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Unintended pregnancy is a world wide problem that affects women, their families, and society. From a total of 175 million pregnancies per year 75 million of them are unintended. This cross-sectional study was undertaken to determine prevalence of unintended pregnancies and pertinent factors and suggests an appropriate solution. A sample of 400 women who were seeking pregnancy tests in laboratories of hospitals affiliated of Tehran University of Medical Sciences, at the obstetric and gynecologic ward, and who had positive tests were selected by the Poisson random sampling method. Women who were found to have diseases such as hydatidiform mole were excluded. A questionnaire was used to collect data. Pregnancy intention was measured using NSFG 2001 questionnaire. Descriptive and analytic tests (chi-square, Fisher exact, t-test) were used to analyze the data. Prevalence of unintended pregnancy was 47.5%, of whom 36.3% hadn’t used contraception methods. Fear of side effects (66.7%) was the most prevalent reason of not using contraception. The main reason for unintended pregnancy was economical problems (42.6%). 63.7% of women with unintended pregnancy had used one of contraceptive method but 86.8% of users had used that method in an incorrect way. Also the results indicated that the age of women, educational status, number of children, husband’s age and education were associated with contraceptive use. The results indicated that prevalence of unintended pregnancy is high and the contraceptive methods weren't used or were used incorrectly by most of them (91.6%). This may show the necessity of training women about contraceptive methods and side effects of unintended pregnancy. Due to the important role of health care providers they should be trained to give such consultation to women.

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Introduction: Satisfaction from marital relation is a fundamental factor in stability and maintenance of marital bond. Sexual satisfaction is one of the effective factors in spouse relation satisfaction.

Materials and Methods: This research is a correlation study. A sample of 400 women referring to health care centers in Arak city was selected randomly in 2003. The information collecting tools were questionnaires. To analyze the data, the descriptive statistical, frequency distribution charts, the mean and central tendency as well as inferential statistics (2 test and Kruskal Wallis) have been applied.

Results: According to the results, there was a meaningful relationship between having orgasm and sexual relation satisfaction, nonsexual relation satisfaction with spouse and marital relation satisfaction. Also, there was a meaningful statistical relationship between orgasm experience and variables of age, spouse s age, education, spouse s education, duration of marriage, number of children, and family s income.

Conclusion: There is a relationship between women s orgasm experience and the amount of satisfaction from marital relation. Hence, it was suggested that the health planners and the officials in charge pay more attention to women s sexual problems and a sexual counseling clinic be established in health care centers.

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Pregnant women can be infected with TORCH (toxoplasmosis, other virus, rubella, cytomegalovirus and herpes) which have been linked to fetal or neonatal malformations. Toxoplasmosis is the most common of these infections. Toxoplasma is an intracellular parasite that is found in animals, including sheep and mice. It is transmitted in the feces of cats who have consumed infected mice and in meat from infected animals. The disease in humans may have no symptoms or may cause lymphadenopathy, fatigue, fever, sore throat, eye pain, and rash. It may be mistaken for influenza or mononucleosis. At least half of all pregnant women in the united states have antibodies to toxoplasma. The rate of infection in pregnancy is 1-5 in 1000 birth. When infection does occur, spontaneous abortion, chorioretinitis, anemia, liver damage, CNS abnormalities and prenatal death may result. Pregnant women should be treated for acute toxoplasmosis to prevent fetal malformations. Neonates must also be treated, even if asymptomatic. Midwives and nurses play an important role in home assessment and prenatal teaching to prevent this infection. This preventive advice has significantly reduced the incidence of toxoplasmosis in areas where it has used systematically.

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Background & Aim: Regarding to increasing of life expectancy, Women spend a greater proportion of their life in menopause that is associated with complications and makes disability for them. One of the safe treatments for these complications is herbal therapy.

Methods & Materials: This research is a semiexperimental study. Randomized cluster sampling method was used to select 50 menopaused women ranging from 45 to 55 years old. Experimental group used vitagnus (40 drops daily) for three months. The data was collected by interviewing and a structured questionnaire and daily diary. The data was analyzed by descriptive (percent, mean, standard deviation) and inferencing (2, t-test, Mcnimar, repeated ANOVA) statistical methods by SPSS software.

Results: The results showed a significant reduction in early menopausal complications after intervention (p<0.05). The most major improvement in menopaused women was realated to hotflash (52.2%) and night sweat (51.3%). The other complications showed moderate improvement. Conclusion: Vitagnus is effective in improving of early menopausal complications and therefore doctors and midwives can prescribe vitex instead of HRT in menopausal women.

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Background & Aim: Because of importance of communication and its defects which has been observed in communication with clients, this study has been planned and done with the aim of investigation of usage of’ communication skills by midwives and its relation to client’s satisfaction.

Methods & Materials: In a correlational study 50 midwives and 400 clients were investigated. Data collection method included observing midwife- client encounter using a checklist and interviewing clients to fill out satisfaction questionnaire. Descriptive and inferential statistics included chi- square test, fisher’s exact test and Pearson correlation (p<0/05) were used for data analysis.

Results: The results of this study showed that midwives’ communication skills (verbal and non- verbal) was undesirable (62% and 56%). There was no relation between demographic variables and midwives’ communication skills application. Just there was a relation between marital status and non-verbal communication skills application. Also clients’ satisfaction with midwives’ verbal and non-verbal communication skills (50% and 48/4%) was related meaningfully to midwives’ communication skills application. There was a relation between clients’ satisfaction and their age, educational status service they needed.

Conclusion: According to undesirable usage of communication skills by midwives, administering interim training programs for midwives is recommended. Also it seems better to include communication skills training to midwifery curriculum.

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Background & Aim: It is important to identify modifiable causes of preterm delivery and low birth weight which are strong predictors of infants&apos later health status and survival. Research findings show that there are less low birth weight and preterm labors in the communities that have high intake of sea food. Consumption of Sea foods rich in w3 fatty acid can increase birth weight by prolonging gestation and reduce the risk of occurrence of preterm delivery.

Methods & Materials: In this prospective cohort study, samples (n=1200) were selected among pregnant women with different pattern of seafood intake at 16^th week of pregnancy receiving routine antenatal care in Gilan prenatal clinics. Subjects were selected by random sampling method. Women who had risk factors for preterm delivery or fish allergy were excluded. During 2004-2005 the pregnant women were visited monthly to determine their dietary habits (seafood intake). Infants&apos weight and mothers&apos gestational age were determined at the time of delivery. Data were collected by means of a validated self-determined questionnaire and a check- list.  Statistical analysis was carried out using SPSS statistical software package.

Results: Results showed that the per cent of term delivery (more than 37 gestational weeks) in women with more than 3 times, 1-3 times, and less than once sea food intake in a day is respectively 94.5%, 91%, and 91.5%. Moreover, birth weights more than 3000 gram in the neonates of these women were respectively 75.7%, 74.7%, and 71.2%. There was significant relationship between more than 3 times consumption of sea food in a month with gestational age (P<0.001) and birth weight (P<0.05).

Conclusion: Sea food consumption is effective in decreasing preterm delivery and low birth weight. Related nutritional educational programs for pregnant women are recommended.

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Background & Aim: Socio-economical changes have increased the women&aposs opportunity to take job in recent decades. The increased levels of women in work places, has resulted in a high interest in the potential adverse effects of work on pregnancy outcome. This study was conducted in order to surveying the association between occupational factors and preterm childbirth.

Methods & Materials: It is a cross-sectional study. Samples consisted of nurses and midwives (518 person) who working in Tehran&aposs universities of medical sciences hospitals. Also they delivered newborns in gestational age more than twenty weeks (term or preterm) in years 2001-2006. The subjects were selected using a multi stage sampling method. Data gathered using a self-administered questionnaire. Occupational factors labeled as fatigue score and working hours. The relation between Occupational factors and preterm birth was analyzed using descriptive and inferential statistics (Chi-squared, t-test and Mann-Whitney U test) by SPSS software.

Results: Based on the study findings, the prevalence of preterm labor was 17.2% (95%CI=0.14-0.20). Although the proportions of unfavorable working conditions include: working at acute clinical wards, standing up more than 3h per each working shift, physical exercise, working in cold or hot weather, working in busy environment with continuous noise, being checker of visual and aural monitoring signals, working hours equal or more than 40 hours per week, and working fatigue score equal or more than 3 were higher in preterm group but it didn&apost show any significant relation with preterm birth.

Conclusion: According to the research findings, it seems that occupational factors do not have explicit effect on preterm childbirth. Therefore more investigations are recommended.

 

Key words: Preterm Labor, Occupational Factors, Fatigue

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Background & Aim: Adverse childbirth experiences as a trauma can evoke fear and post-traumatic stress disorder in some women. This study was conducted to investigate the effect of counseling on post traumatic stress disorder after a traumatic childbirth.

Methods & Materials: This research was a clinical trial which was conducted at Kamaly hospital in Karaj. Samples (300 women) who had experienced a traumatic childbirth were selected by a convenient sampling method and were randomized into an intervention (n=150) and a control (n=150) group. The intervention group received face-to-face counseling within 72 hours of birth for forty to sixty minutes in a session. The control group just received usual care after childbirth. The data collection tool was questionnaire, which was completed via interview. The measuring variables were demographic characteristic, reproductive history, maternity social support, and post-traumatic stress disorder. Data were analyzed using descriptive statistics and inferential tests (Chi-square, Fisher&aposs exact test, and generalized Fisher&aposs exact test) by SPSS v.13 software.

Results: After 4-6 weeks of follow-up there was no significant difference regarding post-traumatic stress disorder between two groups (P=0.295). At 3-month of follow-up, the intervention group reported less post-traumatic stress disorder comparing with the control group (P=0.001).

Conclusion: A midwife-led counseling plan is effective in reducing post-traumatic stress disorder during a long term.

 

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Background & Aim: Preeclampsi which is a common and important disorder in pregnancy is one of the three leading causes of maternal mortality. It is worthy to find out an appropriate screening test for it. This study aimed to assess serum hematocrit level as a screening test for preeclampsia.

Methods & Materials: Using a randomized stratification, 660 women who were in the 24-28 weeks of gestation were recruited to the study from a prenatal clinic of Taamin Ejtemaei hospital in Tehran. Data were collected through observations and interviews. Data were recorded in a questionnaire and recording form. The women were followed up until delivery. Data were analyzed in SPSS.

Results: There was significant differences in 24-28 weeks serum hematocrit levels in preeclamptic and non-preeclamptic women (P<0.001). There were 58.6% sensitivity, 88.9% specificity, 33.7% positive predictive value, and 95.7% negative predictive value for serum hematocrit.

Conclusion: A Serum hematocrit level in 24-28 weeks of gestation is a simple and inexpensive test that can help to detect high-risk preeclamptic women.

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Background & Aim: Premenstrual syndrome (PMS) is a common psychosomatic disorder that affects 30-50% of women in reproductive ages. The purpose of this study was to determine the effect of a counseling program on premenstrual syndrome related symptoms.
Methods & Materials: This study was a randomized clinical trial in which the effect of a 3-sessioned counseling program on the PMS symptoms were assessed in 123 adolescent with PMS. The program included information providing, life style alteration, and providing stress management skills on symptoms of PMS. The participants were randomly allocated to intervention (n=67) and control (n=61) groups. Participants completed the demographic questionnaire, the PMS symptoms&apos daily record scale, and the symptom checklist 90-revised (SCL-90-R). Data were analyzed using the SPSS-11.5.
Results: The comparison of baseline data showed no significant difference between two groups regarding demographic characteristic and the PMS related symptoms. There were significant differences in the mean of total PMS severity, somatic symptoms (P<0.001), anxiety, interpersonal sensitivity, and hostility (P<0.05) between two intervention and control groups. There was not any significant difference in depression between intervention and control groups (P=0.11).
Conclusion: Group counseling resulted in a significant reduction in severity of total PMS, somatic symptoms, anxiety, interpersonal sensitivity and hostility in intervention group compared to the control group. There was no statistically significant difference in depression between two groups.

 

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Background & Aim: Maternal-fetal attachment plays an important role in maternal identity forming. The attachment behavior is different between mothers and most of the reported studies are from Western countries. The aim of this study was to assess maternal-fetal attachment behavior and some related factors among Iranian mothers.

Methods & Materials: This cross-sectional study was carried out in 12 health and medical centers, affiliated to Tehran University of Medical Sciences. Four hundred pregnant women were selected for the study. Data were gathered using two questionnaires. The first one was a self-structured questionnaire and the second one was the maternal-fetal attachment scale. Data were analyzed using the Pearson, Anova and t-test statistical tests. The P<0.05 denoted statistical significance.

Results: Findings showed that the mothers had good attachment toward their fetuses (M=84.72). The race, higher maternal age, higher education, gestational age, planned pregnancy, sex of fetus, and assessing health of fetus had positive effects on prenatal attachment (P<0.05). Tobacco use, multiparity, and high risk pregnancy had negative effects on attachment. There were no relationships between attachment and previous marriage, infertility, abortion, number/type of ultrasound, participation in prenatal classes and healthy baby (P>0.05).

Conclusion: Understanding maternal-fetal attachment behavior could play an important role in quality of prenatal care. Midwives can assess and promote attachment behavior as well as recognize factors influencing maternal-fetal attachment.

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  Background & Aim: Midwives are responsible for providing health services to mothers and infants in crises. The aim of this study was to identify educational needs of midwifery students regarding mother and infant mortality prevention in crisis situations .

  Methods & Materials: In this cross-sectional study, all 235 final-year BSc. and MSc. midwifery students were selected from four medical universities located in Tehran. Informed consent forms were completed and signed by the students. The students completed a researcher-made two-section questionnaire including demographic items and educational needs items regarding mother and child preventive services in crises. Data were analyzed in the SPSS . 

  Results: Mean score of the m aternal and neonatal prevention service dimensions were 70±21.5 ( out of 105 ) and 46.7 ± 9 (out of a 65), respectively. Most of the students (86.8% ) declared that their academic education did not prepare them for their roles in crises. Only 10.6% of the students had some courses on crisis and 11.5% of them had the experience of dealing with crisis. The students in the BSc. degree had more educational needs in both dimensions compared to the students in the MSc. degree (P<0.046). There were significant relationships between the age of students (P<0.001), their clinical experience (P<0.001), previous educational courses (P<0.001) and experience in crisis (P<0.05) with the educational needs. There was no significant relationship between the educational needs and the students’ universities ( P>0.05 ) .

  Conclusion: Educational curriculums should be revised regarding actions to be done on prevention of mother and infant mortality in crises .

  

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Background & Aim: One of the assisted reproductive technologies is the use of donated oocyte. Although, the data about medical aspects of this process is available, knowledge of the psychological aspect related to this therapy is limited. Each individual's psychological aspects can be assessed by the self-concept and the self-discrepancy. Therefore, the present study aimed to assess the self-concept and self-discrepancy among women receiving and donating oocyte.

Methods & Materials: In this descriptive-analytical investigation, carried out in 2015, given the limited research population, 53 women referred to Royan infertility institute, were investigated in each of the donor and recipient groups using the available sampling method. The data were collected by three questionnaires including demographic questions, Rogers’s self-concept scale and self discrepancy scale (ideal-self discrepancy and ought-self discrepancy). The data were analyzed through the descriptive statistics, Chi-square and t-test using SPSS v.16.

Results: Results showed that the self-concept and self-discrepancy scores were poor in both the donor group and the recipient group. Scores of the recipient women (the questionnaire was reverse scored) were more than scores of the donor women. There was no significant difference between the two groups in the mean scores of self-concept (P=0.53). There was a significant difference between the two groups in the ought-self discrepancy score (P=0.02) but no significant difference was found between the two groups in the ideal-self discrepancy score (P=0.15).

Conclusion: According to the results, it should be noted that in the process of oocyte donation, only physical assessment is not enough but individuals’ psychological needs are necessary to be taken into account. So, the authorities should consider measures to assess the psychological aspects of women receiving and donating oocyte.