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Background & Aim: Mother-Child bonding is an emotional aspect of relationship between mother and baby that affects children's psychological development. This study was performed to determine the predictors of mother-child bonding.

Methods & Materials: This cross-sectional study was performed on 270 mothers 8 to 10 weeks postpartum referred to eighteen health centers of Tabriz, 2014-2015. Data were collected using the obstetric and socio-demographic characteristics questionnaire, the Postpartum Bonding Questionnaire, the Edinburgh Postnatal Depression Scale and the Spielberger State-Trait Anxiety Inventory. The statistical tests including Pearson correlation, Independent t, one-way ANOVA and multivariate linear regression were used for data analysis through SPSS v.21. The significance level was considered as P<0.05.

Results: The mean (SD) of mother-child bonding score was 46.2±8.4, with achievable scores range from 0 to 125. 85.2% of mothers had a mother-child bonding disorder. The most frequent disorder pertained to the dimension of impaired mother-child bonding and the least frequent disorder was anxiety about child care. Variables of depression, state anxiety and unwanted pregnancy were among the predictors of mother-child bonding.

Conclusion: The study shows that anxiety, depression, and unwanted pregnancy are the determinants affecting mother-child bonding. Thus, the screening of mothers for the early identification and treatment of anxiety and depression, and also the reduction of unwanted pregnancy rate using purposeful family planning counseling can improve the mother-child bonding, resulting in improved children's growth and development.

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Background & Aim: The physiological and psychological changes in pregnancy, can affect the lives of couples. The present study aimed to determine the effect of sex education on the marital relationship quality of pregnant women.

Methods & Materials: This study is a quasi-experimental. In this study, 100 pregnant women referred to health centers in Zahedan in 2015, were selected and assigned into two groups of intervention and control (50 in each group). Data collection tool was the perceived marital relationship quality components questionnaire. Questionnaires were completed by the both groups before and six weeks after the sex education sessions. Data were analyzed using descriptive and inferential statistics through SPSS software version 20.

Results: There was no statistically significant difference between the two groups (P<0.05) in terms of age, the duration of marriage, gestational age and gravidity. In post-test measurement, the mean of the total score of marital relationship quality and components such as satisfaction, sexual excitement, love, commitment, intimacy, and trust, were significantly higher in the intervention group than in the control group. Analysis of covariance also showed that the total score mean for the marital relationship and its components had significant difference in the pregnant women in two groups, after sex education (P<0.001).

Conclusion: Given the effectiveness of sex education in the improvement of marital relationship quality in pregnant women, this educational intervention is recommended to be integrated into the education program and prenatal care of pregnant women in order to improve the couple’s relationship quality in pregnancy.

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Background & Aim: One of the non-pharmacological ways to reduce labor pain is husband’s attendance during childbirth. So, the present study aimed to evaluate couples' attitudes toward husband’s attendance in delivery room.

Methods & Materials: This study was a descriptive-analytical survey conducted on 259 pregnant women and their spouses who referred to Alzahra hospital in Rasht, in 2014. Samples were selected by convenience method. A questionnaire was used to collect demographic data and assess attitudes of mothers and their husbands toward husband’s attendance in delivery room. Data were analyzed by descriptive and inferential statistics using SPSS software version 17.

Results: The mean age for mothers was 26.42±5.59 years and for their husbands was 30.69±5.71 years. The mean score of mothers' attitudes toward husband’s attendance in delivery room was 102.99±13.47 which 97.3 percent had positive attitude, 1.9 percent had neutral attitude and 0.8 percent had negative attitude. The mean score of husbands’ attitudes toward husband’s attendance in delivery room was 100.88±14.36 which 91.9 percent had positive attitude, 5.8 percent had neutral attitude and 2.3 percent had negative attitude. Also, linear regression determined that there was a significant relationship between mother's education level and attitude score, so that attitude score increased about 0.19 with increasing level of education.

Conclusion: Given the high prevalence of couples’ positive attitudes toward husband’s attendance during labor and delivery, it is suggested that these findings be taken into account when designing essential facilities and measures for the implementation of mother-friendly hospital program and the promotion of natural delivery.

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Background & Aim: Sexual dysfunction is a common complication of diabetes in women. Although sexual function is important, often is neglected as a component of diabetes care. This study aimed to investigate the effect of counseling on sexual function in women with type 2 diabetes.

Methods & Materials: The present study is a clinical trial conducted on 120 married women with type 2 diabetes and sexual dysfunction, referred to diabetes clinic in Gorgan in 2014. Sexual function was assessed using the Female Sexual Function Index (FSFI). Samples were randomly divided into intervention and control groups. Sexual counseling sessions were held once a week for three weeks. Sexual function was assessed in two stages (before the intervention as well as two months after the intervention). Data analysis was performed using SPSS software version 20.

Results: There was a significant difference in the mean score of sexual function between the control and experimental groups two months after intervention (P<0.001). The comparison of different domains of sexual function (desire, arousal, lubrication, orgasm, satisfaction and pain) before and after intervention showed a significant difference in the experimental group compared to the control group.

Conclusion: Sexual counseling has a favorable effect on sexual function in women with diabetes. Sexual function is recommended to be assessed in women with diabetes during routine health care visit.

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Background & Aim: Females’ quality of sexual life is one of the key issues of sexual and reproductive health. This is a subjective concept and defined as individual’s perception of sexual aspect of life. The aim of this study was to explore the factors affecting Iranian women’s quality of sexual life.

Methods & Materials: This qualitative study was conducted by conventional content analysis. Data were collected by 17 in-depth, unstructured interviews and 14 sexual life narratives through purposeful sampling among married and reproductive aged women from five university-affiliated health centers in Tehran and Shiraz. Constant comparative method was used to analyze data.

Results: According to the participants’ experiences, 3 themes emerged as direct factors affecting the quality of sexual life including ‘preparation before sexual relationship’, ‘couple’s interaction and harmony in sexual relationship’ and ‘previous sexual relationship outcomes’. ‘Marital life status’ and ‘passive sexual socialization’ were explored as the factors which can conceptualize the context of females’ quality of sexual life.

Conclusion: In this study, factors affecting females’ quality of sexual life were identified. Attention to these factors is suggested to design appropriate interventions by health care system in Iran.

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Background & Aim: Improving and modifying lifestyle is necessary for health maintenance and promotion. Modification of lifestyle can have an important role in the long-term health of women with Poly Cystic Ovarian Syndrome (PCOS). Therefore, this study aimed to determine the status of health promoting lifestyle and its socio-demographic predictors in women with PCOS.

Methods & Materials: This analytical descriptive cross-sectional study was conducted on 174 women with PCOS referred to gynecology and infertility clinics in Urmia-Iran, in 2015. The data were collected through the socio-demographic and Health Promoting Lifestyle Profile questionnaires. Descriptive statistics, independent t-test, one-way analysis of variance and multivariate linear regression were used to analyze the data through SPSS software version 21.

Results: The mean (standard deviation) of total score of the health promoting lifestyle was 2.2 (0.3) out of 4. The highest mean score was in nutrition subscale [2.9 (0.5)] and the lowest mean score was in the subscale of stress control [1.2 (0.5)]. Based on the multivariate linear regression model, the variables of BMI, spouse’s education level, the first supporter and menstrual bleeding amount were predictors of the health promoting lifestyle in women with PCOS.

Conclusion: Considering that the mean of total score of the health promoting lifestyle and some of its subscales were in the middle of the range of possible scores, it is necessary that besides other therapies, the improvement of health promoting lifestyle in women with PCOS, according to the influencing socio-demographic determinants, be on the agenda of health providers.

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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.

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Background & Aim: Mother’s intense fear of and anxiety about labor pain lead to muscle contractions. Intense muscle contractions especially uterine contractions interfere with the normal process of labor. So, this study aimed to investigate the effect of salvia aroma on reducing the women’s anxiety level during labor.

Methods & Materials: The present study was a two-group randomized clinical trial (IRCT2016042727633N1) conducted in 2015 on 160 pregnant women laboring in Motazedi Hospital in Kermanshah. The subjects were randomly assigned into two groups. Prior to the intervention, the Spielberger’s State-Trait Anxiety Inventory (STAI) was completed by both groups and the anxiety scores were determined. In the intervention group, immediately after the onset of the active phase of labor, a gauze impregnated with three drops of the salvia essence was attached to the samples’ collars and repeated every half an hour. In the control group, a placebo was administered in a similar way. After the intervention, anxiety was measured at a cervical dilation of 5-7 cm. The chi-square test, Fisher test, Kolmogorov-Smirnov test, Wilcoxon and Mann-Whitney tests were employed to analyze the data.

Results: The mean score for anxiety was similar in the two groups prior to the intervention (P=0.15). However, after the intervention the mean score for anxiety was lower in the aromatherapy group (39.86±10.39) than in the control group (64.25±7.41) (P<0.001).

Conclusion: The findings suggested that the level of labor anxiety was reduced using aromatherapy with salvia essence. Accordingly, the use of salvia essence aroma is recommended for reducing anxiety labor.

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Background & Aim: Mothers during pregnancy face many concerns. Identifying mothers’ strategies to manage those concerns can help healthcare providers to promote their mental health. The aim of this study was to explore pregnant mothers’ strategies for the management of their concerns during pregnancy.

Methods & Materials: This qualitative study was conducted in Gorgan city during 2014-2015. The study participants were 20 pregnant women and three of their husbands as well as three experienced midwives who were selected using purposive sampling and interviewed through semi-structured interview. Data were analyzed through conventional content analysis using the MAXQDA software.

Results: Data analysis led to the emergence of five main categories including the utilization of purposive knowledge acquisition, reliance on the leverage of spirituality, thinking management and stress control, the effort to maintain and improve familial interactions and emotional preparation for pregnancy.

Conclusion: The five strategies used by pregnant women to manage their concerns, were identified in this study. Midwives can play an important role in implementing these strategies and empowering pregnant women.

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Background & Aim: Urinary incontinence is a common disorder in women. Pelvic floor muscle exercise is one of the effective treatment methods. Self-efficacy is considered an effective and strong predictor of willingness to perform and continue these exercises. In Iran, there is no appropriate tool for assessing self-efficacy. So this study was performed to determine the psychometric properties of the Broome scale in women with urinary incontinence.
Methods & Materials: A psychometric study of the Broome scale was conducted on women with urinary incontinence who referred to health centers affiliated to Tehran University of medical sciences in 2015.In this study, following processes were implemented: translation, back translation, face validity, content validity using CVR and CVI, reliability using Cronbach’s α coefficient, and construct validity using explanatory factor analysis.
Results: The face validity was confirmed through the modification of ambiguous items based on the patients’ views. Content validity (CVR= 0.8 and CVI= 0.8 to 0.9) and reliability (Cronbach’s α= 0.96) were also confirmed. Explanatory factor analysis showed two factors with eigen value more than 1 including pelvic floor exercise self-efficacy in usual and special situations. These factors explained 82.08 percent of the total variance.
Conclusion: The reliability and validity of the Broome scale were confirmed for using by Iranian women with urinary incontinence, and this scale can be used to measure these women's self-efficacy in performing pelvic floor exercises.
 

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Background & Aim: The premenstrual syndrome (PMS) is a set of physical and psychological symptoms that occurs periodically and affects women’s social and individual functionings. This study aimed to investigate the effect of stress management group counseling on the symptoms of premenstrual syndrome.
Methods & Materials: This semi-experimental study (IRCT2016052127994N1) was conducted on 44 students with PMS (22 in the intervention group and 22 in the control group) from Zanjan University of Medical Sciences in 2016. Data were collected using a demographic characteristics form and premenstrual symptoms screening test (PSST). Descriptive and inferential statistics including independent t-test, Chi-square, ANCOVA and repeated measurement test were used for data analysis via the SPSS software version 21.
Results: Before treatment, the mean scores of mood-behavioral symptoms, physical symptoms and the impact of symptoms on life had not any significant differences between the two groups. At the first month after treatment, mood-behavioral symptoms (P<0.001) and the impact of symptoms on life (P=0.007) were different between the two groups. Two months after the intervention, the mean scores of mood-behavioral symptoms in the intervention group (53.2±4.84) were significantly different from those in the control group (70.2±4.81). There was a significant difference in the mean score of physical symptoms between the intervention group (36.7±5.87) and control group (64.9±7.84). Also, the mean score of the impact of symptoms on life had a significant difference between the intervention group (36±4.73) and control group (58.3±2.73) (P<0.001).
Conclusion: Stress management group counseling is effective in reducing the symptoms of premenstrual syndrome, and it can be used as a non-pharmacological method with no side effects.
 

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Background & Aim: In pregnancy following stillbirth, the parental relationship and attachment to the dead child are denied, and this can impair the mother’s attachment to the new child. The present study aimed to determine the effect of cognitive behavioral training on maternal-fetal attachment in subsequent pregnancy following stillbirth.
Methods & Materials: This quasi-experimental study was performed on 100 pregnant women with the history of stillbirth, referred to health centers in Zahedan in 2017. Mothers were selected using convenience sampling and assigned into two groups of 50 each. Data were collected by a demographic questionnaire and the Cranley maternal-fetal attachment scale. After pre-test, the intervention group received 4 sessions of cognitive behavioral training during 4 weeks. After 8 weeks, the post-test was performed for two groups and data were analyzed using independent t-test, chi-square, Fisher's exact and ANCOVA tests through the SPSS software version 21.
Results: The mean score for maternal-fetal attachment was not significantly different in the baseline but was significantly higher in the intervention group (92.36±11.89) than in the control group (80.90±16.36) after the intervention (P<0.001). The adjustment for the pre-test score, optimism and visit numbers in ANCOVA the mean score for maternal-fetal attachment in the post-test were still significant (P<0.001).
Conclusion: Considering the effect of cognitive behavioral training on the promotion of maternal-fetal attachment, it is recommended that this training be integrated into the care program for pregnant women with a history of stillbirth.
 

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Background & Aim: Waterpipe smoking during pregnancy is a health problem, and interventions must be designed for its cessation. The present study was conducted to examine the effect of motivational interviewing (MI) on self-efficacy to quit hookah smoking in pregnant women.
Methods & Materials: The randomized clinical trial was conducted on 140 pregnant women who smoked hookah and lived in the marginal settlements in Zahedan in 2017. The convenience samples were randomly assigned to intervention and control groups. Data were collected using demographic characteristics and self-efficacy to quit hookah smoking questionnaires. Participants in the intervention received four group sessions of MI, while those in the control only received usual recommendations for quitting hookah smoking. The post-test was performed eight weeks after the completion of the intervention. Independent t-test, paired t-test, Chi-square, and Analysis of Covariance (ANCOVA) were used for data analysis through the SPSS software version 21.
Results: The demographic characteristics and gestational age of women were comparable between two groups, but the duration of hookah consumption in the intervention was more than the control (P=0.008). While the mean score of self-efficacy of two groups in pre-test was alike, in the post-test the score of self-efficacy in the intervention (60.85±7.25) was higher than the control (22.77±3.79) (P<0.001).
Conclusion: Given that MI approach has a positive effect on self-efficacy to quit hookah smoking, it is suggested that this counseling strategy is integrated into health care programs for pregnant women smoking hookah.
Clinical trial registry: IRCT201609240299954N5
 

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Background & Aim: Given the importance of the physical and mental health of pregnant women and the negative effects of worry on maternal and fetal health, identifying the factors affecting the reduction of worries is necessary. Therefore, the present study was performed to determine maternal worries and their relationship with coping strategies.
Methods & Materials: This analytical, cross-sectional study was performed on 465 pregnant women 14-40 weeks referred to health centres in Hamadan in 2015-2016. Data were collected using the obstetric and socio-demographic characteristics questionnaires, the Billings and Moos Coping Strategy and the Cambridge Worry Scale (CWS). Descriptive and inferential statistics including Spearman correlation and One-way analysis of variance were used to determine relationship between worries and coping strategies. A p-value <0.05 was considered significant.
Results: The mean (SD) of worry score was 25.8 (15.1), with achievable scores of 0 to 80. Thus, 67.3% were not worried, 30.1% expressed a small amount of concern and 2.6% had a great deal of concern. The comparison of the total score of coping strategies and the two subscales of problem-focused and emotion-focused coping strategies in the three groups indicated that only the emotion-focused strategy score was different in these groups (P<0.005).
Conclusion: The findings of the study indicate that there is a direct correlation between maternal worries and use of emotion-focused strategy. Therefore, it is suggested that midwives help pregnant women to reduce worry by training coping strategies in order to increase the use of problem-focused strategy.
 

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Background & Aim: Couples face many problems in pregnancies following In vitro fertilization (IVF) compared to normal pregnancies. The majority of studies have focused on women, and men have received less attention. So, this study aimed to explore the perceptions of men awaiting the first child following IVF.
Methods & Materials: This qualitative study was carried out in Shahid Motahari hospital in Urmia during 2017-2018. Data were collected using 19 individual in-depth semi-structured interviews. Participants were selected among men whose wives got pregnant by IVF, through purposeful sampling, until data saturation was reached. Data were analyzed through conventional content analysis approach using the MAXQDA software version 10.
Results: Four categories of "hope and fear of treatment outcome", "fear of social stigma", "financial concern", and "need for participation and training" were emerged from data analysis.
Conclusion: Men whose wives got pregnant through IVF have expectations and needs that must be addressed. On the one hand, the men are concerned about the social stigma of infertility and donation, the outcome of treatment, and the economic problems of treatment, and on the other hand they expect to be involved in the process of treatment and prenatal care.
 

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Background & Aim: Women with cancer face many stresses. Social support can facilitate coping skills and improve active coping strategies. The purpose of this study was to assess perceived stress and its relationship with perceived social support in women undergoing chemotherapy for genital cancers.
Methods & Materials: This descriptive, correlational study was conducted from March to May 2016 on 151 patients undergoing chemotherapy for gynecologic cancers in oncology wards of Alzahra and Shahid Ghazi hospitals in Tabriz. The perceived stress scale (PSS) and perceived social support scale (PRQ-85-part2) were completed through interviews with patients. Data analysis was performed using the Pearson correlation test, one-way ANOVA and independent t-test.
Results: Mean (and standard deviation) total score of perceived stress for women was 42.26 (3.97) in the score range of 0-56. Mean (and standard deviation) total score of perceived social support for women was 127.55 (16.64) in the score range of 25-175. Based on the Pearson correlation test, no statistically significant correlation was observed between perceived stress and perceived social support (P=0.324, r=0.08).
Conclusion: The findings indicated that the perceived stress score for women with genital cancers was high. Nevertheless, no relationship was observed between perceived stress and perceived social support. Therefore, further studies are needed in this area.
 

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Background & Aim: The physiologic childbirth program in Iran is an emerging program that needs to be evaluated like any other program to improve its quality and process. Evidence suggests that the implementation of the physiologic childbirth program faces some challenges. The present research aimed to explore the challenges of the physiologic childbirth program from the perspective of service providers.
Methods & Materials: This qualitative research was carried out through a content analysis method in two mother-friendly hospitals of Ahwaz and Mashhad in 2016-2017. Data were collected through semi-structured interviews with 17 physiologic childbirth service providers. The content analysis method of Elo and Kyngas was used for qualitative data analysis.
Results: Data analysis led to five main categories: low motivation of midwives in performing physiologic childbirth; barriers related to manpower; medical interventions in physiologic childbirth; challenges from the environment and facilities; and educational barriers.
Conclusion: Different challenges in interaction with each other create a complex environment in which the implementation of physiologic childbirth program becomes more difficult. Therefore, policymakers, authorities, doctors, midwives and mothers need to work in a coordinated way to resolve the mentioned challenge.
 

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Background & Aim: Assessment of sexual health literacy requires an appropriate tool. The purpose of this study was to develop and validate a questionnaire to evaluate the level of sexual health literacy among Iranian adults.
Methods & Materials: This study was designed in two phases in Tehran during 2017-2018. In the first step, the questionnaire was developed by item generation through expert panel and literature review. In the second step, the assessment of psychometric properties of the questionnaire including face, content, and structure validity (exploratory factor analysis) and convergence criterion (using general health literacy questionnaire) were done. Reliability of the questionnaire was assessed by internal consistency (Cronbach’s alpha) and intraclass correlation coefficient (ICC). Data were analyzed using the SPSS software version 21.
Results: The content validity indices (CVI and CVR) for all items were 0.84 and 0.81, respectively. Exploratory factor analysis identified four factors including skills of access, reading and understanding, evaluation and analysis, and application of information that explained %68.1 of the variance. Convergent validity of the questionnaire showed a correlation between the questionnaire’s dimensions and general health literacy questionnaire in the range of 0.31 to 0.70. The SHELA showed a high internal consistency reliability with Cronbach’s alpha, ranging from 0.84 to 0.94 and intraclass correlation coefficient (ICC), ranging from 0.90 to 0.97.
Conclusion: The psychometric assessment of the 40-item questionnaire (SHELA) indicates desirable validity and reliability. This questionnaire is suggested for assessing the level of sexual health literacy of adults in future studies.
 

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Background & Aim: Pregnancy is one of the enjoyable and evolutionary aspects of women’s life, which is often associated with many stresses and concerns. Counseling is one of the most appropriate interventions to reduce concerns and increase the decision-making power of pregnant women. This study aimed to determine the effect of solution-focused group counseling on pregnant women’s worries.
Methods & Materials: A randomized clinical trial was conducted on 108 pregnant women with gestational age of 6 to 19 weeks and a score of worry ≥55, from May to September 2017 in health centers of Sabzevar University of Medical. The intervention group received a solution-focused counseling and the control group received routine prenatal care. Concerns of pregnant women were evaluated before, after, and two months after the intervention using the Farsi version of Cambridge Worry Scale. The data were analyzed using t-test, chi-square, and repeated measure analysis of variance through the SPSS software version 22. A P value less than 0.05 was considered statistically significant.
Results: The mean score of worry before the study was 58.9±5.9 for the intervention group and 58.8±4.37 for the control group, and no significant difference was observed. After the intervention, these values for the intervention group and the control group were 34.6±13.3 and 57.7±8.78, respectively. Two months after the study, these values were 31.1±10.1 and 54.6±10.9, respectively. The analysis of variance with repeated measurements showed that pregnant women’s concerns about childbirth, fetal health, maternal health, and family relationships were significantly reduced after the intervention and two months later (P<0.001). Women’s worries about socioeconomic issues were not significantly reduced after the intervention and two months later in comparison with the control group (P=0.563).
Conclusion: The solution-focused counseling is an effective way to reduce pregnant women’s concerns about maternal and fetal health, family relationships and childbirth. It can be used in conjunction with pregnancy care.
Clinical trial registry: IRCT20180123038485N1
 

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Background & Aim: Pregnancy during adolescence is in conflict with the identity structures of adolescents, that can have a negative effect on maternal mental health, and especially cause stress. This study aimed to evaluate the effect of neonatal care education on perceived stress in adolescent mothers.
Methods & Materials: This quasi-experimental study was conducted on 116 adolescent pregnant women referred to Zahedan health centers in 2016. Samples were selected by the convenience sampling method and assigned into two groups of 58 people each. The pre-test was performed before the first session using demographic and perceived stress questionnaires. The intervention group received three educational sessions on neonatal care and stress reduction methods. Routine prenatal education was provided to the control group. A post-test was performed at 38 week of pregnancy and 30 days after delivery. The data were analyzed using the Mann-Whitney, Monte Carlo and Fisher tests through the SPSS software version 21.
Results: Before the intervention, the stress score for the intervention group was higher than that for the control group (P=0.007), but the mean score of perceived stress for the intervention group significantly decreased at the 38th week of pregnancy and 30 days after delivery, compared to the control group. According to the Mann-Whitney test, the decrease was significant (P˂0.001).
Conclusion: Considering the effect of the neonatal care education on reducing stress in adolescent mothers, it is recommended that this type of educational intervention be integrated into care program for adolescent pregnant mothers.