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Revista de La Facultad de Ciencias... Jun 2022To identify contributions of the scientific literature produced in the 2009-2019 period in Latin America on humanized prenatal care. Data sources:
OBJETIVE
To identify contributions of the scientific literature produced in the 2009-2019 period in Latin America on humanized prenatal care. Data sources:
UNLABELLED
Articles produced in Latin America that addressed humanized prenatal care, published between 2009 and 2019 in indexed journals (reported in MIAR) and located in recognized databases, were selected. Study selection: A selection based on the source, quality and relevance of the studies was taken into account, excluding gray literature. After applying filters, 26 articles were obtained. Data extraction: The data was recorded, subsequently using an analytical matrix for its coding. Data: the studies, especially from Colombia and Brazil, were largely qualitative. It is established that the quality of care is reflected in the accessibility and satisfaction of the users with the services. Humanized prenatal care affects maternal-perinatal health. The recognition of the particular needs of pregnant women is relevant. The studies recommend qualifying health personnel to strengthen humanized prenatal care, assuming pregnant women as protagonists of the process, dispelling their doubts and concerns, and providing evidence on the relationship humanized prenatal care / reduction of maternal morbidity and mortality.
CONCLUSIONS
The studies carried out recognize the pregnant woman as the protagonist and her needs as the starting point for humanized prenatal care, conceived as an essential reference for the quality of services with a positive impact on the satisfaction of pregnant women and maternal outcomes. Training of health personnel is required.
Topics: Brazil; Colombia; Female; Humans; Latin America; Pregnancy; Prenatal Care; Retrospective Studies
PubMed: 35700468
DOI: 10.31053/1853.0605.v79.n2.32720 -
PloS One 2021Uganda continues to have a high neonatal mortality rate, with 20 deaths per 1000 live births reported in 2018. A measure to reverse this trend is to fully implement the...
BACKGROUND
Uganda continues to have a high neonatal mortality rate, with 20 deaths per 1000 live births reported in 2018. A measure to reverse this trend is to fully implement the Uganda Clinical Guidelines on care for mothers and newborns during pregnancy, delivery and the postnatal period. This study aimed to describe women's experiences of maternal and newborn health care services and support systems, focusing on antenatal care, delivery and the postnatal period.
METHODS
We used triangulation of qualitative methods including participant observations, semi-structured interviews with key informants and focus group discussions with mothers. Audio-recorded data were transcribed word by word in the local language and translated into English. All collected data material were stored using two-level password protection or stored in a locked cabinet. Malterud's Systematic text condensation was used for analysis, and NVivo software was used to structure the data.
FINDINGS
Antenatal care was valued by mothers although not always accessible due to transport cost and distance. Mothers relied on professional health workers and traditional birth attendants for basic maternal services but expressed general discontentment with spousal support in maternal issues. Financial dependency, gender disparities, and lack of autonomy in decision making on maternal issues, prohibited women from receiving optimal help and support. Postnatal follow-ups were found unsatisfactory, with no scheduled follow-ups from professional health workers during the first six weeks.
CONCLUSIONS
Further focus on gender equity, involving women's right to own decision making in maternity issues, higher recognition of male involvement in maternity care and improved postnatal follow-ups are suggestions to policy makers for improved maternal care and newborn health in Buikwe District, Uganda.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Delivery, Obstetric; Female; Focus Groups; Health Knowledge, Attitudes, Practice; Health Services Accessibility; Humans; Infant; Infant Health; Infant Mortality; Maternal Health Services; Maternal-Child Health Services; Middle Aged; Midwifery; Mothers; Obstetrics; Patient Acceptance of Health Care; Pregnancy; Prenatal Care; Qualitative Research; Uganda; Young Adult
PubMed: 34914783
DOI: 10.1371/journal.pone.0261414 -
Revista Paulista de Pediatria : Orgao... 2021To analyze women's desires, expectations and experiences regarding skin-to-skin contact and breastfeeding in the first hour of life of their newborns.
OBJECTIVE
To analyze women's desires, expectations and experiences regarding skin-to-skin contact and breastfeeding in the first hour of life of their newborns.
METHODS
Qualitative research carried out in a teaching hospital in the Northeast Region of Brazil. The patients were followed longitudinally during prenatal care, at birth and during the puerperium. The participants were pregnant women during normal risk prenatal care, aged over 18 years old. Structured and semi-structured interviews were carried out in the prenatal period, participant observation at the time of delivery and new interviews in the puerperium. Content analysis was applied in the thematic modality.
RESULTS
18 women between 21 and 38 years old were enrolled in the research. Women expressed the desire for skin-to-skin contact and breastfeeding as immediate practices right after delivery and birth. However, many women did not believe it was possible, and the performance of routine procedures was considered the main obstacle. These expectations that skin-to-skin contact and early breastfeeding would not be carried out were confirmed in the experiences immediately after birth.
CONCLUSIONS
The expectations and experiences brought by these women suggest a flaw that starts in prenatal care and implies difficulties in implementing the studied practices. Thus, the empowerment and participation of women can become an important tool in the humanization of birth.
Topics: Adult; Brazil; Breast Feeding; Female; Humans; Infant, Newborn; Longitudinal Studies; Parturition; Patient Preference; Postnatal Care; Pregnancy; Prenatal Care; Qualitative Research
PubMed: 34076200
DOI: 10.1590/1984-0462/2022/40/2020140 -
JAMA Pediatrics Nov 2022Some states have implemented policies that consider substance use during pregnancy as child abuse and require mandated reporting of substance use during pregnancy....
IMPORTANCE
Some states have implemented policies that consider substance use during pregnancy as child abuse and require mandated reporting of substance use during pregnancy. Implications of these policies for health care receipt among pregnant people who engage in substance use are unknown.
OBJECTIVE
To examine the association of state child abuse policies and mandated reporting policies with prenatal and postpartum care among women who engaged in substance use during pregnancy.
DESIGN, SETTING, AND PARTICIPANTS
In this cross-sectional study, data from the 2016-2019 Pregnancy Risk Assessment Monitoring System survey were analyzed. The study population included 4155 women from 23 states who reported substance use during pregnancy. Data were analyzed between August and November 2021.
EXPOSURES
Delivery in a state with a child abuse policy only (n = 6), a mandated reporting policy only (n = 4), both policies (n = 7), or neither policy (n = 5). One state switched from a mandated reporting policy only to having both policies.
MAIN OUTCOMES AND MEASURES
Month of gestation at prenatal care initiation (ie, months 1-10, with a higher number of months indicating later initiation), receipt of adequate prenatal care, and receipt of a postpartum health care visit 4 to 6 weeks after delivery. Sample characteristics were calculated using unweighted frequencies and weighted percentages and means. Associations of state policies with the outcomes were examined using generalized linear regression with generalized estimating equations, adjusting for potential confounders and accounting for the complex sampling design of the Pregnancy Risk Assessment Monitoring System survey.
RESULTS
The study sample included 4155 women who reported substance use during pregnancy; 33.9% of these women delivered in states with a child abuse policy only, 16.4% in states with a mandated reporting policy only, 32.9% in states with both policies, and 16.8% in states with neither policy. Overall, 14.7% of women were Black, 69.0% were White, and 64.6% were aged 18 to 29 years at delivery. Women who delivered in states with a child abuse policy only, mandated reporting policy only, or both policies initiated prenatal care at a later month of gestation (β = 0.44 [95% CI, 0.10-0.78], 0.32 [95% CI, 0.04-0.59], and 0.40 [95% CI, 0.09-0.72], respectively) and had a lower likelihood of adequate prenatal care (risk ratio, 0.85 [95% CI, 0.79-0.91], 0.94 [95% CI, 0.87-1.01], and 0.95 [95% CI, 0.89-1.03], respectively) and a postpartum health care visit (risk ratio, 0.89 [95% CI, 0.82-0.96], 0.89 [95% CI, 0.80-0.98], and 0.92 [95% CI, 0.83-1.02], respectively) compared with women who delivered in states with neither policy.
CONCLUSIONS AND RELEVANCE
The results indicate that state child abuse policies and mandated reporting policies are associated with reduced receipt of prenatal and postpartum care among women who engage in substance use during pregnancy.
Topics: Pregnancy; Child; Humans; Female; Postnatal Care; Cross-Sectional Studies; Prenatal Care; Substance-Related Disorders; Child Abuse; Health Policy
PubMed: 36121649
DOI: 10.1001/jamapediatrics.2022.3396 -
Archives of Disease in Childhood. Fetal... Jul 2020Congenital diaphragmatic hernia (CDH) is associated with high mortality rates and significant pulmonary morbidity, mainly due to disrupted lung development related to... (Review)
Review
Congenital diaphragmatic hernia (CDH) is associated with high mortality rates and significant pulmonary morbidity, mainly due to disrupted lung development related to herniation of abdominal organs into the chest. Pulmonary hypertension is a major contributor to both mortality and morbidity, however, treatment modalities are limited. Novel prenatal and postnatal interventions, such as fetal surgery and medical treatments, are currently under investigation. Until now, the perinatal stabilisation period immediately after birth has been relatively overlooked, although optimising support in these early stages may be vital in improving outcomes. Moreover, physiological parameters obtained from the perinatal stabilisation period could serve as early predictors of adverse outcomes, thereby facilitating both prevention and early treatment of these conditions. In this review, we focus on the perinatal stabilisation period by discussing the current delivery room guidelines in infants born with CDH, the physiological changes occurring during the fetal-to-neonatal transition in CDH, novel delivery room strategies and early predictors of adverse outcomes. The combination of improvements in the perinatal stabilisation period and early prediction of adverse outcomes may mitigate the need for specific postnatal management strategies.
Topics: Delivery, Obstetric; Fetal Diseases; Hernias, Diaphragmatic, Congenital; Humans; Hypertension, Pulmonary; Infant, Newborn; Practice Guidelines as Topic; Prenatal Care
PubMed: 32170029
DOI: 10.1136/archdischild-2019-318606 -
Seminars in Perinatology Aug 2019Antenatal care (ANC) is an important opportunity to diagnose and treat pregnancy-related complications and to deliver interventions aimed at improving health and... (Review)
Review
BACKGROUND
Antenatal care (ANC) is an important opportunity to diagnose and treat pregnancy-related complications and to deliver interventions aimed at improving health and survival of both mother and the infant. Multiple individual studies and national surveys have assessed antenatal care utilization at a single point in time across different countries, but ANC trends have not often been studied in rural areas of low-middle income countries (LMICs). The objective of this analysis was to study the trends of antenatal care use in LMICs over a seven-year period.
METHODS
Using a prospective maternal and newborn health registry study, we analyzed data collected from 2011 to 2017 across five countries (Guatemala, India [2 sites], Kenya, Pakistan, and Zambia). Utilization of any ANC along with use of select services, including vitamins/iron, tetanus toxoid vaccine and HIV testing, were assessed. We used a generalized linear regression model to examine the trends of women receiving at least one and at least four antenatal care visits by site and year, controlling for maternal age, education and parity.
RESULTS
Between January 2011 and December 2017, 313,663 women were enrolled and included in the analysis. For all six sites, a high proportion of women received at least one ANC visit across this period. Over the years, there was a trend for an increasing proportion of women receiving at least one and at least four ANC visits in all sites, except for Guatemala where a decline in ANC was observed. Regarding utilization of specific services, in India almost 100% of women reported receiving tetanus toxoid vaccine, vitamins/iron supplementation and HIV testing services for all study years. In Kenya, a small increase in the proportion of women receiving tetanus toxoid vaccine was observed, while for Zambia, tetanus toxoid use declined from 97% in 2011 to 89% in 2017. No trends for tetanus toxoid use were observed for Pakistan and Guatemala. Across all countries an increasing trend was observed for use of vitamins/iron and HIV testing. However, HIV testing remained very low (<0.1%) for Pakistan.
CONCLUSION
In a range of LMICs, from 2011 to 2017 nearly all women received at least one ANC visit, and a significant increase in the proportion of women who received at least four ANC visits was observed across all sites except Guatemala. Moreover, there were variations regarding the utilization of preventive care services across all sites except for India where rates were generally high. More research is required to understand the quality and influences of ANC.
Topics: Adult; Developing Countries; Female; Health Services Accessibility; Humans; Infant; Infant, Newborn; Maternal-Child Health Services; Pregnancy; Pregnancy Complications; Prenatal Care; Prospective Studies; Registries
PubMed: 31005357
DOI: 10.1053/j.semperi.2019.03.020 -
BMC Pregnancy and Childbirth Apr 2021The quality of prenatal care is critical for the prevention of adverse pregnancy outcomes. However, according to the World Health Organization (WHO), only 64 % of...
BACKGROUND
The quality of prenatal care is critical for the prevention of adverse pregnancy outcomes. However, according to the World Health Organization (WHO), only 64 % of women worldwide have access to over four sessions of prenatal care throughout their pregnancy. Thus, studies that address factors affecting maternal and child health status before and after pregnancy are of immense importance. The primary aim of the mothers and their children's health (MATCH) cohort study is to evaluate the effect of nutrition, sleep quality, and lifestyle on maternal and neonatal outcomes.
METHODS
A prospective cohort of > 2500 pregnant women in the first trimester (before 12 weeks' gestation) will be recruited at Arash Women's Hospital in Tehran, Iran between February 2020 and August 2021. All eligible pregnant women will be followed from their first trimester of pregnancy until delivery at four time points and assessed through a series of in-person visits with interviewer-administered questionnaires and telephone interviews. Detailed data will be collected on maternal demographics, lifestyle, medical history, reproductive history, obstetric history, dietary intake, sleep pattern, blood specimens, and anthropometric measurements, alongside paternal demographics, lifestyle, and family history. The outcomes will include antenatal, peripartum, and postnatal maternal complications and infant growth and neurodevelopment.
DISCUSSION
The results of the MATCH cohort study will support the development of contextual interventions that can enhance antenatal, peripartum, and postnatal status, neonatal outcomes, and longevity mother and child.
Topics: Adult; Female; Follow-Up Studies; Humans; Infant Health; Infant, Newborn; Life Style; Longitudinal Studies; Maternal Health; Maternal Nutritional Physiological Phenomena; Observational Studies as Topic; Pregnancy; Pregnancy Outcome; Prenatal Care; Prospective Studies; Sleep
PubMed: 33845792
DOI: 10.1186/s12884-021-03732-6 -
Midwifery May 2024Antenatal care guidelines used in Australia are inconsistent in their recommendations for childbirth and parenting education (CBPE) classes for preparation of women and... (Review)
Review
PROBLEM
Antenatal care guidelines used in Australia are inconsistent in their recommendations for childbirth and parenting education (CBPE) classes for preparation of women and parents for pregnancy, childbirth, and early parenting.
BACKGROUND
Clinical practice guidelines in maternity care are developed to assist healthcare practitioners and consumers to make decisions about appropriate care. The benefit of such guidelines relies on the translation and quality of the evidence contained within them. In the context of antenatal care guidelines, there is a potential evidence-practice gap with regard to CBPE.
AIMS
This review aims to appraise the quality of Australian antenatal care guidelines in their recommendations for CBPE for women and partners.
METHODS
Publicly available Australian antenatal care guidelines were identified including local health district websites and professional organisations pertaining to maternity care. Guidelines were reviewed independently, and the quality was assessed using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool.
FINDINGS
Five guidelines were included in the review and appraised using AGREE II. With the exception of the Department of Health Pregnancy Care Guidelines, guidelines scored poorly across all six domains. When appraised according to specific CBPE recommendations for rigour of development, presentation, and applicability; all guidelines received low scores.
DISCUSSION
Prenatal services remain largely unregulated across the board, with no systematic approach to make recommendations for CBPE and guidelines lacking in rigour with regard to CBPE.
CONCLUSION
Within the guidelines reviewed there was a lack of evidence-based recommendations provided for educators or consumers regarding childbirth and parenting education.
Topics: Humans; Pregnancy; Female; Australia; Prenatal Education; Prenatal Care; Practice Guidelines as Topic
PubMed: 38461784
DOI: 10.1016/j.midw.2024.103960 -
PloS One 2022The article describes the temporal evolution of prenatal quality indicators in the primary health care network in Brazil and investigates regional differences. This...
The article describes the temporal evolution of prenatal quality indicators in the primary health care network in Brazil and investigates regional differences. This study used data from the external evaluation of Brazil's National Program for Improving Primary Care Access and Quality (PMAQ) with health teams participating in Cycles I, II and III of the Program, carried out respectively in 2012, 2013/14 and 2017/18. The number of visits, physical examination procedures, guidelines and request for laboratory tests were investigated. There was a positive evolution for tests-HIV, syphilis, blood glucose and ultrasound, and for all tests, guidance on feeding and weight gain of the baby and examination of the oral cavity. The indicators that performed the worst were: performance of tetanus vaccine, six or more visits, receiving guidance on exclusive breastfeeding and care for the newborn, and the procedures-all, measurement of uterine height, gynecological exam and cervix cancer prevention. These changes had a varied behavior between the regions of the country.
Topics: Brazil; Cross-Sectional Studies; Family Health; Female; Health Services Accessibility; Humans; Infant; Infant, Newborn; Pregnancy; Prenatal Care; Primary Health Care; Quality of Health Care; Socioeconomic Factors
PubMed: 35041716
DOI: 10.1371/journal.pone.0262217 -
BMC Pregnancy and Childbirth Apr 2021Research suggests that women's experience of antenatal care is an important component of high-quality antenatal care. Person-centered antenatal care (PCANC) reflects...
BACKGROUND
Research suggests that women's experience of antenatal care is an important component of high-quality antenatal care. Person-centered antenatal care (PCANC) reflects care that is both respectful of, and responsive to, the preferences, needs, and values of pregnant women. Little is known in Rwanda about either the extent to which PCANC is practiced or the factors that might determine its use. This is the first study to quantitatively examine the extent of and the factors associated with PCANC in Rwanda.
METHODS
We used quantitative data from a randomized control trial in Rwanda. A total of 2150 surveys were collected and analyzed from 36 health centers across five districts. We excluded women who were less than 16 years old, were referred to higher levels of antenatal care or had incomplete survey responses. Both bivariate and multivariate logistic regression analyses were used to test the hypothesis that certain participant characteristics would predict high PCANC.
RESULTS
PCANC level was found to be sub-optimal with one third of women leaving antenatal care (ANC) with questions or confused and one fourth feeling disrespected. In bivariate analysis, social support, greater parity, being in the traditional care (control group), and being from Burera district significantly predict high PCANC. Additionally, in the multivariate analysis, being in the traditional care group and the district in which women received care were significantly associated with PCANC.
CONCLUSIONS
This quantitative analysis indicates sub-optimal levels of PCANC amongst our study population in Rwanda. We find lower levels of PCANC to be regional and defined by the patient characteristics parity and social support. Given the benefits of PCANC, improvements in PCANC through provider training in Rwanda might promote an institutional culture shift towards a more person-centered model of care.
Topics: Adolescent; Adult; Cross-Sectional Studies; Female; Humans; Multicenter Studies as Topic; Parity; Patient Satisfaction; Patient-Centered Care; Pregnancy; Prenatal Care; Program Evaluation; Quality of Health Care; Randomized Controlled Trials as Topic; Rwanda; Socioeconomic Factors; Surveys and Questionnaires; Young Adult
PubMed: 33838658
DOI: 10.1186/s12884-021-03747-z