Knowledge about unintended pregnancy shortly after childbirth: An issue of ineffective counseling or adherence?

BACKGROUND: Being aware of the possibility of becoming pregnant shortly after childbirth before the resumption of the menstrual period is often overlooked but remains a significant contributor to unintended pregnancies and may lead to maternal and neonatal comorbidities. Exploring the extent of awareness and associated factors could help tailor more interventions toward reducing the rates of short-interval unplanned pregnancies. OBJECTIVE: This study explores the extent to which Ghanaian women are aware of the possibility of becoming pregnant shortly after childbirth before the resumption of the menstrual period and its associated factors. DESIGN: A cross-sectional study was conducted using the 2017 Ghana Maternal Health Survey. The women participants were sampled using a two-stage cluster sampling design. METHODS: We analyzed the 2017 Ghana Maternal Health Survey data of 8815 women who had given birth and received both antenatal care and postnatal checks after delivery in health facilities (private and public) and responded to questions on being aware of short interpregnancy intervals. A multivariable survey logistic regression was used for the analysis. RESULTS: Of the 8815 women, approximately 62% of women who received both antenatal care and postnatal examinations before discharge reported being aware of short interpregnancy intervals. Postnatal examination before discharge but not antenatal care was associated with a higher awareness of short interpregnancy intervals. Women who received a postnatal examination were more aware of short interpregnancy intervals than their counterparts (adjusted odds ratio = 1.29, 95% confidence interval: 1.03-1.61). Also, awareness of short interpregnancy intervals increased with age, education, knowledge of the fertile period, contraceptive use, and delivery via cesarean section. CONCLUSION: Over a decade following the initiation of Ghana's free maternal health policy, there remains a significant gap in the awareness of short interpregnancy intervals, even among women who received both antenatal pregnancy care and postnatal examinations before discharge. The unawareness of the short interpregnancy interval observed in approximately 38% of women raises concerns about the effectiveness of counseling or education provided during antenatal care and immediate post-partum care regarding birth spacing, contraceptive use, the timing of resumption of sexual activity, and the extent to which women adhere to such guidance.

A study found more women were unaware of pregnancy soon after birth before mensesUnplanned pregnancies may lead to worsened health conditions for mothers and newborn infants. One possible way this unplanned pregnancy could happen is through unknowingly becoming pregnant soon after birth before menstruation resumes. However, the more we know about pregnancy soon after birth before menstruation resumes, the better we can introduce measures to reduce it. This study examines how well Ghanaian women are aware of the possibility of becoming pregnant soon after birth before menstruation resumes and factors that may influence the awareness. This study analyzed 2017 data collected from women who received pre-delivery care and post-delivery checks before discharge from a health facility. The study findings revealed that 38% of the 8815 women who received both pre-delivery care and post-delivery checks were unaware of pregnancy soon after birth before menstruation resumed. Factors such as post-delivery checks, contraceptive use, delivery through cesarean section, women aged 30 years and over with secondary education and higher, and having knowledge of the periods more appropriate for a woman to be pregnant were more aware of pregnancy soon after birth before menstruation resumed. We proposed that effective counseling and adherence from women who are not planning to get pregnant soon after birth could help reduce the rate of pregnancy soon after birth before menstruation resumes. These unplanned pregnancies can also be avoided by educating women about birth spacing, contraceptive use, and the timing of resumption of sexual activity.

Predictors of prolonged hospitalization after vaginal birth in Ghana: A comparative study.

Early discharge after child delivery although indispensable, but maybe precluded by several factors. The effect of these factors on prolonged length of stay (LOS) after vaginal delivery has been sparsely investigated in Ghana. This limits understanding of potential leading indicators to inform intervention efforts and optimize health care delivery. This study examined factors associated with prolonged LOS after vaginal birth in two time-separated cohorts in Ghana. We analyzed data from Ghana's demographic and health surveys in 2007 and 2017. Our comparative analysis is based on subsamples in 2007 cohort (n = 2,486) and 2017 cohort (n = 8,065). A generalized estimating equation (GEE) with logistic regression was used to examine predictors of prolonged LOS after vaginal delivery. The cluster effect was accounted for using the exchangeable working correlation. The odds ratios (OR) and 95% confidence interval were reported. We found that 62.4% (1551) of the participants in 2007 had prolonged LOS after vaginal delivery, whereas the prevalence of LOS in the 2017 cohorts was 44.9% (3617). This constitutes a 17.5% decrease over the past decade investigated. Advanced maternal age (AOR = 1.24, 95% Cl 1.01-1.54), place of delivery (AOR = 1.18, 95% Cl 1.02-1.37), child's size below average (AOR = 1.14; 95% Cl 1.03-1.25), and problems suffered during/after delivery (AOR = 1.60; 95% Cl 1.43-1.80) were significantly associated with prolonged (≥ 24 hours) length of hospitalization after vaginal delivery in 2017. However, among variables that were available in 2007, only those who sought delivery assistance from non-health professionals (AOR = 1.89, 95% CI: 1.00-3.61) were significantly associated with prolonged LOS in the 2007 cohort. Our study provides suggestive evidence of a reduction in prolonged LOS between the two-time points. Despite the reduction observed, more intervention targeting the identified predictors of LOS is urgently needed to further reduce post-vaginal delivery hospital stay. Also, given that LOS is an important indicator of medical services use, an accurate understanding of its prevalence and associated predictors are useful in assessing the efficiency of hospital management practices and the quality of care of patients in Ghana.

Patterns of Birth and Family Planning Acceptor Rates in Ghana: An Ecological Study.

Despite a reported decline in Ghana's birth rate (BR), the pattern of ecological percent decrease in BR as corresponding to the percent increase in family planning acceptor rate (FPAR) in Ghana is not clear. This study explicitly explored and compared the pattern of birth and FPAR in Ghana from 2004-2015. National FPAR and BR data were retrieved from Ghana Health Service and World Bank. A time- trend descriptive analysis was performed via tableau software. Additionally, a segmented regression was applied to inferentially identify where statistically significant log-linear distinct segments exist in the trends. All segmented-related analysis was performed using joinpoint trend analysis software. Whereas, the highest decline in BR was observed from 2013-2015 (-1.4%), the highest increase in FPAR was rather observed from 2004-2008 (7.4%). Unexpectedly, from 2008-2013, a much higher decrease in FPAR (-5.8%) also yielded a moderate decline in BR (-0.7%). FPAR over the eleven years (2004-2015) increased by 1.1% whereas BR declined by -0.7%. BR in Ghana continues to be on a moderate declining trend. However, the decline was uninterrupted by an increase or decrease in FPAR. For a further decrease in Ghana's birth rate, a multifaceted approach is needed, not only focusing on increasing FPAR but also targeting adherence to FP control methods.

Patógenos cervicovaginales y parto pretérmino / Cervicovaginal pathogens and preterm labor

Objetivo: Se realizó un estudio prospectivo, descriptivo e investigacional a mujeres embarazadas ingresadas con el diagnóstico de signos de alarma o amenaza de parto pretérmino, en el Hospital Ana Betancourt de Mora, de Camagüey, para determinar la incidencia de patógenos cervicovaginales en el parto pretérmino. Materiales y método: De las mujeres ingresadas, se seleccionaron 147, a las cuales se les realizó examen colposcópico y microbiológico cervicovaginal. Se aplicó un análisis estadístico descriptivo, una distribución de frecuencias y porcentajes, además de un test de hipótesis de proporciones para analizar y exponer los resultados. Resultados: La edad media ± desviación estándar fue de 25,6 ± 6 años; el 47,6% tenía experiencia de parto y el 11,6% tuvo un parto pretérmino previo. De las enfermedades asociadas, primaron la anemia y la infección urinaria; de las dependientes, la incompetencia cervical y la rotura prematura de membranas. Se diagnosticaron patógenos cervicovaginales en el 39,45% de las pacientes antes de las 25 semanas, predominaron los anaerobios responsables de la vaginosis bacteriana y Candida albicans. El parto se presentó en el 78,9% de las pacientes entre las 33 y las 36 semanas. El peso promedio de los recién nacidos fue de 1.082,7 ± 672 g. Entre la morbilidad perinatal prevalecieron el bajo peso al nacer y la depresión respiratoria. Se registraron 5 casos de muertes perinatales (3 de estos neonatos pesaban menos de 1.000 g). Es necesario realizar una detección precoz de la infección cervicovaginal y su respectivo tratamiento. Conclusión: La presencia de patógenos cervicovaginales está fuertemente relacionada con el parto pretérmino; se considera que la detección y el tratamiento precoz de las infecciones causadas por estos microorganismos es esencial para una reducción de la morbimortalidad perinatal y materna

Objective: To determine the incidence of cervicovaginal pathogens in preterm labor, a prospective, descriptive and investigative study was conducted in patients diagnosed with warning signs or threatened preterm labor and admitted to the Ana Betancourt de Mora Hospital in Camagüey (Cuba). Materials and method: Of the admitted patients, 147 were selected and colposcopic and microbiological examinations were performed. Descriptive statistics, frequency and percent distribution, as well as the proportional hypothesis test, were applied to analyze the data collected and the results were tabulated. Results: The average age was 25.6 ± 6 years; 47.6% of the patients had prior births and 11.6% had previous preterm delivery. The most common comorbidities were anemia and urinary tract infection; the most frequent pregnancy-related abnormalities were cervical incompetence and premature rupture of the membranes. Cervicovaginal pathogens were diagnosed in 39.45% of the patients before the 25th week of gestation; anaerobes responsible for bacterial vaginosis and Candida albicans were the most predominant. A total of 78.9% of the patients studied delivered at 33-36 weeks. The average birthweight of the neonates was 1082.7 ± 672 g. The most prevalent perinatal morbidity was low birthweight and respiratory distress. Five perinatal deaths were registered in neonates, of which three weighed less than 1000 g at birth. Conclusion: The presence of cervicovaginal pathogens is strongly linked to preterm labor. Early detection and treatment of the infections caused by these microorganisms is essential to reduce perinatal and maternal morbidity and mortality

Cesárea primitiva: comportamiento en nuestro medio / Primitive cesarean section: behavior in our environment

Se realizó un estudio descriptivo longitudinal y retrospectivo de gestantes que fueron sometidas al parto por cesárea primitiva para determinar su comportamiento y repercusión en el Hospital Ginecobstétrico Provincial Docente de Camagüey en el período comprendido desde enero a junio de 2000 El universo de estudio estuvo constituido por 493 embarazadas Predominaron las de más de 30 años, el 62.6 por ciento no tenía experiencia de partos La hipertensión arterial crónica fue la enfermedad asociada más frecuente y de las dependientes, la ruptura prematura de membranas La indicación operatoria más usual fue el sufrimiento fetal El 36,6 por ciento de los neonatos tuvieron pesos de entre 3000 y 3499 g, el 14,2 por ciento de los niños presentaron bajo peso al nacer, 35 se encontraban deprimidos al primer minuto y 11 continuaban al quinto, de ellos seis pesaron menos de 2500 g la morbilidad perinatal más relevante fue la prematuridad y la fiebre puerperal predominó en la morbilidad materna Se registró una muerte fetal

Cesárea primitiva: comportamiento en nuestro medio / Primitive cesarean section: behavior in our environment

Se realizó un estudio descriptivo longitudinal y retrospectivo de gestantes que fueron sometidas al parto por cesárea primitiva para determinar su comportamiento y repercusión en el Hospital Ginecobstétrico Provincial Docente de Camagüey en el período comprendido desde enero a junio de 2000 El universo de estudio estuvo constituido por 493 embarazadas Predominaron las de más de 30 años, el 62.6 por ciento no tenía experiencia de partos La hipertensión arterial crónica fue la enfermedad asociada más frecuente y de las dependientes, la ruptura prematura de membranas La indicación operatoria más usual fue el sufrimiento fetal El 36,6 por ciento de los neonatos tuvieron pesos de entre 3000 y 3499 g, el 14,2 por ciento de los niños presentaron bajo peso al nacer, 35 se encontraban deprimidos al primer minuto y 11 continuaban al quinto, de ellos seis pesaron menos de 2500 g la morbilidad perinatal más relevante fue la prematuridad y la fiebre puerperal predominó en la morbilidad materna Se registró una muerte fetal(AU)

Embarazo en la adolescencia: incidencia, riesgos y complicaciones / Pregnancy in adolescence: incidence, risks and complications

Se realizó un estudio de casos y controles para analizar la incidencia, los riesgos, así como las complicaciones del embarazo y el parto en la adolescencia en el hospital municipal de Santa Cruz del sur, desde el 1ro. de enero de 2000 hasta el 31 de diciembre de ese año. Se tomó como grupo estudio a las 132 adolescentes que parieron en esta etapa y se comparó con un grupo control de 132 gestantes de 20 años o más que parieron en igual fecha. Esta información fue recogida de los expedientes clínicos de las pacientes y del libro de parto y llevada a encuestas. El bajo peso materno estuvo presente en el 59,8 por ciento de las adolescentes, el 87,1 por ciento de estas eran amas de casa, el 78 por ciento de estas gestantes presentó alguna enfermedad durante el embarazo y sus productos sufrieron mayor número de complicaciones, además de asociarse con mayor frecuencia las complicaciones posparto para la madre. Este estudio muestra todos los riesgos que implica un embarazo en estas edades, por lo que insistimos en lo importante de disminuirlos al mínimo

Embarazo en la adolescencia: incidencia, riesgos y complicaciones / Pregnancy in adolescence: incidence, risks and complications

Se realizó un estudio de casos y controles para analizar la incidencia, los riesgos, así como las complicaciones del embarazo y el parto en la adolescencia en el hospital municipal de Santa Cruz del sur, desde el 1ro. de enero de 2000 hasta el 31 de diciembre de ese año. Se tomó como grupo estudio a las 132 adolescentes que parieron en esta etapa y se comparó con un grupo control de 132 gestantes de 20 años o más que parieron en igual fecha. Esta información fue recogida de los expedientes clínicos de las pacientes y del libro de parto y llevada a encuestas. El bajo peso materno estuvo presente en el 59,8 por ciento de las adolescentes, el 87,1 por ciento de estas eran amas de casa, el 78 por ciento de estas gestantes presentó alguna enfermedad durante el embarazo y sus productos sufrieron mayor número de complicaciones, además de asociarse con mayor frecuencia las complicaciones posparto para la madre. Este estudio muestra todos los riesgos que implica un embarazo en estas edades, por lo que insistimos en lo importante de disminuirlos al mínimo(AU)