The Effects of Social Support on Pregnant Women's Choice of Delivery Method: Application of an Expanded Theory of Planned Behavior

Objectives: The theory of planned behavior (TPB) has been used in pregnant women’s choice of delivery method and other health-related behaviors. This study extended TPB to predict the role of social support in pregnant women’s choice of delivery method. Materials and Methods: This prospective cohort study was conducted on pregnant women referred to Fatimah hospital in Hamadan, Iran, from 2015 to 2016. A total of 206 nulliparous pregnant women, who referred to Fatimah hospital, completed a self-report questionnaire including measures of intentions, attitudes, subjective norms, perceived behavioral control and social support. These women were followed up until the end of their pregnancy. Results: On the basis of structural equation modeling, adding social support variable improved the indices of the model slightly, but this variable cannot be regarded as a predictor of behavior. A gap between intention and behavior and other factors together with social factor may be the reason. The perceived behavioral control of the individuals was a signifcantly effective predictor for selecting the type of delivery. Conclusions: Attitude, subjective norms, perceived behavior control, and social support were distinguished as signifcant predictors of the choice of delivery type. Therefore, it seems that designing an intervention with emphasis and focus on making changes in these variables and considering different dimensions of social support can increase people’s intention towards natural delivery by providing facilities in the childbirth environment

Effect of spinal and epidural Analgesia on maternal and neonatal outcomes in normal vaginal deliveries

Background. One of the main goals of medicine has been to reduce labor pain and requests from patients for pain relief is sufficient reason to use pain relief methods. This study was conducted to compare the efficacy of spinal and epidural Analgesia on maternal and neonatal outcomes. Methods. This study was a quasi-experimental clinical trial that was conducted on 126 pregnant women. Pregnant women who had inclusion criteria and informed consent were enrolled in the study and were assigned to spinal and epidural groups.  The control group were selected from among those meet inclusion criteria but were unwilling to do analgesia. Three groups were compared using statistical tests. P<0.05 was also considered significant. Results. The results showed that during the first and second stages of labor was shorter in the control group compared to spinal and epidural groups but this difference was not statistically significant. Compare the method of delivery, Apgar and episiotomy pain scores showed no statistically significant difference among the three groups. None of the participants did not develop complications such as headache and hyperthermia. Conclusion. The findings of this study showed that none of the methods of analgesia had not the negative impact on maternal and neonatal outcomes. Due to contradictory results in different studies, further studies in the same condition and with matching groups in terms of confounding variables is necessary

The value of ovarian hyperstimulation syndrome in predicting pregnancy outcome in women with polycystic ovarian syndrome and candidate for in vitro fertilization: A case-control study

Abstract Background: Ovarian hyperstimulation syndrome (OHSS) as a known complication in women with polycystic ovarian syndrome (PCOS) may occur following inducible fertility treatments such as in vitro fertilization (IVF) and can affect the sequels of these treatments. Objective: This study aimed to assess the effects of OHSS on pregnancy outcomes through IVF in women with PCOS. Also, we assessed the value of baseline sexual hormones to predict the pregnancy's success. Materials and Methods: This case-control study was conducted on 180 consecutive women suffering from PCOS who were candidates for IVF at Fatemieh hospital in Hamadan, Iran, from May-July 2022. The women were assigned to the case group (with OHSS, n = 129) and the control group (without OHSS, n = 51). Measuring the sexual hormones was performed using the enzyme-linked immunosorbent technique. Results: In the multivariable logistic regression model, OHSS could not predict the likelihood of clinical or chemical pregnancy following IVF. None of the baseline sexual hormones could predict the successful chemical or clinical pregnancy in PCOS women following IVF. Conclusion: OHSS may not influence IVF-related outcomes in PCOS women. The values of sexual hormones may not also determine the pointed outcome

Exploring perceptions of instructors about childbirth preparation training courses: A qualitative study

Background: Childbirth preparation training courses on maternal and neonatal health increase awareness, and capability of pregnant women in overcoming fear and anxiety and managing labor pains. Objective: To identify the affecting factors and barriers of these courses from the perspective of their instructors. Methods: This qualitative study of the content analysis type, has been conducted on 16 certified teachers of the training courses of the Hamadan city in 2015. Data were collected by semi-structured in-depth interviews and were then analyzed by using MAXQDA10 application. Results: Participants' experiences are indicated on three main themes including the objectives of the course, facilitators and barriers. The main objectives of the course were reported as to improve maternal and newborn health, promote natural childbirth and preparedness for parenting and breastfeeding. The main facilitators of the successful implementation include observing educational standards, strengthening the communication and relationship between mothers and staff, mobilization, and the role of instructor. The major barriers are reported as inadequate support from management system, insufficient intra-sector collaboration, poor attitude of obstetricians and physicians, inadequate access, theory-practice gap and not intended to labor naturally. Conclusion: The results of our study show that multiple factors are involved in the participation of pregnant women in antenatal classes. Promoting natural childbirth requires intra-sector and inter-sectoral collaboration, as well as the community participation