Scientific Program |WORLD MIDWIFERY CONGRESS 2021|World Congress on Midwifery, Maternal Health and Gynecology| Conference Series

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Day :

Prenatal care | Pregnancy and its complications | Maternal Health | Postnatal care

Session Introduction

Mark Hayford Dwira

University of Nottingham, England

Title: The Role of Men in the Prevention of Female Genital Mutilation/Cutting (FGM/C) among the Sudanese Population in Nottingham. A Small-Scale Qualitative Study

Biography:

Abstract:

Background: Due to gender inequality in the campaign against cultural-related practises like FGM/C, there is a notion that the practise is considered a feminist agenda, and therefore, it is women's responsibility to champion the practise prevention. This ignores the roles that men can play in preventing FGM/C in practising communities in the UK. This research explored how men can use their roles as fathers, husbands, community leaders, and faith leaders to help prevent FGM/C among Sudanese immigrants in Nottingham.

Methods: Data used for this small-scale qualitative study was obtained using semi-structured interviews and focus group discussions with 11 men, and was thematically analysed. The research situated within a radical feminist theoretical context of The Silences Framework and Post-Feminist Theory.

Results: This research revealed that men's roles (as fathers, husbands, community leaders, and faith leaders) are deep-rooted and related to their dominance and decision-making power that could prevent the decision to circumcise daughters within the Sudanese community. Moreover, the study revealed that the involvement of men as principal educators could give them the forum to discuss the effects of FGM/C practise openly among themselves (young and old), particularly with those married to women with FGM/C from the Sudanese community. Finally, the study revealed that men's assumption of the whistle-blower role from each family might increase people's knowledge of UK FGM/C laws and to encourage reporting of suspected FGM/C cases among people from practising communities living in Nottingham. This could help protect girls and women at risk of experiencing FGM/C.

Conclusion: This study suggests that policymakers and stakeholders, such as the National Health Services (NHS), who have so far largely ignored the role of men in addressing FGM/C, need to prioritise men's inclusion in their policy planning of any prospective FGM/C-related interventions. Further research is required to understand how aspects of masculinity, which could be interpreted at one level to embody power and gender-authority assumptions, are mobilised in a constructive way to examine the roles men can play in preventing FGM/C in the UK.

Jessie T. Orano

St. Alexius College, Philippines

Title: Beyond barriers: factors affecting facility-based childbirth among bâ€™laan Parturients

Biography:

A nurse-midwife by profession who believed in the complexity of healthcare

among women and their children. He collaborates with organizations such as Integrated Midwives Association of the Philippines, Inc. and Association of Philippine Schools of Midwifery (as National Auditor and Trainer) in conducting midwifery training for Midwifery Administrators and Faculty and practicing midwives both in private and government institutions. He is a holder of Master’s Degree in Nursing and and Master’s Degree in Management major in Health Administration.

Abstract:

INTRODUCTION:

The World Health Organization stated in the fact sheet published online that Maternal Mortality is unacceptably high and around 800 women die from pregnancy or childbirth related complications around the world every day. In the Philippines reported high rates were associated with poor birthing practice, including home births without the attendance of skilled health professional and no adequate and quality prenatal care. With this, the researcher was determined to explore how the geographical setting, cultural practices and beliefs affects the Facility-based childbirth likelihood of B’laan tribe in Norala, South Cotabato, Philippines.

METHODOLOGY:

This study used exploratory research method. For quantitative approach, a self-made validated survey questionnaire was utilized composed of two parts: Part I, Demographic Profile; Part II, Factors affecting Facility-based Childbirth likelihood of B’laan Parturients. A Focus Group Discussion was conducted for qualitative approach, a validated guide questionnaire was used to gain more insights on the effects of geographical setting, cultural practices and beliefs. The 30 randomly chosen participants in the study were the married or unmarried B’laan women who submitted for prenatal check-up from March 2019 to March 2020 of the identified locale of the study and 9 participants for the Focus Group Discussion three from each Barangay – Tinago, Puti, and San Miguel.

RESULTS, ANALYSIS AND DISCUSSION:

For Quantitative Results: participants age bracket of 20-30 has the highest percentage of 76.67 while having the lowest percentage of 10 was age bracket 31-40 years old depicting the number of younger mothers, considered one of the risk factors associated with home delivery and cultural norms. As to educational attainment, the highest percentage was elementary level and the lowest percentage of zero was college level affecting their decision to avail the Facility-based Childbirth. In Qualitative Approach three (3) themes were emphasized, pinpointed, examined, and recorded from the gathered data which represent the level of patterned responses related to the study such as Comfort at Home; Support of Significant Other; and Desire in availing Maternal and Newborn Services. Thus, the researcher recommends the construction of “Bahay ni Nanay” to house pregnant women prior to expected delivery; a resident midwife must be available 24/7 in the facility; and strengthen the implemented strategies to increase likelihood of giving birth to Birthing Home.

This project will be coordinated with the Non-Government Organizations, Rotary Club International and other funding agencies. The local government to improve the road for possible access to the recreational facilities. For further research, there should be a study in other tribes like T’boli, Manobo, and Muslim; Interrelatedness and difference of the barriers affecting

different tribes; and a Correlational Study among B’laan, T’boli, Manobo and Muslim Tribes.

Ashish Ramchandra Kale

Ashakiran Hospital, India

Title: Role of laparoscopy in endometriosis or DIE ( deep infiltrating endometriosis)

Biography:

Dr. Ashish Kale is a Gynecologist,Gynecologic Oncologist and Urogynecologist in Pimple Saudagar, Pune and has an experience of 21 years in these fields. Dr. Ashish Kale practices at Dr. Ashish Kale's IVF Center in Pimple Saudagar, Pune. He is a member of Member of F.O.G.S.I.(Fedaration of O&G India) (2006).,Member of Pune Obs & Gyn. Society (2006).,Member of Indian Society of Gynaecological Endoscopy ISGE (2007).,Member of Indian Society for Asisited Reproduction ISAR (2011). and Member of Indian Fertility Society IFS (2011).

Abstract:

DIE is a infiltration of endometriosis below the peritonium more than 5 mm It may be rectovaginal in 5 to 12 % most commonly rectum and sigmoid is involved multiple lesions can be seen at different side according to the involvement DIE can be classified into anterior DIE involving bladder posterior DIE , involving uterosacral ligaments vagina as well as intestines all these DIE can be diagnosed by TVS or MRI sensitivity of both are the same . The indications of the surgeries may be symptoms like dyspareunia , cyclical ,hematuria. Aim of the surgery would be resolution of symptoms but adopting oncological principles of surgery. After proper surgical excision of the disease fertility can be improved.

Incase, of rectovaginal endometriosis indications for surgeries may be symptomatic endometriosis and in those where medical therapy won't show any response.

The preferable way of dealing RV endometriosis would be shaving, full thickness excision segmental resection and anastomosis the complications of these surgeries can be fistula formation anastomotic leak . Or 2% conversion to lapratomy.

When we compare recurrence rate in discoid verses shaving the recurrence rate is less with discoid excision. It is always better to do pre surgical evaluation of the patient and then decide the appropriate surgical treatment options.

Liknaw Bewket Zeleke

Debre Markos University, Ethiopia

Title: Postnatal care service utilization and its determinants in East Gojjam Zone, Northwest Ethiopia: a mixed-method study

Biography:

Liknaw Bewket Zeleke is a midwife lecturer at Debre Markos University. I studied BSc degree in midwifery at University of Gondar and MSc program in Midwifery Education at Mekelle University. Currently, I am an HDR candidate at University of New South Wales Sydney, Australia. I have put my hands both in quantitative and qualitative research methods and managed to publish around 16 articles on reputable scientific journals.

Abstract:

Background: The days and weeks after childbirth are crucial for both the mother and her newborn child leading for the majority of maternal and perinatal mortalities. However, postnatal care utilization remains low worldwide. The World Health Organization recommends at least three postnatal visits within 42 days after birth. This study aimed to assess the barriers to postnatal care service utilization in East Gojjam Zone, Northwest Ethiopia.

Methods: A community-based, mixed type cross-sectional study was conducted from December 15, 2018, to February 15, 2019. The quantitative data was gathered using the interviewer-administered interviewing technique from 751 women, selected by multistage sampling. The qualitative data were collected from purposively sampled women, facility leaders, and health extension workers using in-depth interviews and focused group discussions. The quantitative and qualitative data were analyzed using logistic regression and by the thematic content analysis method, respectively.

Results: The study revealed that postnatal care service utilization was 34.6%. The odds of using PNC services were greater in women aged 25–34 years and used maternity waiting home. In contrast, women who were muslim religion followers, had normal or instrumental birth, not aware of the PNC services and whose partners were not supportive of the use of MCH services were less likely to use PNC services. According to the qualitative findings, lack of awareness, traditional beliefs and religious practices, distance and transportation, environmental exposure, and waiting time were identified as barriers to PNC service utilization.

Conclusion and Recommendation: The study showed low utilization of PNC services by Ethiopian women. Improvements in personal health education, in construction of relevant infrastructure, and to transport, are needed to remove or reduce barriers to PNC service use in East Gojjam Zone, Northwest Ethiopia.

Vincent Bio Bediako

University of Cape Coast, Ghana

Title: Multilevel Geospatial Analysis of Factors Associated with Unskilled Birth Attendance in Ghana

Biography:

Vincent Bio Bediako from Ghana with Master's of Philosophy in Population and Health. My research interests include spatial demography, spatial analysis in public health and the influence of environmental factors on health.

Abstract:

Maternal mortality is still higher, particularly in sub-Saharan Africa and South Asia, where 86% of all deaths occur. This paper explores the spatial distribution of unskilled birth attendance in Ghana. The Geographic Weighted Regression (GWR) was employed to model the spatial relationship of some predictor of unskilled birth attendance. Moreover, a multilevel binary logistic regression model was fitted to identify factors associated with unskilled birth attendance.

Khadigeh Mirzaii

Mashhad University of Medical Science, Iran

Title: The effect of CBT counseling in pre-pregnancy physical activity

Biography:

Khadigeh Mirzai am professor in reproductive health in Mashhad Medical Science University. She was awarded Australian endeavor scholarship in 2008. She supervised many PhD and master student thesis in reproductive and sexual health and around 100 publications. She am currently doing reproductive and sexual health counseling in clinic. She am a member of the Reproductive Health Board in the Ministry of Health of Iran. She have a patent in the field of herbal medicine to reduce menopausal complications in Iran, which has had a very good result.

Abstract:

Introduction: Physical activity is one of the dimensions of a healthy life. Physical inactivity is known as the fourth leading risk factor for global mortality. Physical activity in women is very important because of its major effects on public health. Physical activity of women before pregnancy is associated with proper weight gain during pregnancy and reduces the risk of adverse pregnancy outcomes. Overweight and obese women are usually reluctant to be active. Half of people who start physical activity stop their physical activity program in less than 6 months. Therefore, more effective behavioral interventions than educational methods are needed. The cognitive process plays an important role in following people's instructions and training problem-solving skills. Because lack of physical activity can result from dysfunctional cognitions and behaviors, cognitive-behavioral counseling can correct dysfunctional cognitions and behaviors.

Objective: To determine the effect of cognitive-behavioral counseling on pre-pregnancy physical activity in women with high body mass index, referred to the comprehensive health service centers in Gonabad.

Methods: This quasi-experimental two-group study was performed on 60 pre-pregnancy women who referred to Gonabad Comprehensive Health Service Center No. 2. Subjects were randomly divided into two groups of 30: test and intervention. The intervention group underwent group cognitive-behavioral counseling (6 two-hour sessions twice a week). These sessions were held in the form of three face-to-face sessions and three non-face-to-face sessions in the form of a webinar. The reason for holding the meetings in absentia was the spread of the Corona virus and the ban on holding classes in person. However, the control group received only the usual care of health centers. Immediately after the end of the course and 1 month later, the measurement of physical activity was performed again as a post-test in all subjects. Analysis was performed using SPSS statistical software (version 23)

Results: The amount of physical activity after the intervention and one month after the intervention was statistically significant in the two groups (P = 0.03). Also, the rate of changes in physical activity after the intervention compared to before the intervention (P <0.001) and compared to one month after the intervention (P <0.001) was significantly different.

Conclusion:. The results obtained in this study showed that cognitive-behavioral counseling increases physical activity before pregnancy in women, especially high body mass, by correcting dysfunctional beliefs and modifying behavior, and due to the need to increase physical activity in This method is recommended before pregnancy

Negeso Gebeyehu Gejo

Mekelle University, Ethiopia

Title: Exclusive breastfeeding and associated factors among HIV positive mothers in Northern Ethiopia

Biography:

Mr. Negeso has completed his Msc degree in Clinical Midwifery from Mekelle University and Assistant Professor in Clinical Midwifery, Madda Walabu University, Shashemene Campus, School of Health Sciences, Department of Midwifery,. He is educationla developement center coordinator at Madda Walabu University, Shashemene Campus, School of Health Sciences. He has published more than 8 papers in reputed journals and has been serving reviwer for different journals.

Abstract:

Background: It is estimated that sub-optimal feeding, especially non-exclusive breastfeeding in the first 6months of life, results in 1.4million deaths and 10% of disease burden in children younger than five years. Worldwide, it is estimated that only 34.8% of infants are exclusively breastfed for the first 6months of life, the majority receiving some other food or fluid in the early months. Besides, the Ethiopian demographic and health survey (2016) stated that the median duration of exclusive breastfeeding in Tigray region was 3.8 months which is shorter than the recommended duration. The main purpose of this study was to determine the magnitude of exclusive breastfeeding practice and associated factors among HIV positive mothers in public hospitals of Tigray region, Northern Ethiopia.

Methods: A facility based cross-sectional study was conducted from July 9 to October 11, 2016, in public hospitals of Tigray region. Data was collected by using structured questionnaire using face-to-face interview among 304 eligible women through a systematic sampling technique. Data was analyzed using SPSS version 20.0. Binary and multiple variable logistic regressions (“odds ratio”) analyses were calculated with 95% CI and p value ≤ 0.05 as significance were used.

Result: Two hundred seventy (88.8%) of mothers practiced exclusive breastfeeding for the first six months of life. Infant feeding counseling during antenatal care of last pregnancy [AOR = 6.9, 95% CI; 2.63, 17.99], knowledge on exclusive breastfeeding (AOR = 5.5, 95% CI; (2.12, 14.02] and attitude towards exclusive breastfeeding [AOR = 7.9; 95% CI; 2.96, 21.21] had significant association with exclusive breastfeeding practice.

Conclusions: A high proportion of mothers practiced exclusive breastfeeding for the first six months of life. Infant feeding counseling, knowledge and attitude towards exclusive breastfeeding practice were the predictors of exclusive breastfeeding among HIV positive mothers. Strengthening infant feeding counseling during antenatal care and improving mothers’ knowledge and attitude on exclusive breastfeeding is essential.

Malshani L. Pathirathna

University of Peradeniya, Sri Lanka

Title: COVID-19 infection and perinatal outcomes: a systematic review

Biography:

Malshani Pathirathna completed her BSC in Nursing degree from University of Peradeniya, Sri Lanka and PhD from Niigata University, Japan. Currently she is serving as a senior lecturer in nursing at University of Peradeniya, a premier public university in Sri Lanka. She has published several articles in reputed peer-reviewd journals.

Abstract:

We conducted a systematic review to evaluate the current evidence on the effect of COVID-19 infection on maternal, fetal, and neonatal outcomes. Available literature was searched using MEDLINE, Embase, and Cochrane library from December 2019 to 30 June 2021. A combination of keywords for COVID-19 and perinatal outcomes was used. The quality assessment of the

included studies was done using the National Institute of Health quality assessments tools for observational studies. A total of 21 observational studies that assessed the adverse perinatal outcomes in pregnant women with COVID-19 infection compared to non-infected pregnant women were selected. Out of the total, only 12 studies reported the incidence of COVID-19 among pregnant women, which was ranged from 1.3% to 29.1%. Six studies reported that COVID-19 in pregnancy was not associated with adverse perinatal outcomes. One study found no difference in the overall rate of adverse perinatal outcomes, but the symptomatic status was associated with a modest increase in preterm delivery and intrapartum fetal distress. Cesarean section deliveries,

preeclampsia, prelabour rupture of membranes and maternal death were among reported adverse maternal outcomes, while preterm birth, low Apgar score at 5th minute, low birth weight and admissions to neonatal intensive care units were among reported adverse neonatal outcomes. Cases of fetal distress and intrauterine deaths were also reported. The majority of the studies included in

this systematic review reported one or more significant adverse perinatal outcomes associated with COVID-19 in pregnancy regardless of the symptomatic status. This finding stresses the need for special attention to prevent COVID-19 infection among pregnant women.

Jessie T. Orano

St. Alexius College, Philippines

Title: Equitable and Respectful Maternal Care among Indigenous People

Biography:

A nurse-midwife by profession who believed in the complexity of healthcare

Abstract:

B’laans and T’boli, are indigenous group living in remote and mountainous areas in South Cotabato, access to equitable and respectful maternal and child health was a pressing problem. Some receives prenatal care from the midwives but the tradition calls for women to give birth at home, assisted by untrained birth attendants and their husbands - a practice that more often leads to

pregnancy-related concerns and complications. Disrespectful and culturally insensitive treatment during labor and childbirth in birthing facilities form an important barrier to improving skilled care utilization and improving maternal health outcomes.

The Department of Health through the Human Resource for Health created a program to deploy nurses and midwives to make health more accessible for the Filipino people. Some government and non-government sectors are working together to make maternal and newborn health care accessible to B’laans and T’boli while acknowledging their culture and traditions. The development of a culturally sensitive maternal and newborn care program through the establishment of traditional birthing facilities called Bahay ni Nanay (Home of Mothers) in the community is a manifestation of the support intended for these tribal groups.