Investigation of the effects of perceived stress on antenatal care behaviors and the labor process during the COVID-19 pandemic

Objective:The aim of this study was to examine of the effects of perceived stress on antenatal care behaviors and the labor process during the COVID-19 pandemic.Methods:This study was conducted with a descriptive design.The data were collected using an“Introductory Information Form”and the“Antenatal Perceived Stress Inventory”.Descriptive statistics were analyzed using Kruskal-Wallis,Mann-Whitney U,and multinomial logistic regression tests.Results:The sample of the study included 487 women.The mean total Antenatal Perceived Stress Inventory score of the participants was found as 2.30±0.80.The mean medical and obstetric risks/fetal health,psychosocial changes during pregnancy,and prospect of childbirth subscale scores of the participants were determined to be 2.29±1.08,2.26±0.87,and 2.34±0.86,respectively.It was determined that as the antenatal perceived stress levels of the participants who frequently attended physical examinations increased,they became 1.535 times more likely to perceive the care they received to be adequate(Odds ratio(OR):1.535;1.045–2.254 Confidence interval(CI);P=0.029).It was found that as the antenatal perceived stress levels of the participants whose clinical tests were frequently analyzed increased,they were 1.518 times more likely to perceive the care they received to be adequate(OR:1.518;1.080–2.135 CI;P=0.016).Moreover,as the antenatal perceived stress levels of the participants who frequently underwent fetal health follow-ups increased,they were 1.573 more likely to perceive the care they received to be adequate(OR:1.573;1.042–2.375 CI;P=0.031).Conclusion:It was concluded that as the antenatal perceived stress levels of the women who frequently underwent physical examinations,clinical test analyses,and fetal health follow-ups increases,they were more likely to consider that they received adequate care.

Factors Affecting the Utilization of Antenatal Care among Married Women of Reproductive Age in Merca, Lower Shebelle, Somalia

Worldwide more than thousands of women and new born are at the danger of die from pregnancy and child delivery complications. Antenatal care (ANC)/ pregnancy care is the health care where expecting mothers and new born receive medical care or medical attention. The aim of this study is to examine factors affecting the utilization of antenatal care among married women of reproductive age in Merca, lower Shebelle, Somalia. Methodology: This is a descriptive cross-sectional and qualitative study design that was carried out from June to August 2022 and this study was carried out in Merca, district lower Shabelle, Somalia. Data were collected from 325 married women of reproductive age who have at least one child and more than living in Merca district. Result: Our study found that the magnitude of antenatal care uptake was 31.1% during the examined period. Very low utilization of antenatal care in Somali women is worrying in the face of high vulnerability of maternal complications. In terms of age diverse and utilization of antenatal care, women in younger age group 15 - 30 were more to utilize antenatal care services than with women in older age group 31 years above (p-value < 0.007). Our study also identified that there is association between level of education and level of utilization among women about antenatal care services (p-value < 0.001). In terms of level of awareness about antenatal care services, it is significantly associated with the level of utilization antenatal care (p-value < 0.001). Our study identified that the number of complaining complications related previous pregnancy that have no awareness about antenatal care services was higher than number of utilized antennal care awareness about antenatal care (p-value < 0.001). Based on these results, it is recommended to improve women’s awareness about antenatal care services by using health education program.

Why pregnant women delay to initiate and utilize free antenatal care r service:a qualitative study in the Southern District of Mzimba,Malawi

Aim:The study aimed to explore factors related to the initiation and utilization of focused antenatal care(FANC)in the Southern District of Mzimba,Malawi.Methods:This study used an exploratory qualitative design.Total of 22 in-depth interviews with pregnant women and community midwife assistants were conducted from December 2015 to January 2016 in Mzimba.Thematic analysis approach was adopted to identify the facilitator and harriers of the FANC initiation and utilization.Results:Facilitator of FANC initiation and utilization included seeking pregnancy confirmation,medical treatment for an existing health problem and the support by community health extension workers.Barriers included the additional cost to free FANC service,lack of essential equipment,unfriendly adolescent reproductive health service,and HIV stigma.Conclusion:Early initiation of FANC relies on both woman’s awareness and community support.Promoting the use of FANC should focus on creating an enabling environment,e.g.,increasing investment of essential medical equipment,reducing additional costs of FANC services,eliminating the discrimination against adolescent pregnancy and people living with HIV,and strengthening health personnel’s training.

Analysis of Antenatal Care and its Related Factors among Married Chinese Women

Objective To explore the related factors of antenatal careMethods The data derived from National Demography and Reproductive Health Survey in1997 conducted by National Population and Family Planning Commission. 11 892 women whohad given birth to at least one survival child were involved in this study. SAS software was usedin multivariate analysis.Results The average rate of general antenatal care is 57.3% and has increased dramatically inthe recent 30 years. The major reason why most subjects didn’t have antenatal care was lackingthe recognition of the importance of antenatal care. The antenatal care was associated withresidence in rural area or urban area, age, educational level, parity of the last birth, localaverage income, distance between home and township in rural area and so on.Conclusion Women of childbearing age need to improve their health knowledge; thegovernment should increase the availability of antenatal care.

Knowledge, Attitude and Practice regarding Intermittent Preventive Treatment (IPTs) of Malaria among Pregnant Women Attending for Antenatal Care in Benadir Hospital at Benadir Region, Somalia

Background: Malaria in pregnancy is a preventable public health concern leading to a high prevalence of maternal morbidity, maternal mortality and adverse birth outcomes. Intermittent Preventive Treatment during pregnancy using Sulfadoxine-Pyrimethamine (IPTp-SP) is one of the main strategies used to prevent malaria in pregnancy. This study was aimed to determine knowledge attitude and practice regarding intermittent preventive treatment IPT of malaria in pregnancy utilization among pregnant women attending antenatal center in benadir hospital wadajir district benadir region somalia during the period of the study from April 2021-July 2021. Methods: The study was descriptive cross-sectional retrospective Hospital based. The sample size was 60 respondents of pregnant women at 20 weeks to 36 weeks of gestation. Data were collected by interview method using structured questionnaire. The data were collected and then entered to Statistical Package for Social Science version 20 for analysis. Results: The study displayed that the majority of the respondents (58%) were in the 25 - 34 years’ age group. A total of 51 (85%) were married, while 17 (28%) had primary school education. 43 (72%) were housewives while only 11 (18%) were employed. A total 32 (53%) were had gravid more than Four times, while the study showed that, the majority of mothers 39 (65%) were had knowledge about Intermittent Preventive Treatment during pregnancy using Sulfadoxine-Pyrimethamine (IPTp-SP). The study showed that majority of the respondent 25 (42%) were getting health education awareness towards IPTp were from health care providers at health centers while 8 (13%) from Friends/relatives/neighbors, followed by 4 (6%) from their husband. And 34 (57%) were had convenience IPTp-SP tablet consumption at their current pregnancy while 26 (43%) did not. Conclusion and Recommendations: Inclusion there was good knowledge and positive attitude towards IPT despite poor utilization, the study recommended the ministry of health especially health promotion, maternal and reproductive health and national malaria control programe should intensify strategies and policies to ensure 3 doses of IPTp-SP given at antenatal care centers target coverage in Somalia and provide capacity building for all health care providers. Also, there should be continuous sensitization of pregnant women on the importance of intermittent preventive treatment during each pregnancy by healthcare workers.

Choice of place for childbirth among pregnant women accessing antenatal care at Nnamdi Azikiwe University Teaching Hospital,Nnewi,Nigeria:a descriptive study

Objective:This study determined choice of place of delivery among women accessing antenatal care clinic s in Nnamdi Azikiwe University Teaching Hospital(NAUTH)Nnewi in Anambra state.Methods:A descriptive survey was conducted with three hundred and twenty-two pregnant women who registered for antenatal care at Nnamdi Azikiwe University Teaching Hospital,Nn ewi.Data were collected using a self-structured questionnaire and analyzed with a Chi-square test of association and Fisher’s exact test were used to test the hypothesis at 5%level of significance.Results:Findings from the study showed that 39.75%of the pregnant women chose private hospital s as their place of delivery,37.27%chose NAUTH,6.52%and 7.14%chose other government hospitals and home delivery,respectively.There was a significant difference between education level and occupation of the participants in the choice of place of childbirth.Privacy,finance,distance and approach of health workers were significant predictors of choice of delivery place among the women.Conclusion:Health planners need to recognize the determinant choice of delivery place as more efforts should be given to educate women and empower them.However,utilization of tertiary health facilities for childbirth m ay increase if the privacy of pregnant women is maintained,health workers relate well with clients and the cost of health care services is reduced.

How consultation-relational empathy and demographics influence satisfaction with primary antenatal health care:evidence from rural Nigeria

Objectives:This study aims to explore the role of consultation and relational empathy(CARE)and socio-demographic profile as predictors of patients'satisfaction among pregnant women attending antenatal care(ANC)in selected public primary health facilities in rural sub-districts of Saki,Oyo State,Nigeria.Methods:This cross-sectional study recruited a total of 582 pregnant women in four primary health centers.Expectant mothers responded to a questionnaire covering demographic characteristics,clinic visitation,CARE,and patients'satisfaction.All data was analyzed using descriptive,univariate and multivariate statistical tools.P<0.05 level was considered statistically significance.Results:Findings revealed that the participants had a mean age of 23.15±5.23 years.The pattern of patients'satisfaction revealed that 13.40%(78/582)were highly satisfied with the health care received compared to 86.60%(504/582)with moderate to low satisfaction ratings with ANC.Highly satisfied patients placed higher value on technical quality,interpersonal relation,communication,financial aspects,time spent and accessibility convenience(P=0.001).Multiple linear regression model indicated that relational empathy(β=0.28,P<0.001),2nd trimester of pregnancy(β=0.13,P=0.01),age categories of 30-<40 years(β=-0.12,P=0.02),and 40-<50 years(β=-0.11,P=0.04),religious affiliation(β=0.10,P=0.03)predicted satisfaction with ANC.Conclusion:Low patients'satisfaction with antenatal healthcare services resulting from hostile attitudes from health workers has implication for the delivery and acceptability of services offered to eradicate maternal mor-tality globally.Thus,regular training and re-training of health care personnel in frequent contact and interaction with patients will go a long way in reducing untoward work attitude and maternal mortality in rural ANC centers globally.

Predictors of antenatal health service utilization among left-behind wives of male outmigrants:Evidence from Patna District,India

Objective:To analyze the sociological support system available for left-behind wives of male outmigrants and develop a model that predicts the antenatal care(ANC)services utilization.Methods:A cross-sectional survey was conducted in rural regions of the Patna district,India.The sample size(n=328)was estimated using Cochran’s formula.Five parameters of the social support system were identified(autonomy,spousal support,family support,social circle support,and government support).The score for each was calculated as a composite score using multiple variables;these served as independent variables.The respondents were categorized as efficient and non-efficient users of ANC service based on established criteria.Results:The regression results showed that four out of five social parameters had a significant effect on ANC behavior.Spousal support was the strongest predictor(standardized regression coefficient β=0.57,OR 1.16,95%CI 1.08-1.79,P=0.007).Government support was found to be the second strongest predictor(β=0.40,OR 1.49,95%CI 1.04-2.14,P=0.027),followed by family support(β=0.31,OR 1.36,95%CI 1.23-2.57,P=0.034)and autonomy(β=0.11,OR 1.32,95%CI 1.11-2.26,P=0.030).The social circle support was found to be non-significant in predicting ANC behavior(P>0.05).Conclusions:The policymakers could focus on the identified predictors to strengthen and modify the existing policies for leftbehind wives of male outmigrants.The need of the hour is a strategic intervention for behavioral modification of not only the left-behind wives but also their family members along with reinforcement of the existing social-security net.One strategy we suggest is to launch an awareness campaign focusing on husbands(male outmigrants)and family members.

Male Involvement in the Maternal Health Care: Expectations of Pregnant Women in Bolgatanga Municipality in the Upper East Region of Ghana

Background: Male involvement during pregnancy and childbirth is very important as it has been shown to increase the number of times a pregnant woman undertakes antenatal care visits before delivery. The purpose of this study was to determine whether there is a relationship between the background characteristics of participants and their male partners’ involvement in maternal health care in the Bolgatanga Municipality of Upper East Region. Methods: The study design employed was a facility-based cross-sectional study design in 9 health facilities in the Bolgatanga municipality. The study populations for this study consisted of pregnant women using antenatal services in the health facilities before the commencement of this current study and are residents of the Bolgatanga municipality. A multistage sampling strategy was used in the sampling of participants for this study with an estimated sample size of 422. Results: Findings show that the majority of 403 (95.5%) of the participants expect their male partner accompanies them during the antenatal care clinic. The chi-square test revealed that marital status had a significant influence on male partners’ support in house chore and support in antenatal care service (P-value of 0.001 and 0.002, Conclusion: This study’s findings showed that pregnant women always want their male partners to accompany them to antenatal care and during labour and delivery. The pregnant women expected their male partners to be educated on the effects of pregnancy, how to take care of a pregnant woman, how to tolerate their partners, Sex during pregnancy, and how to prepare for emergencies (blood donation, transportation and finance).

Determinants of Home Deliveries by Pregnant Mothers in Lumbo Chabbobboma Zone of Gwembe District in Zambia

Background: Home deliveries is still high globally at 42% WHO 2022, due to high home deliveries, maternal death is also high at 43% globally. In sub-Sahara region home deliveries still high. Giving birth at health facilities in most of sub-Saharan African countries Zambia inclusive is still a challenge whereby more than 51% of first-time mothers give birth at home and this gives a risk of high maternal and perinatal deaths. Therefore Reducing number of home deliveries is important to improve maternal and perinatal health issues. In this study, the aim was to investigate the determinants of home deliveries by pregnant mothers in the Luumbo zone of Gwembe district, Zambia. Purpose: Access to skilled care and facilities with capacity to provide emergency and newborn care is critical to reduce maternal death. In Zambia 42% of women still deliveries from home, suggesting a persistent challenge for women to seek, reach, and receive quality maternity care. This study aimed investigate the determinants of home deliveries by pregnant mothers in Luumbo zone of Gwembe district, Zambia. Methods: The study was conducted among postnatal mothers who came for postnatal care at 6 weeks in Luumbo Chabbobboma clinic in Gwembe district southern province of Zambia. This was a descriptive cross-sectional study where a Simple random sampling technique was used to select 105 women of childbearing age who attended postnatal and had a recent delivery. Data were collected using a researcher-administered structured questionnaire to identify determinants of home deliveries in Luumbo Chabbobboma zone. Data analysis was done using SPSS computer software version 27.0. Both descriptive and inferential (chi-square test) analyses were performed and statistical significance was taken at α ≤ 0.05. Results: The results show that 46 (43.8%) respondents were in the age bracket 20 - 29 years. Of the 105 respondents included in the study, 24 (22.9%) of them delivered from home. The results show that high maternal age (p = 0.03), occupation (p = 0.024), distance to the facility (p = 0.014), means of transportation (p = 0.023), multiparity (p = 0.01), timing and number of ANC visits (p Conclusion: From this population. The major reason why women still deliver at home was long distance to the nearest facility. To reduce maternal and perinatal mortality access to health facilities by pregnant women needs to be improved. There should also be active engagement of the traditional and religious institutions in the area.

Peripartum Cardiomyopathy Complicated by Ventricular Tachycardia during Labor: A Case Report and Literature Review

Background: Peripartum cardiomyopathy (PPCM) is a rare disease that typically affects young, healthy women. Because PPCM is associated with significant mortality, timely diagnosis and management are essential. Ventricular tachycardia (VT) is a major complication and contributor to sudden death. Available data on VT in patients with PPCM are limited. Aim: This case report demonstrates the clinical presentation, antenatal care, and management of labor and delivery in a patient with PPCM complicated by VT. Case report: 36-year old patient G4P3 presents at 27 weeks gestation to the emergency department complaining of chest tightness, palpitations, and profuse sweating. Peripartum cardiomyopathy was diagnosed after her last pregnancy a few years prior. Ventricular tachycardia was diagnosed at this visit and treated successfully. The remainder of the pregnancy was uneventful until she had another episode of ventricular tachycardia during labor. Treatment using antiarrhythmics (diltiazem, amiodarone, adenosine) highlights the importance of prompt intervention and the need for a range of therapeutic options. Results: This case demonstrated successful VT management during pregnancy and labor, emphasizing multidisciplinary collaboration, influencing maternal and fetal outcomes positively, providing insights into optimal care strategies. Conclusion: Peripartum cardiomyopathy complicated by ventricular tachycardia is a life-threatening combination. This case highlights the importance of timely diagnosis and management with combined care between cardiologists, maternal fetal medicine specialists and anesthesiologists to prevent morbidities and sudden maternal death.

Knowledge and Skills Gap of Midwives to Conduct Obstetric Ultrasonography Screening in Primary Health Care Facilities in Kajiado and Kisii Counties, Kenya

Background: Ultrasound remains a tool of much importance in maternity care with midwives regarded as key health professionals when it comes to care of pregnant mothers. There is however limited study on the knowledge and skills gaps of midwives in conducting obstetric ultrasonography screening. The purpose of this study was to assess the specific obstetric ultrasonography knowledge and skills gaps among midwives based in primary health care facilities. Methods: A cross-sectional study employing both qualitative and quantitative method was conducted between July and August 2019 with 274 midwives. A structured questionnaire was used to collect data while Focus group discussion and Key Informants Interview were used to collect qualitative data. Descriptive statistics were used to summarize the data test associations between variables while the qualitative data were used to compliment the questionnaire data in eliciting more information on the gaps. Findings: Almost all (94.5%) the midwives had never been trained on any basic obstetric ultrasound while six of those that had been trained in early stages by the project lacked equipment to practice the acquired skills. More than three quarters of the respondents opined that they wished to provide personalized care services to mothers/clients seeking Antenatal Care Services (ANC) in their community at a fee while only 13.9% had knowledge that obstetric screening should be done before 24 weeks gestation. Four out of ten of the respondents scored themselves a one (1) on the level of confidence they have using an ultrasound machines or technology. Conclusion: There still remains a huge gap as far as training of midwives on basic ultrasound screening is concerned. The lack of basic obstetric ultrasound screening skills is a barrier to rolling out Point of Care Ultrasound (POCUS) screening services. However, midwives are motivated and willing to learn basic ultrasonography skills to further the objectives of Universal Health Coverage (UHC). Concerted efforts should be made to train midwives on basic obstetric ultrasonography skills in addition to availing mobile/hand held ultrasound technology in Primary Health facilities for them to apply the transferred skills. A sustainable business model to enable mothers continuously afford the services is critical as well.

Factors Associated with the Continuum of Prenatal Care in the Post-Ebola Context in Guinea

Background: The 2018 demographic and health survey reports low coverage in the continuum of antenatal care over the period 2013 to 2018. However, little remains known about this indicator since the Ebola epidemic crisis was over. This epidemic has been reported to decrease utilization of maternal health services. This study aims to determine the coverage and factors associated with four or more antenatal care visits in Guinea in the post-Ebola context. Methods: This was a cross-sectional study using secondary data from the most recent (2018) Guinea Demographic and Health Survey. Women aged 15 to 49 years constituted our study population. Our sample included women who had their most recent birth over the last 24 months preceding data collection and whether or not they had performed 4 antenatal care (ANC) visits. Factors associated with performing four or more antenatal visits were assessed through a multivariate logistic regression analysis using Stata software version 15.1. The final model was constructed using the bottom-up stepwise method. Hosmer and Leeshawn’s goodness-of-fit test was used for model specification. Results: Among the 2634 women in the sample, 41% had four or more ANC visits. Factors associated with attending four or more ANC visits included education level, poverty quintile and region. Women with a secondary or higher education were 44% more likely to attend four or more ANC visits (OR = 1.44, 95% CI = [1.07 - 1.92]. Those whose spouses had secondary or education level were 1.66 times more likely to attend four or more ANC visits. Women from moderately wealthy households were 76% more likely to attend four or more ANC visits (OR = 1.76, 95% CI = [1.30 - 2.39]. Women from wealthier households were 2.52 times more likely to attend four or more ANC visits (OR = 2.52, 95% CI = [1.30 - 2.39]). Women living in Boké and Nzérékoré regions were 44% and 47% less likely to attend four or more ANC visits, respectively (OR = 0.56, IC 95% = [0.35 - 0.94]) and (OR = 0.53, IC 95% = [0.31 - 0.89]). Conclusion: Attending four or more ANC visits declined in the post-Ebola epidemic context in Guinea from 57% in 2012 to 41% in 2018. To improve coverage in four or more ANC visits in this context, there is a need for policies and programs to address education, poverty and administrative region factors.

Socio-Medical and Demographic Factors Associated with Perinatal Mortality in a Southern Benin Health Zone Hospital in 2020: A Case-Control Study

Background: Perinatal mortality remains a major public health concern in developing countries such as Benin. To better steer response interventions, this study was carried out in southern Benin with the aim of identifying the demographic and socio-medical factors linked to perinatal mortality. Methods: The case-control study, held from January 1 to December 31, 2020, covered 154 targets, including 77 cases of neonates deceased within the perinatal period and 77 live-born control neonates selected on a one-for-one basis. Univariate analysis using the McNemar test and logistic regression were used to identify risk factors for perinatal mortality, at a 5% threshold of significance. Results: Sahoué/mina ethnicities, only associated socio-demographic characteristic, increased the risk of perinatal death by 2.47 times (p = 0.008). Mother’s age, education, occupation, marital status, and household size were not associated (p > 0.05). Risk of death was increased 2.5 times when the mother was referred (p = 0.007), 3.3 times when she came from a hard-to-reach locality (p Conclusion: Although attention must also be paid to referral and access to care, this study identifies antenatal consultation as the main target of any intervention to reduce perinatal mortality.

Risk Factors for Birth Defects: A Conditional LogisticRegression Analysis of a Case-Control Study in Guang-dong Province of China

Information was obtained from the same questionnaire (23 risk factors listed) of cases and controls. We used a multivariate logistic model, which described variables significantly increased risk of birth defects. The risk factors included maternal educational levels, medicine taken during pregnancy and antenatal care. It was suggested to strengthen antenatal care was the main preventive measure against birth defects.

Developing a model for reducing maternal mortality in South Africa

Objective:High maternal mortality ratios(MMRs)remain a concern in many parts of the world,especially in developing countries like South Africa.Different models have been developed,tried,and tested worldwide,in the hope that they will reduce maternal mor tality,but without much success.Methods:A qualitative approach was used to conveniently select a sample of 10 women attending an antenatal clinic in a rural area,in one of the districts of Kwa Zulu-Natal(KZN)Province.Data were collected by means of interviews with the women.Data were analyzed employing Burnard’s content analysis approach.Results:Four themes emerged:(1)age at first pregnancy;(2)birth intervals,risks in pregnancy and hospitalization;(3)the use of contraception;and(4)HIV status.All themes that emerged revealed inattention to reproductive health(RH)needs,resulting in poor RH outcomes as an area of concern.Conclusions:Greater emphasis needs to be placed on meeting the sexual and reproductive health(SRH)needs of South African women,if maternal mor tality rates are to be reduced.An alternative model for reducing maternal mor tality in South Africa is proposed.

Determination of Level of Knowledge on Modern Methods of Family Planning among Women of Reproductive Age (18 - 49 Years) at Mathare North Health Center in Nairobi County, Kenya

Introduction: Modern family planning methods (MFPM) prevent unwanted pregnancies, reduce fertility rate, and increase the interval between pregnancies. They prevent pregnancy by preventing fertilization or implantation of the fertilized ovum. MFPM include tubal ligation (TL), vasectomy, oral contraceptive pills, the intrauterine contraceptive device (IUCD), depot injections, sub-dermal implants, and male and female condoms. Objective: To determine the level of knowledge of modern family planning methods (MFPM) among women of reproductive age (18 - 49 years) at the Mathari North Health Center in Nairobi County, Kenya. Methods: The study conducted among women of reproductive age at Mathare North Health Center in Nairobi was a cross-sectional descriptive survey between March 2016 and November 2018. It provided both qualitative and quantitative data. The sample size comprised of 274 women of reproductive age, i.e. (18 - 49 years) attending antenatal and postnatal clinics at the facility. Those excluded were women below 18 years of age, as they could not give consent according to Kenyan Laws. The data were collected using an interviewer-administered structured questionnaire, which consisted of socio-demographic and characteristics, knowledge of modern family planning methods and distance from the facility. Likert scale was used to ensure that data was tabulated on daily basis and subjected to statistical manipulation using Statistical Package for Social Sciences (SPSS). Results: The four leading MFPM in use in order of acceptability were injectables, implants, intrauterine contraceptive device and pills in that order. 91% of respondents were aware or had heard about modern family planning methods. Level of education of mother and father were the two variables that influenced the uptake of MFPM with p-values of 0.0260 and 0.025, respectively. The study further found that knowledge of MFPM had a significant influence on their assimilation and utilization. All secondary variables considered in the research exhibit a substantial relationship concerning the use of MFPM. Conclusion: Communities around Mathari North Health Center need to be given information;education and counselling on MFPM to enable them make an informed decision and choice on their preferred method of family planning.

Assessment of Maternal Readiness for Childbirth and Childrearing among Adolescent Mothers in Ghana

Background: Adolescent pregnancy is a public health problem of concern in developed, developing and underdeveloped countries. Trends in developing and underdeveloped countries are higher and account for most adverse pregnancy outcomes. Adolescence is a period of transition between childhood and adulthood. The burden of coping with changes with this transition and at the same time preparing for childbirth puts pregnant adolescent girls on edge. Childbirth and childrearing are critical moments that require support and specialized skills to nurture healthy infants. Aim: This study aims to assess the readiness of adolescent expectant mothers towards childbirth and childrearing in the Komenda/Edina/Eguafo/Abirem (KEEA) district of the central region of Ghana. Methods: This study utilized the total population sampling technique to collect data from three sites that offer specialized adolescent antenatal services within the KEEA district of the central region of Ghana. Data were analyzed using SPSS version 22.0 and results presented as descriptive statistics. Results: This study assessed maternal readiness for childbirth and childrearing among 98 pregnant adolescent girls. The study was dominated by late adolescents who made up 86.7% of study participants. Regarding readiness for childrearing, the majority (74.5%) said they could not independently cater for their children and will require some support. The majority (52.0%) have had some form of counseling with a greater number (41.2%) coming from parents. Regarding readiness to embrace childbirth, the majority (82.4%) of respondents said they had companions who were willing to support them during childbirth. The majority (57.1%) of respondents have packed their delivery items although only 13.3% of them knew their expected dates of delivery. About 37.8% of respondents had knowledge of the possibility of having blood transfusion during delivery. Conclusion: Adolescent pregnancy is pervasive, and adolescent mothers require optimal support to ensure safe motherhood. Health promotion activities must be streamlined to meet their specific needs. Their significant others must actively be involved in their perinatal counseling to enhance compliance with health and wellbeing programs.

An Overview of Adolescent Pregnancy in Yaoundé, Cameroon

Background: Adolescent pregnancy is high risk and every area should have data specific to it. We here attempted to determine the characteristics of adolescent pregnancy in Cameroon, with special reference to antenatal care (ANC). Materials and Methods: The present cross-sectional descriptive study was carried out in four secondary level hospitals in Yaounde, Cameroon from March to May 2022. Our study included adolescent pregnant females between ages 10 and 19 who received prenatal/post-partum care at these facilities. Results: We studied 101 adolescent pregnant females (pregnant or post-partum). The mean age was 17.6 ± 1.3 years. Most of them were single, Christian, had a secondary level of education, lived in a two-parent home and were from the Central region. ANC was provided by midwives for most of them but prenatal work-up was not done most of the time. Overall quality of ANC was considered poor. Conclusions: Adolescent pregnant females were mainly high-school students and lived at home with both parents. ANC quality was considered poor. These data may be important to improve reproductive health care and may be generalizable to some extent.

Late Intrauterine Foetal Death in a Tertiary Centre of Bangladesh

Background: Late intrauterine foetal death (IUFD > 28 weeks) is a tragedy to mothers and family members. The first step to reduce IUFD is to obtain an accurate and detailed data for IUFD. The present study was done to identify the probable causes of foetal death and determine the risk of recurrence, prevention or corrective action. Methods: This prospective observational study was conducted in a tertiary hospital during a period of one year in Chattogram Maa-O-Shishu Hospital Medical college, from January to December 2018, on all admitted pregnant women with intrauterine foetal death (>28 weeks). Detailed history, clinical examination, associated conditions, mode of delivery, foetal conditions, placenta, condition of cord and investigation reports were analyzed. Results: A total of 188 IUFD were reported amongst 8013 deliveries with its incidence 23.46/1000 live birth and recurrence rate 8.5%. Maximum (89.89%) occurred in antepartum period. Mean maternal age 26.03 years. 59% unbooked cases, 48.93% belonging to lower class family and maximum (59%) from slum and rural area. Most of the cases were Multigravidas (59.6%) and preterm (52.7%) gestation. Regarding causes of IUFD hypertensive disorders in pregnancy (45.2%) were commonest, followed by unexplained 24.5%, diabetes Mellitus and gestational diabetes mellitus (23.9%), anaemia 20.7%, hypothyroidism 11.2%, oligohydramnios 11.2%, maternal infection 9.6%, antepartum haemorrhage 8.5%, malpresentation 7.44%, intrauterine growth retardation 4.8%, fetal congenital anomalies 4.8% & cord accident 4.3%. Maternal complications occurred 14.9% cases. Those were postpartum haemorrhage 11.2%, sepsis 2.6%, acute renal failure 0.53% and disseminated intravascular coagulation (DIC) 0.53%. Most of the patients (86.2%) delivered vaginally. Maximum number of IUFD was seen in birth weight between 1 - 1.5 kg (31.4%), followed by 2 - 2.5 kg (21.8%). Conclusions: HDP, GDM and anaemia were major causes of IUFD. Most of the causes of IUFD may have been preventable by pre-conceptional councelling, regular antenatal checkup, proper screening, early diagnosis and treatment. Large number IUFD remained unexplained. So, to unravel the complex pathophysiology of IUFD further study is needed.