Explaining the Educational Needs of Iranian First-Time Parents for Adaptation to Parental Role: A Qualitative Study.

Background: The transition to parenthood is one of the most challenging experiences in a couple's life, which can be stressful and difficult. A positive transition period affects the quality of parents' behavior and the baby's health. This qualitative study aimed to explain the educational needs of adaptation to parental role among first-time parents in Iran. Materials and Methods: In this qualitative study, 25 participants from a variety of ethnic backgrounds were recruited in Ahvaz, Iran, using purposive sampling. In-depth interviews were used to collect the data which were analyzed by qualitative content analysis. Results: Three main categories emerged from the data analysis: "The need for knowledge improvement training," "The need for psychological adaptation training," and "The need for sociocultural adaptation training." Conclusions: To adapt to the parental role, first-time parents should be equipped with the knowledge to turn the challenges of this period into an opportunity for growth. Moreover, they need to be supported by their family members, the healthcare team, and the government.

Factors Influencing Weight Management in Pregnant Women with Overweight or Obesity: A Meta-Synthesis of Qualitative Studies.

BACKGROUND: Overweight and obesity have multiple negative consequences for the health of both the mother and the child. Interventions to prevent excessive weight gain during pregnancy have had varying success, and the proportion of pregnant women who exceed national guidelines for weight gain continues to increase. OBJECTIVE: To investigate the influence of factors on weight management among pregnant women with overweight or obesity. METHODS: This meta-synthesis of qualitative studies involved searching databases PubMed, Embase, Cochrane, Scopus, and Web of Science. The databases were searched on October 4, 2022, and the search was updated on April 21, 2023. The screening of titles, abstracts, and full texts was conducted utilizing Covidence software. The quality assessment of the articles was performed using the Critical Appraisal Skills Programme checklist. The Enhancing Transparency in Reporting the Synthesis of Qualitative Research statement was used to enhance transparency in reporting. A meta-aggregation approach was used to guide the data extraction and synthesis. RESULTS: A total of 46 studies with appropriate Critical Appraisal Skills Programme scores were included for qualitative synthesis. Findings were extracted and integrated into 4 themes: psychological factors (personally driven negative emotions and society-driven negative emotions), social factors (societal attitudes and beliefs and social support resources), factors related to education and counseling (information provision and communication), and factors associated with effective care (provided care components and the method of providing effective care). CONCLUSIONS: To improve weight management during pregnancy, health care providers should provide tailored and individualized recommendations that take into consideration the factors influencing these women.

The relationship of pre-pregnancy body mass index with maternal anthropometric indices, weight retention and the baby's weight and nutrition in the first 6 months post-partum.

PURPOSE: Pre-pregnancy body fat mass is one of the important indicators of the mother's and the infant's health. Therefore, the purpose of this study was to investigate relationship of pre-pregnancy body mass index (PPBMI) with maternal anthropometric indices and weight retention as well as the baby's weight and nutrition in the first 6 months post-partum. MATERIALS AND METHODS: This is a prospective cohort study including 397 mothers giving birth to healthy babies and referring to health centers in Ahvaz (southwest of Iran) in 2022. The following data were extracted from the participants' electronic record: body mass index (BMI) before or at the beginning of pregnancy, gestational weight gain, and weight at the time of delivery. In addition to demographic information, the following data were also evaluated: maternal anthropometric indices including weight, hip and waist circumference, and conicity index during the first 10 days post-partum, along with the weight and nutrition pattern of the baby 2, 4 and 6 months post-partum. RESULTS: The mean age of the mothers was 29.96±5.7 years. The frequency of mothers according to BMI classification (i.e., underweight, normal, overweight, and obese) was 4.3%, 38.5%, 37%, and 20.3%, respectively. In this study, PPBMI had a significant relationship with decreasive changes of weight, waist and hip circumferen and conicity index after child birth, 2, 4 and 6 months post-partum (P<0.05) but the mean reduction of these anthropoemetric indices at 6th month postpartum were not related to PPBMI (P>0.05). However, this relationship was not significant when it came to the weight of the baby (P > .05). The lowest reduction in weight, waist and hip circumference and conicity index belonged to overweight mothers but the highest frequency of mothers with excesive gestational weight gain, the lowest frequency of breastfeeding until 6 months and also the lowest values of postpartum weight retention were observed in obese mothers (P<0.05). CONCLUSION: According to the findings of this study, the decrease in anthropometric indices up to 6 months after delivery in overweight mothers is less than other BMI groups, but the consequences related to weight and nutrition in infants of obese mothers need special attention. Also, the results re-emphasize the importance of focusing on provision of educational and counseling services to mothers in order to improve their nutrition and weight, especially before pregnancy.

Prioritizing the Psychosocial Support Needs of Mothers with Gestational Diabetes: A Delphi Study.

Background: Gestational diabetes is the most common medical complication in pregnancy, and the psychosocial health of women suffering from this condition affects their adherence to treatment and self-efficacy. However, since it is not possible to design interventions dealing with all of these needs, the aim of this study was to prioritize the psychosocial supportive needs of women with gestational diabetes. Materials and Methods: This was a modified Delphi design study involving 22 experts who were selected using purposive and snowball sampling methods. The study was conducted between April 2021 and June 2021. First, the psychosocial needs of diabetic pregnant women were extracted through a qualitative study involving interviews with multidisciplinary specialists and diabetic pregnant mothers (22 participants) and a systematic review of reputable scientific databases. Throughout the two Delphi stages, the questionnaire was classified, quantified, and analyzed. Results: Based on the results of this study, the following are the top priorities when addressing the psychosocial needs of mothers with gestational diabetes: paying attention to and identifying the mother's worries and anxiety, husband and family support for diabetic pregnant women, the inclusion of specialized nutrition counseling services in mothers' treatment plan, timely education of mothers about diabetes and its complications, and proper nutrition for diabetic mothers. Conclusions: The priorities of the supportive needs obtained in this study can be used to design interventions aimed at promoting psychosocial health, reducing stress and anxiety, and improving medication adherence in women with gestational diabetes.

Effect of the Parenting Preparation Program on Maternal Role Competence: A Systematic Review and Meta-Analysis.

Background: The maternal sense of competence refers to the mother's sense of ability to care for the baby. Maternal competence can affect the mother's parenting capacities. Maternal preparation programs are aimed to increase mothers' knowledge and improve their maternal competence. This systematic review and meta-analysis investigated the effect of a maternal preparation program on maternal role competence. Materials and Methods: A systematic search was conducted using the following MeSH terms: "education", "program", and "parenting sense of competence" in databases including PubMed, Web of Science, Cochrane Central, and Scopus, from inception till July 2022. All Randomized Controlled Trials (RCTs) published in any language were extracted. Articles were screened based on predefined inclusion and exclusion criteria. The quality of the included articles was assessed by two qualified reviewers based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results: Of the 170 published works that were retrieved in the initial stage, five articles including 647 first-time mothers were analyzed. A meta-analysis showed that parenting preparation program interventions increased maternal role competence in first-time mothers as opposed to those who received routine care Mean Difference (MD) = 3.31, 95% Confidence Interval (CI) [2.07, 4.55]. Conclusions: The results of this study encourage health policymakers to develop maternal preparation programs for first-time mothers and their children.

"Living in a vacuum": Lived experiences of maternal near-miss among women with placenta accreta spectrum.

BACKGROUND: Placenta accreta spectrum (PAS) is one of the life-threatening complications of pregnancy, the prevalence of which has increased in parallel with the caesarean section rate. OBJECTIVE: The purpose of this study was to investigate the experiences of mothers with PAS who have also experienced maternal near miss. METHODS: The participants of this study included 8 mothers who had experienced near miss due to placenta accreta during the past year, as well as two husbands and two health care professionals. Data collection was done using face-to-face, in-depth virtual and in-person interviews. In this qualitative study, the interpretive phenomenological analysis approach was used to analyse the data. RESULTS: The superordinate theme that emerged from the lived experiences of the studied mothers is 'Living in a vacuum', which was derived from 3 main themes. The theme of 'distorted identity' is related to the mothers' experience of losing the uterus as a symbol of femininity and nostalgia for the former self. The theme of 'exacerbated exhaustion' indicates the burnout and fatigue perceived by these mothers and has dimensions far beyond the exhaustion caused by performing parenting duties. The third theme, 'a threatened future', reflects these mothers' vague image of the future in terms of health, preservation of life, and the continuation of living together with the husband. CONCLUSIONS: It seems that mothers with PAS need to be covered by integrated and well-organised psycho-social support from the time they are diagnosed with the complication until long after delivery due to the high potentiality of maternal near miss.

Frequency, Risk Factors, and Pregnancy Outcomes in Cases with Placenta Accreta Spectrum Disorder: A Case-Control Study.

Background: Placenta accreta spectrum (PAS) disorder is an important life-threatening problem. The purpose of the current study was to determine the frequency, risk factors, and pregnancy outcomes of PAS in our population. Methods: This is a case-control study using the data from a main tertiary referral university hospital in Ahvaz, southwest of Iran. The sample included 187 cases diagnosed with placenta accreta spectrum from 2015 to 2019 and 552 controls without PAS. A multivariable logistic regression model was used to find independent risk factors with 95% confidence interval. Pregnancy outcomes were evaluated using chi-square, t-test, and Mann-Whitney U test and p<0.05 were considered statistically significant. Results: The frequency of PAS during the study period was 3.7/1000 deliveries (0.37%). It was found that multiparity (≥3 deliveries, OR=2.05: 95%CI:1.21-3.47) and multigravidity (≥3 deliveries, OR=2.98: 95%CI:1.55-5.72), prior cesarean delivery (OR=52.55: 95%CI:19.73-139.96), and placenta previa (OR=27.48: 95%CI: 9.62-78.5) are the independent risk factors of PAS. Complications and morbidity associated with PAS included hysterectomy (60.4% vs. 0.7%, p<0.001), cystostomy (24.1% vs. 0.2%, p<0.001), the need for blood transfusion (73.7% vs. 1.4%, p<0.001), intensive care unit admission of mother (42.8% vs. 0.2%, p<0.001), duration of hospitalization (7.52±6.34 vs. 1.97±1.83, p<0.001), preterm birth <37 weeks (61.4% vs. 16.8%, p<0.001), and perinatal mortality (7.4% vs. 1.8%, p<0.001) which manifested statistically significant values. Conclusion: The frequency of PAS is similar to other populations. Prior cesarean delivery, placenta previa, multigravidity, and multiparity were independent risk factors and also perinatal hysterectomy and preterm birth were the most important complications.

Effectiveness of mindfulness-based intervention in the improvement of maternal role adaptation among first time mothers: A randomized controlled trial.

BACKGROUND AND PURPOSE: Mindfulness-based intervention (MBI) has been suggested as a method to alleviate mental health difficulties during the perinatal period. However, few studies have examined its use in improving maternal role adaptation. This study aimed to investigate the effectiveness of mindfulness in maternal role adaptation among first-time mothers. MATERIALS AND METHODS: This randomized controlled trial study was performed on 40 first-time mothers who were randomly assigned into experimental (n = 20) and control (n = 20) groups. Research instruments included a demographic questionnaire and a validated Maternal Role Adaptation Questionnaire (MRAQ). In addition to receiving routine care, mothers in the experimental group attended eight 90-min sessions of mindfulness-based intervention. The control group, however, received only routine care. Both groups completed MRAQ before intervention, and immediately, one month, and two months after it. RESULTS: After intervention, there was a significant increase in the mean scores of MRAQ and its seven domains in the experimental group at all three follow-up intervals (P < 0.001). These domains included "support and strengthening of the couples' relationships", "hardship and dissatisfaction", "mother-infant attachment", "stress and anxiety", "emotional growth", "functionality" and "social adaptation development". CONCLUSION: The intervention implemented in this study could be effective in promoting maternal role adaptation.

Psychosocial needs of inpatient women with gestational diabetes mellitus: a qualitative study.

BACKGROUND: Gestational diabetes mellitus (GDM) is one of the most common medical complications associated with pregnancy. Its treatment requires multidisciplinary cooperation, and identifying the psychosocial needs of patients is important in the management of their condition. OBJECTIVE: This study investigates the psychosocial needs of inpatient mothers with GDM from the joint perspectives of future mothers and healthcare providers. METHODS: This qualitative study used a content analysis approach. Semi-structured individual interviews focusing on the psychosocial needs of women with GDM were conducted with twelve women suffering from GDM and eight medical staff. Sampling continued until data saturation. RESULTS: According to the findings of this study, the psychosocial needs of these mothers were classified into the following categories: Support for worries related to the consequences of the disease, Interpersonal support, Infrastructural support, educational support. CONCLUSION: The psychosocial needs of inpatient mothers with GDM were identified in this study. Attention to these needs can help enhance the mother's satisfaction and treatment adherence, and reduce worries and anxiety during hospitalisation. ABBREVIATIONS: GDM: Gestational Diabetes Mellitus; hPGH: human placental growth hormone; COREQ: Consolidated criteria for reporting qualitative research; WHO: World Health Organization; HCP: healthcare provider.

The Effect of Citrus Aurantium Aroma on the Sleep Quality in Postmenopausal Women: A Randomized Controlled Trial.

Background: One of the most common problems in menopausal women is sleep disturbance. Citrus aurantium has sedative, hypnotic, and anti-anxiety effects. The aim of this study was to investigate the effect of Citrus aurantium aroma on the sleep quality of postmenopausal women. Methods: This was a double-blind randomized controlled trial that was conducted from Feb to Dec 2019 on 80 postmenopausal women who suffered from sleep disturbances. The participants were assigned into two groups randomly. Women in the intervention group were requested to use 2 drops of essential oil of Citrus aurantium, twice a day, for 4 consecutive days in a week, for 4 weeks as inhalation. The control group received almond oil in the same way. The quality of sleep was evaluated using the Pittsburgh Sleep Quality Index (PSQI) before the intervention and 4 weeks after the intervention started. The data were analyzed using the SPSS statistical software, version 21, and P<0.05 was considered statistically significant. Results: After 4-weeks of intervention, the mean score of sleep quality was significantly lower in the Citrus aurantium group compared to the control group (5.75±1.33 vs 13±1.59, P<0.001). In the intervention group, all dimensions of PSQI were improved significantly (P<0.001). Conclusion: The results of this study showed that the aroma of Citrus aurantium essence could significantly improve the sleep quality of postmenopausal women. Therefore, it is recommended that health care providers should inform the postmenopausal women and advise them to use this intervention for reduction of sleep disorders. Trial Registration Number: IRCT20160427027633N7.

The psychosocial challenges associated with gestational diabetes mellitus: A systematic review of qualitative studies.

BACKGROUND: Gestational diabetes is a disease with complex management that requires multidisciplinary collaboration. To achieve treatment goals, in addition to using medications and paying attention to exercise and diet, it is also important to take into account the mental health and psychosocial aspects of diabetes management. This study aimed to highlight these challenges associated with gestational diabetes. METHOD: This qualitative systematic review involved a search of the following databases: CINAHL, EMBASE, MEDLINE, and PsycINFO. Title, abstract, and full-text screening was done using Covidence software, and quality assessment of the included papers was conducted using the Critical Appraisal Skills Programme Checklist. Enhancing transparency in reporting the synthesis of the qualitative research statement (ENTREQ) was used in the design of this paper. Data synthesis was done using meta-aggregation method. RESULTS: Out of the 2440 articles searched, 24 were qualitatively analyzed. The CASP score of the included papers was optimal. The 514 findings extracted from the 24 studies were aggregated into five broad conceptual categories: psychological challenges, socio-cultural challenges, information-communication challenges, challenges associated with a lifestyle change, and challenges related to health care. CONCLUSION: Recognizing the psychosocial challenges associated with gestational diabetes and developing support packages tailored to psychosocial needs can help improve the management of these patients.

Effects of a mindfulness-based childbirth and parenting program on maternal-fetal attachment: A randomized controlled trial among Iranian pregnant women.

BACKGROUND AND PURPOSE: Although mindfulness-based childbirth and parenting is suggested to promote maternal-fetal attachment, no study has yet addressed its potential effects. This study aimed to determine the effects of a mindfulness-based childbirth and parenting program on maternal-fetal attachment among Iranian pregnant women. MATERIALS AND METHODS: This study was conducted on pregnant women, who were divided into two groups to either receive routine care plus mindfulness training for childbirth and parenting (i.e., eight 2-h group sessions once a week and one 3-h session of silent meditation) or receive routine care alone. Maternal-fetal attachment was evaluated by the Cranley's Maternal-Fetal Attachment Scale. RESULTS: After the intervention, the total score of maternal-fetal attachment was significantly higher in the experimental group (P < 0.001; effect size = 0.640). In the intervention group, all dimensions of maternal-fetal attachment significantly improved, except the dimension of "differentiation of self from the fetus", whereas in the control group, only the dimension of "attributing characteristics to the fetus" improved. CONCLUSION: The implemented program in this study was potentially effective in promoting maternal-fetal attachment.

The Relationship between Gestational Weight Gain and Postpartum Depression in Normal and Overweight Pregnant Women.

OBJECTIVE: To investigate the relationship between weight gain in pregnancy and postpartum depression (PPD) in normal and overweight pregnant women. METHODS: The participants of this prospective cohort study were 223 healthy pregnant women with the first trimester body mass index (BMI) between 18.5 and 30 and the gestational age of 10-14 weeks and depressed women were excluded with Beck questionnaire in the first trimester. The evaluation included weight gain at the end of the second and third trimesters and the screening of PPD in 6-8 weeks after delivery by Edinburgh scale. RESULTS: 49 participants were excluded from the study and data from 174 people were analyzed. 32.2% of mothers were scored above 12 in the Edinburgh scale. The only variable associated with depression was the third trimester weight gain (OR 1.17, 95%CI 1.04-1.32). CONCLUSION: In addition to considering other risk factors for postpartum depression, health care providers should consider the higher probability of PPD in prepregnancy normal and overweight women who have excessive weight gain especially in the third trimester of pregnancy.

Psychometric properties of the Iranian version of mindful eating questionnaire in women who seeking weight reduction.

BACKGROUND: The aim of the present study was to test the validity, reliability and factor structure of the original Mindful Eating Questionnaire (MEQ) for use in an Iranian population. METHODS: This was a cross-sectional study conducted on 150 women who attended four athletic gyms and met the inclusion criteria in Ahvaz city in July of 2015. After linguistic validation of the Iranian version of the MEQ, the content validity ratio (CVR) and content validity index (CVI) were assessed by an expert panel. Then, exploratory factor analysis (EFA) was performed on the scale constructs and scale reliability (internal consistency and test-retest reliability) was assessed with respect to the psychometric properties of the scale. RESULTS: The CVR and CVI scores for the MEQ were 0.89 and 0.93, respectively. EFA loaded all 28-items with a 5-factor solution ('awareness', 'distraction', 'disinhibition', 'emotional response' and 'external cues') that jointly accounted for 53.78% of the observed variance. The results of the EFA supported the item 'When a restaurant portion is too large, I stop eating when I'm full' being placed in the external cues rather than the disinhibition subscale. This displacement improved the reliability coefficient for this subscale.The results of internal consistency analysis, including Cronbach's alpha (ranging from 0.73 to 0.81) and intraclass correlation coefficients (ranging from 0.73 to 0.91) were satisfactory. CONCLUSIONS: The Persian version of the MEQ appears to be valid and reliable; therefore, it can be an effective tool in designing mindfulness-based interventions for the treatment of individuals with eating disorders, overweight and obesity in an Iranian population.

Sexual and reproductive healthcare needs of Iranian men: A cross-sectional study.

BACKGROUND: The sexual and reproductive health (SRH) needs of men have received little attention in Iran's healthcare system. Developing appropriate strategies to meet men's needs requires careful assessment and recognition of their health needs. OBJECTIVE: The objective of this study is to assess men's SRH needs and satisfaction with received services. MATERIALS AND METHODS: This descriptive cross-sectional study was conducted with 1068 adult men aged between 20 and 60 years in Ahvaz in 2014. For obtaining the SRH services needs of men, in addition to the self-reported felt needs, expressed needs and unmet needs, a need assessment was also done using a questionnaire that was developed for the research; its validity and reliability were assessed. RESULTS: The men's perceived, expressed and unmet needs for SRH services were, priority-wise, screening and diagnosis of male genital cancers (63.3%), receiving contraceptive methods (36%), diagnosis, and treatment of male sexual dysfunction (86.9%), respectively. Preventing sexually transmitted disease/AIDS (72.1%), using contraceptives correctly (39.5%), and resisting peer pressure (86.6%) were, respectively, the first felt, expressed, and unmet skills men needed. The results of multivariate logistical regression showed that there was a significant statistical correlation between men's SRH needs and their socio-demographic factors (age, marital/educational status, income) ( p < 0 . 05 ). CONCLUSION: Iranian men have many unmet SRH needs. Felt and expressed SRH needs were different. Educational and counseling services are as important as clinical services.

The Prevalence, Subtypes and Obstetric Risk Factors of Urinary Incontinence in Reproductive Age Women Referred to Community Health Care Centers of Dezful, Iran- 2015.

BACKGROUND: Urinary incontinence (UI) is a common health problem and has a profound effect on the quality of life and psychosocial aspects of the affected women. The aim of this study was to investigate the prevalence and risk factors of UI in reproductive age women. METHODS: This cross-sectional study was conducted on 2000 reproductive age women from February to June 2015. The women were selected from all of the primary health care centers of Dezful, using easy access sampling method. Body mass index (BMI) was measured and data were collected by demographic, detailed information regarding obstetric and International Consultation on Incontinence Questionnaire- Urinary incontinence - Short Form(ICIQ-SF) ICIQ-SF questionnaires. RESULTS: The women's mean age was 33.6±8, and 57.7% (1154) of them reported UI. The prevalence of UI subtypes was recorded in 38.2% (441) stress UI (SUI), 44.9% (518) mixed UI, and 16.9% (195) urge UI. There was a significant association between the mean of pregnancies, mean of deliveries, mode of delivery, abortion, neonate>4 kg, irregular menstruation and UI (P<0.05). Multiple logistic regression analysis showed that age, irregular menstruation and vaginal delivery increased the risk of UI in this age group. CONCLUSION: The findings suggest that a significant proportion of reproductive age women were undiagnosed with UI and MUI was the most common type of UI in this age group. Regular menstruation was a protective factor but older age and vaginal delivery were risk factors for UI in this study.

Journey to Motherhood in the First Year After Child Birth.

Objective: Child bearing is a period of psychological challenges that must be viewed in a social context. This study reports the maternal transition from the perspective of Iranian first-time mothers in the first year after childbirth. Materials and methods: Qualitative method was chosen for explanation of mothers' individual experiences of motherhood.26 first-time mothers (aged 18-35 years old with various socio-economic status) who had delivered between 0-1 year prior to the interviews participated in the study.Data were collected through in-depth semi-structured interviews and interview transcripts were analyzed using the constant comparison method. Results: The core category was called "Regaining advanced balance." There were several themes within this category: "internal conflicts", "encounter and interaction" and "internalization". They felt unpreparedness, lack of control over their lives, incomplete maternal feelings and unstable relation to their husbands and others. Within the first postpartum days and weeks a sort of attachment develops between mother and child as the mother starts to attain a better understanding of maternal feelings; she begins to accept the child as an independent identity and reconstructs herself. As the attachment to child deepens, the mother feels control over the affairs. She realizes a kind of development and integration in herself which specifically stems from becoming a mother and attempts to strengthen family bonds. Conclusion: Through the expression of new mothers' experiences toward motherhood, healthcare providers can reach a better perception of the emotional and psychological changes as well as the various aspects of mothers' acceptance of their maternal role and helps a better preparation and presentation of effective training programs for mothers and families.

The Relationship Between Body Image and Sexual Function in Middle-Aged Women.

INTRODUCTION: An individual's social and marital function, interpersonal relationships, and quality of life may, sometimes be affected by negative body image. This study is aimed at determining the relationship between body image and sexual function in middle-aged women. METHODS: In this cross-sectional study, 437 middle-aged women, who were referred to various public healthcare centers in Ahvaz, Iran during 2014-2015, were selected. The Female Sexual Function Index (FSFI) and Body Shape Questionnaire (BSQ) were used for data collection. Chi-square, one-way analysis of variance, Spearman's correlation test, and logistic regression analysis were performed for statistical analysis. RESULTS: Approximately 58% of the participants expressed satisfaction with their body image, 35% were mildly dissatisfied, and 7% were moderately dissatisfied with their body image. Body image had a significant negative relationship with sexual satisfaction and sexual function (p=0.005). Furthermore, there was a significant relationship between body image and sexual desire (p=0.022), pain (p=0.001), sexual arousal (p<0.0005), sexual orgasm (p=0.001), and sexual satisfaction (p<0.0005). CONCLUSION: As the results indicated, body image is an important aspect of sexual health. In this study, women with a positive body image had higher sexual function valuation, compared to women with a negative body image. Also, body shape satisfaction was a predictor of sexual function.

The relation between stress and sexual function and satisfaction in reproductive-age women in Iran: a cross-sectional study.

The present study aimed to evaluate the relation between stress and different aspects of female sexual function and satisfaction. This cross-sectional study was conducted on 228 reproductive-age women who were referred to the public Health Centers in Ahvaz, Iran. All eligible participants were asked to complete a demographic questionnaire, the Female Sexual Function Index, and the Perceived Stress Scale. The data were analyzed using independent t test, Pearson correlation, and logistic regression. The mean score of stress was 32.9 (SD = 4.7) in the normal sexual function group and 33.3 (SD = 5.5) in the unfavorable sexual function group. There was a significant correlation between stress and sexual function score, sexual desire, arousal, orgasm, lubrication, sexual pain, and satisfaction (p <.001). Spouses' education (OR = 0.15, CI [0.02, 0.97], p =.04) and frequency of sexual intercourse per week (OR = 1.8, CI [1.3, 2.5], p <.001) had a significant relation with stress. There is a significant relation between women's perceived stress and sexual function and satisfaction. Further analytical studies are needed to show the harmful effects of stress on women's sexual activity and satisfaction.

Internal conflicts of Iranian first-time mothers in adaptation to maternal role.

BACKGROUND: Studies indicate that becoming a mother is accompanied by prominent physical, social, and psychological changes which can affect not only mother's psychological healthiness, but also all other aspects of her personal and family life. The purpose of this research was to explore the struggles experienced by Iranian first-time mothers in adapting to their maternal role between 0 and 1 year after giving birth. MATERIALS AND METHODS: A qualitative design was used in this study. Twenty-one first-time mothers with diverse ethnic backgrounds were recruited in their home or healthcare centers in Tehran and Ahwaz. Data collected through in-depth interviews were analyzed by qualitative content analysis. RESULTS: THE ANALYSIS PRODUCED FOUR THEMES: "Unpreparedness," "lack of control," "incomplete maternal feelings," and "unstable relations." The main theme, "internal conflict," integrates all other categories and encapsulates the major changes to which women are subjected, as well as the factors distressing this experience. CONCLUSION: Discrepancies between subjective expectations and postnatal experiences take an influential role in causing postpartum conflict and strain. The more accurate information mothers and families have about this transitory stage, the better they can get prepared to deal with it. This specifies the pivotal role of midwives, midwifery educators, and healthcare policy makers in incorporating these concepts into training programs and protocols of healthcare and support services in due time, form, and content that is in accordance with mothers' mental and psychological needs.