Journal of Education and Health Promotion

The effect of couple supportive counseling on self‑efficacy in women with insulin‑treated gestational diabetes: A randomized clinical trial

. Sahar Rostampour; . Fatemeh Erfanian Araghvanian; . Masoumeh Kordi; . Farideh Akhlaghi; . Seyyed Mohsen Asghari Nekah; . Mohammad Taghi Shakeri

Volume 13, Issue 2 , February 2023, , Pages 1-7

Abstract

  BACKGROUND: Gestational diabetes is the most common medical complication and a commonmetabolic disorder during pregnancy. Increasing people’s self‑efficacy is one of the best ...  Read More BACKGROUND: Gestational diabetes is the most common medical complication and a commonmetabolic disorder during pregnancy. Increasing people’s self‑efficacy is one of the best ways tocontrol this disease. As there is a lag of intervention in this regard, the purpose of this study was todetermine the effect of couple supportive counseling on self‑efficacy in women with insulin‑treatedgestational diabetes.MATERIALS AND METHODS: In this randomized clinical trial, 64 women with gestational diabeteswho referred to diabetes clinic of Mashhad Ommolbanin Hospital were divided into intervention andcontrol groups through block randomization during 2019. Their gestational age was in 26–30 weeks.For the couples in the intervention group, three couple supportive counseling session was held. Eachsession lasted 1 h and was held one time per week. The instruments were diabetes self‑efficacyquestionnaire, fasting and 2‑h postprandial checklist and Cassidy social support, which were assessedbefore and 4 weeks after intervention in both groups. Data was analyzed by SPSS software version 25through Mann–Whitney and Wilcoxon test. P values of < 0.05 were reported to be significant.RESULTS: In the preintervention, the diabetes self‑efficacy score had no significant differencein the intervention (30/6 ± 38/50) and control groups (09/8 ± 56/51) (P = 515/0). However, inthe postintervention, the diabetes self‑efficacy score was significantly higher in the interventiongroup (58/6 ± 41/71) compared to the control group (15/7 ± 31/51) (P < 001/0). Also, before theintervention, there was no significant difference between the intervention (30/2 ± 72/10) and controlgroup (87/1 ± 63/11) (P = 137/0) regarding social support. However, after the intervention, there wasa significant difference between the intervention and control groups (879/0 ± 53/13, 03/2 ± 41/11,P < 0/001 respectively). Also, data analysis showed a significant correlation between self‑efficacyand social support (r = 0.451, P < 0.001), self‑efficacy and fasting blood sugar (P < 0.001, r = ‑0.577),and 2 h post prandial (r = ‑0.778, P < 0.001).CONCLUSION: Couple supportive counseling leads to increased self‑efficacy and social supportin pregnant women with gestational diabetes. Therefore, it is recommended to use this counselingas an effective method in the management of diabetic pregnant women during their prenatal careto have a healthier pregnancy.

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Pregnant women’s experiences of well‑being in high‑risk pregnancy: A qualitative study

. Kobra Mirzakhani; . Abbas Ebadi; . Farhad Faridhosseini; . Talat Khadivzadeh

Volume 13, Issue 1 , January 2023, , Pages 1-9

Abstract

  BACKGROUND: Physical changes in high‑risk pregnancy (HRP) can lead to changes in mood andsocial relationships and negative effects on women’s well‑being. Individuals in different ...  Read More BACKGROUND: Physical changes in high‑risk pregnancy (HRP) can lead to changes in mood andsocial relationships and negative effects on women’s well‑being. Individuals in different socioculturalcontexts have different perceptions of well‑being. Yet, there is limited information about perceptions ofwell‑being in HRP. This study aimed to explore the Iranian women’s experiences of well‑being in HRP.MATERIALS AND METHODS: This qualitative study was conducted in 2019–2020 through directedcontent analysis based on the conceptual framework of well‑being in HRP. Participants were 26women with HRP purposively recruited from public and private healthcare settings in Mashhad, Iran.Face‑to‑face semistructured interviews were held for data collection until data saturation. Data wereanalyzed through directed content analysis proposed by Elo and kyngäs (2008) and were managedusing the MAXQDA (v. 10) program.RESULTS: Well‑being in HRP had seven attributes in the five main dimensions of physical,mental‑emotional, social, marital, and spiritual well‑being. The seven attributes of well‑being in HRPwere controlled physical conditions, controlled mood, emotions, and affections, perceived threat,self‑efficacy, and competence for multiple role performance, maintained social relationships, meaningseeking and relationship with the Creator, and positive marital relationships.CONCLUSION: The present study provide an in‑depth understanding about well‑being in the Iranianwomen with HRP. It is a complex and multidimensional concept with physical, mental‑emotional,social, marital, and spiritual dimensions. Comprehensive multicomponent interventions are needed topromote well‑being among women with HRP and designed the guidelines to provide woman‑centeredcare.

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Functionality of self‑care for pregnancy mobile applications: A review study

. Behnaz Pouriayevali; . Asghar Ehteshami; . Shahnaz Kohan; . Sakineh Saghaeiannejad-Isfahani

Volume 12, Issue 11 , December 2022, , Pages 1-8

Abstract

  Self‑care may help prevent pregnancy complications and mortality by informing parents. Mobilehealth applications (apps) can help individuals to improve the quality of self‑care. ...  Read More Self‑care may help prevent pregnancy complications and mortality by informing parents. Mobilehealth applications (apps) can help individuals to improve the quality of self‑care. Although it hasbeen claimed that mobile apps have various benefits, their functionalities in pregnancy self‑careare still unclear. A clear understanding of current apps can help researchers, practitioners, and appdevelopers to identify appropriate functionalities for new development and future refinement of currentapps. This review endeavored to identify appropriate functions for pregnancy self‑care mobile appsand user interface (UI) features. The scope of this review integrates self‑care for pregnancy appspublished in Google Play and Cafe Bazaar (an Iranian Android marketplace), popular Android appstores, from July to October 2019 by sing the systematic search technique. All 4196 downloaded appswere installed, and it was found that 76 of them met the inclusion criteria. This way, their featureswere extracted and categorized by the conventional content analysis. Three main themes and 69subthemes in terms of apps functionalities and their UI features were extracted as follows: 1) Trainingmaterials (maternal and paternal) with 27 subthemes; 2) self‑care functionalities (consultations, fetustracking, clinical examination, supportive assistance, and reminders) with 26 subthemes; and UIfeatures with 16 subtheme. The findings underlined the mHealth solutions for pregnancy self‑careand the need for development of the apps regarding the extracted functionalities and UI features;however, controlled trials are needed. It is recommended that transparent reporting of mHealthinterventions needs to be prioritized to enable effective interpretation of the extracted data.

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Development of application‑based education model and prenatal yoga in reducing the occurrence of cesarean section (CS) delivery: Study protocol

. Ni M. Dewianti; . Stang; . Sukri Palutturi; . Masyita Muis; . I. Nyoman M. Karmaya; . Suriah

Volume 12, Issue 10 , November 2022, , Pages 1-5

Abstract

  BACKGROUND: In the last 20 years, the public health community has expressed concerns overthe unprecedented increase of cesarean section (CS) delivery. Rising global concerns over thisescalation ...  Read More BACKGROUND: In the last 20 years, the public health community has expressed concerns overthe unprecedented increase of cesarean section (CS) delivery. Rising global concerns over thisescalation that has gone out of control should not be overseen. The purpose of this study is todevelop an application‑based education model and prenatal yoga to reduce the occurrence ofcesarean section (CS) delivery.MATERIAL AND METHOD: This studywasan exploratory mixed methodsresearchthat consisted oftwostages: stage 1, which wasa qualitative study on model formulation through in‑depth interviewsand forum group discussions (FGDs); and stage 2, which aimed to test whether the formulated modelwas effective in reducing the occurrence of cesarean section delivery.CONCLUSION: The result of this study wasused todevelop an application‑based education model,which wascombined with prenatal yoga, to reduce the occurrence of cesarean section delivery.

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Mobile health applications for pregnancy in Iran: Current state investigation

. Mahboubeh Shirvanian-Dehkordi; . Firoozeh Zare-Farashbandi; . Rahele Samouei; . Rasool Nouri

Volume 12, Issue 9 , October 2022, , Pages 1-5

Abstract

  BACKGROUND: The expansion of pregnancy‑related mobile applications has led to an increasein the usage of these applications by Iranian women, which has the potential to have a long‑termimpact ...  Read More BACKGROUND: The expansion of pregnancy‑related mobile applications has led to an increasein the usage of these applications by Iranian women, which has the potential to have a long‑termimpact on women’s pregnancy health and, as a result, community health. The goal of this researchwas to investigate the state of pregnancy‑related mobile applications in Iran.MATERIALS AND METHODS: This was a descriptive‑applied research approach which wasconducted in 2020. One hundred and fifty‑seven pregnancy apps from different Iranian mobile appmarkets were installed and were examined in terms of the resources used and their validity, subjectdistribution, participation of obstetricians in the app development, apps volume, rank acquired byusers and distribution of apps according to the developers. The relationship between the number ofresources used and user rankings was also tested.RESULTS: A total of 157 apps were categorized into 12 subject categories based on their content.Only 1.3% of the apps were developed with the participation of obstetricians. Only 5% of the appshad used reliable information resources. Furthermore, the number of resources referenced in thestudied apps did not have a significant relationship with star ratings (r = 0.03, P = 0.64), accordingto the Pearson correlation test.CONCLUSION: Iranian mobile applications in the field of pregnancy have grown significantly interms of quantity, subject diversity, and user acceptance; however, the credibility of the informationin these apps cannot be validated. This serves as a reminder to users to exercise caution whileusing such apps.

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Comparison of the effect of face‑to‑face training and telemedicine on self‑care in adolescent pregnant women: A quasi‑experimental study

. Samira Khayat; . Maryam Palizvan; . Ali Navidian; . Hamed Fanaei; . Zahra Pahlavani Sheikhi

Volume 12, Issue 9 , October 2022, , Pages 1-8

Abstract

  BACKGROUND: Improving self‑care in adolescent pregnancy leads to improved maternal andneonatal outcomes of pregnancy. However, self‑care in adolescent pregnancy is less than otherwomen. ...  Read More BACKGROUND: Improving self‑care in adolescent pregnancy leads to improved maternal andneonatal outcomes of pregnancy. However, self‑care in adolescent pregnancy is less than otherwomen. The aim of this study was to compare the effect of face‑to‑face training and telemedicineon self‑care in adolescent pregnant women.MATERIALS AND METHODS: The present study is a quasi‑experimental study that was conductedin Zahedan in 2021 and 120 adolescent pregnant women with a gestational age of 15–20 weeksparticipated in it. The sampling was done in multistage, and the samples were divided into three groups:Face‑to‑face training, telemedicine, and control. Face‑to‑face training was presented in five sessionsand the telemedicine group received the similar educational content through the mobile applications.The samples completed a researcher‑made self‑care questionnaire before the intervention and at28 weeks of gestation. SPSS software version 21 was used for the analysis, and data were analyzedby ANOVA, Tukey post hoc, Kruskal–Wallis, and Mann–Whitney tests.RESULTS: There was no significant difference in face‑to‑face and telemedicine training in improvingthe scores of nutritional performance, smoking and narcotics use, personal hygiene, and routinepregnancy care (P > 0.05), but face‑to‑face training caused more improvement in the scores ofsports and physical activity as compared to telemedicine group (P = 0.04). Face‑to‑face trainingand telemedicine training in all domains led to a significant improvement in scores as compared tothe control group (P < 0.05).CONCLUSION: The results of this study showed that the face‑to‑face training and telemedicinemethods were proper methods for self‑care education in pregnant adolescent women. It isrecommended to use these methods in promoting self‑care in pregnant adolescent women.

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Online versus face‑to‑face metacognitive educational counseling program on anxiety and meta‑worry in women with a history of miscarriage: A randomized clinical trial

. Mina Ghiasi Shahamabadi; . Tahmineh Farajkhoda; . Hassan Zareei Mahmoodabadi

Volume 12, Issue 7 , August 2022, , Pages 1-8

Abstract

  BACKGROUND: In the COVID‑19 outbreak, women with a history of miscarriage need more mentalhealth. Anxiety and meta‑worry as consequences of miscarriage, besides concerns due to ...  Read More BACKGROUND: In the COVID‑19 outbreak, women with a history of miscarriage need more mentalhealth. Anxiety and meta‑worry as consequences of miscarriage, besides concerns due to pregnancyduring coronavirus, show the necessity of appropriate online and face‑to‑face educational counseling.This study aimed to evaluate the effectiveness of online metacognitive educational counseling versusface‑to‑face method on anxiety and meta‑worry in these women.MATERIALS AND METHODS: In this randomized clinical trial, 80 women with a history ofmiscarriage, anxiety, and meta‑worry referred to Imam Jafar Sadegh hospital (labor, women wardand women clinic), Meybod, Iran, were selected conveniently and randomly assigned into twogroups (n = 20/each). The participants received 8‑session metacognitive educational counselingpackage online or face‑to‑face. Data were collected by Beck Anxiety Inventory, Wellz meta‑worryquestionnaire at baseline, week eight, and follow up as primary outcomes and analyzed via SPSSsoftware (Anova and Repeated measure statistic tests).RESULTS: Anxiety in the 12th week (online group 13.75 ± 3.59 vs. face to face 18.25 ± 5.91,P = 0.04) was statistical significantly less than baseline (respectively 22.15 ± 5.67 vs. 22.35 ± 4.93,P =  0.56); with fewer anxiety scores in the online group. Meta‑worry in the 12th week (onlinegroup 11.90 ± 2.59 vs. face to face 15.70 ± 4.06, P = 0.03) was statistically significant compared tobaseline (respectively 17.15 ± 2.70 vs. 18.50 ± 3.47, P = 0.36); with fewer meta‑worry scores in theonline group. Belief about worry in 12th week (online group 66.50 ± 14.60 vs. face to face 78.45 ± 9.27,P = 0.01) was statistical significantly less than baseline (respectively 85.50 ± 8.87 vs. 86.05 ± 8.85,P = 0.96); with less score of belief about worry in the online group.CONCLUSION: Online and face‑to‑face metacognitive educational counseling methods decreasedanxiety, meta‑worry, and belief about worry in women with miscarriage. But online educationalcounseling was more effective. Distance online counseling in COVID‑19 can help the mental healthof women with miscarriage.

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Asymptomatic bacteriuria of pregnant women in a tertiary care centre

. Meenakshi Totadhri; . Anandhi Lakshmanan; . Saraswathy M P; . Manisha S. Mane

Volume 12, Issue 7 , August 2022, , Pages 1-7

Abstract

  BACKGROUND: Asymptomatic bacteriuria (ASB) is commonly seen during pregnancy due to thevarious morphological, hormonal, and physiological changes the body undergoes. If left undiagnosed,it ...  Read More BACKGROUND: Asymptomatic bacteriuria (ASB) is commonly seen during pregnancy due to thevarious morphological, hormonal, and physiological changes the body undergoes. If left undiagnosed,it can lead to conditions such as pyelonephritis and preterm delivery which could culminate in causingmaternal and fetal morbidity and mortality. Therefore, this study aims to determine the prevalence,risk factors, microbial profile, and antibiotic susceptibility patterns associated with ASB in a tertiaryhealthcare center.MATERIALS AND METHODS: A cross‑sectional study was carried out where 150 urine sampleswere obtained from pregnant women within the gestational age of 13–36 weeks. Randomizedstratified sampling was the method of sampling used. A questionnaire was also administered tothem to determine potential risk factors. The samples were cultured and identified using biochemicaltests. Antibiotic susceptibility tests were carried out by Kirby–Bauer disc diffusion method. Statisticalanalysis was carried out using Chi‑square test. The graphs and tables were generated using MicrosoftExcel and Word.RESULTS: Out of the 150 samples that were obtained, 8 samples had significant bacteriuria whichis a prevalence of 5.33%. Escherichia coli was the most frequently isolated organism accountingto 45% of the isolates. The other organisms that were isolated were Enterococcus, Klebsiellapneumoniae, Coagulase negative staphylococcus (CONS), Candida albicans, and Group BStreptococcus which measured to 11% of the total distribution each. In the antibiotic sensitivitytests, among the gram‑negative isolates, marked resistance to Ampicillin and Amoxycillin along withsensitivity to Cotrimoxazole and Nitrofurantoin. Of the gram‑positive isolates, there was sensitivityto Ampicillin and Nitrofurantoin. A positive correlation was seen between the age groups of 23–27and the prevalence of ASB.CONCLUSION: The prevalence of ASB in this study shows that ASB is not uncommon in thepopulation. Despite the World Health Organization (WHO) guidelines and National Health Missionrecommendations to make urine check‑ups a routine, it not carried out, possibly due to costimplications. However, it poses a risk for severe maternal and fetal outcomes and hence, should bescreened for on a regular basis. Thus, this study emphasizes the importance of screening pregnantwomen for ASB for promoting better maternal and fetal health.

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Assessment of knee and ankle proprioception during the third trimester of pregnancy and postpartum period among primiparous women: An observational longitudinal study

. Aditya Wakkar; . Shubhangi P. Patil

Volume 12, Issue 6 , July 2022, , Pages 1-7

Abstract

  BACKGROUND: Pregnant women experience falls, particularly in the third trimester. In this population, physiological changes, as well as ligament laxity, might influence joint proprioception ...  Read More BACKGROUND: Pregnant women experience falls, particularly in the third trimester. In this population, physiological changes, as well as ligament laxity, might influence joint proprioception and do not return to normal during the postpartum period. The prevalence of falls during pregnancy and postpartum periods imposes a need to study proprioception in pregnant women and the postpartum period. MATERIALS AND METHOD: An observational longitudinal study was conducted in June 2018 in outpatient clinic Chinchwad Pune. A total of 36 primiparous women were included in the study by using purposive sampling. The mean and standard deviation of the age was 25.92 (2.59). Proprioception was assessed for the knee joint and the ankle joint during the third trimester of pregnancy and 6th and 12th week postpartum. Outcomes included were the Joint Reposition Test for both knee and ankle joints using UTHSCSA Image Tool Software 3.0. Repeated‑measure ANOVA was performed for the normally distributed data, and nonparametric test Friedman’s test was performed for data that were not distributed normally. The data was statistically analyzed using the SPSS software version 26. The level of significance was set at 0.05, confidence intervals of 95% were used. RESULT: The result revealed significant (P < 0.05) improvement in both knee and ankle proprioception during the third trimester of pregnancy and postpartum period 6th and 12th week. CONCLUSION: Knee proprioception and ankle proprioception were found to improve significantly during the postpartum period 6th and 12th weeks compared to the third trimester of pregnancy but do not return to the prepregnancy state.

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Determining the status of preconception care model in pregnant woman of Gorgan city (North of Iran) using structural equation modeling (SEM)

. Narjes Sadat Borghei; . Tayebeh Ebady; . Roghaieh Bayrami; . Roya Nikbakht

Volume 12, Issue 6 , July 2022, , Pages 1-8

Abstract

  BACKGROUND: Preconception reduces unplanned pregnancies and plays an important role in reducing maternal and infant mortality. Considering the importance of these care services, ...  Read More BACKGROUND: Preconception reduces unplanned pregnancies and plays an important role in reducing maternal and infant mortality. Considering the importance of these care services, this study was conducted to determine the status of preconception care (PCC) model with Structural Equation Modeling (SEM).MATERIALS AND METHODS: This cross-sectional descriptive study was conducted on 394 pregnant women referring to Gorgan’s health centers. Samples were selected by multi‑stage stratified sampling method. The instrument used in this research was a researcher-made questionnaire by Bayrami. Data were analyzed using R software version 4.1.4. Structural equation modeling (SEM) with weighted least square mean and variance method was used to fit the conceptual model and the significance level of the tests was considered 0.05.RESULTS: The results showed that PCC model was deemed appropriate as optimum conditions indicators of goodness of fit; knowledge with a coefficient of 0.182 leads to self‑efficacy (SE), and SE affects the accessibility of facilities with a coefficient of 0.465 and the expected outcome with a coefficient of 0.500. After facility structure with a coefficient of 0.500, SE construct with a coefficient of 0.215 had the most effect on performing PCC behavior.CONCLUSIONS: Facilities and SE as a key element of empowerment have an important role in promoting PCC. Identifying the factors associated with this care appears to help health policymakers to planning for these caregivers more precise and sensitive.

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Individual counseling in mothers bereaved by pregnancy loss: A randomized clinical trial

. Mahmonir Haghighi; . Khatereh Oladbaniadam; . Hamideh Mohaddesi; . Javad Rasuli

Volume 12, Issue 5 , June 2022, , Pages 1-7

Abstract

  BACKGROUND: The loss of a pregnancy can result in grief, guilt, self‑doubt, anxiety, andpost‑traumatic stress disorder (PTSD). Considering the side effects mentioned for mental ...  Read More BACKGROUND: The loss of a pregnancy can result in grief, guilt, self‑doubt, anxiety, andpost‑traumatic stress disorder (PTSD). Considering the side effects mentioned for mental healthand the fact that the symptoms will linger if left untreated and even adversely affect the subsequentpregnancies. The current study was designed to assess the impact of individual counseling on stress,anxiety, and depression in mothers with pregnancy loss.MATERIALS AND METHODS: The study commenced 100 women who experienced pregnancy loss(in Urmia/2018-2019); they were enrolled using convenience sampling and block randomization. Theintervention group received four individual counseling sessions (weekly sessions with a duration of1 h) based on Warden’s principles. The control group received routine care. The Depression AnxietyStress Scale (DASS‑42) was filled out at baseline, the pre‑ and post‑intervention. Analyses wereperformed using the Chi‑square, paired, or individual t‑tests, when necessary. P value < 0.05 wasconsidered significant.RESULTS: There were no significant differences regarding socio‑demographic characteristics andclinical features between groups at baseline. Intra‑group analysis showed that all outcome measuresin the intervention group were significantly improved. According to inter‑groups analysis, a significantassociation was found between pre‑test and post‑test in the intervention group (P < 0.05).CONCLUSION: Results of this study can clarify the psychological effects of pregnancy loss in thesemothers and help the officials and responsible parties to plan the treatment and rehabilitation of thesewomen and include them in the healthcare system.

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Awareness and understanding of COVID‑19 among pregnant woman in northern India

. Manisha Jhirwal; . Pratibha Singh; . Charu Sharma; . Priyanka Kathuria; . Shashank Shekhar; . Satya Prakash Meena

Volume 12, Issue 5 , June 2022, , Pages 1-7

Abstract

  BACKGROUND: The severe acute respiratory syndrome coronavirus (SARS‑CoV‑2) has becomea public health concern worldwide. It is important for pregnant women to know about the mode ...  Read More BACKGROUND: The severe acute respiratory syndrome coronavirus (SARS‑CoV‑2) has becomea public health concern worldwide. It is important for pregnant women to know about the mode oftransmission, symptoms, and preventive measures against COVID‑19. The aim of this study wasto evaluate the awareness and outlook of pregnant women and practical measures taken by themagainst COVID‑19.MATERIALS AND METHODS: This cross‑sectional questionnaire‑based study was conducted for1 month (June 10, 2020– July 10, 2020) in the Department of Obstetrics and Gynecology, All IndiaInstitute of Medical Sciences, Jodhpur, Rajasthan, India. A prevalidated questionnaire was given to109 pregnant women to assess the knowledge, attitude, and practice acquired against COVID‑19infection. The Chi‑square test or Fischer’s exact test was used to compare categorical data.RESULTS: Among 109 participants, 103 (94.5%) had good knowledge, 4 (3.7%) had averageknowledge and 2 (1.8%) had poor knowledge about COVID‑19. Majority of them had a positiveattitude for the protective measures taken for the prevention of disease.CONCLUSIONS: Since there is no valid treatment for COVID‑19, prevention is the only key to curvethis infection. In the present study, 94.5% pregnant women had overall good knowledge score aboutthe ode of transmission, symptoms, and preventive measures against COVID‑19.BACKGROUND: The severe acute respiratory syndrome coronavirus (SARS‑CoV‑2) has becomea public health concern worldwide. It is important for pregnant women to know about the mode oftransmission, symptoms, and preventive measures against COVID‑19. The aim of this study wasto evaluate the awareness and outlook of pregnant women and practical measures taken by themagainst COVID‑19.MATERIALS AND METHODS: This cross‑sectional questionnaire‑based study was conducted for1 month (June 10, 2020– July 10, 2020) in the Department of Obstetrics and Gynecology, All IndiaInstitute of Medical Sciences, Jodhpur, Rajasthan, India. A prevalidated questionnaire was given to109 pregnant women to assess the knowledge, attitude, and practice acquired against COVID‑19infection. The Chi‑square test or Fischer’s exact test was used to compare categorical data.RESULTS: Among 109 participants, 103 (94.5%) had good knowledge, 4 (3.7%) had averageknowledge and 2 (1.8%) had poor knowledge about COVID‑19. Majority of them had a positiveattitude for the protective measures taken for the prevention of disease.CONCLUSIONS: Since there is no valid treatment for COVID‑19, prevention is the only key to curvethis infection. In the present study, 94.5% pregnant women had overall good knowledge score aboutthe mode of transmission, symptoms, and preventive measures against COVID‑19.

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Do mothers who meet the minimum standard of antenatal visits have better knowledge? A study from Indonesia

. Wahyul Anis; . Rize Budi Amalia; . Erni Rosita Dewi

Volume 12, Issue 4 , April 2022, , Pages 1-5

Abstract

  BACKGROUND: Maternal knowledge is one of the indirect causes of maternal mortality in Indonesia. Maternal knowledge that mothers must possess includes knowledge about pregnancy, ...  Read More BACKGROUND: Maternal knowledge is one of the indirect causes of maternal mortality in Indonesia. Maternal knowledge that mothers must possess includes knowledge about pregnancy, childbirth, and postpartum. Maternal knowledge should be provided during pregnancy. The aim of this study is to identify maternal knowledge in postpartum women who have a history of the frequency of pregnancy visits according to the minimum standard.MATERIALS AND METHODS: A descriptive quantitative design was performed by assessing maternal knowledge to postpartum mothers using an online questionnaire which conducted in 2020 at two public health centers of Surabaya, Indonesia. A sample of this research involved postpartum mothers who completed inclusion criteria, namely physiological postpartum mothers and had regular pregnancy at least 6 antenatal care (ANC) visits. In contrast, the exclusion criteria were postpartum mothers who were not included in the target areas of research. It uses random sampling techniques and performs an analysis using descriptive statistics.RESULTS: Three research questions showed a large percentage of wrong answers, namely preparation to face complications (64%), contraceptive methods in breastfeeding mothers (50%) and the first time using contraception during childbirth (42%). Meanwhile, all the correct results (100%) are exclusive breastfeeding and supplementary feeding for babies.CONCLUSION: Completing minimal standards of ANC visits cannot ensure adequate maternal knowledge, particularly crucial health information that influences maternal and neonatal health status.

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Attitudes and knowledge of pregnant women about oral health

. Lidia Gavic; . Ana Maretic; . Sanda Putica; . Antonija Tadin

Volume 12, Issue 2 , February 2022, , Pages 1-7

Abstract

  BACKGROUND: This cross‑sectional study aimed to evaluate attitudes and knowledge regarding oral health and infant oral health among pregnant women.MATERIALS AND METHODS: The ...  Read More BACKGROUND: This cross‑sectional study aimed to evaluate attitudes and knowledge regarding oral health and infant oral health among pregnant women.MATERIALS AND METHODS: The study involved 325 pregnant women in the Republic of Croatia who completed an anonymous online questionnaire (Google forms) from January to June 2019. The questionnaire was divided into three parts. The first part contained questions about the demographic data experience about oral health in pregnancy. The second part was related to the knowledge of the relationship between oral health and pregnancy. The third section consisted of questions related to knowledge about the oral health of children at the earliest age. The results were analyzed with descriptive statistics, Spearman correlation analysis, and Chi‑square test.RESULTS: The women are mostly informed about oral health in pregnancy from their dentists (53.54%) and least from their general doctors (4%). In pregnancy, gingival bleeding was observed by 52.31% of respondents and tooth mobility by 12.31%. The Chi‑square test found that there was a difference in attitude regarding the age at which they should stop breastfeeding between respondents who had their first pregnancy and those who already had children. Only 9.23% of respondents are aware that breastfeeding can cause tooth decay.CONCLUSION: Pregnant women in the Republic of Croatia do not have sufficient knowledge, and they are neither aware of the importance of oral health during pregnancy nor infant oral health.

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Development of sexual health promotion package in pregnancy: The Delphi method

. Shiva Alizadeh; . Giti Ozgoli; . Hedyeh Riazi; . Hamid Alavi Majd

Volume 12, Issue 1 , January 2022, , Pages 1-8

Abstract

  BACKGROUND: The World Health Organization recommendation requires the development and useof effective, brief, clear, and evidence‑based education packages to improve health‑care ...  Read More BACKGROUND: The World Health Organization recommendation requires the development and useof effective, brief, clear, and evidence‑based education packages to improve health‑care outcomes.No comprehensive sexual health improvement package exists for the pregnancy period in the Iranianhealth system. This study aimed to develop a package to promote sexual health in pregnancy.MATERIALS AND METHODS: The present study is a qualitative study, which was conductedin 2019 in Tehran, Iran. Sexual health package during pregnancy was developed based on theNational Institute for Health and Clinical Excellence (NICE) steps. The first step included reviewing ofinternational guidelines, strategies, handbooks, education packages, and articles in this regard. Thepackage was developed in the second step. In the third step, quality assessment was performed usingexpert opinion with the Appraisal of Guidelines for Research and Evaluation Instrument II (AGREEII) tool, and validation was performed using Delphi method.RESULTS: Package content was designed in two sections: for midwives and health‑care providersand for pregnant mothers in three sessions (in each trimester of pregnancy). The quality assessmentusing the AGREE II guidelines revealed excellent quality (>89%). The package was validated basedon expert opinion (>95%).CONCLUSION: The sexual health promotion package during pregnancy was designed with highquality and validity based on NICE steps. It is recommended, midwives be performed this designedand validated package in routine pregnancy care to promote the couple’s sexual health.

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The effect of educational intervention based on self‑efficacy theory on pregnancy anxiety and childbirth outcomes among Iranian primiparous women

. Narges Gandomi; . Gholamreza Sharifzadeh; . Marzieh Torshizi; . Ensiyeh Norozi

Volume 12, Issue 1 , January 2022, , Pages 1-8

Abstract

  BACKGROUND: Pregnancy anxiety is associated with a diverse birth outcomes. Mothers’ educationcould have a critical role in increasing their self‑efficacy to defeat their anxiety ...  Read More BACKGROUND: Pregnancy anxiety is associated with a diverse birth outcomes. Mothers’ educationcould have a critical role in increasing their self‑efficacy to defeat their anxiety and improve pregnancyand child birth outcomes. The study was conducted to examine the effect of intervention based onself‑efficacy theory on pregnancy anxiety and child birth outcomes.MATERIALS AND METHODS: The study was conducted as a quasi‑experimental design on60primiparous women (26–28 weeks) in Birjand (East Iranian province) from May to September 2017,who were randomly divided into intervention and control groups. The intervention group received8 sessions of 90‑min educational intervention based on self‑efficacy theory strategies besides theroutine prenatal care. Vanden Bergh’s pregnancy anxiety questionnaire and checklist of pregnancyand delivery outcomes were used for data collection.RESULTS: The level of pregnancy anxiety was similar in both groups before the intervention, butimmediately and 1 month after the intervention, the mean score of pregnancy anxiety significantlyreduced in the intervention group and significantly increased in the control group (P < 0.001). Therewas a significant difference in mean neonatal weight (P < 0.001) between the two groups. Emergencyand elective cesarean section were significantly lower in the intervention group compared to thecontrol group (P < 0.001), but there were no significant differences in the frequency of pretermdelivery between two groups (P < 0.05).CONCLUSION: The results provide support for the effectiveness of intervention based on self‑efficacytheory in reducing pregnancy anxiety and enhancing positive pregnancy outcomes. Hence,theory‑based educational interventions may serve as a cost‑effective and noninvasive approach toreduce pregnancy anxiety in Iran.

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Effective factors on nutrition behaviors of pregnant women based on the beliefs, attitudes, subjective norms, and enabling factors model: A cross‑sectional study

. Azam Mohammadi; . Fatemeh Effati‑Daryani; . Fatemeh Ghelichkhani; . Somayeh Zarei; . Mojgan Mirghafourvand

Volume 12, Issue 1 , January 2022, , Pages 1-7

Abstract

  BACKGROUND: One of the useful models in health education is the Beliefs, Attitudes, SubjectiveNorms, and Enabling Factors (BASNEF) model. The model is used to study behavior and to ...  Read More BACKGROUND: One of the useful models in health education is the Beliefs, Attitudes, SubjectiveNorms, and Enabling Factors (BASNEF) model. The model is used to study behavior and to planfor change it and to determine the factors that influence people’s decision‑making. The aim of thisstudy was to investigate the factors affecting the nutritional behavior of pregnant women based onBASNEF model.MATERIALS AND METHODS: This cross‑sectional study was performed on 360 pregnant womenreferring to health centers of Tabriz‑Iran by two‑stage cluster sampling method from April to December2016. Data were collected using sociodemographic, nutrition subdomain of Health PromotingLifestyle‑II (HPLP‑II), and researcher‑made questionnaire based on constructs of BASNEF model.Data were analyzed using the SPSS software version 21 and Pearson correlation test and GeneralLinear Model (GLM).RESULTS: Mean ± standard deviation (SD) of nutrition subdomain of HPLP‑II was 24.65 ± 4.75within the range 9–36. Mean ± SD of BASNEF model constructs (score range) was also obtainedas 45.30 ± 10.80 (0–100), 17.98 ± 2.40 (8–24), 9.30 ± 2.82 (0–20) and 2.47 ± 1.74 (0–6) for belief,attitude, subjective norms, and enabling factors, respectively. Based on the GLM, there was significantrelationships between nutritional behavior and BASNEF model constructs (belief [P < 0.001],attitude [P = 0.043], enabling factors [P < 0.001], and subjective norms [P = 0.038]) as well as thevariables of job, husband’s education, and job and sufficiency of income for expenses.CONCLUSION: The results of the present study showed the impact of BASNEF model constructsand some sociodemographic variables on nutrition behaviors in pregnant women. Therefore, in orderto improve nutrition behaviors of pregnant women, designing and implementation of interventionsbased on the BASNEF model are recommended.

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Investigating the relationship between the dimensions of mindfulness and maternal attachment to the fetus during pregnancy

. Nahid Golmakani; . Fatemeh Shaghaghi; . Zohre Ahmadi; . Mahboobe Gholami; . Zahra Kamali; . Zahra Mohebbi‑Dehnavi

Volume 11, Issue 10 , November 2021, , Pages 1-6

Abstract

  BACKGROUND: Maternal attachment to the fetus is a term used to describe the emotional relationshipbetween mother and fetus. This emotional connection increases during pregnancy and ...  Read More BACKGROUND: Maternal attachment to the fetus is a term used to describe the emotional relationshipbetween mother and fetus. This emotional connection increases during pregnancy and is reflectedin her feelings, perceptions, and behaviors. Mindfulness is important as one of the factors affectingthe mental health of people during pregnancy. Therefore, the present study was conducted todetermine the relationship between the dimensions of mindfulness and maternal attachment to thefetus during pregnancy.MATERIALS AND METHODS: The present study was performed on 500 pregnant mothers referredto health centers affiliated to Isfahan University of Medical Sciences. The samples were entered intothe study by available sampling method and if they had inclusion criteria and no exclusion criteria.The research instruments were the Fetal Attachment Questionnaire and the Bauer MindfulnessQuestionnaire. The collected data were analyzed by SPSS software version 22.RESULTS: The results of the data showed that there was no significant relationship between theoverall score of mindfulness and the overall score of maternal attachment to the fetus (P = 0.62).While from the dimensions of mindfulness such as “action with awareness” there was a significantnegative relationship (P = 0.03) with maternal attachment to the fetus and a significant positiverelationship “observation” with maternal attachment to the fetus (P = 0.03).CONCLUSION: According to the results of this study, there is a relationship between maternalattachment to the fetus during pregnancy and a number of dimensions of mindfulness. For thispurpose, since mindfulness can increase the mother’s interactions with the fetus, and this interactionbegins during pregnancy and with the mother’s attachment to the fetus, it is important to pay attentionto this.

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Comparing the effect of face-to-face education and using educational films on couples’ sexual dysfunction during pregnancy

. Maryam Mohammadi; . MohammadBagher Khani

Volume 11, Issue 8 , September 2021, , Pages 1-9

Abstract

  BACKGROUND: Pregnancy is a special period in a woman’s life during which physical, mental,social, and cultural changes would affect sexual desires during this period. The present ...  Read More BACKGROUND: Pregnancy is a special period in a woman’s life during which physical, mental,social, and cultural changes would affect sexual desires during this period. The present study wasconducted to compare the effect of face‑to‑face education and using educational films on the sexualdysfunction in couples.MATERIALS AND METHODS: The present study was a semi‑experimental research. Studypopulation contained pregnant women and their husbands. Samples were selected randomly. Datawere gathered using demographic characteristic questionnaire and sexual dysfunction in men andwomen questionnaire. Sample size was 96 couples (32 couples in the face‑to‑face group, 32 in theeducational films group, and 32 in the control group). Data were analyzed using SPSS20 software.RESULTS: The mean total score of preintervention sexual function in face‑to‑face education groupwas 46.72 ± 9.79, in educational film group 47.82 ± 13.07, and in control group 43.84 ± 12.76. Inthe case of postintervention, it was, respectively, 60.62 ± 9.72, 57.37 ± 14.74, and 43.61 ± 14.21.Face‑to‑face education led to the treatment of sexual dysfunction during pregnancy (P < 0.001). Inthe educational film group (P = 0.40), sexual dysfunction during pregnancy was not treated, but therewas an improvement in sexual function (P = 0.001). In the control group, there was a significantdifference regarding the decrease in the score of sexual function and untreated sexual dysfunctionduring pregnancy (P = 0.001). Furthermore, no improvement was observed in the sexual dysfunctionduring pregnancy (P = 0.90).CONCLUSIONS: According to the results, face‑to‑face and film education are effective in sexualfunction during pregnancy, but face‑to‑face education in pregnancy is more effective in the treatmentof sexual dysfunction, and so this causes promoting sexual health during this period.

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Mobile‑application intervention on physical activity of pregnant women in Iran during the COVID‑19 epidemic in 2020

. Neda Kiani; . Asiyeh Pirzadeh

Volume 11, Issue 8 , September 2021, , Pages 1-7

Abstract

  BACKGROUND: Considering the low level of physical activity in pregnant women in the COVID‑19pandemic period, and on the other hand, the benefits of mobile application (mobile app) ...  Read More BACKGROUND: Considering the low level of physical activity in pregnant women in the COVID‑19pandemic period, and on the other hand, the benefits of mobile application (mobile app) learning,we decided to conduct a study to determine the impact of educational intervention based on mobileapp on physical activity in pregnant women.MATERIALS AND METHODS: The present study was quasi‑experimental and examined 93 pregnantwomen aged 16–20 weeks of gestation. Sampling was done on pregnant women participating inthe childbirth preparation classes in Isfahan. We used the validated and reliable questionnaireincluding perceived benefits, perceived barriers, perceived enjoyment, perceived social support,and Pregnancy Physical Activity Questionnaire. The intervention was based on mobile app, and thecontent of the application contained 12 main domains such as description of physical activity andbenefits and barriers of exercise in the pregnancy, different types of proper pregnancy exercise,planning for exercise, and different types of exercise. Finally, data were analyzed using SPSS20,and the Chi‑square test, independent t‑test Paired t‑test were employed. The significance level wasconsidered to be <0.05.RESULTS: The results showed that, after the intervention based on mobile app, the mean scoreof perceived benefits and enjoyment were significantly higher than before the intervention inthe intervention group. Finally, total mean score of physical activity significantly increased in theintervention group, while the change decreased in the control group.CONCLUSION: The results indicated that the use of mobile app can be used to promote physicalactivity in pregnant women. Therefore, it is recommended that mobile app education should applywith face‑to‑face classes in health centers for physical activity in pregnant women in the pandemicsituation.

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The effect of pregnancy training classes based on bandura self‑efficacy theory on postpartum depression and anxiety and type of delivery

. Fatemeh Mohammadi; . Shahnaz Kohan; . Sedigheh Farzi; . Mojgan Khosravi; . Zeinab Heidari

Volume 11, Issue 6 , July 2021, , Pages 1-6

Abstract

  BACKGROUND: Postpartum depression and anxiety is one of the most common complicationsthat women face and cause many problems for mother, baby, and family. Considering the effect ofself‑efficacy ...  Read More BACKGROUND: Postpartum depression and anxiety is one of the most common complicationsthat women face and cause many problems for mother, baby, and family. Considering the effect ofself‑efficacy on women’s adaptation to pregnancy and delivery conditions and their mental healthduring this period, the present study was designed to investigate the effect of pregnancy trainingclasses based on Bandura self‑efficacy theory on postpartum depression and anxiety and type ofdelivery.MATERIALS AND METHODS: In this clinical trial study, 64 pregnant women were randomly dividedinto intervention and control groups. Mothers in the intervention group received pregnancy trainingin eight sessions (each session was 2‑hour) from the 20th week of pregnancy. The classes were runby a trained midwife and the content of the training was based on Bandura self‑efficacy components.The mothers in the control group received routine care. The demographic‑reproductive informationform, Beck Depression and Spielberger Anxiety Questionnaire were completed by pregnant womenof both groups at several times, before the program, 1 week and 1 month after delivery.RESULTS: The results showed that the training program significantly decreased the depressionscore in 1 week and 1 month after delivery in the intervention group compared to the control group.In addition, this training program decreased the mean score of apparent and hidden anxiety in theintervention group 1 month after delivery, although this decrease was not statistically significant.Furthermore, 80.55% of the intervention group and 58.33% of the control group had vaginal delivery,which were significantly different between the two groups in terms of the type of delivery.CONCLUSION: The findings showed that pregnancy training classes based on Bandura self‑efficacytheory decrease depression and anxiety and increases vaginal delivery rate.

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Predictability of constructs of theory of planned behavior in adopting urinary tract infection prevention behaviors among pregnant women

. Sheida Moradpour; . Hossein Shahnazi; . Akbar Hassanzadeh

Volume 11, Issue 5 , June 2021, , Pages 1-5

Abstract

  BACKGROUND: Urinary tract infection is a common infection in women during pregnancy, leading tomany complications for both mother and fetus if untreated. The present study aimed to ...  Read More BACKGROUND: Urinary tract infection is a common infection in women during pregnancy, leading tomany complications for both mother and fetus if untreated. The present study aimed to investigate thepredictability of constructs of the theory of planned behavior (TPB) in adopting urinary tract infectionprevention behaviors in pregnant women.MATERIALS AND METHODS: In the present cross‑sectional study, we selected 100 pregnantwomen who visited the comprehensive health service centers of Zarrinshahr using conveniencesampling from July to September 2019. We collected data by a questionnaire designed based onthe constructs of the TPB and analyzed data using SPSS 20 and linear regression test and Pearsoncorrelation coefficient. A significant level was considered as α < 0.05.RESULTS: In the study, the Pearson correlation coefficient showed direct relationships between thescore of behavior and the scores of knowledge (P = 0.005), attitude (P = 0.02), perceived behavioralcontrol (P < 0.001), and behavioral intention (P = 0.001). Linear regression analysis indicated thatamong the above variables, the perceived behavioral control, knowledge, and behavioral intentionwere significant predictors of scores of urinary tract infection prevention behaviors, respectively, interms of their importance.CONCLUSION: In this study, perceived behavioral control is detected as the main predictor ofdoing urinary tract infection prevention behaviors in pregnant women and should be considered indesigning educational interventions.

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Investigating the interaction between fertility, pregnancy, and multiple sclerosis

. Freshteh Ashtari; . Fatemeh Mokhtari; . Mahboubeh Valiani; . Mohammad Soudavi; . Homa Saadat; . Hamidreza Tolouei; . Marjan Mansourian

Volume 11, Issue 5 , June 2021, , Pages 1-7

Abstract

  BACKGROUND: Multiple sclerosis (MS) is a chronic disease of the central nervous system. Mostwomen with MS are diagnosed during their reproductive ages. The aim of this study was to ...  Read More BACKGROUND: Multiple sclerosis (MS) is a chronic disease of the central nervous system. Mostwomen with MS are diagnosed during their reproductive ages. The aim of this study was to evaluatethe interaction between fertility, pregnancy, and MS.MATERIALS AND METHODS: A retrospective descriptive–analytic study was conducted on 110women suffering from MS with a history of pregnancy (between 2007 and 2017 years) in Isfahan,Iran. Samples were selected in a census model. Women completed a researcher-constructedquestionnaire by telephone. The questionnaire consisted of three parts: demographic information, MSand its symptoms and treatment, and reproductive system and the history of pregnancy associatedwith MS. The data were analyzed by SPSS software version 16 using Chi-square, ANOVA, and t-test.RESULTS: The mean age of women was 32.4 years. In this population, the average number ofpregnancies was 1.61, the number of deliveries was 1.35, the number of abortions was 0.24, thehistory of ectopic pregnancy was 0.01, the number of alive children was 1.36, and the number of deadchildren was 0.01. The average time of the last MS attack before the pregnancy was 21.36 months.Fatigue (24.5%) was the most common symptom exacerbated during pregnancy. MS symptomsimproved in 55.0% of women in the second trimester.CONCLUSIONS: MS had no effect on the pregnancy status, such as the number of abortions,ectopic pregnancy, alive and dead children, and the duration of pregnancy. Symptoms of the diseaseimproved during pregnancy. Therefore, pregnancy has a protective role against MS.

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Evaluation of clinical outcomes of neonates born to mothers with coronavirus (COVID‑19) in Shahid Beheshti Hospitals

. Maryam Sadat Hosseini; . Afsaneh Hosseini; . Elnaz Ghaffari; . Mitra Radfar; . Fariba Shirvani; . Shahrzad Tabatabai; . Dariush Abtahi; . Mahsa Mirhadi; . Maziyar Mortazavi; . Shideh Ariana

Volume 11, Issue 4 , May 2021, , Pages 1-9

Abstract

  BACKGROUND: The coronavirus, which is caused by acute respiratory syndrome, appeared inWuhan, China, in December 2019 and gradually spread around the world until almost all countriesbecame ...  Read More BACKGROUND: The coronavirus, which is caused by acute respiratory syndrome, appeared inWuhan, China, in December 2019 and gradually spread around the world until almost all countriesbecame infected with the coronavirus. In Iran, the outbreak of coronavirus began on February 21,2020, with the report of infection of two people in the city of Qom. The aim of this study is to evaluatethe clinical findings of neonates born to pregnant women with corona disease.MATERIALS AND METHODS: During this case study (February 21 to November 30, 2020), out of88 pregnant mothers who referred to the hospitals of Shahid Beheshti University of Medical Sciences,44 live neonates were born from 42 pregnant women with COVID‑19, who were evaluated for clinicalsigns by studying their files and reported as a case series, due to limited samples, No statisticalanalysis of the study was performed.RESULTS: In studies of clinical records of hospitalized mothers and infants, among the polymerasechain reactions (PCRs) provided for all infants, one PCR was reported positive 2 days after birth,whereas this infant 10 min after birth, immediately after routine procedures, due to positive mother’sPCR was isolated from the operating room. However, all of the infant’s clinical symptoms were normalduring the 3‑day hospital stay for routine postpartum care. Twenty‑eight days after birth, the babywas reevaluated for clinical, laboratory, and chest X‑ray symptoms, all of which were normal. ThePCR of other neonates was negative, and five intubated neonates, two twin, and two single died, andthe other neonates were discharged. In evaluating the clinical records of mothers of these infants,the mean age is 30 years, and the average gestational age is 35 weeks, 32 cases of caesareansection, and 10 cases of normal delivery.CONCLUSION: We describe epidemiological data, demographics, signs and symptoms onadmission, laboratory results, comorbidities, infection COVID‑19 in the mothers and neonates,chest radiography and computed tomography findings, treatment received for COVID‑19, andclinical maternal, fetal, and neonatal outcomes. Due to the fact that the study population issmall consist of 42 mothers with COVID‑19 infection, among all PCR samples from infantsborn to COVID‑19 positive mothers, the PCR result of one case was positive, and the rest ofwas negative. Therefore, vertical transmission of COVID‑19 through the placenta to the fetuscannot be confirmed or denied, nor can the COVID‑19 confirmed or denied the baby’s postnatalcomplication during pregnancy.

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Ottawa prenatal educator e‑survey: Experiences and perceptions of public health nurses and allied childbirth educators

. Rowan M. Terrell; . Nura L. Soucy; . Rebecca A. Chedid; . Karen P. Phillips

Volume 11, Issue 4 , May 2021, , Pages 1-9

Abstract

  BACKGROUND: Prenatal education provides opportunities for health promotion of healthy behaviorsand risk reduction. Quality and coherence with prenatal health promotion best practices ...  Read More BACKGROUND: Prenatal education provides opportunities for health promotion of healthy behaviorsand risk reduction. Quality and coherence with prenatal health promotion best practices depend onan individual class instructor. The objective of our study was to document the experiences, practices,and perceptions of our diverse Ottawa, Canada community of prenatal educators.MATERIALS AND METHODS: In this quantitative, mixed methods e‑survey conducted in Ottawa,Canada, prenatal educators were asked to describe their prenatal class settings, delivery formats,content, perceptions of pregnant women, and recommendations. Data were analyzed by descriptivestatistics and thematic content analysis.RESULTS: Respondents included public health nurses and a diverse group of “allied childbirtheducators” (ACE). Topics related to pregnancy, labor, and postpartum issues were well addressed;however, established and emerging risks to pregnancy were omitted. Nurses were more likely todiscuss lifestyle risks to pregnancy and general prenatal health promotion, whereas ACE respondentsemphasized informed consent and individualized counseling. Women marginalized by social exclusionincluding Indigenous women, immigrants, and women with disabilities were perceived as missingfrom prenatal educational settings.CONCLUSIONS: Heterogeneity of prenatal education provides opportunities for collaboration;however, established and emerging risk factors to pregnancy are neglected topics. Addressing theneeds of diverse communities of pregnant women requires timely, evidence‑based, inclusive, andculturally safe delivery of prenatal health promotion.

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