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Shahnaz Tork Zahrani , Khadijeh Ghobadi, Dr Reza Heshmat, Dr Nozhat Shakeri,
Volume 11, Issue 2 (11-2014)
Abstract

Background and Objective: Delivery period can be an effective factor on pregnancy outcomes and feto-maternal complications. Since its prolongation may lead to medical and surgical interventions, we aimed to determine the effect of acupressure on delivery duration of nulliparous women. 
Material and Methods: This clinical trial was conducted on 150 parturients referring to Dezianii Hospital in Gorgan, Iran. They were assigned to three groups of acupressure by researcher, acupressure by mother and routine care (control group). The intervention was 20 minutes of pressure for one to five sessions. Data was analyzed by SPSS-17 software, using ANOVA and Kruskal-wallis.
Results: The first stage of labor in researcher (269.78±102.27), mother (302.72±115.83) and control group (345.92±140.63) was not significantly different (P=0.084(.Furthermore, the period of second stage in all three groups showed no significant difference (P=0.77). 
Conclusion: Given that acupressure is a simple, accessible and free of side effect method, it has not significant impact on the duration of labor.

Azam Evin , Farnoosh Khojasteh , Hossein Ansari ,
Volume 17, Issue 0 (4-2020)
Abstract

Background: Introduction: Since birth, a stressful experience, self-efficacy and self-confidence play an important role in mother's perception of delivery. Today, yoga is used to control anxiety and increase the sense of self-efficacy in different areas. The purpose of this study is to determine the effect of yoga on the self-efficacy of primiparous women.
Methods: This randomized clinical trial was conducted in 2017 on 60 primiparous women aged 18-40 and referred to Zahedan health centers. The participants were randomly assigned to two groups of intervention and control. During the weeks 26-27 of pregnancy, 30 mothers of the intervention group, received 12-15 sessions of Yoga exercises and 30 mothers of control group received normal care. Data were collected using a demographic an self-efficacy questionnaires. The pre-test was completed at week 26 and post-test at weeks 34-36 with two weeks in between; the data was analyzed using paired t-test Mann-Whitney and chi-square tests, linear regression tests and SPSS 16.
Results: The mean of self-efficacy score before intervention in the experimental and control group was (78.43 ± 24.7) and (62.69 ± 21.74) and after the intervention (124.45 ± 13.26) and (16.33±92.75) respectively, and (P=0001).
Conclusions: After the intervention, the mean of self-efficacy increased. It seems that Yoga has been used to increase self-efficacy of primiparous women in the second and third trimesters.


Aniseh Pourrasmi Mamaghani, Mohammadhiwa Abdekhoda, Parvin Bastani Alamdari, Masoud Mohammadi,
Volume 17, Issue 0 (4-2020)
Abstract

Background: The rate of cesarean delivery in Iran is four times higher than the standard defined by the World Health Organization. Information counseling is a method for providing accurate information and helping primiparous women to make evidence-based decisions. This research was conducted to determine the effect of information counseling on decision making process of delivery.
Methods: This was a before and after clinical trial in which 120 pregnant women in the 28thweek of the pregnancy with no indication of cesarean sections (CS) and a health record were included. Sample size was calculated using cluster sampling and the formula n= (〖(Z_(α⁄(2- Z_(β  ) )) )^2 δ〗^2  )/d^2  . The sample size was approximately 63 individuals. To correct the effect of cluster sampling, the calculated sample volume was multiplied by a factor of 1.4. To further validate the data, the number reached 120. Data gathering tool was a questionnaire designed based on reviewing previous studies and considering the purpose of the study whose validity and reliability were measured. The questionnaires were given to the women in two stages at week 28 and week 36. The interventions were in the form of packages containing brochures and information booklet on the benefits and disadvantages of natural childbirth and cesarean section in addition to training sessions taught by a midwifery specialist. Pros and cons of vaginal and cesarean modes of delivery were presented by training sessions. Women's preferential delivery mode were measured by a pre- and post- questionnaires and follow-up. After data collection, the analysis was performed at two levels of descriptive and inferential statistics. Finally, data were analyzed by SPSS16using t-test.
Results: The findings showed that the main indicators for determining the type of delivery, including awareness about delivery, making decision for delivery mode, understanding the risks of delivery mode, and self-efficacy were significantly associated with educational intervention and counseling (P<0.01). In the pre-intervention phase, 66.7% of women had normal delivery and 33.3% had cesarean section. After intervention, with a significant increase in choosing normal delivery, 78.4% chose natural childbirth and 15.3% chose cesarean section as the best option for delivery. Follow-up results after educational intervention showed that 44.2% of participants in this study performed normal delivery and 50% cesarean section. 8.5% were excluded from the study for certain reasons. After reviewing the results, it was found that encouraging physicians’ team to cesarean section was the main and primary cause of cesarean.
Conclusions: The implementation of information counseling has a great effect on encouraging women to change their decision patterns and self-making decision for VD maternity and reducing CD. However, in practice, certain factors, especially the constant recommendation of physicians’ team to CD as a programmable and convenient delivery, undermine the role of these interventions.

Houri Alijani , Narjes Sadat Borghei, Naser Behnampour ,
Volume 17, Issue 0 (4-2020)
Abstract

Background: Pregnancy is considered as a critical stage in the life of a woman due to the creation of new tasks and anxieties, If we consider the fear of childbirth as one of the main causes of pregnancy anxiety, To reduce it, we need to look for other solutions, such as psychological solutions. This study was conducted with the aim of determining the effect of group-based cognitive-behavioral Educations on the fear of delivery of Primiparous mothers.
Methods: This quasi-experimental study with pre-test and post-test design, three groups were conducted in the second half of the year in 1396 cities of Gorgan.The data collection tool was a demographic data form and Wijma Delivery/Expectency fear of childbirth Questionnaire (version A). Primiparous Pregnant mothers who were 20-28 weeks old were asked to participate in the study through the Lean system, and 211 patients were referred to relevant health centers and clinics. They completed the maternity fear questionnaire. Among these mothers, 104 nulliparous women with average score of fear of childbirth of 55 and above were divided into three groups: first and second intervention and control group. Based on ethical considerations, the allocation of mothers to intervention and control groups conducted based on their desire. The first intervention group performed eight sessions of group training based on cognitive-behavioral techniques, the second intervention group spent eight sessions of conventional pregnancy training, and the control group did not receive any training. The scores of fear of childbirth in all three groups before and immediately after intervention were analyzed by ANOVA, Kruskal-Wallis, Wilcoxon and paired t-test using SPSS software version 18, were compared and analyzed statistically. The significance level of the tests was considered to be 0.05.
Results: The results showed that before the intervention, the mean scores of fear of childbirth in the three groups were statistically significant and the first group of intervention (group training based on cognitive-behavioral techniques) had a higher mean scores 92.58 ± 12.70, compared to the second group of intervention (conventional education during pregnancy) was 66.54 ± 10.48 and the control group was 73.33 ± 13.13 (P-value <0.0001). Therefore, comparison of the difference before and after the mean scores and the rate of change in the three groups were used. Also, the mean scores of fear of childbirth after intervention in group training based on cognitive-behavioral techniques were 42.81 ± 18.45 in the conventional education group 67.19 ± 11.91 in control group 83.83 ± 18.28 and (P-value< 0/0001). The comparison of the mean scores of fear of delivery before and after intervention showed that group training based on cognitive-behavioral techniques -49.76 ± 19.86 was more than that of the conventional education groups in the period of pregnancy of 0.65 ± 10.14 And control group 11.5 ± 11.36 had a significant reduction in fear scores, which was statistically significant (P-value <0.0001).
Conclusions: Group-based cognitive-behavioral techniques focusing on reducing childbirth fears have the potential to reduce the fear of childbirth in all domains, for the promotion of normal delivery, the Changing the routine content of traditional pregnancy education is a matter of community based on cognitive-behavioral techniques, Focus on reducing fear of childbirth should be considered by healthcare providers.


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