The prevalence of obstetric violence experienced by women during childbirth care and its associated factors in Türkiye: A cross-sectional study

Objective This study determined the prevalence of obstetric violence experienced by women during childbirth and related factors in Türkiye. Design Cross-sectional study Setting This study was conducted in the mother-child health and gynecology outpatient clinics of the training and research hospital in Türkiye. Participants The study was completed with 513 women who gave birth in the last two years between January and May 2022. Methods Data were collected using a questionnaire prepared by the researchers. Bivariate and multivariate logistic regression analyzed the relationship between obstetric violence and socio-demographic and obstetric characteristics. Findings Obstetric violence was reported by 76.4% of the women: 44.4% physical abuse, 44.4% abandonment of care, 26.5% non-consented care, 25.1% non-dignified care, 3.3% non-confidential care, and 0.4% discrimination. Low income (OR=1.98), physician-attended birth (OR=2.91), vaginal birth (OR=6.04), and newborn admission to the neonatal care unit (OR=2.99) were associated with higher reporting of obstetric violence. Primiparous women (OR=0.51), whose pain was controlled by non-pharmacological methods (OR=0.34) and who received companion support (OR=0.24) were less likely to report experiencing obstetric violence (p < 0.05). Key conclusions Approximately three out of four Turkish women report that they have been exposed to obstetric violence during childbirth. In Türkiye, vaginal birth is the type of childbirth with the highest rate of obstetric violence reporting. Women who are low-income and multiparous, who are deprived of midwife, companion, and pain control support during childbirth, are more likely to experience obstetric violence. Implications for practice Supporting low-income women, protecting women from traumatic acts and unnecessary interventions in a vaginal birth, increasing births under the attendance of midwives, and providing pain control with non-pharmacological methods, and companion support during labor may be protective factors against obstetric violence.

Secondary traumatic stress among midwifery students

PURPOSE

This study aimed to examine the factors affecting secondary traumatic stress on midwifery students.

DESIGN AND METHODS

This descriptive study was conducted between November and December 2018. Data were collected using information form and the Secondary Traumatic Stress Scale.

FINDINGS

The study found that 22.2% of midwifery students met all the trauma criteria for posttraumatic stress disorder according to the Secondary Traumatic Stress Scale. Midwifery students who were unhappy to continue their education and those who wished to switch to another profession after graduation respectively showed a 2.8- and a 4-fold higher risk of meeting the trauma criteria (p < 0.05).

CONCLUSION

The secondary traumatic stress rate in midwifery students is particularly high considering the fact that one in five students fulfills all of the Secondary Traumatic Stress criteria. However, to reduce their secondary traumatic stress rate, students should be thoroughly assessed by the educators who could provide the support necessary.

IMPLICATIONS FOR NURSING PRACTICE

Before graduation from the midwifery departments, students traumatic stress symptoms could be assessed mental health nursing courses, which might enable to change their attitudes towards to cope with this situation. Especially after traumatic childbirths, midwifery students should be supported by mental health nurses to cope with traumatic stress. Midwifery students should be encouraged each and every possible moment to express their feelings when they experience traumatic stress and thus their skills for effective coping can be reinforced.

The risk factors for postpartum posttraumatic stress disorder and depression

PURPOSE

In this study, we examined the association between specific birth-related variables and postpartum posttraumatic stress disorder (PTSD) and depressive symptoms.

DESIGN AND METHODS

In this descriptive study, data were collected using a personal information form, the City Birth Trauma Scale, and the Edinburgh Postpartum Depression Scale.

FINDINGS

The findings revealed that 8.5% of participants met all the diagnostic criteria for PTSD. The risk of developing depression was 9.7 times higher among women who met all the criteria for PTSD than among those who did not meet all the criteria.

PRACTICE IMPLICATIONS

During the postpartum period, at-risk mothers should be followed and screened for PTSD and depressive symptoms.

The adaptation of the Postpartum-Specific Anxiety Scale into the Turkish language

Background: The Postpartum Specific Anxiety Scale (PSAS) is used as a descriptive instrument to measure anxiety. Aim: The aim of this study was to examine the validity and reliability of the Turkish version of the PSAS. Study Design: The study is of methodological design. Methods: The study was conducted with 360 women who had given birth four months ago and presented at a Family Health Center. The validity analysis of the data was performed using the content validity index, exploratory factor analysis, confirmatory factor analysis, reliability analysis, Pearson's Moments Multiplication Correlation and Cronbach's Alpha Coefficient of Reliability. Correlation analysis, Cronbach's alpha analysis, and exploratory/confirmatory factor analysis were used in the evaluation of the data. Results: To assess the consistency of the scale over time, test-retest measurements were taken in a two-week interval. In the analysis of the internal consistency of the PSAS, Cronbach's alpha coefficient of reliability was .90 for maternal competence and attachment anxieties, .89 for infant safety and welfare anxieties, .83 for practical infant care anxieties, .83 for psychosocial adjustment to motherhood, and .94 for the overall scale. Conclusion: Our study has demonstrated that the Turkish version of the scale is a valid and reliable tool to use.

The effects of simulation-based education on initial neonatal evaluation and care skills

OBJECTIVE

Neonatal evaluations performed at the very first minutes following postpartum are the most important steps in deciding for neonatal resuscitation. Therefore, the newborn initial care and evaluation notion and skills of midwives in the delivery hall are quite important. The study was planned to determine the effects of simulation education on newborn evaluation and care skills in midwifery students.

METHODS

This is a quasi-experimental study. The population of the study was composed of the 4th year students of Marmara University Faculty of Health Sciences (65 students in total), who selected the Intern Newborn course in the 2017-2018 Fall and Spring semesters.

RESULTS

The areas where the control group students did not apply at all or needed the help of the trainer were observed as delivery room preparation (86.2%), initial neonatal evaluation (96.6%) and registration/safety (69%). According to "the Guide for Newborn Evaluation at the Delivery Room," the differences in the mean total scores and all sub-dimension scores were found to be significant in favor of the experiment group.

CONCLUSION

Education programs that are carried out by computer-assisted simulation and in accordance with the teaching guide were effective on improvement of knowledge-skills on newborns' first evaluations in the delivery room.

The effects of three different distraction methods on pain and anxiety in children

This study aims to investigate of three different distraction methods (distraction cards, listening to the music of cartoon and balloon inflation) on pain and anxiety relief of children during phlebotomy. This study is a prospective, randomized, and controlled trial. The sample consisted of 6 to 12 years old children who require blood tests. Children were randomized into four groups as the distraction cards, the music, the balloon inflation, and the control. Data were obtained by conducting interviews with the children, their parents, and the observer before and after the procedure. The pain levels of the children were assessed by the parent and observer reports as well as self-report using the Wong-Baker FACES. The anxiety levels of children were assessed by parent and observer reports using Children Fear Scale. One hundred and twenty children (mean age: 9.1 ± 1.6 years) were included. The self-reported procedural pain levels showed significant differences among the study groups (p = .040). The distraction card group (2.33 ± 3.24) had significantly lower pain levels (p = .057) than the control group (4.53 ± 3.23). The procedural child anxiety levels reported by the observer showed a significant difference among the study groups (p = .032). All the forms of distraction significantly reduced pain and anxiety perception.

Women's Preferences of Method of Delivery and Influencing Factors

Background

Currently, the rate of caesarean section has been substantially increased in developing and developed countries. To determine the factors causing such an increase, it is important to determine reasons for women to refuse vaginal delivery and preferring caesarean section.

Objectives

To determine Turkish women’s attitudes and basal knowledge regarding vaginal delivery and caesarean section, as well as factors causing women to prefer caesarean section even when a medical indication does not exist.

Patients and Methods

This descriptive study consisted of 840 women, completing the questionnaire developed by the researchers.

Results

Mean age rate of participants was 39.8 ± 11.8 years. The most significant reasons of vaginal delivery preferred by participants (n = 685) were determined to be healthy and swift recovery period after delivery, whereas those preferred by participants (n=155) for caesarean section were being safer for babies, easier than vaginal delivery and a less painful method. Higher educational status, pregnancy after infertility treatment and undergoing caesarean section for the last delivery were determined to be among important factors affecting to choose caesarean section.

Conclusions

Information gained misleadingly and fears related to vaginal delivery were seen as factors affecting women’s preferences for delivery. Thus, midwives are required to train both pregnant women during antenatal care and all women in society about methods of delivery and to give effective counseling.