RESUMO
Background: Caesarean section is life-saving, but rising rates are a cause for concern. Perceptions surrounding caesarean delivery may play a significant role in the shared-decision making process. Objective of this study was to explore the perceptions of caesarean section among antenatal, postnatal women and healthcare providers in a rural maternity hospital in Ramanagara district, Karnataka.Methods: Qualitative research methodology was adopted to explore perceptions regarding preferred birthing mode, caesarean and its perceived complications. Focus group discussions and in-depth interviews were conducted with antenatal and postnatal women, their caregivers and health care providers. Inductive coding approach and thematic framework analysis was done.Results: Five major themes emerged regarding perceptions of caesarean section among women in a rural area of Karnataka: understanding, fears, decision making, after-care and prevention. Women had a strong preference for normal vaginal birth, but willing to accept doctor’s decision for caesarean as they believed that it would protect the life of unborn child. Women perceived that caesarean was profitable to the hospital. Common mentioned side effects following caesarean were backache and pain at the surgical site.Conclusions: The understanding regarding caesarean section was adequate. Women had fears linked to caesarean such as pain, inability to work, weight gain, prolonged recovery and caesarean deliveries in subsequent pregnancies. Husbands and other family members as well as the doctors were the important decision makers, while the women themselves had little say in the matter. Obstetricians need to focus on alleviating concerns among pregnant women and their family members regarding caesarean section.
RESUMO
Background: Cervical cancer is a leading cause of cancer-related deaths among women worldwide. Almost 87% of cervical cancer deaths occur in low and middle-income countries. The study was conducted to assess the awareness of cervical cancer and practice of Papanicolou (Pap) smears among women availing health services or visiting a rural maternity hospital, Karnataka.Methods: A hospital-based cross-sectional study was conducted using a 50-item interview schedule. The interview was administered to women >18 years of age who availed services at the hospital and their caretakers.Results: Mean age of the 158 women interviewed was 32.68±13.7 years. Only 21% of women had heard about cervical cancer. Only 11.4% knew at least one symptom and 1.9% knew one risk factor of cervical cancer. Most of the women (99%) were not aware about prevention of cervical cancer. Only 4% of the women had heard about Pap smears and 3% of the women had undergone a Pap smear test.Conclusions: Women in our study had very poor awareness of cervical cancer and practice of Pap smears. Gainfully employed women (OR=32; 8.8-111.2) and women who reported cervical cancer among family members or friends (OR=116; 20.2-665.4). were more likely to have heard about cervical cancer. This study indicates a need to increase the awareness on cervical cancer and its prevention especially regarding Pap smears among rural women in Karnataka.
RESUMO
Background: Male involvement in maternal health is associated with significant positive health outcomes in the mother. We aimed to assess the antenatal womens’ perception of their husbands’ involvement in antenatal care in a maternity hospital in rural Karnataka, India.Methods: 200 pregnant women in a maternity hospital in Karnataka were interviewed using a semi-structured pilot tested questionnaire on their perception about their husbands’ participation in antenatal care.Results: The mean score of women’s perception of husband’s awareness of antenatal care was 10.1±2.2 out of a maximum of 12, while that of husband’s attitude to antenatal care was 7.7±1.4 out of a maximum of 9 and of husband’s participation was 21.7±5.4 out of a maximum of 30. The score of perception of husband’s awareness was significantly higher among multigravidae and among women who had a planned pregnancy. The score of perception of husband’s attitude was significantly higher among women from nuclear families, multigravidae, those with a living child and those with no complications in the current pregnancy. The score of perception of husband’s participation was significantly higher among women with no complications in the current pregnancy.Conclusions: Husbands play a vital role in the antenatal care of their wives. This should be harnessed by health care workers by providing health education to them, encouraging husbands to accompany their wives to antenatal checkups and labour and promptly communicating clinical findings to them.
RESUMO
Background: Antenatal care and supplementary nutrition are evidence-based strategies to improve neonatal outcomes and birth weight, and are currently provided free of cost by the government in every village through the ICDS. This study aims to assess the utilization of Anganwadi services by pregnant and lactating mothers in a rural area and the various barriers to utilization of Anganwadi services.Methods: A hospital-based, cross-sectional study was conducted among pregnant women (more than 28 weeks gestation) and lactating mothers (up to 6 months after delivery) availing maternal and child health services at a maternity hospital in a rural area of Ramnagara district in South Karnataka, using a pre-tested questionnaire.Results: Awareness regarding Anganwadi services available for pregnant and lactating mothers like IFA, calcium and deworming tablets, TT and health check-ups was found to be poor. While more than half of the women had received health education from Anganwadi teacher, important topics like dangers signs, birth preparedness and essential antenatal care were not discussed.Conclusions: Utilization of health care services at the Anganwadi was poor among the subjects. Supplementary nutrition was not utilized by 54% of pregnant women and 43% of lactating mothers. Those who had been visited by Anganwadi teacher at home and those who received nutrition education by the Anganwadi teacher had significantly higher consumption of supplementary nutrition. The common barriers to utilization were lack of awareness of services and perception of poor quality and hygiene of the supplementary nutrition.
RESUMO
Background: Birth weight is a reliable and sensitive predictor of a new-born’s chances for survival, growth and long-term physical and psychosocial development. There are few studies done in rural South India documenting valuable data such as detailed maternal nutritional intakes and psychological factors, and linking them to LBW. The objective was to estimate the proportion of LBW in a maternity center, Snehalaya hospital, Solur, Ramnagar district, Karnataka and to assess the factors affecting birth weight. Methods: We conducted a cross-sectional study in a maternity centre, Snehalaya, in Solur Village, Ramnagar District, Karnataka between September and November 2014. Consecutive sampling was used to recruit 144 patients and the questionnaire was then administered to them. Results: Among the 144 women, the proportion of LBW was found to be 14.6% and the mean birth weight was 2.6± 0.4kg. We also found a significant association of birth weight with per capita income, maternal pregnancy weight gain, number of antenatal visits, maternal education, tobacco consumption, and stress and egg consumption in diet. Multivariate analysis showed significant association of birth weight with maternal pregnancy weight gain, tobacco consumption and stress. Conclusions: A greater number of the subjects were found to have access to the basic antenatal care measures such as nutrition, free iron supplements and regular antenatal check-ups and this has shown to have a positive effect on the birth weight in the study population. Though various factors have been already proven to be associated, psychological and nutritional factors have to be concentrated henceforth.