Pedro Hidalgo-Lopezosa

Background/Objectives: There is international consensus that breastfeeding is the best form of nutrition for newborns. Many studies demonstrate the effectiveness of educational interventions in maintaining exclusive breastfeeding up to 6 months. The aim was to assess the effectiveness of an educational and support intervention in breastfeeding by a lead midwife on the postnatal ward. Methods: A retrospective quasi-experimental pre-post study complemented by a supplementary descriptive survey was conducted at a tertiary hospital in southern Spain with women (N = 136) who expressed a desire to breastfeed their babies. An institutional intervention, consisting of the support provided by a midwife employed exclusively to offer support with breastfeeding for a period of two months, was carried out. An inferential analysis was performed using the corresponding statistics. A multiple logistic regression analysis was performed to identify potential confounding variables and determine factors associated with the dependent variable of exclusive breastfeeding at 6 months. In addition, a brief institutional survey was conducted among these women after the first 6 months postpartum as a complementary component to the quantitative analysis. Data were obtained from hospital records and from the survey. Results: Exclusive breastfeeding at discharge and at two months postpartum was higher in the intervention group than in the control group. The need for supplementary feeding and phototherapy among infants was lower in the intervention group. A higher level of satisfaction with the support received regarding breastfeeding was also observed among mothers in the intervention group (95.7% vs. 63%; p < 0.001). However, we did not detect a between-group difference in exclusive breastfeeding at six months. Conclusions: Availability of support from a breastfeeding specialist midwife in hospital and in the weeks following birth can assist women to exclusively breastfeeding and supports to improve maternal satisfaction.

Background/Objectives: There is international consensus that breastfeeding is the best form of nutrition for newborns. Many studies demonstrate the effectiveness of educa-tional interventions in maintaining exclusive breastfeeding up to 6 months. The aim was to assess the effectiveness of an educational and support intervention in breastfeeding by a lead midwife on the postnatal ward. Methods: A retrospective quasi-experimental pre-post study using a mixed-methods approach was conducted at a tertiary hospital in southern Spain with women (N = 136) who expressed a desire to breastfeed their babies. An institutional intervention, consisting of the presence of a leading midwife in breastfeeding for a period of two months, was carried out. An inferential analysis was performed using the corresponding statistics. A multiple logistic regression analysis was performed to identify potential confounding variables and determine factors associated with the dependent variable of exclusive breastfeeding at 6 months. In addition, a brief institutional survey was conducted among these women after the first 6 months post-partum as a complementary component to the quantitative analysis. Results: Exclusive breastfeeding at discharge and at two months postpartum was higher in the intervention group than in the control group (97.8% versus 83.2%; p= 0.031). The need for supple-mentary feeding and phototherapy among infants was lower in the intervention group (1.5% versus 11.8%, P=0.033). A higher level of satisfaction was also observed among mothers in the intervention group (95.7% versus 63%; p< 0.001). However, we did not detect a between-group difference in exclusive breastfeeding at six months. Conclusions: The presence of a breastfeeding-specialist midwife was associated with higher early breastfeeding rates and maternal satisfaction during hospitalization. Sustained effects are likely to require ongoing support after discharge.

Enquadramento: A indução do parto resulta frequentemente em partos complicados e numa maior intervenção, o que pode levar à frustração e ansiedade. Objetivo: Analisar a satisfação com o processo de parto em mulheres submetidas a indução. Metodologia: Estudo observacional. Amostragem não probabilística e de conveniência. Foram estabelecidos critérios de inclusão e exclusão. A amostra foi constituída por 46 participantes. Foi utilizado um questionário sociodemográfico e obstétrico e da versão espanhola da Mackey Childbirth Satisfaction Rating Scale. Resultados: A satisfação global foi boa. A subescala melhor classificada foi a relacionada com o recém-nascido e as dimensões com pior classificação foram as relacionadas com as fases de dilatação e expulsão. A satisfação com o parceiro e o conforto foi maior em mulheres com idade entre 30-34 anos do que em mulheres com idade ≥ 40 anos. A satisfação global foi maior nas mulheres que tinham recebido informação prévia sobre o processo de indução e cujas expectativas tinham sido satisfeitas. Conclusão: A satisfação global e por dimensão foi elevada. Os resultados fornecem evidências de cuidados de qualidade para melhorar os níveis de satisfação de mulheres induzidas.

RESUMEN Objetivo: Describir y analizar la relación entre la ansiedad relacionada con el embarazo, el distrés prenatal y la resiliencia individual, en mujeres gestantes durante el primer trimestre de embarazo y compararlo con la variable obstétrica de paridad. Método: Estudio cuantitativo, descriptivo y transversal utilizando muestreo no probabilístico circunstancial. Participaron 144 mujeres. Se emplearon el Cuestionario de Distrés Prenatal, la Escala de Resiliencia y el Cuestionario de Ansiedad Relacionada con el Embarazo. Se realizó un análisis descriptivo con medidas de tendencia central y se evaluó la confiabilidad de los instrumentos. Resultados: La edad promedio fue de 33,57 años. El 58,3% eran multíparas y el 41,7% primíparas. El 21,5% presenta ansiedad y el 54,9% niveles muy altos de resiliencia. Las primíparas mostraron mayores niveles preocupación sobre el futuro y miedo al parto que las multíparas. Las gestantes con alta resiliencia muestran valores más bajos en ansiedad y estrés. Conclusiones: Las gestantes con niveles más elevados de resiliencia manifiestan menos ansiedad y estrés durante el primer trimestre de embarazo. Las primíparas presentan más ansiedad y estrés que las multíparas.

Objective: To describe and analyze the relationship between pregnancy-related anxiety, prenatal distress, and individual resilience in pregnant women during the first trimester of pregnancy and compare it with the obstetric variable of parity. Method: Quantitative, descriptive, cross-sectional study using non-probabilistic circumstantial sampling. A total of 144 women participated. The Prenatal Distress Questionnaire, the Resilience Scale, and the Pregnancy-Related Anxiety Questionnaire were used. A descriptive analysis with measures of central tendency was performed, and the reliability of the instruments was assessed. Results: The average age was 33.57 years. 58.3% were multiparous and 41.7% primiparous. Anxiety was found in 21.5% and very high levels of resilience in 54.9%. Primiparous women showed higher levels of worry about the future and fear of childbirth than multiparous women. Pregnant women with high resilience showed lower levels of anxiety and stress. Conclusion: Pregnant women with higher levels of resilience show less anxiety and stress during the first trimester of pregnancy. Primiparous women show more anxiety and stress than multiparous women.

(1) Background: The rate of cesarean sections in late fetal mortality remains high. We aimed to determine the prevalence of late fetal mortality in Spain and risk factors for cesarean birth in women with stillbirth ≥ 28 weeks gestation between 2016–2019. (2) Methods: A retrospective observational study with national data between 2016–2019. A total of 3504 births with fetal dead were included. Sociodemographic, obstetrical and neonatal variables were analyzed using univariate and multivariate logistic regression (MLR), with cesarean birth with a stillborn ≥ 28 weeks gestation as the dependent variable. (3) Results: The late fetal mortality rate was 2.8 × 1000; 22.7% of births were by cesarean section. Factors associated with cesarean were having a multiple birth (aOR 6.78); stillbirth weight (aOR 2.41); birth taking place in towns with over 50,000 inhabitants (aOR 1.34); and mother’s age ≥ 35 (aOR 1.23). (4) Conclusions: The late fetal mortality rate increased during the period. The performance of cesarean sections was associated with the mother’s age, obstetric factors and place of birth. Our findings encourage reflection on how to best put into practice national clinical and socio-educational prevention strategies, as well as the approved protocols on how childbirth should be correctly conducted.

(1) Background: Female sexual dysfunction (FSD) has a high prevalence globally, and perinatal factors favor FSD, especially in the postpartum period. The aim was to determine the prevalence and factors influencing FSD in the postpartum period; (2) Methods: An observational study carried out in three primary care centers in southern Spain, with women in the postpartum period who had a single low-risk birth. One hundred and seventeen women answered the Female Sexual Function questionnaire during the 4th month postpartum, between January 2020 and December 2021. Sociodemographic, obstetric, neonatal variables and level of self-esteem were analyzed. A multiple logistic regression model was carried out; (3) Results: 78.4% had high level of self-esteem. FSD prevalence was 89.7%. Factors related to FSD were having an instrumental vaginal delivery, women with university studies, and prenatal preparation. Maternal age ≥ 35, multiparity, pathological processes in the child, a medium–low level of self-esteem and newborn weight were associated with disorders in some of domains of sexual function; (4) Conclusions: FSD is highly prevalent in the postpartum period and is associated with preventable factors. A preventive approach by health professionals to these factors is essential. Health services should implement postpartum follow-up programs, which may coincide in time and place with newborn follow-up programs.

The COVID-19 pandemic has posed a high risk to the mental health of the entire population. Pregnant women are strongly affected by the consequences of COVID-19, resulting in increased anxiety and stress. Social support can be a protective factor when it comes to mental health disturbances such as anxiety, fear, or stress in pregnant women. This research aims to describe the anxiety and stress of women in the first trimester of pregnancy in times of pandemic and its relationship with social support. A quantitative, descriptive, cross-sectional study was conducted. A total of 115 women in the first trimester of pregnancy participated. Anxiety was found in 78.3% of the women. Self-perceived stress correlated significantly with the dimensions “concern for changes in oneself”, “feelings about oneself”, “concern about the future”, and very weakly with social support. In addition, a negative correlation was observed between “feelings about oneself” and social support. During the COVID-19 pandemic, anxiety levels of women in our population are elevated. Pregnant women during the first trimester of pregnancy showed higher levels of fear of childbirth and concern about the future than multiparous women. Increased social support and decreased stress seem to influence “feeling about oneself”.

Background: Healthcare systems advocate for quality care and humanized relations in routine birth care, and have therefore created the Birth Plan, a document available to pregnant women to state their preferences in relation to the birth process. Methods: This qualitative research with a phenomenological design was carried out to record the experiences of women who presented a Birth Plan. Sample selection was carried out using non-probabilistic, intentional and convenience sampling, selecting seven participants who were willing to participate and share their experiences. Results: After analyzing the content of the interviews, four categories emerged: “respecting the woman’s wishes: humanizing the birth process”, “information and primary Care”, “expectations regarding the care received” and “results of using the birth plan”, with their corresponding subcategories. Conclusion: Women consider it beneficial to present a Birth Plan, because it informs them about the process and gives them the opportunity to have a better experience, which takes into account their preferences for making the delivery less instrumental. In addition, they state the importance of having trained professionals involved, and call for more attention to be paid to the birth process in general.