Search Results (332)

Background: Midwifery’s Intangible Heritage was officially recognized by the United Nations Educational, Scientific and Cultural Organization on 6 December 2023, highlighting that elements of midwifery knowledge and practice, shaped over generations, constitute cultural heritage worth safeguarding. While previous studies have investigated midwives’ perceptions of professional identity, none have done so within the explicit framework of MIH. Objective: this study explored how midwives and student midwives in Cyprus perceive the intangible heritage of their profession and how it relates to their shared professional identity. Methods: A qualitative descriptive study was conducted between April and July 2023. Three focus groups were held, involving 22 participants: 15 registered midwives and 7 student midwives. A semi-structured interview guide consisting of 10 questions was used, developed by the lead author (M.P.) based on the literature and improvisation and finalized with the research team (E.H., S.V., N.M.) after expert input. Thematic analysis was performed inductively to identify recurrent themes. Results: Four major themes emerged: (1) key elements of Midwifery’s Intangible Heritage and their transmission across generations; (2) a sense of shared professional identity; (3) perceived threats to the midwifery profession; and (4) midwives’ expectations for the future of the profession. Conclusions: The findings reflect the historical background of midwifery in Cyprus and its contrast with contemporary practice, particularly within the context of the overmedicalization of birth and societal perceptions of midwifery in the socio-cultural setting. Safeguarding Midwifery’s Intangible Heritage requires both empowering women to seek midwifery-led care and enabling midwives to practice autonomously within their full professional scope. In addition, policymakers and educational bodies must support the preservation of midwives’ core skills through targeted educational curricula, structured mentorship, and continuous professional development. Full article

Background: Empowerment during pregnancy is linked to improved maternal and infant health outcomes and greater maternal well-being. Group Antenatal Care (GANC), a participant-centered model of care, promotes empowerment, active engagement, and the deconstruction of hierarchy between participants and care providers. It combines health assessment, interactive learning, and community building. While empowerment is a core concept of GANC, the ways it manifests and the elements that facilitate it remain unclear. Method: We conducted a generic qualitative study across four organizations in Brussels, using multiple data collection methods. This included interviews with 13 participants and 21 observations of GANC sessions, combining both the insider and outsider perspective. An adapted version of the Pregnancy-Related Empowerment Scale (PRES) guided the interviews guide and thematic analysis. Results: We identified seven themes that capture how empowerment occurs in GANC: peer connectedness, provider connectedness, skillful decision-making, responsibility, sense of control, taking action, and gaining voice. Several aspects of GANC contribute to empowerment, particularly the role of facilitators. Conclusions: This study highlights how GANC enhances empowerment during pregnancy through interpersonal, internal, and external processes. Important components within GANC that support this process include the group-based format and the interactive nature of the discussions. The presence of skillful GANC facilitators is an essential prerequisite. In a diverse and often vulnerable context like Brussels, strengthening empowerment through GANC presents challenges but is especially crucial. Full article

Background/Objectives: Despite legal frameworks acknowledging the need to protect the rights of female prisoners, penitentiary systems often neglect gender-specific needs, particularly for foreign women. Among them, Muslim women face distinct challenges linked to cultural and religious practices, which are frequently unmet in prison contexts. This review aims to explore the academic literature on the experiences of Muslim women in detention. Methods: A systematic review was conducted using three major bibliographic databases—Scopus, PubMed, and Web of Science—covering the period from 2010 to 2024. Inclusion criteria focused on peer-reviewed studies examining the condition of Muslim women in prison. Of the initial pool, only four articles met the criteria and were included in the final analysis. Results: The review reveals a marked scarcity of research on Muslim women in prison at both national and international levels. This gap may be due to their limited representation or cultural factors that hinder open discourse. The selected studies highlight key issues, including restricted access to services, limited ability to practice religion, and language and cultural barriers. These challenges contribute to increased psychological vulnerability, which is often underestimated in prison settings. Conclusions: There is an urgent need for targeted research and culturally competent training for prison staff to adequately support Muslim women in detention. Greater academic and institutional attention is essential to develop inclusive policies that consider the intersection of gender, religion, and migration, particularly in the post-release reintegration process. Full article

Background: Interprofessional collaboration (IPC) is considered fundamental for integrated, high-quality woman-centered care. This study analyzes concordance/differences in the perspectives of midwives and physicians on IPC and Equitable Communication (EC) in prenatal/postpartum (PPC) and birth care (BC). Methods: The short form of the ICS Scale (ICS-R with eight items) adapted for the midwifery context, and the EC scale (three items) were completed by 293 midwives and 215 physicians in Germany. Profession- and the setting-specific differences were analyzed using t-tests and ANOVA with repeated measurements. Confirmatory factor analysis with nested model comparisons test the fairness of the scales. Results: Midwives’ ratings of all IPC aspects were systematically lower than physicians’ in both care settings (variance component professional group: η²_p = 0.227/ 0.318), esp. for EC (d = 1.22–1.41). Both groups rated EC higher in BC. The setting effect was less pronounced among physicians for the ICS-R items than among midwives. Violations of test fairness reveal validity deficiencies when using the aggregated EC sum score for group comparisons. Conclusions: Fundamental professional differences were found in the IPC assessment between physicians and midwives. The results enhance the understanding of IPC dynamics and provide starting points for action to leverage IPC’s potential for woman-centered care. Full article

Introduction: Overactive bladder (OAB) and urinary incontinence (UI) are prevalent, particularly in older adults, and affect quality of life. OAB involves urgency, frequency, nocturia, and urgency incontinence, often linked to involuntary detrusor contractions. Treatment guidelines recommend a stepwise approach, starting with pelvic floor muscle training (PFMT), followed by pharmacological or minimally invasive therapies, such as neuromodulation. However, the combined effects of PFMT and neuromodulation have not been well established. This study aimed to evaluate the impact of combining pelvic floor exercises with neuromodulation versus PFMT with sham neuromodulation or standard physiotherapy after a 12-week intervention in individuals with OAB and UI. Methods/Materials: A double-blind, randomized controlled trial was designed with three groups: PFMT + neuromodulation, PFMT + sham, and conventional physiotherapy (control) in a 1:1:1 ratio. This study followed the CONSORT guidelines and was registered at ClinicalTrials.gov (NCT06783374). The sample size was calculated using GPower^® software, assuming a Cohen’s effect size of 1.04, a power of 0.80, an alpha of 0.05, and a 15% dropout rate, totaling 63 participants (21 per group). Participants attended 24 sessions over 12 weeks (2 sessions per week). The interventions were based on previously validated protocols. Outcomes: The primary outcomes included health-related quality of life, pelvic floor muscle function, pain, adherence, and general health. The secondary outcomes included Incontinence Quality of Life questionnaire, 3-day bladder diary, International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form, kinesiophobia, and electromyographic data. Full article

Objectives: Scarce data are available regarding preventive medicine in forcibly displaced populations especially regarding non-communicable diseases like neoplasia, while even more limited data are available on Ukrainian refugees in Romania. To address this research gap, the present analysis was performed to investigate Ukrainian refugee women’s beliefs, attitudes, and opinions towards the Romanian and Ukrainian healthcare system in a comparison model while focusing on the HPV immunization rates and factors influencing the uptake for themselves and their children. Methods: Participants were recruited using the snowball sampling method through their General Practitioner (GP) and a health mediator. Results: In total, 105 women completed the online or physical survey. The mean age was 50 years. In total, 40% of women had not been to a gynecological check-up in 3 or more years, and more than 56% had never been screened. Only four were vaccinated against HPV, and none remembered which type of vaccine was dispensed or how many doses were utilized. The primary hindrances to accessing health services or immunization programs were language barriers, financial burdens, and a lack of information. Respondents’ general distrust of health systems and healthcare workforces were recurrent themes. Relationship status, living arrangements, and previous engagement in screening practices influenced immunization rates. Perceiving the healthcare officials as proactive concerning optional vaccination programs such as HPV immunization and actively receiving recommendations drove respondents to pursue vaccination. Conclusions: This analysis offers a foundational insight into the specific needs of refugee women. It can guide the development of effective public health interventions to improve health outcomes and vaccination rates among Ukrainian refugees in Romania. Tailored preventive campaigns with adequate native language information and prompts from medical experts in designated centers should be deployed to ensure inclusive tactics for vulnerable populations. Full article

Background: Histologic chorioamnionitis (HCA) is a placental inflammatory condition characterized by neutrophilic infiltration of the fetal membranes, often occurring without overt clinical signs or symptoms. Risk factors include prolonged labor, premature rupture of membranes (PROM) exceeding 12 h, nulliparity, labor dystocia, and lower socioeconomic status. Although HCA frequently presents as a subclinical condition, its early diagnosis remains challenging. Nevertheless, HCA is associated with an increased risk of maternal and neonatal morbidity, including early-onset neonatal sepsis, cerebral palsy, and long-term neurodevelopmental impairment. We report the case of a 29-year-old primigravida at 40 + 0 weeks of gestation, admitted for decreased fetal movements. Discussion: Cardiotocographic (CTG) monitoring revealed a “zigzag pattern” in the absence of maternal fever, leukocytosis, or tachycardia. Due to the CTG findings suggestive of possible fetal compromise, in addition to reduced fetal movements, an emergency cesarean section was performed. Intraoperative findings included heavily meconium-stained amniotic fluid, then the examination of the placenta confirmed acute HCA with a maternal inflammatory response, without evidence of fetal inflammatory response. Conclusion: This case highlights the crucial role of CTG abnormalities, particularly the “zigzag pattern,” as an early marker of subclinical intrauterine inflammation. Early recognition of such patterns may facilitate timely intervention and improve perinatal outcomes in cases of histologic chorioamnionitis. Full article

Cold knife hysteroscopic myomectomy (CKHM) is a minimally invasive surgical technique used to remove submucosal fibroids, commonly associated with infertility. Methods: A comprehensive literature search was conducted across databases including PubMed, Scopus, and Google Scholar, focusing on studies published from 2011 to 2024. The aim of this narrative review was to highlight the minimally invasive cold loop resectoscopic approach for the treatment of submucosal fibroids. Results: The review revealed that CKHM is associated with favorable fertility outcomes, with studies reporting increased pregnancy rates; most studies indicated that CKHM did not negatively affect endometrial function. Conclusions: Cold knife hysteroscopic myomectomy is a safe and effective option for women with submucosal fibroids who wish to preserve fertility due its minimal invasiveness and low complication rates. Full article

Background/Objectives: Breast cancer (BCA) is one of the most common cancers affecting women worldwide. Screening has been linked to up to a 33% reduction in breast cancer-related deaths by helping detect tumors at an early stage. The successful implementation of community-based breast cancer screening programs depends on understanding the attitudes of women within the target community. This study aims to systematically review the literature to assess the association between women’s attitudes toward breast cancer screening and their life satisfaction and general attitudes toward life. We also aimed to examine women’s attitudes toward breast cancer screening recommendations and the factors that influence these attitudes. Methods: A systematic review of English-language literature was carried out. PubMed and Scopus were searched up to November 2024 for studies that met the predefined inclusion criteria. Methodologic quality was assessed using the adapted Newcastle–Ottawa Scale for cross-sectional studies and the corresponding scale for cohort studies. Results: Eleven studies met the inclusion criteria. The percentage of women who had undergone at least one breast cancer screening ranged from 8.3% to 94.5%. Women’s attitudes toward and participation in breast cancer screening were linked to psychological, social, and demographic factors. Lower levels of life satisfaction, self-efficacy, and perceived control or mastery in life, along with higher levels of non-work-related stress, and higher levels of optimism, were associated with a lower likelihood of participating in breast cancer screening. Full article

Background/Objective: Menopause marks a significant life transition for women, signaling the end of reproductive ability and triggering various physiological and psychological changes. During this phase, women may experience a range of physical and emotional challenges that can affect their quality of life. This study aims to assess the relationship between women’s mental health and their menopausal quality of life. Methods: A descriptive correlational study was conducted among 350 women aged 45–60 years who had either experienced menopausal symptoms or undergone menopause. Using convenience sampling, participants were recruited from academic institutions in Riyadh, Saudi Arabia. Data were collected using validated tools, including the Menopause Rating Scale (MRS) and the Depression Anxiety Stress Scales (DASS-21). Descriptive and inferential statistical analyses assessed symptom severity and its association with mental health and quality of life. Results: Findings indicated that 27.8% of participants experienced moderate to severe menopausal symptoms. Urogenital symptoms were the most common, reported by 59% of women. Significant correlations were observed between menopausal symptoms and high levels of depression (63%), anxiety (60%), and stress (58%), all of which significantly impacted quality of life. Conclusions: Menopausal symptoms have a profound impact on both physical and mental health, significantly affecting quality of life. Depression, in particular, was found to be the most influential factor. These findings highlight the need for integrated healthcare approaches that address both physical and psychological aspects of menopause. Full article

Objective: Utilizing the Health Care Access Barriers (HCAB) Theoretical Framework, this study examined latent profiles of barriers to prenatal care among pregnant women in Alabama and whether these profiles mediate or moderate the relationship between pregnancy intentionality and early prenatal care initiation. Methods: An explanatory mixed-method design was employed, integrating quantitative analysis of Alabama Pregnancy Risk Assessment Monitoring System (PRAMS) Phase 8 data (2016–2021) with qualitative insights from expert interviews. Latent class analysis (LCA) identified subgroups based on reported barriers. Multivariable logistic regression assessed the association between pregnancy intentionality and early prenatal care initiation, controlling for covariates. A Firth-penalized multivariable logistic regression model tested interaction effects. Results: Planned pregnancy was associated with higher odds of early prenatal care initiation (OR = 0.78, 95% CI [0.49, 1.23], p = 0.286), though this association was not statistically significant. Barrier profiles did not significantly moderate or mediate the relationship. The interaction term was nonsignificant (OR = 5.19, 95% CI [0.22, 828.94], p = 0.309), and the mediation pathway was also not supported (indirect effect = 0.012, p = 0.518). Expert interviews emphasized ongoing systemic and cognitive barriers that hinder timely access. Conclusions: Although pregnancy intentionality was not a statistically significant predictor of early prenatal care initiation, qualitative findings highlighted persistent barriers that continue to constrain access. These results underscore the need for multilevel strategies to address informational and logistical challenges. Future research should evaluate additional pathways that influence care-seeking behaviors. Full article

Pregnancy and birth are biological processes shaped by social factors, requiring sociological approaches to explain reproductive behaviour. This narrative review outlines the importance of health sociology against the background that health and illness behaviour is influenced by the social environment. The aim of this paper is to summarize the current state of research on the influence of social systems and social milieu behaviour on reproduction, pregnancy, and childbirth in order to make it easier for midwives and doctors to take these factors into account in their everyday clinical and outpatient work. First, the paper lays out the basics of how health and illness are socially constructed, looking at it from both a structural and action-oriented perspective. It then goes on to explain what this means for pregnancy and childbirth as social processes, how women’s health is related to the social construction of gender roles, that breastfeeding is also a social process, and what conclusions can be drawn for the work of midwives. Pregnancy and birth are social processes based on norms and role attributions: “Decisions” regarding one’s own reproductivity are usually only “self-determined” to a limited extent and tend to occur in the context of social norms and milieu-specific role expectations. The promotion of women’s health depends on how milieu-specific norms and logics of action are understood. For all the professions involved in obstetrics, this results in the need for a critical examination of the sociological aspects of health. This implies the necessity for all obstetric professions to critically examine aspects of the sociology of health in order to provide women and their families with appropriate, evidence-based and client-centred care in the context of pregnancy, birth and the postpartum period, against the background of constant social change. Full article

Vulvar hygiene is an important part of general hygiene: the goals are to clear the vulvar area of microbial and cellular debris and vaginal and fecal secretions, ensure local comfort, provide natural levels of hydration, and protect the vulvar microbiota. There are few national and international guidelines on vulvar hygiene. We searched the PubMed database up until 30 November 2024, using logical combinations of the following terms: hygiene, washing, vulva, vulvar, microbiota, hydration, syndet, soap, detergent, water, and customs. The abstracts were reviewed, and potentially relevant full-text articles were retrieved and examined. The subregions of the vulva vary with regard to the presence of sweat and sebaceous glands, the keratin content, the water content, the pH, and the microbiota (notably Lactobacillus, Corynebacterium, Staphylococcus, and Prevotella). An alteration in the vulvar microbiota can cause an imbalance in the vaginal microbiota, and vice versa. Vaginal douching may have negative effects on vulvar microbiota. Hair removal might increase the risk of long-term dermatological complications. Repeated washing with water alone exposes the stratum corneum to damage, and washing with soap alters the stratum corneum proteins and lipids, increases skin water loss, and accentuates the risk of irritation. Syndet-based products have a mild detergent effect, promotion of hydration, a suitable pH for the vulvar area, and protection of the vulvar microbiota. Syndet-based products (containing a blend of surfactants, emollients, antioxidants, and buffering agents) appear to be the most appropriate for vulvar care. Full article

Background/Objectives: Anemia and undernutrition are severe public health concerns in Ethiopia. These are the two most common nutritional disorders in pregnant women and frequently coexist. However, to our knowledge, there is little evidence of the coexistence of anemia and undernutrition among pregnant women. Therefore, this study aimed to examine the prevalence of coexisting anemia and undernutrition (CAU) and associated factors among pregnant women. Methods: A community-based cross-sectional study was conducted from 1 to 25 June 2024, on 515 pregnant women in the Hawela Lida district of Sidama, Ethiopia. We utilized a multi-stage sampling method to choose eligible study participants. A pre-tested and structured questionnaire was used to collect data via the online Open Data Kit mobile tool. We controlled the effect of confounders and clustering by using a multi-level mixed-effect modified Poisson regression analysis model. Results: The prevalence of CAU among pregnant women was 25.4% (95% CI: 21.9–28.9). The prevalence of CAU was associated with household food insecurity (adjusted prevalence ratio [APR]: 2.17; 95% CI: 1.43–3.28), training on model family (APR: 0.66; 95% CI: 0.45–0.96), inadequate dietary diversity (APR: 1.51; 95% CI: 1.18–1.95), and having poor knowledge of nutrition (APR: 1.55; 95% CI: 1.06–2.26) at individual levels. Low community-level women’s autonomy (APR: 6.19; 95% CI: 3.42–11.22) and community-level road accessibility (APR: 0.65; 95% CI: 0.43–0.98) were the identified determinants of CAU at the community level. Conclusions: One in four pregnant women had CAU in the study area. Household food insecurity, inadequate dietary diversity, and poor nutrition knowledge were associated with an increased likelihood of CAU, while participation in model family training and improved road accessibility were associated with reduced CAU. We have also indicated that low community-level women’s autonomy significantly increased the risk of CAU. Therefore, inter-sectorial collaboration should be required to comprehensively address CAU’s determinants at different levels. Additionally, any CAU prevention and intervention programs should provide model family training explicitly targeting women with poor nutritional knowledge and low autonomy in healthcare decision-making. Full article

Background: The aim of this study was to explore the effects of distance yoga learning in improving depression and pregnancy stress in pregnant women during the pandemic. Methods: A preference-based quasi-experimental study design with an experimental group (n = 30) and a control group (n = 31) was used to test both self-reported depression and stress status. The experimental group received a 12-week pregnancy yoga program, including one weekly 60 min distance yoga class followed by two sessions of DVD yoga exercise at home, while the control group received only routine nursing care. Results: There were significant differences in the depression and pregnancy stress indices between the two groups. As the number of weeks of pregnancy increased, both pregnancy depression and stress tended to gradually increase (p < 0.001). However, the experimental group had less pregnancy depression than the control group (p < 0.001), while there was no significant difference between the two groups in stress (p = 0.970). Conclusions: The findings inform clinical practice regarding the use of alternative exercise options such as distance yoga classes for pregnant women’s mental health during a pandemic to reduce depression and pregnancy stress. Full article