Purpose: The purpose of this study was to compare birth outcomes between Korean women and immigrant women. Methods: Medical records were reviewed retrospectively from 201 immigrant women and 201 Korean women who delivered babies at K women's hospital in U city from January 2006 to December 2009. Maternal outcomes related factors included nationality, age, obstetric history, delivery type, indications of cesarean section, and complications of pregnancy and delivery. Principal neonatal outcomes were birth weight, Apgar scores, and complications of newborns. Results: Immigrant women were younger and had fewer pregnancies, abortions, and surviving children than Korean women. The rate of primary cesarean section and its indication in immigrant women were not significantly different from Korean women. However, immigrant women's newborn were more likely to have low birth weight and meconium staining. Conclusion: The results of this study indicate less equity of immigrant women in women's health care, although immigrant women's babies had lower Apgar score and more meconium staining. Nurses should help immigrant women cope with labor process effectively to prevent adverse health outcomes for their newborns.
Along with the low birth rate in Korea, the aging of mothers is progressing very rapidly. Recent studies have reported that the obstetric infrastructure is crumbling due to the accelerating closures of obstetric medical institutions resulting from the low birth rate and low reimbursement rates for obstetric procedures. The number of birth centers has also decreased, but women's interest in natural birth has actually increased, such that deliveries at birth centers now account for 11.8% of deliveries in obstetric clinics. In the Netherlands, Japan, and the United Kingdom, initiatives to promote natural birth through care provided by midwives increased the rate of natural births, decreased the number of cesarean sections, and lowered the rate of postpartum complications. In light of these examples, South Korea should also encourage natural delivery by midwives. A national support system for midwife applicants is necessary, and the requirements for institutions that train midwives should be revised. Independent birth centers should have emergency prescription privileges, and women should be given the choice to have a natural delivery by creating birth centers within hospitals.
The Journal of Korean Academic Society of Nursing Education
/
v.5
no.2
/
pp.267-284
/
1999
The purpose of this study are 1. Evaluate the degree of knowledge of Vaginal Birth After Cesarean(VBAC) of Korean nurses. 2. To gather and develop educational material for VBAC. The sample was surveyed Korean Nurses knowledge about VBAC, from November 1998 through March 1999. For the data analysis, the SPSS computer program percentage and frequency were used for descriptive statistics. The x2 and the t-test were used to compare the results of the two sample groups. Open questions asked in the survey were sorted out by content, then displayed in chart form. For the education material, the Internet was the main source of information. Information on the Internet was provided by professional doctors and prenatal educational nurses. The results of the survey are as follows: 1. Out of 97 Nurses 15.3% answered that cesarean deliveries do not need to be performed after previous cesarean sections : however. 46.4% answered that cesarean sections must be performed after previous cesarean sections. 2. Of the nurses surveyed 14% had no knowledge or had never heard of VBAC. 3 Nurses did not have questions from patients concerning VBAC was 34.7%. This led to the conclusion that patients either do not have knowledge about VBAC or patients have no interest in the trial of labor. 4, Nurses indicated that their information about VBAC originated from other people's experiences (31%), Nursing School (25%), Media information (9%), and through literature review (6%). This data led to the conclusion that the knowledge about VBAC may not be extensive enough to counsel and guide patients who are willing to endure the trial of labor. 5. Nurses preferred hospital education programs to develop their knowledge concerning VBAC. Based upon survey, the conclusion was made that General Nurses and Maternity Nurses did not have knowledge about VBAC success rates and the possibility of a trial of labor. In order for nurses to help patients make decisions concerning VBAC, nurses have to gam more knowledge through hospital educational programs. Further more, the study suggests that through hospital educational programs, the possibility and importance of VBAC must be emphasized to nurses who work in maternity areas. Second, through prenatal educational programs, the possibility and importance of VBAC must be explained and emphasized to patients who had previous cesarean sections. Third, the clinical pathways of VBAC need to be developed. Fourth, each hospital needs to develop multi-disciplinary teams, consis-ting of obstetricians, risk management/quality management, staff registered nurses, and the director for perinatal services. This team can review cesarean section rates and help to increase the practice of VBAC.
From of old, labor has been accompanied by pain and much effort has been mode to eliminate or diminish the amounts of pain during labor. Little concern has yet been given to the subjective meaning of pain in labor. Recently, rates of cesarean section in Korea and in some other nations have increased rapidly and some investigators are reporting negative reactions such as anger, disappointment and feeling of loss due to lack of control over labor and its pain. These findings are thought to suggest that control of labor and its pain gives some meaning to the laboring woman. Thus the investigators sought to discover the meaning of pain during labor for Korean women. Specific objectives of this study were to explore the meaning of pain in labor to the mothers, their reactions to the experience of labor add their preference for delivery method. The subjects of this study were 95 mothers who delivered their babies in hospital from September 989 to May 1990 : 45 gave birth by vaginal delivery, and 50 by cesarean section. Data were gathered through direct interviews by the investigators, and questions were focused on five areas i.e. mothers' feelings about delivery and their babies, their feelings about of having more children, the most difficult aspect about this labor and delivery, and what they thought the differences were between vaginal delivery and cesarean section. After interview, mothers' answers were summarized, and classified according to the degree of positive or negative attitude. To ascertain the difference in meaning of labor pains and reaction to delivery experience between mothers delivered vaginally and by cesarean section a Median test was done using an SAS. Results were as follows. 1. More mothers who had delivered vaginally realized that they “have became a mother” than those who had a cesarean section(X$^2$=8.409, df=3, p=0.038). 2. Immediate reaction to their delivery experience was more positive for mothers who had a cesarean section. 3. These Korean mothers expressed preference for vaginal delivery. Suggestions for further research on the meaning for mothers of their experience of labor, and on the meaning of pain for mothers who have a cesarean section were made.
The objective of this study is to assess the effect of interpregnancy interval on fetal outcome among women with term premature rupture of membrane in public hospitals, Ethiopia, 2017. Facility based follow up study was conducted in Southern Ethiopia public hospitals from February 30, 2017 to August 20, 2017. Among 150 observed mothers with interpregnancy interval of less two years, 46.67 % (95% CI: (7.170, 29.93) of them experienced adverse birth outcome, but among 173 women with interpregnancy interval of two and above years, 5.78% (95% CI: (7.170, 29.93) of them experienced adverse birth outcome. The odds of adverse birth outcome were more among women with interpregnancy interval of less than two years (AOR=17.899, 95%CI: [6.425, 49.859]. The effect of interbirth interval of less than two years on adverse birth outcome of newborn was increased by length labor of >=24 hours, induction of labour and cesarean section delivery. Interpregnancy interval of less than two years, in collaboration with other risk factors, is the main predictor of adverse birth outcome. Therefore especial attention should be given to mothers with birth spacing by using family planning methods to reduce adverse birth outcome.
Background: The consequences of severe acute respiratory syndrome corona virus 2 on mother and fetus remain unknown due to a lack of robust evidence from prospective studies. Purpose: This study evaluated the effect of coronavirus disease 2019 (COVID-19) on neonatal outcomes and the scope of vertical transmission. Methods: This ambispective observational study enrolled pregnant women with COVID-19 in North India from April 1 to August 31, 2020 to evaluate neonatal outcomes and the risk of vertical transmission. Results: A total of 44 neonates born to 41 COVID-19-positive mothers were evaluated. Among them, 28 patients (68.3%) (2 sets of twins) were delivered within 7 days of testing positive for COVID-19, 23 patients (56%) (2 sets of twins) were delivered by cesarean section; 13 newborns (29.5%) had low birth weight; 7 (15.9%) were preterm; and 6 (13.6%) required neonatal intensive care unit admission, reflecting an increased incidence of cesarean delivery and low birth weight but zero neonatal mortality. Samples of cord blood, placental membrane, vaginal fluid, amniotic fluid, peritoneal fluid (in case of cesarean section), and breast milk for COVID-19 reverse transcription-polymerase chain reaction tested negative in 22 prospective delivery cases. Nasopharyngeal swabs of 2 newborns tested positive for COVID-19: one at 24 hours and the other on day 4 of life. In the former case, biological samples were not collected as the mother was asymptomatic and her COVID-19 report was available postdelivery; hence, the source of infection remained inconclusive. In the latter case, all samples tested negative, ruling out the possibility of vertical transmission. All neonates remained asymptomatic on follow-up. Conclusion: COVID-19 does not have direct adverse effects on the fetus per se. The possibility of vertical transmission is almost negligible, although results from larger trials are required to confirm our findings.
Recently, the rate of cesarean section in Korea has been increasing. The results of several previous studies in foreign countries on the emotional responses of cesarean section mothers showed that they might experience difficulties in the mother- infant interaction due to fatigue, lack of early mother - infant interaction, disappointments, anger, feelings of loss of control, and other factors. Human behavior is said to be determined by one's self concept, and self concept is influenced by both internal and external environmental factors. A scale to measure the self concept of cesarean section mothers was needed in order to identify those who might have difficulties in the mother- infant interactions in future. The purposes of this study were to develop a measuring scale, and to test its reliability and validity. The process of this study was as follows. A structured interview was done with 50 cesarean section and vaginal delivery mothers to find their state of emotional reaction after giving birth to their babies. Based on the results of the interviews, a 50 items Likert scale was developed. The self concept of 268 cesarean section and vaginal delivery mothers who were hospitalized at six hospital in seoul were measured, during the period between Feb. 1 and April 30. Reviewing the discriminating power of each item by means of crosstabulation, ten items were selected for the final scale. The reliability and validity of this ten item scale were tested by Cronbach's alpha and t-test, using spss pc+package. The results of this study and recommendation are as follows. 1. The ten selected items were as follows. I feel pains in my breast. (-) I have a good appetite now. (+) I feel pains in my flank. (-) I feel fine now. (+) My body seems to have returned to its prepregnant state. (+) Thinking of the delivery process, I feel sorry. (-) I want to hold my baby in my arms. (+) I want to keep my own life, even if I became a mother. (-) I want to delegate the care of the baby to my mother / mother in law. (-) I think baby is my alter ego. (+) 2. The reliability of this scale was tested by Cronbach's alpha, and the coefficient of this scale was .8066. 3. The construct validity of this scale was tested by means of known group methods. The value of self concept for cesarean section mother was significantly lower than for vaginal delivery mothers(t=-5.51, df=266, p=0.007). 4. The criterion validity of this scale was tested indirectly. Though this scale could discriminate the differences in the self concept between cesarean section and vaginal delivery mothers, the five items on the personal self concept scale didn's show any differences between cesarean section and vaginal delivery mothers. Therefore, the study indicates that those who shows lower values in the personal self concept measurement, that is, lower than 12.03 points, could be regaled as “risk mothers” 5. Further studies using this scale to clarify the influencing factors on negative self concept are strongly recommended.
The purpose of this study was to fine out the general physical status of the neonates, and to identify the risk factors of the mothers and the neonates which were significantly related to the neonatal diseases during hospitalization. The data were obtained from clinical records of 1098 neonates born in Seoul Red cross Hospital between January 1st of 1984 and December 31th of 1986. The results of this study were summarized as follows: 1. General characteristics of the maternal group. 1) The average of maternal age was 26.6 years, the $91.7\%$ of the mothers de liveried at the age of 20-34 years old. 2) The distribution of the types of delivey were as follows : spontaneous delivery $39.9\%$, cesarean section $32.4\%$, vaccum extraction $25.7\%$, and breech delivery$2.0\%$. 3) The $40.3\%$ of the total de liveried mother had experienced abortion. 4) The $42.3\%$ of the total deliveried mother had one or more obstetric risk factors. 2. General characteristics of the neonatal group. 1) In the distribution of sex, male was $49.4\%$, female $50.6\%$. 2) The average of birth weights was 3,020gm. The distribution of birth weight were as follows; nomal weight $85.5\%$, low birth weight $12.7\%$ and high birth weight $2.5\%$. 3) The average of gestational age was 39.2 weeks. The distribution of gestational age were as follows; full term $77.4\%$, preterm $13.7\%$, and postterm $8.9\%$. 4) The average of Apgar Score was 9.0 at one minute and 9.6 at five minutes. 5) The $5.7\%$ of the neonates had one or more neonatal risk symptoms and signs at birth. 3. Apgar Score by the maternal and neonatal factors. In Apgar Score at one minute, normal group was higher than that of abnormal group. Apgar Score at five minutes was slightly higher than that at one minute. 4. The distribution of the maternal risk factors and the neonatal risk factors. 1) The total numbers of the maternal risk factors were 1376. The distribution of the maternal risk factors were as follows: obstetric factor $33.7\%$, abortion $32.2\%$, breech and cesarean section delivery $27.5\%$ and maternal age under 19 years and over 35 years $6.6\%$. 2) The total numbers of the neonatal risk factors were 517. The distribution of the neonatal risk factors were as follows: gestational age under 37 weeks and over 42 weeks $48.0\%$, birth weight under 2500gm and over 4000gm $12.2\%$, Apgar score under 4 at one munute $6.4\%$ and Apgar score at five munutes $2.7\%$. 3) The total numbers of the obstetric risk factors were 661. The types of the obstetric risk factors were meconium stained amniotic fluid $22.0\%$, premature rupture of membrane $17.5\%$. absence prenatal care $14.1\%$, unmarried pregnancy $10.3\%$, placenta problem $9.0\%$, toxemia $8.0\%$. 4) The total numbers of the neonatal risk symptoms and signs at birth were 83. The types of the neonatal risk symptoms and signs were respiratory distress $65.1\%$, neonatal apnea $14.4\%$, convulsion $13.3%$, meconium aspiration syndrome $4.8\%$, cyanosis $2.4\%$. 5. The relationship between the maternal risk factors and the neonatal risk factors. 1) Maternal age under 19 years or over 35 years was significantly related to Apgar Score under 4 at 5 minutes. 2) Breech delivery or cesarean section was significantly related to neonatal risk factor at birth such as birth weight, gestational age, Apgar Score at one minute and at five minutes. and neonatal risk symptoms and signs. 3) Obstetric risk factors were significantly related to the neonatal risk factors at birth. 4) Abortion was not related to the neonatal risk factors. 6. The relationship between neonatal diseases during hosptalization and the maternal or the neonatal risk factors. 1) The total numbers of neonatal diseases during hospitalization were 281. The distribution of neonatal diseases were as follows: birth trauma $38.1\%$, infectious disease $31.3\%$, hematologic disease $21.4\%$, respiratory disease $6.0\%$, neurologic disease $2.5\%$. cardiovascular disease $0.7\%$. 3) Most maternal risk factors except abortion were significantly related to neonatal diseases. 4) Most neonatal risk factors at birth were significantly related to neonatal diseases.
We studied 100 neonates to enter a Dongguk University Oriental Hospital Postpartum Care Center, during 9 months from February 10. 2001 to November 4. 2001. The conclusion is following. 1. Newborn sex ratio was 1.70. 2. Delivery method : Normal vaginal delivery was 66 and cesarean section was 34. 3. Gestation age : Premature infants less than 37 weeks were 2 term infants from 37 to 41 weeks were 98 and post-term infants 42 or more weeks were zero. 4. Period between birth and admission : First to fifth day was 66 sixth to tenth day was 32 and eleventh or more day was 2. 5. Period of admission : 1 to 7 days were 8. 8 to 14 days were 65. 15 to 21 days were 23. and 22 to 28 days were 4. 6. Weight : Birth weight less than 2500g was 3. 2500 to 3999g was 92. and 4000g or more was 5. 7. Height : Zero week after birth the average height was 48.8cm, one week after birth was 50.0cm, two weeks after birth was 51.8cm, three weeks after birth was 53.2cm, four weeks after birth was 54.5cm. 8. Head circumference : Zero week after birth the average head circumference was 34.6cm, one week after birth was 35.3cm, two weeks after birth was 35.7cm, three weeks after birth was 36.3cm, four weeks after birth was 36.8cm. 9. Chest circumference : Zero week after birth the average chest circumference was 33.2cm, one week after birth was 33.5cm, two weeks after birth was 34.4cm, three weeks after birth was 35.1cm, four weeks after birth was 36.6cm. 10. Feeding : There was not breast feeding, artificial feeding was 8, and mixing feeding was 92. 11. Jaundice : Physiologic jaundice was 10, pathologic jaundice was 1.
Purpose: This study was done to identify the effects of self-breast pumping on breastfeeding rates and, the degree of breast milk fullness among primiparous women giving birth by cesarean section. Methods: The study design was a non-synchronized posttest control group experiment with repeated measures. The participants were 60 women, 31 in the experimental group who used a manual pump 5 times a day after exclusive breastfeeding and 29 in the control group who breastfed exclusively with no other interventions. Results: While self-breast pumping did not improve breastfeeding rates or the degree of breast milk fullness at any of the time points studied, breastfeeding rates continued to remain high till 12 weeks postpartum in both groups. Conclusion: Although some modifications in research methods will be required to identify the effects of breast pumping and exclusive breastfeeding, both these approaches can be used as interventions to improve breastfeeding rates and breast milk quantity.
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