Pregnancy is a natural physiological process. However, it significantly affects mothers' health-related quality of life through various physical, psychological, social, and environmental changes. Understanding the determinants of health-related quality of life during antenatal care can guide maternal health interventions. To assess health-related quality of life and associated factors among mothers attending antenatal care in South Wollo Zone public hospitals, Northeast Ethiopia. An institution-based cross-sectional study. Systematic random sampling method was used in five randomly selected hospitals among mothers attending antenatal care from March 1 to 30, 2024. Health-related quality of life was measured using World Health Organization Quality of Life - BREF (WHOQOL-BREF) questionnaire. Data were entered into EpiData 3.1 and exported to SPSS 25 for analysis. Multivariable linear regression analysis was performed by selecting variables with a p-value of <0.25 in simple linear regression. Then, variables having p-value <0.05 at 95% confidence interval with an unstandardized B-coefficient were considered significant predictors. The mean scores for physical, psychological, social relationship, and environmental health-related quality of life domains were 71.0, 72.1, 66.1, and 65.7, respectively. Among the participants, 76.1% rated their health-related quality of life as neither poor nor good, and 42.3% reported being neither dissatisfied nor satisfied in terms of their health satisfaction. Physical health was negatively affected by pregnancy-related illness, older age, and depression. Psychological domain declined with depression, rural residence, and perceived social stigma. Depression and perceived social stigma impaired social relationships. Environmental quality of life was lower among depressed participants, rural residents, and those reporting current alcohol use. Overall, participants demonstrated moderate health-related quality of life across all domains, with most perceiving their health status as neutral. Health professionals should follow holistic care, including physical, psychological, social, and environmental interventions. Targeted interventions are needed to address negatively associated predictor variables for all domains of health-related quality of life. Pregnant mothers health-related quality of life and associated factors Why was the study carried out? Pregnancy is a process that can affect mothers’ health-related quality of life. It causes changes in women’s physical, emotional, social and environmental aspects of health. Although Ethiopia has implemented antenatal care programs, the quality-of-life aspects of pregnant mothers remain neglected. This motivated us to investigate health-related quality of life and associated factors among mothers attending antenatal care in Northeast Ethiopia. Understanding these factors can help health workers provide better counseling and support during pregnancy. What did the researchers do? The researchers looked at what affects the quality of life of pregnant women attending antenatal care in Northeast Ethiopia. By identifying these factors, they aimed to help improve counseling services and develop better care and support programs for pregnant women during their antenatal visits. What did the researchers find? The physical, psychological, social relationship and environmental domains of health-related quality of life average scores were 71.0, 72.1, 66.1, and 65.7, respectively. Depression was negatively associated with all four domains of health-related quality of life. What do the findings mean? Attentions should be needed for all domains of health-related quality of life among pregnant mothers to ensure positive maternal-child health outcomes. This study identified important target variables that could be a focus of future efforts to ensure positive health related quality of life. Health professionals should provide holistic care, including physical, psychological, social and environmental interventions, with particular attention to address negatively associated predictor variables.
Health workforce shortages are a serious impediment to the delivery of effective and person-centered care, particularly in conflict settings. Midwives are a critical cadre who can help avert maternal and child death, but face persistent barriers to education, employment, regulation, and professional development-challenges that are especially pronounced in conflict-affected areas. Few studies have systematically explored midwives' experiences in these settings. The EQUAL midwifery cohort study was established to systematically examine midwives' educational and professional trajectories in Northeast Nigeria and in Central and Southeast Somalia, with the goal of identifying context-specific factors influencing retention, deployment and professional growth. Multiple cohorts of students and recent graduates will be enrolled, complete an intake survey, and be followed with additional surveys approximately 6 months after enrollment and then annually. Focus group discussions and in-depth interviews with a sub-set of participants will follow each round of surveys to expand on survey findings. Qualitative data analysis will focus on the lived experiences of participants, and how these experiences shape their professional identities and career trajectories. Survey analysis will assess levels of attrition, including withdrawal from training and exit from the profession post-graduation. Cox regression models will estimate hazard ratios and 95% confidence intervals for these outcomes, and median survival time in the profession will be calculated to determine when attrition is most likely. Risk factors for attrition during both training and professional practice will be examined. Ethical approval was obtained from John Hopkins Bloomberg School of Public Health, the Somali Research and Development Institute, and Yobe State Health Ministry of Health Ethics Committee. This research will offer insights into a critical yet under-explored segment of the global health workforce: early career midwives in conflict-affected settings. It serves as a proof-of-concept for the feasibility of longitudinal health workforce research in conflict-affected areas of Nigeria and Somalia, offering unprecedented evidence on the lived experiences and expressed needs of midwives to inform the improvement of midwifery education, working conditions, and support networks in these settings. A protocol for a cohort study among midwives in Somalia and Nigeria• This will be the first study to follow midwives in humanitarian settings over time, filling a gap in knowledge about the experiences of this important group within the health workforce.• The research is part of a multi-country research consortium and involves partnership with local researchers, including midwives, who contribute deep knowledge of the health systems and firsthand understanding of the realities of midwives in conflict settings.• Following midwives over time enables the study to observe their professional journeys, measure how many leave the field, and capture changes in motivation in a way that a studies conducted at a single point in time cannot provide.• The study focuses on conflict-affected areas of Nigeria and Somalia, so findings may not reflect the experiences of midwives in other areas within or outside of the two countries.
Women in the United Kingdom face noticeable challenges in accessing and receiving reproductive health care. The emotional impact of these challenges is seldom evaluated. Recent research and wider societal discourse suggest that many women experience 'gaslighting', a form of psychological manipulation where their health concerns are not taken seriously, leading to feelings of dismissal and resulting in withdrawal from mainstream healthcare services. This can culminate in delayed diagnoses and poorer health outcomes. A qualitative systematic review of the literature investigating gaslighting and dismissal in women's reproductive health in the UK, with a focus on how these experiences differ across intersecting identities such as ethnicity, sexuality, and socioeconomic status. Search of qualitative literature across key databases including PubMed, PsycInfo, CINAHL plus, Web of Science, Medline, Scopus, Embase, Science Direct, and HMIC retrieving 25,258 papers. The review identified no papers explicitly addressing gaslighting in women's reproductive health in the UK. However, seven related studies were found containing relevant themes (e.g. dismissal), providing a basis for the review. A thematic summary based on the extracted data resulted in the development of four themes 1) dismissal of symptoms and needs (patients experiences, systemic issues), 2) marginalised experiences (ethnic minority women, LGBTQ+ people), 3) stigma and fear of judgement, and 4) poor communication and limited autonomy. The review highlights the need for more targeted research in this area as the scarcity of literature underscores the importance of exploring the emotional impact and framing of dismissal as gaslighting by women in reproductive healthcare. Better conceptualisation and understanding could inform practice and policy changes aimed at validating women's experiences and improving equity in reproductive healthcare access and outcomes.
Perinatal mental health is a critical public health concern. Women experiencing moderate to severe perinatal mental health conditions often require specialist support. Discharge from specialist services is a potentially challenging time; however, literature examining service discharge remains limited. Understanding multiple stakeholder perspectives of specialist perinatal mental health services is essential for informing evidence-based improvements. To understand women's and multidisciplinary team members' experiences of care and discharge from an Irish specialist perinatal mental health service. A multiperspectival interpretative phenomenological analysis study. Women (n = 6) who were discharged after receiving treatment from an Irish specialist perinatal mental health service and multidisciplinary team members (n = 6) working within this service participated in individual semi-structured interviews. Data were analysed using interpretative phenomenological analysis. This paper presents a multiperspectival synthesis with four themes and subthemes: (1) In sanctuary, I return to myself, (2) Building strength through collaboration, (3) A tailored discharge, and (4) On the path forward. Women felt a sense of safety and connection during their care, marking a turning point from feelings of isolation and perceived judgement. Women advocated for person-centred, flexible discharge approaches. Post-discharge community support provided women with a sense of stability, continuity, and confidence. The service provided a place of sanctuary where women received advocacy support until they regained self-agency. Individualised discharge care planning can enhance consistent communication and facilitate a supported, coordinated transition of care. Expanding community support, equitable care, and a national mother and baby unit are essential for the progress of Irish services.
Sexual myths during pregnancy can shape women's beliefs about sexuality, increase anxiety, and reduce sexual satisfaction, thereby negatively affecting sexual quality of life. This study examined the relationship between sexual myths prevalent during pregnancy and women's sexual quality of life using a cross-sectional, correlational design. Conducted between January and April 2025, this study included 332 pregnant women attending the obstetrics outpatient clinic and wards of a university hospital. Data were collected through face-to-face interviews using a Personal Information Form, the Sexual Myths Scale, and the Sexual Quality of Life Scale. The primary outcome was sexual quality of life, assessed in relation to the level of endorsement of sexual myths during pregnancy. Sexual myths varied significantly according to age, education, occupation, spouse's occupation, marital duration, and pregnancy planning (P < .05). Sexual quality of life was also significantly associated with these variables and with pre-pregnancy pain during intercourse (P < .05). A strong negative correlation was found between overall sexual myths and sexual quality of life. While the "sexual orientation" subscale showed a positive correlation, the subscales of gender, age and sexuality, sexual behavior, masturbation, and sexual violence were negatively correlated with sexual quality of life (P < .005). Midwives should provide evidence-based education and counseling to address sexual myths, thereby supporting healthier sexual experiences and improving well-being during pregnancy. This study is among the first to systematically examine this relationship; however, its cross-sectional design limits causal inference, and the findings may not be generalizable beyond the study population. Integrating sexual health education into routine prenatal care may enhance women's sexual quality of life during pregnancy. This study is the first in the Central Black Sea Region of Türkiye to examine the impact of sexual myths on pregnant women's sexual quality of life.Sexual myths were found to be negatively correlated with sexual quality of life, indicating that false beliefs increase anxiety and reduce satisfaction during pregnancy.Sociodemographic factors such as age, education, occupation, marital duration, and pregnancy planning significantly influenced both sexual myths and sexual quality of life.The findings emphasize the importance of evidence-based sexual health education and counseling by midwives to dispel myths and promote healthier sexual experiences during pregnancy.Integrating sexual health education into prenatal care can improve individual well-being and broader community sexual health outcomes.
Scotland has a strong policy foundation for continuity of midwifery care; however, there is no research strategy informed by the perceptions of consumers of maternity services. To develop a Scottish research mission, vision, and agenda for continuity of midwifery care informed by women's perspectives. An exploratory survey was conducted, using an online questionnaire. Structural text reduction, interquartile ranking, and prioritisation were used to develop and validate the mission and vision statements. Factors informing the relationship between the strategy and its implementation were mapped using the Tailored Implementation for Chronic Diseases framework. Participants proposed and ranked research topics according to their importance. The questionnaire was completed by 82 Scottish maternity care consumers. A research mission and vision statement were developed. Capacity for change, individual health professionals, and evidence-related factors are the most often reported contextual domains for shaping the strategy's implementation. Seventeen research topics were identified and ranked. The highest priorities were the impact of continuity of midwifery care on maternal mental health and midwives' experiences of delivering this model of care. The mission emphasises continuity of midwifery care research that leads to meaningful, practice-focused change and reflects women's perceptions and experiences. The vision underscores understanding what makes this research effective and meaningful, with recognition of the midwife's role. Prioritised research topics focus on issues grounded in the voices and experiences of childbearing women.
Advanced practice providers (APPs), including certified nurse-midwives (CNMs)/certified midwives and nurse practitioners, are well positioned to meet the growing demand for women's health care services. In interprofessional obstetric and gynecologic settings, APPs' scope of practice includes performing hereditary cancer risk assessments (HCRAs) and genetic evaluations, comparable with physicians. However, time constraints, limited confidence, and inadequate resources may hinder APPs' ability to routinely and effectively incorporate HCRA and genetic testing into practice. This prospective, single-arm health care quality improvement initiative introduced workflow innovations and tools to improve HCRA workflow. This intervention included training on using online family history screening and virtual patient education tools within a standardized HCRA. Metrics related to genetic evaluation and testing completion and the experiences of women and APP respondents were recorded preintervention and postintervention. Data were analyzed using descriptive statistics and univariate conditional logistic regression models. Following workflow standardization, APPs noted increases of 27.1 percentage points in the proportion of women offered genetic testing and 26.4 percentage points in the genetic testing completion rate (26.4%). APPs agreed or strongly agreed that the workflow modification improved their confidence in performing HCRA (91.7%) and meeting the standard of care (91.7%) and supported guideline adherence (83.3%) and ease of practice integration (66.7%). APPs care for women with similar risk profiles as physicians and are equally capable of implementing novel tools and processes to provide evidence-based, personalized HCRA consistent with their scope of practice.
Perinatal mental health issues are a global problem that constitutes a significant part of the burden on maternal and infant health. This situation could pose a risk, especially for immigrant women, who are a vulnerable group. This study aimed to investigate the effect of midwife-led education based on Pender's Health Promotion Model on the perinatal mental health of immigrant women. This randomised controlled experimental study was conducted with 52 participants in the intervention group and 54 participants in the control group (n = 48 in the post-test). The study consisted of five interviews. While the pre-test was administered during the first interview in the pregnancy period, the post-test was administered in the first month postpartum. Data were collected through the Personal Information Form, the Edinburgh Postnatal Depression Scale, and the Perinatal Anxiety Screening Scale. While the intervention group women's depression scores did not show a significant difference over time, the control group women's scores showed a significant difference. The intervention group had significantly lower depression scores in the third and fourth interviews. However, no significant difference was observed between the groups in terms of their anxiety scores. The midwife- led education based on Pender's Health Promotion Model was found to protect and improve immigrant women's perinatal health. In light of these results, it is recommended that education programs may contribute to the development of perinatal mental health within the framework of midwifery care models should be planned and implemented in clinical practice.
Fear of childbirth (FOC) is a significant psychological concern that can adversely affect maternal well-being and childbirth outcomes. While various factors influencing FOC have been investigated, the influence of sexual quality of life (SQOL) has not yet been sufficiently researched. This study aimed to examine the relationships among FOC, SQOL, and depression in pregnant women. A descriptive, cross-sectional study. A cross-sectional study was conducted among 614 low-risk primiparous pregnant women aged 18-35 years in Kerman, Iran, between June 2022 and April 2023. Data were collected using the Wijma Delivery Expectancy/Experience Questionnaire Version A, the Edinburgh Postnatal Depression Scale, and the Female Sexual Quality of Life Questionnaire. A path analysis was conducted to examine the effects of SQOL, depression, and sociodemographic factors on FOC. The average age of the mothers was 26.9 ± 4.5 years, and that of the spouses was 29.9 ± 4.2 years. The average gestational age was 35 weeks. SQOL was not significantly correlated to FOC. In contrast, FOC was positively associated with depression (p < 0.001) and the age of the spouse (p = 0.008). The mother's age (p = 0.004) and the presence of chronic diseases (p < 0.001) were also significant negative predictors. In addition, maternal age was associated with better SQOL (p = 0.022), while depression (p < 0.001) and gestational age (p = 0.029) were significant negative predictors. Depression was a significant factor negatively related to both FOC and SQOL. Early detection and timely intervention for depression may reduce fear before labor and improve overall well-being during pregnancy. Depression, sexual quality of life, and fear of childbirth: A study of first-time pregnant women in IranFear of childbirth is a common concern for many women during pregnancy, especially those expecting their first child. In this study, more than 600 first-time mothers in Iran were surveyed to investigate whether depression and sexual quality of life were related to fear of childbirth. The results showed that women with depressive symptoms and women with older spouses were more likely to fear childbirth, while older women and women with chronic illnesses reported less fear of childbirth. Sexual quality of life was not related to fear of childbirth; however, it was influenced by other factors: older women reported better sexual quality of life, while depression and later stage of pregnancy were associated with poor sexual quality of life. These findings indicate the importance of early detection and timely intervention for depression in antenatal care to reduce fear of childbirth.
The lack of consistent information and frequent provision of unsolicited advice create challenges for women when making decisions about being physically active during pregnancy and post-partum. Despite the benefits of physical activity, pregnant women are often inactive. Many women experience a conflict between maintaining their own and their unborn child's health through physical activity and societal expectations to slow down. This study offers a novel insight into the perspectives of women who remained active throughout pregnancy. To explore the facilitators and barriers to physical activity from the perspective of women who remained active during their pregnancies. Semi-structured telephone interviews were conducted with five women living in several countries. Interpretative phenomenology framed the data collection and analysis. The women's experiences are reflected through four superordinate themes: Listening to my body to know what to do, Experience of control over my pregnant body, Having a sense of accomplishment, and Support and surveillance: navigating social expectations. The themes highlight a lack of advice, negative societal judgements, and unsolicited comments. Despite these challenges, the women ignored external pressures to reduce activity. Women described several factors that contributed to their decisions to remain active. Crucial to these were the support of key social contacts, reliance on internal signals, and wanting to remain in control. Despite barriers and societal expectations, the women remained active during pregnancy. Lack of commentary regarding advice from health care professionals suggests clear and consistent guidance could help women manage external expectations and support women to remain active during pregnancy and postpartum.
Maternal health care disparities persist in the Southern areas of the United States because of limited perinatal providers and scarce resources. Certified nurse-midwives (CNMs), certified midwives (CMs), and women's health nurse practitioners (WHNPs) can improve outcomes in these settings and the experiences of newly graduated clinicians as they transition into practice need further exploration. This qualitative study used a phenomenological approach to explore the lived experiences of 9 newly graduated CNMs and WHNPs practicing in medically underserved communities in the Southern United States. Participants were recruited and interviewed using a semistructured guide. Interviews were transcribed, coded, and thematically analyzed by a team of researchers. Field notes and reflexive journaling were used to enhance interpretive depth and rigor. Four themes emerged: community ties, lack of resources, tailoring communication to patient context, and challenges transitioning from novice to competent practice characterized by limited mentorship and professional isolation. Newly graduated CNMs and WHNPs bring unique strengths to medically underserved practices, including cultural familiarity and a commitment to community care. However, resource constraints, insufficient support, and restrictive practice environments hinder their ability to thrive. Structured mentorship, comprehensive orientation, full practice authority, and education about the new role are essential strategies to improve retention, provider satisfaction, and, ultimately, patient outcomes in underserved regions.
Understanding how women navigate induced abortion care pathways is critical to ensuring person-centred, quality reproductive health services. Evidence indicates that persistent abortion stigma, the lack of choices of abortion methods and respectful care during abortion remain a global challenge to reproductive healthcare. Yet there is minimal evidence regarding abortion care pathways. This study explored induced abortion care pathways in Addis Ababa healthcare facilities. We used a descriptive qualitative approach, adopting purposive sampling techniques to recruit women who sought induced abortion care from seven facilities. The data were collected from May to July 2024. In-depth semi-structured interviews with sixteen women were digitally recorded and transcribed into the local language before being translated into English. Data were coded, organised, and analysed using inductive thematic analysis. Five main themes and their corresponding subthemes were developed through data analysis. Themes were: (i) social and emotional support, (ii) moral and social meanings shaping abortion care, (iii) accessibility and service delivery, (iv) perceived competency of abortion providers, and (v) physical and emotional effects of abortion. Many women attended the clinic alone, without their families, and received no support. Women often sought care at clinics away from their community due to concerns related to fear of stigma and social pressure. This study found long waiting times to receive abortion care, a lack of medicine and ultrasound at some facilities and limited availability of second-trimester abortions. Women reported that many providers were welcoming and competent, while others reported poor communication, the use of medical jargon, and stigmatising behaviours. Participant reported pressure to accept methods they did not want during contraceptive counselling and fear of breaches in privacy and confidentiality. Participants also described physical symptoms such as bleeding and pain, and felt ashamed and upset after the abortion, which could be associated with negative experiences. Inadequate social support, abortion stigma, and barriers to accessing abortion services, such as long waiting times and insufficient resources, were identified as significant gaps. These findings emphasised the need to strengthen person-centred abortion care and address systemic and socio-cultural barriers that undermine the quality of care. Abortion care should be easy to access, fair for everyone, and respectful of women’s needs. Kind communication and emotional support during abortion enhance the quality of care. This study explored abortion care experiences in healthcare facilities in Addis Ababa.We spoke with women who came for abortion care. We conducted face-to-face interviews employing open-ended questions. We analysed the data by thoroughly reading and checking the information to identify common patterns in women’s experiences.Women had varied experiences of support. Some received strong support from family or friends, which made them feel less worried and more confident. Some went through the abortion procedure alone as they feared pressure or shame. Many women felt abortion was a “sin” or morally wrong, while others felt confident that they had made the best decision for their lives. Women reported waiting times and service availability as challenges to accessing quality care. In addition, negative experiences such as feeling judged and ignored, as well as poor communication from providers, are reported. Women explained physical symptoms such as bleeding, fatigue and emotional outcomes including anxiety, guilt and self-blame after abortion. At the same time, some felt relieved after the abortion and satisfied with the care received.This study found that women faced challenges such as stigma and judgment, long waiting times, and limited availability of abortion services in some places. Improving the quality of abortion care can help women feel supported, reduce emotional distress, and protect their health and dignity.
Fear of pregnancy can affect women's mental health, reproductive decisions, and quality of life, and may overlap with tokophobia. This study aims to assess its prevalence and determinants among women in Tabriz, Iran, and to develop evidence-based strategies to reduce it. This sequential explanatory mixed-methods study consists of three phases. First, a cross-sectional survey will be conducted among 450 married women aged 15-49 years (nulliparous or with one previous pregnancy) using validated instruments, including the Fear of Pregnancy Scale (FOPS), Satisfaction with Life Scale (SWLS), Social Support Appraisals Scale (SSA), Health-Promoting Lifestyle Profile-2 (HPLP-2), and Depression, Anxiety, and Stress Scale (DASS-21). The psychometric properties of the FOPS will also be assessed. Quantitative data will be analyzed with descriptive statistics, correlations, and multivariable models in SPSS-26. In the qualitative phase, women with the highest and lowest FOPS scores will be purposively selected to ensure diversity, and semi-structured interviews will be analyzed through conventional content analysis. In the final phase, results from both stages, supported by a literature review, will be integrated and refined using the Delphi method to develop culturally appropriate strategies for reducing pregnancy-related fear. This first mixed-methods study in Iran addresses a critical gap in understanding fear of pregnancy. Integrating quantitative and qualitative findings with expert input, it will inform evidence-based, culturally sensitive strategies and guide policies and clinical practice to support informed reproductive decisions. This study focuses on fear of pregnancy and the factors that contribute to it among women of reproductive age. Fear of pregnancy can affect women’s wellbeing, family life, and important decisions about the future. However, little is known about how common this fear is or why it occurs. First, we will give a questionnaire to a large group of women to measure their level of fear and explore possible related factors, such as social support, and lifestyle. Next, we will invite a smaller group of women those with very high or very low levels of fear for interviews to learn more about their personal experiences, thoughts, and feelings about pregnancy. By integrating the survey and interview results, we hope to understand both how widespread fear of pregnancy is and the reasons behind it. The findings will help healthcare providers, counselors, and policymakers design better education and support programs, reduce unnecessary anxiety, and help women make informed decisions about their reproductive health.
Background/Objective: In Spain, 99% of births occur in hospital settings, and planned home birth is neither funded nor regulated by the Public Health System. Despite growing interest in this birth option, qualitative evidence exploring the experiences of women who opt for a planned home birth after a previous hospital birth remains scarce, particularly in contexts where this practice is not integrated into the healthcare system. This study aimed to explore the perceptions and experiences of Spanish women who opted for a planned home birth following a previous hospital birth, focusing on the reasons that motivated this decision and the care received during the process. Methods: A qualitative descriptive design was employed. Semi-structured interviews were conducted between July and December 2025 with 19 women who had experienced a planned home birth in Spain after a previous hospital birth. Data were analysed using inductive thematic analysis following Braun and Clarke's approach. The study adhered to the Standards for Reporting Qualitative Research (SRQR). Results: Three main themes emerged: (1) motives related to choosing a planned home birth, including negative hospital experiences characterised by loss of autonomy, medicalisation of birth without consent, and fragmented care; (2) seeking a physiological and humanised birth, reflecting women's desire for empowerment, control, and a transformative experience, alongside barriers such as lack of professional support and financial burden; and (3) the need to increase visibility and establish regulation, highlighting demands for professional training, dissemination strategies, and integration of planned home birth into the Public Health System to ensure equitable access. Conclusions: Women who opted for a planned home birth after a hospital experience reported highly positive and empowering outcomes. However, the absence of regulation, professional support, and public funding creates significant inequalities. Integrating planned home birth into the Public Health System, educating healthcare professionals, and developing strategies to increase the visibility of planned home births are essential to guarantee women's right to choose where they give birth.
COVID-19 disrupted healthcare systems globally, particularly challenging maternity services which continued to be operated as an essential service. Reconfigurations were implemented to continue providing care in a safe manner and in line with infection control restrictions. This systematic review of women's experiences of maternity care during the COVID-19 pandemic in high-income countries (HICs), aimed to synthesize published literature and inform future responses to global disasters. Electronic database of Scopus, MEDLINE, EMBASE, CINAHL PsychINFO, and the Cochrane COVID Study Register, were searched from June 2021- June 2024 to identify eligible records. Thematic synthesis was used to synthesise the data. 79 studies were included with data from over 20,000 perinatal women, most were of moderate to high methodological quality. Data synthesis showed 11 themes across five main concepts related to maternity service reconfigurations, namely: (1) Care-seeking and care experience, (2) Virtual care, (3) Self-monitoring, (4) Vaccination, and (5) Ethical future of maternity care. Women predominantly viewed changes to maternity care negatively. Future strategies to ensure safeguarding of mothers and infants during crises should include enhancing service accessibility, emphasizing women-centered care, and prioritizing support systems for mothers and infants. https://www.crd.york.ac.uk/PROSPERO/view/CRD42022355948, identifier: CRD42022355948.
Timely and equitable access to contraceptive services is a key component of sexual and reproductive health and rights. Evidence shows that immigrant women in high-income countries often receive inadequate contraceptive counselling. There is also limited knowledge about how contraceptive services can best be organised within health systems to meet their needs. In Sweden, the Somali population is one of the country's largest immigrant groups facing a higher risk of adverse pregnancy and childbirth outcomes compared to Swedish-born women. This study aimed to gain a deeper understanding of Somali-born women's perceptions of and experiences with contraceptive services in Sweden. Eight focus group discussions were conducted, with a Somali-speaking moderator, and data were analysed using Braun and Clarke's reflexive thematic approach. All participants (N = 60) were Somali immigrants who had given birth in Sweden. Two main themes were constructed: (1) Factors shaping reproductive choices: community, household, and partner influences, and (2) women's perspectives on contraceptive services. The findings suggest opportunities to advance reproductive justice in contraceptive services in Sweden. Incorporating women's preferences and needs is essential to establishing person-centred contraceptive services, aligning with Sweden's health system priorities. Services must adapt to and reflect clients' experiences to avoid being shaped by preconceived notions and intersecting power dynamics. Our findings have implications for moving towards reproductive justice in the delivery of sexual and reproductive health services. Access to good-quality contraceptive services is an important part of sexual and reproductive health and rights. Research shows that immigrant women often do not get enough support or information about contraception. In Sweden, Somali-born women face more health risks during pregnancy and childbirth compared to Swedish-born women. This study looked at how Somali-born women in Sweden experience and think about contraceptive services. We conducted eight group discussions with 60 women, led by a Somali-speaking moderator. From the conversations, we found two main themes: 1) factors shaping reproductive choices and 2) Women’s perspectives on contraceptive services. The findings show that the health system needs to listen better to women’s needs and experiences to improve contraceptive services. To be fair and respectful, services should avoid stereotypes and take each woman’s situation into account. These findings can help improve sexual and reproductive healthcare for others in similar situations.
 Early enrolment for antenatal care (ANC) is an important strategy in improving perinatal and maternal outcomes. Treatable conditions in pregnancy, such as anaemia, human immunodeficiency virus (HIV), and syphilis can be identified and treated in the early antenatal period, thereby improving maternal and foetal outcomes. However, late enrolment for ANC is a concerning problem, especially in high HIV-prevalence settings, such as South Africa. The aim of this study was to evaluate screening of pregnant women fro HIV, syphilis and anaemia on the first antenatal visit at a midwife-run obstetric unit in KwaZulu-Natal, South Africa.  This audit of maternity case records at a primary health care facility in South Africa focuses on the screening for treatable conditions (i.e. HIV, syphilis and anaemia) among women presenting for their first antenatal visit.  Data were extracted from the files of 400 (87.7%) of the 456 women who enroled for ANC between July and December 2023. There was good coverage for screening of HIV, syphilis and anaemia. The prevalence of anaemia among women enrolling for ANC was 25% (n = 99), 40.8% (n = 100) of participants were HIV positive (n = 100) and 2.5% (n = 10) tested positive for syphilis. Of concern, less than 20% (n = 72) enrolled for ANC in the first trimester, thereby limiting the effectiveness of ANC interventions.  The low uptake of early ANC services is of concern, especially in high HIV-prevalence settings.Contribution: Training of primary health care providers in point-of-care ultrasounds may improve community awareness of the benefits of early ANC. Further investigation is required into the knowledge and perceptions of women regarding ANC services.
Long-term pelvic floor symptoms after childbirth may impair women's quality of life. The aim of this study was to assess the prevalence of self-reported pelvic floor symptoms 1 year postpartum in primiparous women by degree of perineal tear, with a focus on minor and major second-degree tears, and their association with quality of life. This prospective cohort study was based on data collected within a randomized controlled trial (the Oneplus trial). Women in the trial who had a vaginal birth and responded to a 1-year postpartum follow-up questionnaire were included. Data were collected between January 2020 and May 2021. The main outcome measures were pelvic floor symptoms assessed using the Pelvic Floor Distress Inventory (PFDI-20), the Pelvic Floor Impact Questionnaire (PFIQ-7), and study-specific items related to suturing and perceived body image. Associations between type of perineal tear and pelvic floor symptoms and their impact on quality of life were examined using generalized linear models, estimating adjusted risk ratios (aRRs) with 95% confidence intervals (CIs). ClinicalTrials.gov, NCT03770962. The cohort consisted of 1911 primiparous women. Among the tear categories investigated, major second-degree tears were the most common (30.4%), followed by minor second-degree tears (18.4%), episiotomy (9.8%), and obstetric anal sphincter injury (OASI) (5.3%). PFD symptoms were reported by 31.4-51.5% of the women. Women with OASI had an increased risk of colorectal-anal distress compared with those with no tear or a first-degree tear (aRR 1.56, 95% CI 1.24-1.96). No associations were observed between minor or major second-degree tears and pelvic floor symptoms. Increasing tear severity was associated with a higher likelihood of perceiving the vagina as narrow. No differences between tear categories were observed regarding impact on quality of life. Episiotomy was associated with a negative body image related to vaginal symptoms (aRR 1.45, 95% CI 1.03-1.99). Pelvic floor symptoms and their impact on quality of life were common 1 year postpartum, irrespective of perineal tear category. Minor and major second-degree tears were not associated with an increased risk of pelvic floor dysfunction or reduced quality of life.
To examine the relationship between the reproductive health attitudes and psychological well-being levels of female patients with psychiatric diagnoses. This research was conducted with a descriptive and relationship-seeking design and was completed with 193 female patients with psychiatric diagnoses. Data were collected using a personal information form, the Psychological Well-Being Scale, and the Scale for Determining the Reproductive Health Preventive Attitudes of Married Women. The women's Psychological Well-Being Scale total mean score was 36.50 Å} 11.74, and their Scale for Determining the Reproductive Health Preventive Attitudes of Married Women total mean score was 122.31 Å} 25.47. A moderate positive relationship was found between the Psychological Well-Being Scale total and the Scale for Determining the Reproductive Health Preventive Attitudes of Married Women total (r = 0.572; p < .001). The study findings revealed that the psychological well-being and reproductive health protective attitudes of the female patients who participated in this study were at a moderate level and that there was a significant relationship between their psychological well-being and reproductive health protective attitudes (p < .01). Psychosocial support programs should be organized to increase the psychological well-being of patients, and reproductive health training should be integrated into these intervention programs. Cite this article as: Polat, H., Bal, Z., & Karataş-Okyay, E. (2026). Relationship between psychological well-being and reproductive health attitudes in female patients with psychiatric diagnoses: A cross-sectional study. Florence Nightingale Journal of Nursing, 34, 0142, doi: 10.5152/FNJN.2026.25142.
To examine the association of childhood maltreatment with sexual attitudes during pregnancy and fear of childbirth among pregnant women. This cross-sectional study was conducted using an online survey across Türkiye. A total of 313 pregnant women aged ≥18 years and at ≥14 weeks of gestation were included. Data were collected using the Childhood Trauma Questionnaire-33 (CTQ-33), the Attitudes Toward Sexuality During Pregnancy Scale (ASSP), and the Childbirth Fear Scale (CFS). Childhood maltreatment was assessed based on CTQ-33 total scores. Descriptive statistics, group comparisons, and Pearson correlation analyses were performed. Structural equation modelling (SEM) was used to evaluate direct and indirect relationships between childhood maltreatment, sexual attitudes, and fear of childbirth. Childhood maltreatment was positively associated with sexual attitudes during pregnancy (standardized β = 0.25, p < 0.001, 95% CI [0.15, 0.38]). No meaningful direct association was observed between childhood maltreatment and fear of childbirth (β = 0.03, p = 0.648, 95% CI [-0.10, 0.16]). Correlation analyses supported these findings, showing a positive relationship between CTQ-33 and ASSP total scores (r = 0.247, 95% CI [0.14, 0.35]), while the association with CFS total scores was very weak (r = 0.045, 95% CI [-0.06, 0.15]). At the subtype level, small positive correlations were observed between emotional abuse (r = 0.134, 95% CI [0.02, 0.24]) and physical abuse (r = 0.159, 95% CI [0.05, 0.26]) with fear of childbirth. Higher levels of fear of childbirth (indicated by lower CFS scores) were associated with higher maternal education, higher partner education, and lower perceived income levels. The SEM demonstrated acceptable fit (χ2/df = 2.69, RMSEA = 0.074, CFI = 0.901, GFI = 0.992) and explained 6.1% of the variance in sexual attitudes (R2 = 0.061), while explaining very weak variance in fear of childbirth. Childhood maltreatment was associated with sexual attitudes during pregnancy but did not show a clear direct association with fear of childbirth at the total score level. Nevertheless, small subtype-specific associations suggest that different forms of maltreatment may influence fear of childbirth through more complex and indirect pathways. These findings highlight the importance of trauma-informed and context-sensitive antenatal care, particularly in addressing sexual health and psychosocial well-being.