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13INVESTIGATING THE CAUSES OF FEAR OF CHILDBIRTH IN PREGNANT
WOMEN IN MAZAR-E-SHARIF
Abdulhakim(Hekmati) Mirwise B.
Balkh University Afghanistan
Introduction
Pregnancy is the biggest event in a woman's life that is not a pleasant event for all women and in cases that are not managed properly, it puts a lot of stress on the mother and those around her [1].
It can be said that the biggest stress in any woman's life is pregnancy and fear of childbirth.
This is an important problem during pregnancy and after childbirth. It is estimated that one in five pregnant women has a fear of childbirth and about 6 to 13% of pregnant women experience severe and debilitating fears [2].
Fear of natural childbirth during pregnancy is one of the predictors of emergency cesarean section and increasing demand for elective cesarean section [3]. There are psychological and social factors influencing the fear of natural childbirth, including: fear of the unknown, tendency to painlessness and intolerance of pain, physical and mental calm, personality traits of the mother, genetic backgrounds that make a person vulnerable to stress, adverse experience Encouraging others, worrying about adverse side effects for the mother, inappropriate communication between medical staff, feeling of death and loneliness, worrying about the baby's health and lack of social support are enough [4].
Considering the importance of fear of childbirth during pregnancy and its effects on maternal and fetal health, as well as one of the predictors of elective and emergency cesarean section in pregnant mothers and due to the increase in cesarean section, it is necessary for health professionals Pay attention. Therefore, the present study was designed and conducted to determine the causes of fear of childbirth among pregnant mothers in Mazar-e-Sharif.
materials and methods
The present descriptive cross-sectional study was performed on pregnant women referring to the staff hospital of Balkh School of Medicine and examination in 1397-1398. A total of 130 pregnant women who met the inclusion criteria were selected by non-random quota sampling method, according to the population of Mazar-e-Sharif health centers and examination houses.
Inclusion criteria included pregnant mothers with a gestational age of 23 to 32 weeks of gestation and having at least a bachelor's degree and a bachelor's degree.
Exclusion criteria: Mothers who had mental disorders and psychosis or a history of neurological and mental illnesses and were unwilling to cooperate were excluded from the study.
Data collection tool: Two-part questionnaire including: demographic characteristics (age, gestational age, education, number of pregnancies and occupation) and questions related to fear of childbirth, which was completed by interview.
This questionnaire has 14 questions, which is determined by the answer of the 4-point Likert scale, which has a minimum score of 14 and a maximum of 56. Cronbach's alpha coefficient of the fear of childbirth questionnaire was reported to be 0.85 [5].
Value of research: No such research has been conducted in Afghanistan so far.
Research questions: Is there a fear of childbirth in all pregnant women? Are primiparous and multiple primiparous in the process of fear of childbirth or not? The degree of birth awareness in the case of fear of childbirth What effect does fear of childbirth have?
Limitations of research problems: Lack of standard staff hospital, Lack of cooperation of the patient with the investigating doctor Low level of patient knowledge about birth constitutes the limitation of our research.
Literature review
Fear of giving birth is a major psychological problem for a number of pregnant women around the world
Pregnancy and childbirth are an important part of a woman's life. It is true that childbirth and the birth of a baby are a time of happiness for the family, but in some cases it can also be a source of stress and anxiety. These are very common concerns that all women experience during childbirth. Fears and anxieties about childbirth usually improve with the help of medical, educational, and counseling strategies, but in some cases these fears can become so severe that women are generally reluctant to conceive or become pregnant.
It is normal for pregnant women to give birth or have a baby for themselves, but this can increase abnormally in some cases and become a disorder. Tokophobia is the fear of pregnancy and childbirth. Women who develop this type of phobia usually avoid pregnancy and, even if they do get pregnant one day, prefer to have a cesarean delivery.
It is possible for tocophobia to occur in women who have never been pregnant and have no children, however, this phobia is also common in women who have had childbirth before.
Labor pain is considered the most severe pain and many of our women seek cesarean section for fear of labor pain.
Cesarean section and surgical delivery is one of the most useful and life-saving interventions.
Methods such as non-pharmacological and pharmacological low-pain deliveries can promote natural childbirth.
Many people expose themselves to cesarean section for fear of pain, which has both anesthesia and surgical complications, but painless deliveries can be used to manage the pain process and the mother to give birth without pain.
Non-pharmacological methods of reducing pain, such as massage therapy, water birth, are minimally invasive and harmless, and greatly reduce the mother's pain and make the delivery and delivery pleasant for the baby and mother.
Because stool is present in the large intestine at almost all hours of the day, some of it may come out when you squeeze; So do not worry unnecessarily about this simple and natural thing. 713
Tocophobia is a specific type of phobia that is an anxiety disorder. In this phobia, the person is abnormally and irrationally anxious, leading to sleep disturbances, panic attacks, nightmares, or avoidant behaviors. Other symptoms may include:
Feeling afraid of thinking about pregnancy and childbirth.
Stress and depression.
Extreme fear of miscarriage, death of the child or the mother herself.
Excessive insistence on cesarean delivery.
In some cases, women with tocophobia may also avoid sexual intercourse for fear of becoming pregnant. These types of people may not be able to bond well with their child, even during pregnancy. Establish Hood's husband with a legitimate sexual problem.8-12
It is interesting to note that even men can experience tocophobia. Researchers have found that men with tocophobia often have high levels of stress and fear about the health and safety of their spouse and children.
Tokophobia has different causes in different people. Some of the factors that can contribute to the development of this disorder include unknown stress, loss of control, attempts to maintain privacy, past sexual abuse experience, fear of pain, and lack of trust in physicians.9-12
Results
The majority of mothers (40%) had a bachelor's degree and the majority of their occupations were housekeeping (79.2%). According to the results of the present study, 11.5% of mothers were primiparous and 88.5% were multiparous.
The mean age of mothers participating in the study was 27.22 23 5.23 years and the mean gestational age was 28.5 92 2.92 weeks. Also, the average number of pregnancies of mothers was 1.42. 0.71.
According to the results of Pearson and Spearman correlation coefficient, there was no significant relationship between the fear of childbirth score and gestational age, women's education level and their job. Fear of childbirth was less observed in rural women than in urban areas.
(P> 0.05), but there was an inverse relationship with the number of pregnancies, so that with increasing the number of pregnancies, the fear of childbirth had decreased (p <0.001).
Safe without less war came to us.
The results showed that 94.61% of mothers reported painful injections during childbirth, 91.53% of sutures during labor, 87.71% of labor pains, 62.31% due to loss of control during childbirth. They are afraid (Figure 1).
According to the results of independent t-test, the mean score of fear of childbirth in multiparous women (66.27 11 5.11) was lower than primiparous women (83.68 7 7.55), which was statistically significant (p0.001).
Discussion or dispute
In this study, the majority of mothers were somewhat afraid of childbirth, which was more severe in cases such as painful injections, stitches during childbirth, labor pains and loss of control during childbirth.
In the study of the causes of fear of childbirth by Negahban and his colleague, fear of labor pain and fetal injury was the most common cause of fear and anxiety among mothers. It was completely similar to our study [6].
Also, Szeverenyi et al.
In a study examining the content of fear of childbirth among 216 couples, found that in more than 80% of cases, the cause of fear of childbirth was related to having a defective baby, severe pain, the possibility of childbirth with surgery and being alone in an environment Has been unfamiliar [7].
Which was consistent with our study
The findings of Jamshidimanesh et al. Also showed that the most important reasons for fear of childbirth and desire for cesarean section in pregnant women include fear of the unknown, labor pain, adverse experience, fear of complications, inadequate communication between treatment staff, death and loneliness and infant health [ 3].
Which was relatively similar to our study.
Based on the results of our present study, an inverse relationship was observed between the number of pregnancies and fear of childbirth, which is mentioned in the literature or the world medical literature, and also, the fear of childbirth was higher in pregnant women than in multiple women. Our findings show that primiparous women, because they have never experienced pregnancy and childbirth, have more fear and anxiety than unfamiliar situations of pregnancy and childbirth [8] and consider natural childbirth unattainable, so high fears in They experience during pregnancy and have low belief and ability to give birth, and on the other hand, having an unfavorable experience of previous childbirth has been one of the reasons for fear of childbirth in women with multiple births.
Tanglakmankhong et al. In their research came to the same conclusion as the present study. In this study, the fear of childbirth score in multiparous women was significantly lower than primiparous women [9]. The results of a study by Katri et al. Also showed that the fear of childbirth was significantly higher in primiparous women than in multiparous women [8].
According to the results of this study, most pregnant women experience fear of childbirth and this fear can be one of the reasons for elective and emergency cesarean section. Considering that the number of cesarean sections is increasing in all countries of the world such as Afghanistan, Iran, Tajikistan and Uzbekistan and some of its causes are preventable, so the fear of childbirth during pregnancy as one of the predictors of elective and emergency cesarean section should be Managers and officials should be considered. Failure to study the influential factors (social, economic status, social support, marital satisfaction, self-esteem, etc.) on the fear of childbirth in pregnant women is one of the limitations of the present study, which is recommended to be considered in future studies. Fear of childbirth in women who have been waiting for years to have children in proportion to women who have unwanted pregnancies. They became less seen without homework and expectation.
Final conclusion
The results of the present study showed that the rate of fear of childbirth in primiparous women is higher than that of multiparous women and due to the controllability of fear of labor and its effect on increasing the number of cesarean sections, Medical to be performed. Fear of childbirth was less common among women under the stress of war and terrorism in proportion to my place without war. Fear of childbirth was less common among rural women than in urban areas.
Suggestion: In order to overcome the fear of childbirth in the conditions of Afghanistan, we make the following suggestions
1- Teach women how to deal with the fear of childbirth.
2. Not arriving at the hospital on time is one of the common problems in our country to listen to patients
3. Fear of defecating when forced to give birth, which is listened to by the medical staff of the maternity ward. If this is a normal thing for most women.
4. Fear of vaginal rupture or episiotomy is not dangerous for a woman. With hygienic conditions, it was completely healed and returned to normal.
5. The average time of delivery in the first pregnancy is about 20 hours and in subsequent pregnancies is about eight hours, listen and understand for the pregnant woman.
Instead of worrying about being late, try your doctor as soon as you have symptoms of labor, when your contractions do not go away when you lie down or change position and occur every five minutes for up to two hours, or when your amniotic sac ruptures. Let yourself know.
7. Because the stool is present in the large intestine at almost all hours of the day, some of it may come out when you squeeze; So do not worry unnecessarily about this simple and natural thing.
Summary
Investigating the Causes of Fear of Childbirth in Mazare sharife AFGHANISTAN
Background and Objective: Fear of childbirth (FOC) is an important psychological problem that is studied worldwide because it affects the well-being of pregnant women Pregnancy is a major event in a woman's life that can bring a lot of stress for her. Fear of childbirth is a common problem for pregnant women. This fear can be a predictor of caesarean section in them. This study aimed to investigate the causes of fear of childbirth in pregnant women in Mazare sharife AFGHANISTAN .
Materials and Methods: This descriptive-cross-sectional study was performed on 130 pregnant women referred to health centers in Mazare sharife city. AFGHANISTAN Fear of Childbirth Questionnaire was used to collect the data. For data analysis, it was used descriptive and analytical.
Results: The results showed that, the main cause of fear of childbirth in pregnant women was fear of painful injections during labor. The mean score for fear of delivery in multiparous women was significantly greater than the nulliparous women (p<0.001).
Conclusions: Concerningthe increase of caesarean rates, it is important that health care providers pay more attention to the causes of this fear.
Key words: Fear, Childbirth, pregnant woman'Mazare sharife Afghanistan
REFERENCES
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2-Ayers, S. (2014). Fear of childbirth, postnatal post-traumatic stress disorder and midwifery care. Midwifery, 30, 145-148. dob 10.1016/j.midw.2013.12.001
3-Bahl, R., Strachan, B., & Murphy, D.J. (2004). Outcome of subsequent pregnancy three years after previous operative delivery in second stage of labour: cohort study. British Medical Journal, 328, 311-315. doi: 10.1136/bmj.37942.546076.44
4-Bewley, S., & Cockburn, J. (2002). Responding to fear of childbirth. Lancet, 359,2128-2129. doi: 10.1016/S0140-6736(02)09113-4
5- Hosseini nasab D, Taghavi S, Ahmadian S. The effect of maternal education on anxiety, pain, and labor for mothers. Medical J of Tabriz Univ Med Sci 2008; 31(4): 24-30.
6- Alipour Z, Lamyian M, Hajizadeh E, Vafaei M. The association between antenatal anxiety and fear of childbirth in nulliparous women: a prospective study. Iran J Nurs Midwifery Res 2011; 16(2): 169-73.
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8- Poikkeus P, Saisto T, Unkila-Kallio L, Punamaki R, Repokari L, Vilska S, et al. Fear of childbirth and pregnancy-related anxiety in women.
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11- Szeverenyi P, Poka R, Hetey M, Torok Z. Contents of childbirth-related fear among couples wishing the partner's presence at delivery. Journal Psychosom Obstet Gynaecol 1998; 19(1): 38-43.
12- Katri N, Olof S, Ryding EL. Women's fear of childbirth and preference for cesarean section- a cross-sectional study at various stages of pregnancy in Sweden. Acta Obstetricia et Gynecologica 2009; 88: 807-13.
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Вожах,ои калидй: Управление, Хаёт, Хусусият, Маудудиятуо,Табий , Довталаб, Таваллуд кардан , Муцаррарй, Таусил, Баус .
ИССЛЕДОВАНИЕ ПРИЧИН СТРАХА РОДОВ У БЕРЕМЕННЫХ
В МАЗАРИ ШАРИФ
Предпосылки и цель: Беременность - это важное событие в жизни женщин, которое подвергает мать сильному стрессу. Боязнь родов - распространенная проблема и один из предикторов кесарева сечения у беременных. Этот страх родов не позволяет некоторым женщинам забеременеть. Это состояние часто встречается у женщин, подвергшихся изнасилованию. Настоящее исследование исследует причины страха перед родами у беременных женщин.
Материалы и методы. Это перекрестное описательное исследование было проведено на 130 беременных женщинах, направленных в больницу медицинского персонала Балхской медицинской школы в период с 1397 по 1397 годы. Инструментом сбора данных была анкета о страхе родов.
Результаты. Результаты показали, что наиболее важными причинами страха перед родами у беременных женщин были страх родовой боли и болезненных инъекций во время родов. Кроме того, средний балл боязни родов у первородящих женщин был выше, чем у повторнородящих (р <0,001).
Заключение: учитывая важность страха перед родами при частом кесаревом сечении, медицинским исследователям необходимо рассмотреть причины этого страха.
Ключевые слова: менеджмент, жизнь, спецификация, ограничения, естественный, соискатель, рождение ребенка, обычное, учеба, диспут.
INVESTIGATING THE CAUSES OF FEAR OF CHILDBIRTH IN PREGNANT
WOMEN IN MAZAR-E-SHARIF
Pregnancy is a major event in women's lives that puts a lot of stress on the mother. Fear of childbirth is a common problem and one of the predictors of cesarean section in pregnant women.
This fear of childbirth prevents some women from becoming pregnant. This condition is common in women who have been raped. The present study investigates the causes of fear of childbirth in pregnant mothers.
Materials and Methods: This cross-sectional descriptive study was performed on 130 pregnant women referred to the staff hospital of Balkh Medical School between 1397-1397. The data collection tool was a questionnaire about fear of childbirth.
Results: The results showed that the most important causes of fear of childbirth in pregnant mothers were fear of labor pain and painful injections during childbirth. Also, the mean score of fear of childbirth in primiparous women was higher than multiparous women (p <0.001).
Conclusion: Considering the importance of fear of childbirth in increasing cesarean section, it is necessary for medical researchers to consider the reasons for this fear.
Keywords: Managment, Life, Specification, Limitations, Natural, Applicant, Giving birth, Usual, Study, Dispute.
Сведения об авторах:
Профессор доктор Абдулхаким (Хекмати) и доцент доктор Мирвайз Бахо, преподаватель медицинского факультета Балхского университета Афганистана. [email protected]
Information about authors:
Professor Dr. Abdulhakim (Hekmati) and Associate Professor Dr. Mirwayz Baho, Lecturer at the Faculty of Medicine, Balkh University of Afghanistan. [email protected]
THE ROLE OF WAR STRESS AND THE COMBINATION OF DIET AND BODY
MASS IN GASTROESOPHAGEAL REFLUX DISEASE
Abdolhakim Hekmati
Balkh University Nilofar Hekmati,
Rahnavard University
Introduction GASTROESOPHAGEAL REFLUX DIDEASE (GERD):
Mucosal damage due to abnormal reflux (return) of stomach contents (acidic substances) into the esophagus. Gastroesophageal reflux disease (GERD) is one of the most common diseases of the present century, which is diagnosed with specific symptoms of recurrent heartburn and regurgitation (return of stomach contents to the esophagus) (1, 2). According to epidemiological studies, the prevalence of GERD in Western countries is between 10-48%, in Asian countries (> 5%) (3) and in Iran 2.7% (4) in our country. As far as we estimated, these figures are 20%. . is. If left untreated, GERD can lead to esophageal lesions, including ulcerated esophagitis, Barrett's esophagus, and finally, esophageal adinocarcinoma (5). Identifying modifiable risk factors for GERD, including diet and BMI, can have potential effects on general health. The results of various studies on the relationship between diet and GERD are contradictory. Most studies have been performed physiologically to investigate the effect of lumen fat content on postpartum esophageal contact with acid (6, 7). Or focus on the motor function of the lower esophageal sphincter, LES (8 and 9). So far, few studies have been conducted to evaluate food intake in patients with GERD symptoms (10-12) with different results. The results of physiological studies on food volume and energy dissipation in GERD are also unclear. According to a study, the rate of gastroesophageal reflux due to the consumption of a meal is considered to depend on the volume of food rather than the amount and dissipation of its energy (13). On the other hand, it is suggested that the GERD treatment regimen should focus on reducing the caloric load of meals instead of the fat content of food (14). . Studies on the role of obesity as another risk factor for GERD indicate conflicting results (15). Therefore, due to the existing contradictions, the present study was conducted to investigate the relationship between diet and BMI and their interventional effect on GERD.
materials and methods
