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In an international project in 1987, the world health organization (WHO), UNICEF, UNFPA and the world bank suggested the maternal safety program and the following objectives were considered:1. Reducing maternal mortality from 1990 to 2000 to the half of thepresent rate throughout the prenatal care2. Availability of the whole pregnant women to the prenatal care,qualified personnel during the delivery and required facilities fortransferring women in high risk pregnancies and midwifery emergencies.3. Availability of appropriate services and information to prevent low ageand high age pregnancies ,short interval pregnancies and multiparous.Since 1987, an international cooperation has been established to support the maternal safety program.Relating to this program, essential changes in the structure of the health services system, in laws and policies and also in training programs of medical doctors ,midwives and other related professions have been made.The international confederation of midwifery (ICM), a professional organization of midwifery, and also midwifery societies in the developed countries are the most active organizations involved in providing maternal safety program. Some researches relating to this program was performed in some undeveloped and developing countries such as Africa, Asia and latin America. Some confernces and congresses were also held.Researchers have indicated that traditional midwifery can not be successed in reducing the rate of maternal mortality unless be supervised by qualified midwives.Since in our country and some other developing countries, the rate of maternal mortality and morbidity is high, therefore the maternal safety program should be perfectly performed and midwives should do their best in applying this program.WHO declared midwives are responsible for the maternal safety program performance, and they will be supported by WHO in different ways, WHO also announced the year 1998 as the maternal safety year.Thus, as midwives, we should recognize our essential role in this program and in other national and international reproductive health programs.

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This is a retrospective research in order to compare the side effect of DMPA with OCP in reproductive women referring to health center in Kalaleh in year 1998. In this assessment the total number of women participated were 198, from this 115 were using Depo medroxy progesterone injection, and 83 women taking OCP. All the research subjects were assessed for having specifice character necessary for this research, and participated willingly. Data collecting was done by the means of questionnaire and checklist, data analysis was performed. The result revealed most users of DMPA were older with higher incidence of pregnancy and more children, lower socio - economical education and using injection for shorter period, comparing to women taking tablets, however the users of injection were taking OCP before, but those taking OCP never used any other method of contraceptive. There was a significant differences in headache, nausea, decreased vaginal discharge and menstrual problems, but no significant differences in acne, backache, leg cramps, mastalgia and hair loss were observed.

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Introduction: Midwifery practice is involved with clinical judgments which have direct effect on mother&aposs and embryo&aposs health. A midwife should be able to make vital decisions based on her knowledge and skills in emergency situations. A midwife can reach correct decisions by using critical thinking.

Materials and Methods: In this cross-sectional, descriptive-comparative study we compared critical thinking of the first and last trimester baccalaureate and post graduate midwifery students of Medical Sciences Universities of Tehran. A total of 259 qualified students of 2002-2003 educational year were selected by census method. After description the goals and methods of study, we applied California critical thinking skills test (form B) in order to measure level of student&aposs critical thinking. This test is a valid tool for measuring critical thinking and skills, including analysis, inference, deductive reasoning, inductive reasoning and evaluation. Scores were analyzed by statistical tests (ANOVA, t test and Pearson correlation coefficient).

Results: No significant difference between total critical thinking scores of first and last trimester students was found but the scores of critical thinking of the last trimester students showed a significant decrease in Tehran University (p=0.009) and a significant increase in Iran University (p=0.007). No significant difference was found in skills of critical thinking among students. In last trimester students, scores of inductive reasoning showed a significant decrease in Tehran University (p=0.001) and a significant increase in Iran University. There was a significant decrease in evaluation ability scores in Tehran and Azad (open) Universities (p=0.002) a significant increase in these scores was found at Iran University (p=0.008).

Conclusion: According to the results of this study, despite importance of critical thinking, enough attention is not being paid to it during the educational course. The current midwifery education strategies are unable to increase level of critical thinking in students. It is essential to utilize new teaching strategies and active learning methods.

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Introduction: Job satisfaction of midwives, as key members of healthcare system, has special importance in the quality of midwifery care to the vulnerable groups of the society i.e. mothers and children.

Materials and Methods: This is a survey and cross sectional study. Sampling size was 251 midwives, which were chosen through cluster sampling. Data were gathered by questionnaire in one stage and were analyzed by SPSS software, using descriptive and analytic (2, Pearson correlation) statistical methods. Results:

Results of this research demonstrated that satisfaction level of midwives in two aspects of job position (62.9%) and relationship with colleagues (48.2%) was moderate. It was low in the aspects of salary and benefits (92.8%), job security (69.7%), managerial policies and work condition (64.9%), supervisory (48.6%) and relationship with personal life (49.8%). There was a significant relationship and correlation between job satisfaction and all of its aspects, strongest with the aspect of managerial policies (r=0.87) and weakest with the relationship with colleagues (r=0.547). There was no significant relationship between job satisfaction and demographic characteristics such as age, academic degree, marital status, the number of children and monthly salary but there was a significant relationship between job satisfaction and the condition of house ownership, the years of job experience, the condition of employment, the place of work, work shift and whether they liked midwifery when they chose it (p<0.05).

Conclusion: Half of midwives (49.4%) had moderate job satisfaction, 49% had low and only 1.6% had high job satisfaction. Considering the results of this research, it can be concluded that the authorities must take efficient measures to omit the most important causes of low job satisfaction through increasing salaries and benefits, promoting job security, improving work condition, reformation of managerial and supervisory systems and using midwives’ professional ability in areas of their skill’s.

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Background & Objective: Studies show, clients&apos satisfaction is an important indicator for service quality assessment. Finding causes of dissatisfaction helps to promote health care services quality.  High quality prenatal care services and clients&apos satisfaction decreases maternal and neonatal mortality and morbidity. The perceived quality of the prenatal care by the mothers can not be effectively evaluated unless considering the opinions, demands and satisfaction rate of mothers who receive the care. The objective of this study is to measure prenatal care utilization rate and patients satisfaction in the clinics of Tehran University of Medical Sciences in 2005.

Methods & Materials: In this cross-sectional study, 380 pregnant women who had received prenatal care services in two hospitals and eight health centers were selected randomly and interviewed. Data were gathered using a questionnaire including demographic characteristics and satisfaction questions. Data were analyzed using SPSS and tested with chi-square and Pearson exact test.

Results: According to the results, 53.4 % and 14.8% of the pregnant women had received complete and incomplete prenatal care, respectively. Most of the pregnant women (54.7%) were completely satisfied, 23.7% and 21.6% were moderately and poorly satisfied, respectively. There was a significant relationship between the utilization rate and satisfaction of mothers (P<0.001). 53.4% of mothers in health centers and 46% in hospitals had received complete prenatal care. Satisfaction with prenatal care in health centers and hospitals were 57.5% and 47%, respectively. This difference was probably related to the amount of emotional and physical care received by the patients in the different settings and the characteristics of the centers in which these services are provided. The kind of setting had significant relationship with the utilization and satisfaction rates (P=0.003, P=0.005, respectively). The results showed that the utilization and satisfaction rates in the health centers in which health-care providers were midwives were better than the hospitals in which health-care providers were medical and midwifery students. But in both settings it was lower than 60%.

Conclusion: As a result, the utilization rate and satisfaction of mothers were inadequate in health centers and hospitals (lower than 70%). In the hospitals, they were lower than the health centers. The standardization of prenatal care and improvement of educational programs in hospitals should be considered.

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Background & Objective: Prenatal period is a unique opportunity to assist the women to adopt healthy behaviors. The nutritional behaviors of pregnant women affect not only their own health but also the fetal growth and development. The purpose of this study was to determine the effect of nutrition education on nutritional behaviors in pregnant women.
Methods & Materials: In this randomized trial, 272 primigravida women were recruited using stratified cluster sampling method from eight family health clinics in Semnan. The participants were allocated in two groups randomly. The intervention group received the nutrition education through two 90-minute sessions with one week interval. Data were gathered using a questionnaire including demographic characteristics and nutritional behaviors at baseline and six weeks after the education. Data were analyzed in the SPSS.
Results: The results showed that there was not any significant difference in the mean score of the nutritional behaviors between two groups before the intervention. Significant difference was found between two groups after the intervention. The mean score in the intervention group was higher than in the control group (P<0.001).
Conclusion: The results of the study showed that nutrition education affected the nutritional behaviors in pregnant women. Therefore, the nutrition education should be integrated in educational topics provided for pregnant women.

 

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Background & Aim: Home care visits have unique advantages in many social problems and health complications such as psychologic complications and adverse birth outcomes. The aim of this study was to identify the effect of postpartum care at home on quality of life among low risk mothers.

Methods & Materials: This interventional study was conducted in Akbarabad health center of Tehran University of Medical Sciences in 2010. A total of 200 mothers were randomly allocated in two intervention and control groups. Mothers in the control group received two post partum visits in health care center and the intervention group received care at home. Data were collected through a questionnaire including demographic characteristics and the mothers&apos quality of life items along with a growth and development monitoring chart for newborns. For analyzing data, Mann-Withney U, Wilcoxon and Chi-square tests were used.

Results: Most of the mothers aged 20-29 years old. The number of visits were statistically different between the two groups (P=0.00, P=0.01). Dimensions of quality of life in the two groups were not statistically different: (Physical dimension: P=0.052), (Emotional dimension: P=0.775), (Public health dimension: P=0.068), (Social performance dimension: P=0.780) and (Total score: P=0.213).

Conclusion: the results of our study did not show no positive improvements in home postpartum care in comparison with the health care centers care. More studies are recommended.

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Background & Aim: Teamwork (between obstetricians and midwives) is one of the main pillars of success in the provision of appropriate services in the maternity wards. Therefore, this study aimed to identify the factors influencing teamwork in a maternity ward in a public hospital in Tehran, Iran.

Methods & Materials: In this qualitative study, nine midwives and four obstetricians were selected through purposive sampling. Data were collected through semi-structured interviews from an affiliated hospital of Tehran University of Medical Sciences in 2013-2014. Data were analyzed using conventional content analysis.

Results: Two themes including the teamwork barriers (four categories) and facilitators (three categories) were extracted from the data analysis. The main categories of teamwork barriers were the underlying issues (inter-professional conflicts, legal issues, and salary and financial issues), individual problems (physical problems, negative personality characteristics and domestic problems), lack of skills (lack of abilities and motivation, educational weakness and lack of experience) and the external management system (inappropriate policy making and planning, hierarchical structure, lack of team evaluation and lack of justice). The main categories of teamwork facilitators were the internal management of team (good leader or manager, appropriate workplace climate, values clarification of the team members’ practices, and proper implementation of regulations), cooperation, collaboration and empathy (help and cooperation and empathy and support), and essential personal qualities for teamwork (good communication and good personality characteristics).

Conclusion: In this study, the teamwork barriers and facilitators in the maternity wards were comprehensively identified at different levels. According to the results, interventions can be designed and implemented to enhance teamwork.

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Background & Aim: Mastalgia is one of the most common complaints of women and its cyclic type constitutes two-thirds of the cases. This study aimed to determine the effect of Nigella Sativa syrup on cyclic mastalgia.

Methods & Materials: This study is a triple-blind randomized clinical trial (IRCT201104304785N3). The study samples included 65 women with cyclic mastalgia referred to the Breast Cancer Research Center (BCRC), Academic Center for Education, Culture and Research (ACECR) in Tehran in 2014-2015. The samples were randomly divided into two groups: intervention group (Nigella Sativa=36) and placebo group (oral paraffin=36). The pain was measured by the VAS and McGill Short Form questionnaire two months before and three months after the intervention. Data were analyzed using statistical tests on the SPSS software version 18.

Results: The results of the VAS and McGill pain score changes showed a significant difference between the two groups. Considering that the interaction between time and group was significant, the two groups were compared at each stage using independent t-test and the Bonferroni correction test. Thus, there was no significant difference between the two groups of Nigella Sativa and placebo on the basis of the McGill instrument but a significant difference was observed between the two groups on the basis of the VAS (P=0.002).

Conclusion: According to the results, Nigella Sativa reduces pain more than placebo. Therefore, it can be used along with other medications for the treatment of mastalgia.