Concerns of Childbearing Women: A Maternal Concerns Questionnaire as an Assessment Tool

Objective: To determine if a tool measures maternal concerns in different populations of women.
Design: Secondary analysis of data in five master's theses using the maternal Concerns Questionnaire.
Setting: Data were collected in postpartum units and homes. Populations were composed of rural and urban women.
Participants: Five groups of childbearing women (N = 187) during the antepartum or postpartum periods.
Main outcomes: Subjects responded to 46 items related to concerns about themselves and their infants. partners, families, and community activities.
Results: The maternal Concerns Questionnaire discriminates specific concerns between populations.     

Cannabis Use During the Pre-Conception Period and Pregnancy After Legalization

ObjectiveThere is limited evidence of the impact of cannabis legalization on the prevalence of cannabis use and use of other substances. The aim of this exploratory observational study was to compare rates of cannabis use, cigarette smoking, alcohol consumption, and the use of any street drugs during the preconception period and in pregnancy in two convenience samples of pregnant persons in British Columbia, Canada, before and after the legalization of cannabis.MethodsAny pregnant person residing in British Columbia, aged >19 years, at any gestational age was eligible to participate. Pre- and post-legalization study participants were recruited between May and October 2018 and July 2019 and May 2020, respectively. Multivariate models were constructed to examine the effect of legalization on cigarette smoking and the use of cannabis, alcohol, and street drugs, adjusting for demographic, pre-pregnancy, and pregnancy confounders.ResultsFrom pre- to post-legalization, the prevalence of self-reported cannabis use during the preconception period increased significantly, from 11.74% (95% CI 9.19%–14.88%) to 19.38% (95% CI 15.45%–24.03%). Rates of cannabis use during pregnancy also increased from 3.64% (95% CI 2.32%–5.69%) before legalization to 4.62% (95% CI 2.82%–7.47%) after; however, this difference was not statistically significant. Adjusting for potential confounders, the post-legalization group had significantly higher odds of cannabis use during the preconception period (adjusted odds ratio 1.71; 95% CI 1.14–2.58) but not during pregnancy (adjusted odds ratio 1.66; 95% CI 0.75–3.65). Legalization was also not associated with significant changes in cigarette smoking, alcohol consumption, or the use of street drugs during the preconception period and pregnancy, after adjusting for potential confounders.ConclusionThe preliminary evidence presented in this study shows that the legalization of cannabis was associated with 71% higher odds of cannabis use during the preconception period. Studies examining the effects of cannabis use on perinatal outcomes, as well as public health interventions and educational programs related to cannabis use, should include the preconception period as an area of focus.     

Concerns of Multiparas During the Second Postpartum Week

A study was conducted to identify concerns of multiparas during the early postpartum period. Twenty multiparas were interviewed at home 10 to 14 days postpartum. Family, mother, and baby items were sorted into three categories; worry, interest, and no concern. Meeting the needs of everyone at home and other family items were most frequently sorted as a concern. Feeding method, mother's educational level, yearly household income, sex of the newborn, and childbirth preparation were related to the number of concerns.     

Infections During the Postpartum Period

Postpartum infections are costly in terms of delayed mother-infant interaction; lactation difficulties; prolonged hospital stay or readmittance to the hospital and increased expense; and possible permanent injury or death. The nurse is in a unique position to identify the woman at risk, recognize early warning signs, and provide teaching and counseling for prevention and care. Shortened hospital stays challenge the nurse to develop, research, and discover funding for new interventions to provide care and teaching to minimize the effects of this problem.     

Dimensions of Sexuality in the Perimenopausal Transition: A Model for Practice

A biopsychosocial-cultural model of the sexuality of women during the perimenopausal transition includes dimensions related to physiology, psychosocial issues, and culture. It is an amalgam of biomedical and psychosocial models, yet has the added focus on culture. This holistic approach to sexual health is recommended by researchers and clinicians engaged in the study of midlife women. Clinicians can use this model to guide assessment and interventions, examining all of the dimensions of sexuality during the perimenopausal transition.     

The Impact of Mental Health and Stress Concerns on Relationship and Sexuality Amidst the COVID-19 Lockdown

BackgroundSince January 23, 2020, the Chinese government has imposed restrictive measures including self-isolation, travel restrictions and lockdown of Wuhan city in order to prevent the incoming waves of COVID-19 outbreak in the country. However, the impact of mental health and stress concerns on relationship and sexuality amidst the COVID-19 lockdown was currently unclear.AimThe cross-sectional study was designed to determine the changes in health, relationship and sexuality among the Chinese couples who lived together amid the early stages of COVID-19 pandemic in China.MethodsParticipants of Chinese nationality aged ≥18 years were asked to complete a self-administered online questionnaire regarding sexuality behaviour and impact of event scale (IES) in March 2020. Nonrandom sampling was used for participant recruitment. Also assessed were sociodemographic data including sex, age, employment, region, sexual dysfunction, and whether participants tested positive for COVID-19.OutcomesIES score, frequency of sexual intercourse per week, quality of usual sex life, emotional bonding and duration of relationship were measured.ResultsA total of 1,139 participants (ie, 735 males and 404 females) were included in the study. Mean age and IES of participants was 33.6 ± 9.5 years and 27.4 ± 8.6, respectively. Being male was significantly associated with increased frequency of sexual intercourse amid the COVID-19 pandemic (P = .012). Also, participants with an IES score <26 were more likely to report that they had increased frequency of sexual intercourse per week (P < .001) and the COVID-19 pandemic had positively affected the quality of their usual sex lives (P < .001). On the other hand, participants with IES score ≥26 were more likely to report that the COVID-19 pandemic had positively affected their emotional bonding (P < .001).Clinical implicationsFrequency of sexual intercourse and quality of sex life in participants who experienced high stressful impact were more likely to be affected by the COVID-19 pandemic.Strengths and limitationsThis was one of the first studies to assess sexual behavior during the COVID-19 pandemic in Chinese adults. Since participants were asked to self-report their sexual behavior, this potentially introduced self-reporting and recall bias into our findings.ConclusionsOur study reported that despite the moderate-to-severe stressful impact due to the COVID-19 pandemic, the majority reported no significant changes in the frequency of their sexual intercourse per week, quality of their usual sexual lives and emotional bonding. Zhang Y, Wen C, Zhang Y, et al. The Impact of Mental Health and Stress Concerns on Relationship and Sexuality Amidst the COVID-19 Lockdown. J Sex Med 2021;18:1843–1850.     

Use of Dolutegravir for Antiretroviral Therapy for Women of Childbearing Age

The purpose of this article is to offer an update on the use of antiretroviral therapy (ART) for HIV among women of childbearing age. We focus specifically on the use of dolutegravir (DTG) because of a recently identified potential safety issue related to neural tube defects in the fetuses of women who used DTG at the time of conception. Nurses and advanced practice registered nurses should engage in shared decision-making processes for reproductive life planning with women of childbearing age who are living with or are at risk for HIV. During these processes, exploration of the full range of ART regimens is essential. Consistent and reliable contraception is necessary with the use of DTG because it is not recommended in the first trimester of pregnancy.     

Relationship between Social Support and Quality of Life in Childbearing Women during the Perinatal Period

ObjectiveTo explore demographic and social support predictors of health‐related quality of life (HRQoL) (mental and physical) for childbearing women in the perinatal period.DesignLongitudinal.SampleThree public hospitals in metropolitan Brisbane, Australia.ParticipantsFour hundred seventy‐three (473) women recruited at 36 weeks of pregnancy, and 6 and 12 weeks following childbirth.MethodsThe Short Form‐12 (SF‐12) Version 2 Health Survey was used to measure the mental and physical domains of HRQoL. Social support was measured using the Maternal Social Support Scale (MSSS).ResultsMean scores for the mental and physical domains of HRQoL were lower than population norms. Social support was found to be a significant and consistent predictor of higher HRQoL scores, particularly in the physical domain at 12 weeks following child birth and mental domain during the perinatal period. The relationship between social support and HRQoL was found to be independent of other factors including education, length of relationship with partner, age, parity, and antenatal visit. The only other significant predictor was length of relationship with partner in the mental domain at 36 weeks of pregnancy.ConclusionSocial support is a significant and consistent predictor of a mother's HRQoL during the perinatal period. Nurses and midwives need to assess social support, rather than making assumptions based on demographic factors.     

Clitoral Changes,Sexuality, and Body Image During the Menstrual Cycle: A Pilot Study

Introduction.A relationship between sexual function and all body image variables has been reported. However, there are no studies analyzing the relationship between menstrual cycle, body image, and sexuality.Aim.To evaluate clitoral changes, sexual behavior, and perceived body image during the menstrual cycle.Methods.Twenty‐four women underwent ultrasonographic (US) clitoral measurements, color Doppler evaluation of the clitoral artery, and hormonal testing. In addition, they were administered the McCoy Female Sexuality Questionnaire (MFSQ), the Stunkard Figure Rating Scale (FRS), and the Beck's Depression Inventory questionnaire (BDI).Main Outcome Measures.The main outcome measures were clitoral volume, clitoral artery pulsatility index (PI), the MFSQ, the FRS, and the BDI.Results.The subjects had a mean age of 29.3 ± 4.5 years and a mean body mass index (kg/m² = BMI) of 21.2 ± 2.0. US and color Doppler assessments showed significant increase in clitoral body volume (P = 0.039) and a decrease in the PI (P = 0.027) of the clitoral artery during the periovulatory phase of the menstrual cycle. These changes were significantly and positively correlated with estradiol levels (P = 0.009 and P = 0.017, respectively). The two‐factor Italian MFSQ for sexuality and partnership was similar in all the phases of the cycle. The number of intercourses/week slightly increased in the periovulatory phase. The mean BDI was normal in all women and did not change during the cycle. The FRS showed no difference in all examined parameters during the three phases of the menstrual cycle.Conclusions.In young, lean, eumenorrheic Italian women, there is no significant change, during the menstrual cycle, in sexual function, body image perception, and symptoms of depression, as assessed by the two‐factor Italian MFSQ for sexuality and partnership, the FRS, and the total BDI score. However, our results suggest that estrogens, influencing clitoral anatomic and vascular changes, may favor genital arousability.     

Group B Streptococcus During the Perinatal Period

The beta hemolytic streptococcus group B (GBS) emerged as a major pathologic threat to infants in the 1960s and continues to both leading cause of maternal and neonatal morbidity in the 1990s.Current approaches to prevention are directed toward eliminating exposure to the pathogen through chemoprophylaxis or enhancing host resistance through immunoprophylaxis. Because research is advancing rapidly in this area, perinatal nurses should keep abreast of changes in prevention and treatment strategies to enhance patient education and improve care.     

Ambivalent Childbearing Motivations: Predicting Condom Use by Urban,African-American,Female Youth

Study ObjectiveTo describe a model of how interactions between positive and negative childbearing motivations affect the use of condoms for contraceptive purposes and test hypotheses based on that model.DesignPsychological and behavioral data were collected during a study that sampled randomly selected census block groups.SettingRespondents were household residents of Baltimore City, Maryland, between 2004 and 2007.ParticipantsEnglish-speaking, sexually active African-American women between the ages of 15 and 24 who had completed a reliable and valid measure of both positive and negative childbearing motivations.Main Outcome MeasuresRegularity of condom use during the past 90 days and contraceptive method at last sex.ResultsThe results of regression analyses with the total sample confirm that antinatal childbearing motivations predicted more regular condom use and that ambivalent, pronatal, and indifferent childbearing motivations acting together each predicted less regular condom use. The results with a subgroup using condom and not hormonal contraception confirmed that ambivalent childbearing motivation alone predicted less regular condom use.ConclusionsOur findings demonstrate how positive and negative childbearing motivations interact to create a dynamic effect on contraceptive behavior that transcends the effect of either positive or negative motivation acting alone. We conclude that the dynamics of these motivational interactions have important implications for further research on contraceptive decision-making, for augmenting the understanding of caretakers and providers, and for the formation of new policies that focus on the prevention of unplanned pregnancy among youth.     

Female Urinary Incontinence During Intercourse: A Review on an Understudied Problem for Women's Sexuality

IntroductionCoital urinary incontinence is a frequently underreported symptom, with a relevant impact on women's sexuality and quality of life.AimThis article will review the available evidence on incidence, pathophysiology, and treatment of coital urinary incontinence with the attempt to present the current state of the art.MethodsPubMed was searched for reports about coital urinary incontinence that were published from 1970 to 2008, and the most relevant articles were reviewed.Main Outcome MeasuresReview on epidemiology, pathophysiology, diagnosis, and treatment of coital incontinence.ResultsThe incidence of coital incontinence in incontinent women has been reported to range between 10% and 27%. At present, some evidence suggests an association between urinary leakage at penetration and urodynamic stress (USI) incontinence as well as urinary leakage during orgasm and detrusor overactivity (DO). When treatment for these conditions are based upon urodynamic findings, pelvic floor muscle training, surgery, and pharmacotherapy show satisfactory cure rates.ConclusionsCoital urinary incontinence deserves much more attention in clinical practice: women should be specifically interviewed for this disturbance because it has a very negative impact on their sexuality. If a reliable urodynamic diagnosis is made, coital urinary incontinence at penetration can be cured in more than 80% of cases by surgery in the presence of USI. The form of coital incontinence during orgasm is curable by antimuscarinic treatment in about 60% of cases when associated with DO. Serati M, Salvatore S, Uccella S, Nappi RE, and Bolis P. Female urinary incontinence during intercourse: A review on an understudied problem for women's sexuality. J Sex Med 2009;6:40–48.