Preconceptional care of women at booking visit at De Soysa Maternity Hospital and Castle Street Hospital for Women.

OBJECTIVE: To study the preconceptional preparedness of women attending two antenatal clinics. DESIGN: Cross-sectional descriptive study done in August and September 2001. SUBJECTS AND SETTING: Pregnant women attending the antenatal clinics De Soysa Maternity Hospital and Castle Street Hospital for Women for their booking visit. MATERIAL AND METHODS: Pregnant women were randomly selected. Before collecting data the purpose of the study was explained and those who consented were recruited for the study. Data were collected on the basis of an interviewer administered questionnaire. Ethical approval was obtained from the Ethical Review Committee of the Faculty of Medicine, University of Colombo. RESULTS: 225 pregnant women were recruited. 55% of them were between the ages of 18 and 30 years. 96% had achieved an educational level of above year five. 55% were in their first pregnancy and 2.75 were grand-multipara. 186 (82.7%) were housewives. 81% had a planned pregnancy. Only 21% had received pre-pregnancy counselling, 52% of them from a specialist obstetrician, and 21% and 19% from a general practitioner and public health midwife. Only 15 (6.6%) had taken preconceptional folic acid supplementation, and all of them had a level of education of GCE (A/L) or above. 11 of those who took preconceptional folic acid were primipara. 159 (70.6%) had received rubella vaccination. Of those who did not take the vaccine, 44% knew about it but did not know its importance, and 38% did not know about its availability. 18% did not take it because of various myths that they believed in. Preconceptional health knowledge regarding pregnancy was assessed by asking 10 questions and expressing it as a score out of 10. This score showed a positive correlation to the level of education of the woman. A majority received information from the print (81.7%) and electronic (72.4%) media. 50% received information from a public health midwife, and 36% from doctors. CONCLUSIONS: Preconceptional preparedness among our women is poor. However, rubella vaccination is relatively successful compared to other aspects of preconceptional preparedness.

Children of imprisoned mothers.

OBJECTIVES: To describe the problems faced by children during separation from their imprisoned mothers, and evaluate the health of children who accompanied their mothers into prison. DESIGN: A prospective observational study. SETTING: Welikada Prison, Colombo, Sri Lanka. METHODS: 200 randomly selected mothers who had left their children at home were interviewed using a questionnaire. During a period of 8 months 30 children living with their mothers in prison underwent physical and developmental examination and tuberculin testing. The living conditions within the prison were evaluated. RESULTS: During 18 months from January 1999, 4089 women were imprisoned. 88% were remanded, 20% awaited trial for more than one year in prison. 2416 were mothers. 1411 had at least one child under 12 years of age. The 200 mothers interviewed had 262 children under 12 years at home. Their care arrangements were: a relative (69%), father (16%), older sibling (4%), religious organisation (2.7%), neighbour (1.3%). None had received social services support. 70 children accompanied mothers into prison. In the 30 children followed up regularly 23% had scabies, 10% pediculosis, and 7% impetigo. No severe malnutrition was found and screening for tuberculosis was negative. 70% were breastfed. The child-friendly dormitory was inadequate to accommodate all children. CONCLUSION: Care arrangements and schooling were affected and no counselling services were provided during the imprisoned mothers' absence. The children within the prison enjoyed close bonds with the mothers and their physical needs were met. The child's best interest had not always been considered by court when deciding on custody during the mothers' imprisonment.