Julia Król, Oliwia Makowska, Aleksandra Ciurzyńska, Jakub Zblewski,
Volume 21, Issue 2 (6-2024)
Abstract
Hayedeh Arbabi, Mahin Badakhsh,
Volume 21, Issue 2 (6-2024)
Abstract
Background: Pregnancy and childbirth can be considered as an opportunity to expand thoughts or renew feeling on spiritual beliefs. The present study was conducted with the aim of investigating the relationship between spiritual health and childbirth experience among Iranian pregnant women.
Methods: This is a cross-sectional study that was conducted on 250 pregnant women referred to the Labor, Delivery and Recovery Room (LDR) of Amir al-Momenin Hospital in Zabol (Eastern Iran) for childbirth. Non-random convenience sampling method was used to collect the samples. Data collection tools included a personal characteristics questionnaire, childbirth experience questionnaire (CEQ), and spiritual health questionnaire. Data analysis was conducted using statistical tests, such as Pearson correlation test, independent t-test, and One-Way ANOVA. The level of statistical significance was set at 0.05.
Results: The results of present study showed that the mean age of pregnant women was 25.66 ± 5.73 years, with their mean score of birth experience being 64.97 ± 4.62 and their mean score of spiritual health being 88.89 ± 7.1. The results also showed a statistically significant relationship between birth experience and spiritual health (R =1, P=0.007).
Conclusion: In this study, as the score of spiritual well-being increased, the score of childbirth experience also increased. Thus, we suggest the findings of this study to be used as a basis for further research in other regions of the country and among a more diverse population of mothers with different backgrounds and cultures.
Lisnawati Lisnawati, Rani Widiyanti, Pepi Hapitria, Dena Latif Setiawan,
Volume 21, Issue 2 (6-2024)
Abstract
Background: The Pregnant Mother Game application is designed to enhance midwifery services, particularly for online antenatal classes. It is developed by experts in learning media and presented in a game format. The objectives of this research are to develop apps for antenatal classes and to assess how well these applications increase mothers' knowledge.
Methods: It is a level 3 Research and Development, which is developing and refining products. The participants were selected using a purposive sampling technique. Limited trials of the application, which is downloadable on Android devices, were carried out with 10 first-time pregnant women in Cirebon City, Indonesia. Data collection tools included a questionnaire for experts and mothers. Data were analyzed using IBM SPSS Statistics 16, with univariate analysis employing a frequency distribution and bivariate analysis utilizing the Wilcoxon test. The significance level was set at 0.05, with a 95% confidence interval.
Results: The material experts’ qualifying test yielded a score of 85% (very decent), and the media members' score was 84.4% (very decent). There was a 50% increase in the mean knowledge value. The pretest score ranged between 10 and 25, while the posttest score ranged between 25 and 29. The use of the application was correlated with increased knowledge score, and the correlation coefficient was significant at 0.05.
Conclusion: The program can be used as an effective technology medium for conducting online classes for mothers. The mothers’ knowledge significantly improved after taking online classes with the application.
Nhan Thi Nguyen, Quang Minh Lam, Huong Thi Do,
Volume 21, Issue 2 (6-2024)
Abstract
Background: Labor pain and perineal trauma are the most common complications during childbirth and negatively impact a woman’s physical and emotional well-being. The World Health Organization recommends using warm compresses during the second stage of labor to mitigate perineal injuries. This systematic review evaluates the effectiveness of this intervention to guide informed clinical decisions.
Methods: Searches were conducted on PubMed, Google Scholar, and ScienceDirect from inception up to the present day (as of July 2023) for randomized and quasi-experimental trials in English, focusing on vaginal births using warm compresses and measuring outcomes related to pain and perineal trauma. The review followed PRISMA guidelines, and biases were assessed with the Cochrane risk-of-bias tools.
Results: The search strategy identified a total of 75 articles, of which 13 were included in the review. In most studies, pain scores in the warm group were significantly lower than in the control group. Warm compress intervention was also associated with lower rates of perineal laceration and a higher rate of intact perineum. Results in suturing-required perineal injuries, severity of perineal trauma, or episiotomy were mixed.
Conclusion: It is suggested that the application of warm compresses during the second stage of labor has been shown to be an effective method for reducing labor pain and perineal trauma that does not require suturing. Due to the mixed results found, considerations should be made before applying this intervention for the purpose of reducing perineal tears or episiotomies during labor.
Mehrdad Rohaninasab, Masumeh Hesari, Zahra Mollazadeh Narestan , Akram Gazerani,
Volume 21, Issue 3 (10-2024)
Abstract
Background: The increasing prevalence of preterm birth in many societies has raised concerns. This study was conducted to determine the prevalence and risk factors associated with preterm birth in hospitals in Neyshabur, Eastern Iran.
Methods: This cross-sectional study was conducted on 273 neonates born before 37 weeks of gestational age between 2017 and 2019 in the educational hospitals of Neyshabur. The infants were included in the research through convenience sampling. The research tool consisted of items addressing issues related to both mothers and newborns. Data analysis was performed using SPSS version 22, employing descriptive and analytical statistics, including chi-square and Fisher's exact tests.
Results: The rate of preterm birth in Neyshabur over the three-year period was 2.85%. Bicornuate uterus (1.83%) and cervical insufficiency (1.46%) were the most observed uterine factors, while umbilical cord prolapse (1.83%) and placental adhesion (1.46%) were the most prevalent placental factors. Moreover, breech presentation (10.98%) was the most common co-occurring fetal factor in preterm birth. A significant difference was found between the length of pregnancy and the type of delivery (vaginal or cesarean section) (P=0.003).
Conclusion: Due to the high prevalence of preterm birth in Neyshabur, it is recommended that mothers undergo periodic evaluations before and during pregnancy to identify and manage any accompanying problems or underlying conditions promptly.
Saliha Yurtçiçek Eren, Şükran Başgöl,
Volume 21, Issue 3 (10-2024)
Abstract
Background: Breastfeeding is a complex process influenced by various factors, including social support, perceived milk insufficiency, and breastfeeding self-efficacy. This study aimed to explore the relationships between perceived social support, breastfeeding self-efficacy, and the perception of insufficient milk among breastfeeding mothers in eastern Türkiye in 2022.
Methods: This correlational study was conducted at a state hospital in eastern Türkiye with 500 breastfeeding mothers of infants aged 0-6 months attending the pediatric outpatient clinic. The participants completed the Sociodemographic Data Form, the Multidimensional Scale of Perceived Social Support, the Breastfeeding Self-Efficacy Scale-Short Form, and the Perceived Insufficient Milk Questionnaire. Pearson correlation analysis was used to examine the relationships between the scales, with a significance level set at p < 0.05.
Results: The mean scores were 62.91 ± 16.16 for perceived social support, 52.49 ± 9.03 for breastfeeding self-efficacy, and 38.25 ± 10.04 for perceived insufficient milk. Significant positive correlations were found between perceived social support and breastfeeding self-efficacy (r = 0.188, p < 0.001), perceived social support and the perception of insufficient milk (r = 0.251, p < 0.001), and breastfeeding self-efficacy and the perception of insufficient milk (r = 0.251, p < 0.001).
Conclusion: High levels of social support are associated with increased breastfeeding self-efficacy and improved perceptions of milk supply, thereby supporting both maternal and infant health. Healthcare professionals can enhance these outcomes by providing targeted training programs, motivational interviews, and social-cognitive support to breastfeeding mothers.
Batool Zeidabadi, Abedin Iranpour, Fatemeh Alavi-Arjas, Mohammad Reza Baneshi, Salman Shamsadini Moghadam , Mohammd Moqaddasi Amiri, Mahdiye Taheri,
Volume 21, Issue 3 (10-2024)
Abstract
Background: Fetal health and pregnancy outcomes are significant contributors to increased prenatal stress. The effect of fetal anomaly screening on a mother’s stress is controversial. The present study aimed to explore maternal stress throughout a multi-stage anomaly screening program among healthy pregnant women.
Methods: This prospective cohort study was conducted at the public health centers of Sirjan, Iran from March 2022 to January 2023 using the convenience sampling process. The population included 228 healthy pregnant women. Data were collected using a researcher-made checklist for demographic and obstetrics characteristics. Cohen's Perceived Stress Scale (PSS) was utilized to measure maternal stress at three distinct intervals, including before (weeks 6-10 of pregnancy), during (weeks 11-14 of pregnancy), and after fetal anomaly screening tests (weeks 15-20 of pregnancy). Friedman test was used for measuring the association between maternal stress and fetal abnormality test results. Data were analyzed with Statistical Package for the Social Sciences (SPSS) software version 26 at a significance level of 0.05.
Results: The mothers with higher educational levels (p =0.05, β=1.74), and having a live child experienced lower levels of initial stress (p =0.016, β=2.27). Throughout the time, receiving a normal nuchal translucency (NT) result was associated with a significant decrease in perceived mother's stress (p <0.0001), and abnormal NT ultrasound results (reported in 3.8% of women) led to a rise in the downslope of stress in the third measurement; however, it was not significant.
Conclusion: The present study revealed that maternal stress decreased over time following normal results of fetal anomaly screening. Three factors were associated with lower maternal stress, including university education, having at least a living child, and a normal ultrasound result. Moreover, women at first pregnancy and/or with an abnormal ultrasound result experienced high-stress levels. The findings may be useful in guiding the formulation of health policies and the distribution of resources.
Masoumeh Abbasi Shavazi , Manoj Sharma, Tayebeh Mokhtari Sorkhani ,
Volume 21, Issue 3 (10-2024)
Abstract
The total fertility rate has declined in certain countries, dropping below the replacement level. The attitudes and desires of some families regarding having children have also shifted. To cultivate positive societal views on childbearing, there is a need for updated educational initiatives, such as a multi-theory model. Although the multi-theory model has been used in various contexts to facilitate health behavior change, with its effectiveness validated in predicting and influencing behaviors, there has been no documented use of this model in the context of fertility, either in Iran or globally. Developing fertility encouragement programs requires cultural sensitivity and attention to accepted social norms and customs, which can enhance program efficacy. We believe the Multi-Theory Model can be effective and useful in encouraging couples to increase fertility.
Nouzar Nakhaee, Fahimeh Amiri, Muhammad Samari, Hamid Sharifi, Abedin Iranpour,
Volume 21, Issue 4 (12-2024)
Abstract
Background: Declining fertility rates pose significant demographic challenges globally, particularly in Europe, the Asia-Pacific region, and Iran. Female marriage volunteers, as a group capable of having children, are a key target for pronatalist policies. We aimed to identify the factors influencing fertility intention among Iranian female marriage volunteers.
Methods: We conducted a province-wide cross-sectional survey from January to April 2023. Using a convenience sampling approach and a validated questionnaire (Determinants of Childbearing Intention Questionnaire), we assessed the childbearing intention (i.e., intention to have a child during the next three years) and fertility intention (i.e., ideal number of kids) among 1,506 female marriage volunteers in Kerman, Iran. Data were collected through face-to-face interviews and the sealed ballot box method was applied to ensure the confidentiality of the participants’ information. Multivariate logistic regression was used to identify the factors associated with childbearing and fertility intentions.
Results: The majority of the female marriage volunteers (83.7%) intended to have two or more children, and 61.8% of them intended to have a child during the next three years. They believed that the most appropriate time to have a child after marriage was 2.2 (±1.8) years. Physical and mental health, with a mean of 4.37 (0.94) out of a possible score range of 0 to 5, was the most important perceived barrier to having children. The participants stated that the most appropriate ages for women and men to marry were 22.1 (3.7) and 26.2 (3.9) years, respectively. The vertical collectivism score was 3.90 (0.85) out of the maximum attainable score of 5. The working or educational situation of premarital women was a barrier against fertility intention (OR=0.82; CI95%= 0.71-0.94, p<0.001) and childbearing intention (OR=0.81; CI95%= 0.73-0.89, p<0.001).
Conclusion: Despite the decline in the total fertility rate, the tendency to have children is still promising in Iranian female marriage volunteers. Their concern about work and education was the main obstacle to their childbearing intention. This finding underlines the need to implement supportive measures for having children, as seen in the law.
Ashraf Beirami , Zahra Rahemi,
Volume 21, Issue 4 (12-2024)
Abstract
Background: Labor pain is a common concern among pregnant women, leading to fear and anxiety. Enhancing self-efficacy can play a crucial role in managing these complications. This study aims to evaluate the effect of mindfulness-based art therapy on the self-efficacy of multiparous and nulliparous women.
Methods: The present study was a randomized clinical trial with three parallel intervention arms (multiparous and nulliparous groups) and a control. The statistical population of the study included pregnant women (multiparous and nulliparous groups) referring to health centers (public and private) in Bandar Abbas city for prenatal care. A total sample size of 90 participants was determined, with 30 individuals randomly assigned to each group using a block randomization method. Participants were selected based on inclusion and exclusion criteria. Interventions were conducted in eight sessions, with 3 to 15 people in each group, in a face-to-face and coherent manner. Participants in the intervention and control groups were assessed three times: before the intervention, immediately after the intervention, and four weeks after the intervention using the Iranian Childbirth Self-Efficacy Questionnaire and the Five-Factor Mindfulness Questionnaire. The data were then analyzed using SPSS version 26 software, employing ANOVA and repeated measures tests. A significance level of less than 0.05 was considered.
Results: The mean self-efficacy scores for expectations during the active stage of labor immediately after the intervention were 162.07±11.28 (nulliparous), 163.07±12.02 (multiparous), and 145.77±27.50 (control group). Four weeks post-intervention, the scores were 162.07±11.98 (nulliparous), 163.07±12.02 (multiparous), and 145.77±27.50 (control group). The mean self-efficacy scores for expectations during the fourth stage of labor immediately after the intervention were 155.21±10.80 (nulliparous), 156.21±11.12 (multiparous), and 122.77±24.96 (control group). Four weeks after the intervention, these scores were 152.46±10.29 (nulliparous), 154.23±11.34 (multiparous), and 121.23±27.42 (control group). The mean mindfulness scores in both intervention groups (multiparous and nulliparous) were significantly higher immediately after the intervention (p=0.001) and four weeks later (p=0.001) compared to baseline.
Conclusion: The results indicated the effectiveness of mindfulness-based art therapy in enhancing self-efficacy and mindfulness among pregnant women. Thus, it is recommended that this therapeutic method be utilized to manage and reduce the fear of childbirth in pregnant women.
Bahareh Mohammadian, Saeed Bakhtiarpour , Farah Naderi , Zahra Dasht Bozorgi ,
Volume 22, Issue 1 (3-2025)
Abstract
Background: Postpartum depression (PPD) is a significant mental health concern affecting many women worldwide. While various factors contribute to PPD, the role of perceived stress and marital satisfaction remains underexplored. This research aimed to investigate the mediating role of marital satisfaction in the relationship between perceived stress and PPD among postpartum women in Ahvaz.
Methods: A cross-sectional study utilizing structural equation modeling examined the relationships among perceived stress, marital satisfaction, and PPD. A convenience sample of 319 postpartum women who visited healthcare centers in Ahvaz, southern Iran, in 2023 was recruited. Data were collected using the Edinburgh Postnatal Depression Scale, the Perceived Stress Scale, and the Marital Satisfaction Scale. Data analysis was performed using structural equation modeling with SPSS-26 and AMOS-26 software.
Results: The findings indicated a significant negative correlation between perceived stress and marital satisfaction (β = -0.45, P < 0.001). Both marital satisfaction (β = -0.31, P = 0.008) and perceived stress (β = 0.20, P = 0.028) were significantly related to PPD. Bootstrapping results also confirmed a significant indirect effect of perceived stress on PPD via marital satisfaction (β = 0.17, P = 0.027).
Conclusion: The interplay between perceived stress, marital satisfaction, and PPD is complex and multifaceted. This research highlights the potential importance of marital satisfaction as a critical factor in understanding the pathway between stress and PPD. Future interventions might consider incorporating strategies to enhance marital quality to reduce the risk of PPD.
Masoumeh Rostami , Abbas Ebadi , Hamid Sharif-Nia , Fidan Shabani , Reza Ghanei Gheshlagh ,
Volume 22, Issue 2 (6-2025)
Abstract
Background: Some men use a nuanced set of attitudes, behaviors, and beliefs referred to as “invisible violence” to exert control over women. Although these behaviors are culturally accepted, they remain risk factors for intimate partner violence. Early detection of invisible violence can prevent domestic violence and its negative consequences. Therefore, this study aimed to evaluate the psychometric properties of the Persian version of the Questionnaire for the Invisible Violence Against Women (Q-IVAW).
Methods: This cross-sectional study was conducted on 520 married women who were referred to health centers in Western Iran (Asadabad) in 2023. Sampling was performed using a convenience sampling method. After forward-backward translation, face, content, and construct validity (through exploratory and confirmatory factor analysis) were conducted. Internal consistency was assessed using Cronbach's alpha and McDonald's omega coefficients and stability was assessed using a test-retest. The data were analyzed using SPSS version 16 and Amos version 26 software.
Results: In the exploratory factor analysis, four factors, including ‘utilitarian-benevolent sexist behaviors’, ‘crisis sexist behaviors’, ‘coercive sexist behaviors’, and ‘ambivalent sexist behaviors’, were extracted using the maximum likelihood method and Promax rotation. Cronbach's alpha for the four factors was 0.803, 0.724, 0.733, and 0.704, respectively. These factors account for 47.17% of the total variance. In confirmatory factor analysis, the final model demonstrated a good fit (CMIN/DF = 2.140, GFI = 0.952, AGFI = 0.932, NFI = 0.924, IFI = 0.958, CFI = 0.958, RMSEA = 0.047).
Conclusion: The Persian version of the Q-IVAW has acceptable psychometric properties and can be used to measure invisible violence in Iranian women.
Faride Majdi , Azizeh Farshbaf-Khalili , Mohammadreza Mirzayi , Parvin Hakimi , Khadije Hajizadeh, Mahnaz Shahnazi ,
Volume 22, Issue 2 (6-2025)
Abstract
Background: Polycystic Ovary Syndrome (PCOS) is one of the most significant reproductive and endocrine disorders in women. This study aims to assess the impact of nettle extract on both clinical and paraclinical symptoms in women with PCOS.
Methods: This Triple-Blind Randomized Controlled Clinical Trial involved 60 women (n = 30 per group) aged 18 to 45, all diagnosed with PCOS based on definitive diagnostic criteria in Tabriz, Iran. Participants were randomly assigned in a 1:1 ratio using block sizes of 4 and 6 into two groups: an intervention group (receiving 500 mg of oral nettle extract containing flavonoids, tannins, and sterols daily for three months) and a control group (receiving combined oral contraceptives [COCs] for three months). Independent t-test and ANCOVA test were used in SPSS version 24 for data analysis. A p-value of <0.05 was considered statistically significant.
Results: The study showed that after the intervention, there were no statistically significant differences between the nettle extract group and the control group regarding mean levels of dehydroepiandrosterone sulfate (P=0.197), total testosterone (P=0.24), follicle-stimulating hormone (FSH) (P=0.549), luteinizing hormone (LH) (P=0.398), hirsutism score (P=0.149), or duration of menstrual bleeding (P=0.982), based on ANCOVA adjusted for baseline values, education level, and number of pregnancies. However, the two groups exhibited statistically significant differences in fasting blood glucose levels (P=0.020), intervals between menstrual bleeding (days) (P=0.031), and menstrual bleeding intensity (P = 0.008).
Conclusion: The findings indicate that nettle extract is as effective as low-dose oral contraceptive pills in reducing levels of dehydroepiandrosterone, total testosterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH), as well as in decreasing hirsutism scores and the duration of menstrual bleeding. Midwives can use nettle extract, which is a cheap, easy, and non-invasive method to improve PCO symptoms.
Asieh Sadat Baniaghil , Kosar Amini , Naser Behnampour ,
Volume 22, Issue 3 (9-2025)
Abstract
Background: Domestic violence is a pervasive issue characterized by a pattern of coercive and controlling behaviors within an intimate relationship. While traditional gendered models often portray males as perpetrators and females as victims, this perspective oversimplifies the complex reality of intimate partner violence (IPV). Research indicates that domestic violence can affect individuals of any gender. Therefore, this study aims to examine domestic violence as it is experienced by both males and females.
Methods: This cross-sectional study investigated 240 cohabiting couples in Gorgan, northern Iran, in 2022. The researchers used a simple random sampling method, facilitated by R software (version 4.4.2) and the national electronic health information system, to identify eligible participants. Participants included females aged 20–49 and their husbands, all of whom had been married for at least two years. Data were collected via the online, self-administered Persian version of the Conflict Tactics Scale 2 (CTS2), which measures the following subscales of conflict: Psychological aggression, physical assault, sexual coercion, and injury. Data analysis included descriptive statistics (mean and standard deviation) and qualitative statistics (frequency and percentage). The Kruskal-Wallis test was employed to compare mean scores between groups, with statistical significance set at P < 0.05.
Results: This study's findings revealed that 52.8% of couples (95% confidence interval [CI]: 40.72–58.45) experienced domestic violence. The research further specified the prevalence of various forms of violence as follows: Bilateral violence: 25% (95% CI: 19.48–30.52), male-to-female partner violence (MFPV): 19.58% (95% CI: 14.53–26.64), and female-to-male violence (FMPV): 7.5% (95% CI: 4.14–10.86). The most frequently reported types of abuse were psychological aggression (male: 5.0 ± 3.48; female: 5.07 ± 3.67) and sexual coercion (male: 2.71 ± 1.8; female: 2.93 ± 2.42).
Conclusion: The results of this study suggest that IPV can be perpetrated by any individual within a relationship, regardless of gender. Consequently, educational initiatives and screening programs should be developed to include both members of a couple, instead of being focused on a single individual. These findings can be utilized by healthcare professionals to develop more comprehensive prevention strategies and to enhance the effectiveness of existing screening protocols for IPV.
Tayebeh Mokhtari Sorkhani, Mahshid Bokaie , Farzan Madadizadeh , Manoj Sharma , Seyed Saeed Mazloomy Mahmoodabad,
Volume 22, Issue 3 (9-2025)
Abstract
Background: The total fertility rate (TFR) has dropped to below the replacement levels in numerous countries, which necessitates new educational approaches and behavioral models to encourage a more positive societal view of childbearing. The present research aims to design, implement, and evaluate an intervention based on the multi-theory model (MTM) aiming at boosting childbearing intentions among Iranian single-child women of reproductive age.
Methods: This mixed-methods study, designed in three phases, will first explore childbearing intentions qualitatively through in-depth interviews, with the resulting data analyzed using a directed content analysis based on the MTM. Second, the themes identified from this phase will then be used to develop and psychometrically validate a new measurement tool. Third, a field trial will be conducted to implement and evaluate an MTM-based educational intervention. Data will be collected with the validated tool both pre- and post-intervention, with follow-ups at three, six, and nine months to assess pregnancy outcomes. The effectiveness of the program and participant feedback will be analyzed via descriptive statistics, paired t-tests for within-group comparisons, and repeated measures analysis of variance (ANOVA) for between-group differences over time. All statistical analyses will be performed using SPSS version 22.
Conclusion: This study represents the first known application of the MTM to investigate childbearing intentions among single-child women. Developing and assessing a culturally-adapted intervention has the potential to boost individuals’ childbearing intentions and generate evidence for guiding reproductive health policies in settings experiencing a decline in fertility.
Nurdan Kaya Yilmaz , Ümmügülsüm Demirci , Tuğçe Söylemez , Hamdiye Alper ,
Volume 22, Issue 3 (9-2025)
Abstract
Background: Emotional violence during pregnancy may negatively affect maternal and fetal health and impair sleep quality. The study aimed to evaluate pregnant women’s exposure to emotional violence and their sleep quality.
Methods: A cross-sectional study was conducted with 262 pregnant women at Samsun Education and Research Hospital in the city of Samsun, Turkey, between February and May 2024. The sample was obtained using simple random sampling. Data were collected using the Sociodemographic and Obstetric Checklist, the Pittsburgh Sleep Quality Index (PSQI), and the Exposure to Emotional Violence Scale (EVS). Data were analyzed using independent samples t-test, one-way analysis of variance (ANOVA) with Tukey’s post hoc comparisons, and all data were analyzed using SPSS v.25. Statistical significance was set at p <0.05.
Results: Spousal violence during pregnancy was reported by 16.0% (CI 95%: 11.5 – 20.5) of participants. The mean (standard deviation) total PSQI score was 5.77 (3.49), and 54.2% (CI 95%, 48.2–60.2) of the pregnant women had poor sleep quality. The mean (SD) total EVS score was 38.80 (13.25), indicating a low level of emotional violence exposure. Pregnant women with poor sleep quality had significantly higher EVS total scores (p=0.020), as well as higher scores in the subdomains of obstruction (p=0.044), humiliation (p=0.046), harm (p=0.021), and verbal abuse (p=0.022).
Conclusion: It was demonstrated that half of the pregnant women had poor sleep quality and were exposed to low levels of emotional violence. Pregnant women with poor sleep quality were found to be more exposed to emotional violence.
Habiba Khanom , Sharmin Hossain , Rabiul Islam , Liton Baroi , Eashmin Akter Rima R , Jannatul Ferdoues Mitu , Chandra Das , Sumaia Afroz , Jannatul Ferdowsy , Aysha Sultana Luvna, Lita Bose , Shukla Sarker , Alamgir Hossain ,
Volume 22, Issue 4 (12-2025)
Abstract
Background: Fear of childbirth (FOC) is a widespread maternal health concern associated with heightened anxiety, increased medical interventions, and negative birth experiences. While prevalent globally, FOC remains underexamined in low-resource settings such as Bangladesh. This study aimed to determine the level of FOC and identify associated factors among pregnant women in Bangladesh.
Methods: A cross-sectional study was conducted among 262 pregnant women attending antenatal care at Shariatpur Government Upazila Health Complex (December 2023–May 2024). Data were collected using a structured questionnaire and the Melender FOC Scale. Participants were selected using a convenience sampling technique. Fear was categorized as low, moderate, or high. Descriptive analysis, Chi-square tests, ordinal logistic regression, and multivariate logistic regression were performed to identify predictors of FOC using SPSS version 25.
Results: A survey of 262 pregnant women revealed a moderate mean level of fear of childbirth (FOC) (47.45 ± 6.9). Regression analysis identified several significant predictors of higher FOC. The strongest associations were with limited spousal support (AOR = 2.64; 95% CI: 1.38–5.06; p = 0.003) and not attending childbirth classes (AOR = 2.33; 95% CI: 1.21–4.49; p = 0.011). Other significant factors included younger maternal age, lower education (in both the woman and her husband), rural residence, and lower socioeconomic status. These findings underscore the multifactorial nature of FOC, highlighting the need for interventions that address its key social and educational determinants.
Conclusion: FOC is highly prevalent among pregnant women in Bangladesh and is influenced by sociodemographic, obstetric, and psychosocial factors. Routine screening, culturally sensitive prenatal education, improved communication, and partner-inclusive support are recommended to reduce FOC and improve maternal outcomes.
Sakineh Nazari, Zohreh Keshavarz, Mohammad Jalal Abbasi- Shavazi, Abbas Ebadi, Seyedeh Mahboobeh Rezaeean, Zohre Abbasi,
Volume 23, Issue 1 (5-2026)
Abstract
Background: Assessing fertility levels is considered one of the most critical indicators in population forecasting and reproductive health research. Therefore, this qualitative study was conducted to explore women’s and experts’ perspectives on childbearing, including the views of healthcare professionals, university faculty members, and sociologists, regarding factors influencing childbearing.
Methods: This qualitative study was conducted in 2025 in North Khorasan Province, Iran. Participants were selected through purposive sampling and included three groups: women with two or fewer children (n = 35), women with more than two children (n = 16), and experts in the field of childbearing (n = 13). Data were collected through in-depth individual interviews and analyzed using MAXQDA 10 software according to conventional content analysis procedures.
Results: Analysis of the participants’ narratives identified four main themes influencing the decision to have more than two children: “gaining power, passive social acceptance, inefficiency of educational and health approaches, and a specific lifestyle pattern.” In contrast, rethinking the value of children and reconsidering fertility emerged as key factors influencing the decision to have fewer than two children.
Conclusion: The findings indicate that fertility preferences are shaped by a complex interplay of social and personal factors. While empowerment, passive social acceptance, ineffective educational and health strategies, and lifestyle considerations tend to promote larger family sizes, reassessment of the value of children and fertility considerations support smaller family choices. These results highlight the need for tailored reproductive health policies and context-sensitive educational interventions to support informed decision-making and balanced population strategies.
Hediye Karakoç , Huriye Altinkaynak , Cenner Nur Bircan ,
Volume 23, Issue 1 (5-2026)
Abstract
Background: Although societal change and evolving family roles shape generational identities, limited research has investigated whether these shifts are reflected in psychosocial adaptation during pregnancy. This study compared marital adjustment, pregnancy acceptance, and maternal role adaptation between pregnant women from Generation Y and Generation Z.
Methods: This cross-sectional study was conducted between November 30, 2022, and February 29, 2023, among 347 married pregnant women in Türkiye (Generation Y: n = 170; Generation Z: n = 177). Participants were recruited from pregnancy-related social media platforms using non-probability convenience sampling. Inclusion criteria were birth between 1980 and 2015, being married and pregnant, being literate, and providing consent to participate. Data were collected online using the Prenatal Self-Evaluation Questionnaire and the Marital Adjustment Test. Independent-samples t-tests, chi-square tests, and multiple linear regression analyses were performed using IBM SPSS Statistics version 27.0 (IBM Corp., Armonk, NY, USA).
Results: In bivariate analyses, marital adjustment scores were higher among Generation Y participants (p = 0.026). However, this association was no longer statistically significant after adjustment for age, duration of marriage, number of pregnancies, employment status, and planned pregnancy (β = -0.148, p = 0.122). No significant generational differences were observed in pregnancy acceptance or maternal role adaptation (p > 0.05).
Conclusion: Initial comparisons suggested a generational difference in marital adjustment; however, this difference was attenuated after adjustment for sociodemographic and reproductive characteristics and was no longer statistically significant. No statistically significant differences were observed between generations in pregnancy acceptance or maternal role adaptation. Because the overall regression model was not statistically significant, adjusted findings should be interpreted cautiously.
Tayebeh Mokhtari Sorkhani, Seyed Saeed Mazloomy Mahmoodabad, Mahshid Bokaie , Manoj Sharma , Farzan Madadizadeh ,
Volume 23, Issue 1 (5-2026)
Abstract
Background: Declining fertility and childbearing are significant public health concerns. The Multi-Theory Model (MTM), which addresses both the initiation and maintenance of behavior, may provide a useful framework for promoting childbearing intentions. However, no validated theory-based instrument currently exists to measure MTM constructs in this context. Therefore, this study aimed to develop and validate a Persian questionnaire based on MTM to assess childbearing intentions among women of reproductive age.
Methods: A cross-sectional descriptive survey was conducted in 2025 with 275 married women recruited from comprehensive health centers in Yazd, Iran. Women with only one child and willing to participate from the selected health centers were included in this study. An initial 37-item researcher-developed instrument based on MTM was refined through expert evaluation (CVR, CVI) and quantitative face validity (Impact score). Construct validity was assessed via confirmatory factor analysis (CFA), and reliability evaluated using via Cronbach’s alpha and test–retest ICC analyzed with SPSS 22 and AMOS21.
Results: During the psychometric validation process, four items were removed. The final questionnaire with 33-items demonstrated high reliability (Cronbach’s α = 0.93; construct-level α = 0.71-0.92; test-retest ICC =0.81 (95% CI: 0.68-0.90)) and acceptable construct validity (CFA: CFI =0.932, TLI =0.921, RMSEA = 0.06, χ²/df =1.97). Content validity was strong, with CVR ranging from 0.62-1, S-CVI/Ave =0.929, and overall CVI =0.91. All items also showed acceptable face validity (Impact score >1.5).
Conclusion: The validated MTM-based Persian childbearing intention questionnaire is a reliable and valid tool for assessing childbearing intentions among women with only one child. It can guide public health research, educational interventions, and policy planning to support informed reproductive decisions.
