The effect of midwifery led counseling based on Gamble's approach on childbirth fear and self-efficacy in nulligravida women.

BACKGROUND: Studies show that childbirth fear is a common problem among Iranian women. Therefore, most Iranian women prefer caesarean section for giving birth. This study investigated the effectiveness of a psychoeducational intervention by midwives (birth emotions - looking to improve expectant fear (BELIEF)) on decreasing childbirth fear and self-efficacy among first-time pregnant women who were afraid of giving birth. METHODS: A number of 80 pregnant women participated in the study. They had received a score of ≥66 on the Wijma delivery expectancy/experience questionnaire. They were randomly assigned into two groups: intervention (n = 40) and control groups (n = 40). The intervention group received two face-to-face counseling sessions based on the BELEF protocol in the 24th and 34th weeks of pregnancy. Between these two sessions, it also received eight telephone-counseling sessions once a week. The control group only received the prenatal routine care. The outcome measures were childbirth fear, childbirth self-efficacy, and childbirth preference. RESULTS: The intervention group showed significantly more reduction in childbirth fear and more increase in childbirth self-efficacy compared to the control group. In addition, more women in the intervention group reported that they preferred to give normal vaginal birth than women in the control group. CONCLUSION: The BELIEF protocol could be an effective approach in reducing childbirth fear and increasing childbirth self-efficacy among first-time pregnant women who are afraid of giving birth. TRIAL REGISTRATION NUMBER: IRCT20101219005417N3, Date of Registration: 19-12-2018.

Knowledge of and attitudes toward breast self-examination in Iranian women: a multi-center study.

BACKGROUND: In Iran, breast cancer is the second most common malignancy among women and diagnosed in advanced stages almost a decade earlier than women living in western countries. OBJECTIVE: To determine the level of knowledge and attitudes toward breast self-examination (BSE) among Iranian women. METHODS: In a cross-sectional multi-center study, 3,060 women aged between 25 and 54 years attending between July and October 2009 to 11 general health care centers located in 11 cities of Iran, were interviewed to assess their knowledge and attitudes toward BSE. RESULTS: Of the total, the data of 3,030 were found eligible for analyses. The median (interquartile range [IQR]) age of participants was 40 (14) years; 2,687 (88.7%) were married; 1496 (49.4%) women performed BSE, 290 of whom (19.4% of performers and 9.6% of all studied women) did it using a correct method and at an appropriate time. More than three-quarters of performers (n=1141) learned about BSE from a health care provider; 248 (16.6%, 95% confidence interval [CI]: 14.7% to 18.5%) had abnormal findings, 11 (0.7% , 95% CI: 0.3% to 1.2%) of which were malignant. Of 1,534 (50.6%) non-performers, 474 (30.9%) did not know how to do BSE; the remaining women did not do BSE for fear of being found positive for cancer or did not care about it. Being a health care provider, married, educated, and knowing of a person with breast cancer was associated with performing BSE. CONCLUSIONS: The level of BSE practice and knowledge among Iranian women is unsatisfactory. We should emphasize appropriate education of women.