were confirmed through the exploratory factor analysis (EFA). The factor loadings of no items were below 0.3, and the X2/df ratio was smaller than 5. The overall model validity was confirmed by having the Root Mean Square Error of Approximation (RMSEA) smaller than 0.08. Cronbach\u27s alpha and intraclass correlation coefficient (ICC) were 0.93 and 0.96, respectively, indicating the acceptable reliability of the questionnaire. Conclusion: The Persian version of this questionnaire, entitled SCECQ is a valid and reliable instrument for measuring Iranian women\u27s satisfaction with childbirth education classes

Primiparous women\u27s knowledge and satisfaction based on their attendance at childbirth preparation classes

Aim: To compare primiparous women\u27s childbirth knowledge and their satisfaction with the childbirth preparation classes between regular and irregular attenders. Design: A cross-sectional study. Method: This study was conducted on 136 primiparous pregnant women attending health centres in Tabriz, Iran. Women\u27s knowledge on childbirth and their satisfaction with childbirth preparation classes were measured by using reliable tools via interviews. An independent t test was applied to compare women\u27s knowledge and satisfaction scores between regular and irregular attenders. Results: The mean score of knowledge was significantly higher among women who were regular attenders compared to irregular attenders (p \u3c.001). Although there were no significant differences in total satisfaction score between the women (p =.342), women with regular attendance reported that childbirth preparation classes reduced their anxiety about labour. Conclusions: Regular attendance at childbirth preparation classes is associated with higher women\u27s knowledge and lower feelings of anxiety regarding labour and birth