1) The study examined the effects of a digital prenatal program called the Baby Care Program (BCP) on 512 first-time mothers. The BCP included mindfulness activities like meditation, yoga, music, and baby bonding exercises.
2) Results showed statistically significant benefits for mothers who used the BCP, including lower stress, better sleep, fewer preterm births and higher birth weights, compared to mothers who did not participate.
3) The BCP was found to help mothers develop a stronger bond with their babies, better manage nutrition and pregnancy symptoms, and have an overall healthier pregnancy experience.
This presentation is all about the epidemiology of stillbirths, in India. It talks about the different challenges in controlling the stillbirths and the strategies of controlling it. The INAP guideline of Government of India, which is a stepping stone for controlling stillbirths in India, is also discussed here.
IUI is a basic but effective form of fertiltiy treatment and can be a viable alternative to the expensive IVF / test tube baby treatment that is normally advised.
This presentation will be very useful for the practising gynecologists, IVF specialists and General practitioners who perform IUI.
Even patients on going through this presentation will be more educated about iui.
Please reach out to me on 9833032120 by whatsapp / Telegram or phone call or email on dalalsj@gmail.com for further details / treatment options.
This presentation is all about the epidemiology of stillbirths, in India. It talks about the different challenges in controlling the stillbirths and the strategies of controlling it. The INAP guideline of Government of India, which is a stepping stone for controlling stillbirths in India, is also discussed here.
IUI is a basic but effective form of fertiltiy treatment and can be a viable alternative to the expensive IVF / test tube baby treatment that is normally advised.
This presentation will be very useful for the practising gynecologists, IVF specialists and General practitioners who perform IUI.
Even patients on going through this presentation will be more educated about iui.
Please reach out to me on 9833032120 by whatsapp / Telegram or phone call or email on dalalsj@gmail.com for further details / treatment options.
Ahmed Walid Anwar Morad, Professor Obstetrics and Gynecology
Optional procedures alongside the standard IVF protocol to increase the chance of a live birth.
Indications and Outcomes of Emergency Caesarean Section at St Paul’s Hospital...Crimsonpublishers-IGRWH
Cesarean Section (CS) rates and their indications vary all over the World. Audit of indications and factors affecting infant and maternal outcome remain an important activity in rationalizing the use of this major procedure in obstetrics practice. Cesarean section (CS) carries a higher maternal morbidity and mortality compared to vaginal delivery. Noresearches have been done on this area.
Maternal sepsis is a severe bacterial infection, usually of the uterus (womb), which can occur in pregnant women or more commonly, in the days following childbirth. Infection that occurs just after childbirth is also known as puerperal sepsis
Antenatal care is the routine health control of presumed healthy pregnant women without symptoms (screening), in order to diagnose diseases or complicating obstetric conditions without symptoms and to provide information about lifestyle, pregnancy and delivery.
International Journal of Pharmaceutical Science Invention (IJPSI) inventionjournals
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online
Ahmed Walid Anwar Morad, Professor Obstetrics and Gynecology
Optional procedures alongside the standard IVF protocol to increase the chance of a live birth.
Indications and Outcomes of Emergency Caesarean Section at St Paul’s Hospital...Crimsonpublishers-IGRWH
Cesarean Section (CS) rates and their indications vary all over the World. Audit of indications and factors affecting infant and maternal outcome remain an important activity in rationalizing the use of this major procedure in obstetrics practice. Cesarean section (CS) carries a higher maternal morbidity and mortality compared to vaginal delivery. Noresearches have been done on this area.
Maternal sepsis is a severe bacterial infection, usually of the uterus (womb), which can occur in pregnant women or more commonly, in the days following childbirth. Infection that occurs just after childbirth is also known as puerperal sepsis
Antenatal care is the routine health control of presumed healthy pregnant women without symptoms (screening), in order to diagnose diseases or complicating obstetric conditions without symptoms and to provide information about lifestyle, pregnancy and delivery.
International Journal of Pharmaceutical Science Invention (IJPSI) inventionjournals
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online
A descriptive study on newborn care among postnatal mothers in selected mater...pharmaindexing
The newborn health challenge faced by India is more formidable than that experienced by any other country in the world. The newborn health is inevitably affected by the traditional care practices of the mothers causing high infant morbidity and mortality.The aim of the study were determine the knowledge, attitude and practice of postnatal mothers regarding new born care and find out the association between knowledge, attitude and practice of postnatal mothers regarding new born care and to determine the association between these as well as with the selected demographic variables. A descriptive study was conducted to assess the knowledge, attitude and practice of postnatal mothers regarding new born care in selected maternity centres in Madurai. Survey approach was employed to select sample and it consisted of 100 postnatal mothers. Data was collected using structured interview schedule. Findings of the study showed that 65% of postnatal mothers had moderate knowledge; 61% had favourable attitude and 57% of them had high practice of new born care. There was a significant association between knowledge and attitude (r=+0.567), knowledge and practice (r=+0.388), attitude and practice (r=+0.321) .There was a significant association between knowledge and education, monthly family income and obstetrical score at p<0.05. Findings of the study indicated the need to conduct frequent assessment of knowledge, attitude and practice of postnatal mothers regarding new born care. Awareness and attitude of the mothers towards new born care still has lots of lacunae especially in those who belong to the lower socio economic statusand poorly educated postnatal mothers. So it is imperative to provide comprehensive training in the field of new born care for mothers during pregnancy
Breastfeeding Practices of Postnatal Mothers: Exclusivity, Frequency and Dura...IJEAB
Mothers who perceive breastfeeding to be healthier, easier and more convenient breastfeed longer than those who perceive that breastfeeding is restrictive, inconvenient and uncomfortable. This study focused on the breastfeeding practices of postnatal mothers with regard to exclusivity, frequency and duration. It was a cross-sectional research design covering the three levels of health care institutions in the South-East Zone of Nigeria. Convenient sampling method was used to select 299 postnatal mothers who visited infant welfare clinics along with their infants. Three research questions and one null hypothesis guided the study. The instruments used for data collection were questionnaire on patterns of breastfeeding by postnatal mothers (QPBF) and checklist on health status of infants with varied breastfeeding patterns (CHSIVBP). Frequency distribution and percentages were used to answer the research questions while chi-square test was used in testing the null hypothesis at 0.05 level of significance. The result showed that most of the postnatal mothers practiced EBF for a short period, majority breastfed their infants on demand day and night, and majority also reported that their infants suckle the breast for more than 20minutes. Also breastfeeding patterns of the postnatal mothers was found to differ significantly across the three levels of health care institutions. Childbearing mothers need to be motivated on the need to practice EBF for six month postpartum.
LITERATURE SELECTION2LITERATURE SELECTION6Lite.docxSHIVA101531
LITERATURE SELECTION 2
LITERATURE SELECTION 6
Literature Selection
Augustina Ferguson
Grand Canyon University: NRS-441V
August 30, 2015
Running head: LITERATURE SELECTION 1
Literature Selection
#1
Nwaru, B. I., & Hemminki, E (2011). Infant Care practice in rural China and their relation to prenatal care utilization.Global Public Health, 6(1), 1- 14.doi:10.1080/17441691003667307.
How does each article describe the nature of the problem, issue, or deficit you have identified?
Studies describing postpartum childcare practices and the influence of prenatal care on infant care outcomes in rural China are scarce. Inadequate care was positively associated with never breastfeeding, early introduction of milk formula and cereal/porridge, and early start of work after delivery.
Does each article provide statistical information to demonstrate the gravity of the issue, problem, or deficit?
Yes! Data were available from a Knowledge, Attitude and Perception cross-sectional survey collected from 2001 to 2003, after a prenatal care intervention in Anhui County, China, with a response rate of 97%.
What are example(s) of morbidity, mortality, and rate of incidence or rate of occurrence in the general population?
None Identified
Does each article support your proposed change?
Yes, it does
#2
Udgiri, R., K. J., S., & Sorganvi, V. (2015). Breast Feeding Practices among Postnatal Mothers-a Hospital based Study. Journal of Advanced Scientific Research, 6(1), 10-13. Grand Canyon University Library. (2015). Research & Resource LopeSearch. Retrieved from http://library.gcu.edu/
How does each article describe the nature of the problem, issue, or deficit you have identified?
It assesses the knowledge and practices of mothers about breastfeeding Practices Cross- sectional study was carried out for a period of one month.
Does each article provide statistical information to demonstrate the gravity of the issue, problem, or deficit?
A total of 162 postnatal mothers admitted in postnatal ward constitute the sample size. The data was collected using semi-structured questionnaires. Data was analyzed by using SPSS 16th version. The study shows that 21(12.9%) of the babies were feed with prelacteal feeds like honey and sugar water.
What are example(s) of morbidity, mortality, and rate of incidence or rate of occurrence in the general population?
None was identified.
Does each article support your proposed change?
Yes.
# 3
Geçkil, E., Şahin, T., & Tunçdemir, A. (2012). The Effect of * The Following and Supporting Breast-feeding Programme*, That Is Applied by Family Health Staff, on The Mother's Effective Breastfeeding Behaviors in The First Six Months of The Post-Birth Period. (English)
How does each article describe the nature of the problem, issue, or deficit you have identified?
This study investigates the effect of the education and observation of supporting breast-feeding programme that is applied by family health staff on the mothers of the post birt ...
Effectiveness of pre delivery preparation on anxiety among Primigravida mothe...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care.
Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice
To evaluate traditional neonatal beliefs and care practices among urban and rural residents and assessing predictors of early initiation of breastfeeding, a cross-sectional study was conducted in two districts, Lahore and Rawalpindi of Pakistan. A total of 218 mothers having infants (< 2 years of age) were interviewed through collecting information through a questionnaire. In the logistic regression analysis, presence of professional birth attendant (P-value = 0.012, OR = 3.909), sterilization of feeding bottle (P-value = 0.013, OR = 3.280) and knowledge about reason of vaccination (P-value = 0.010, OR = 2.058) we re significantly associated with urbanization. Maternal education was significantly associated with correct timing to start weaning practice, breast milk was sufficient for infant, hand washing practice before breastfeeding, good cord care, vaccination status, reason of vaccination and knowledge about Jaundice in neonatal period (P <0.05). The results of multivariate ordinal regression showed that young literate mothers ((P < 0.001; OR = 3.192) started breastfeeding earlier than the elder and illiterate mothers. Furthermore, the women with normal delivery (P < 0.01; OR = 0.301) and low socioeconomic class (P < 0.10; OR = 0.339) started breastfeeding earlier. Among 218 mothers 44.5%, newborns were bathed immediately. A significant proportion of mothers 77.1% reported giving prelacteals as fi rst feed. Majority of mothers 30.7% apply oil on umbilical cord. also, 72.5% mothers administered gripe water to their infants. Traditional risky newborn care practices stress the need for promoting health education programs on improving newborn care practices.
A Study to Assess the Effectiveness of Structured Teaching Programme on Knowl...ijtsrd
Background Low birth weight is one of the important causes for the high infant mortality rate in developing countries. In India during the year 1991, the IMR was 80 per 1000 live births and neonatal mortality rate NMR was 51 per 1000 live births.LBW babies have been reported to lag behind their heavier counterpart in development for the rest of their lives. Objective The present study attempted to assess the effectiveness of structured teaching programme on knowledge regarding management of low birth weight LBW babies among postnatal mothers. Methods In the present study, evaluative research approach was selected one group pre test and post test design was adopted. The structured interview schedule on management of low birth weight LBW babies among postnatal Mothers was used to collect the data. The main study was conducted at Kedarpur and Barai rural community Gwalior, Madhya Pradesh, with the sample size of 40 postnatal mothers selected by using convenient sampling technique and the collected data were analyzed and interpreted based on descriptive and inferential statistics. Results The overall mean score of the subjects in pre test was 56.25 with standard deviation 2.80. In post test, the mean percentage of the Overall means score of the subjects in post test was 76.25 with standard deviation 2.28. The obtained ‘t’ value was greater than the table value and found to be highly significant at the level of p 0.005. The findings evidenced structured teaching programme was effective in increasing the knowledge of the postnatal mothers regarding management of low birth weight LBW babies. Conclusion The study concluded that there was a significant improvement in the knowledge after structured teaching programme. Thus structured teaching programme is effective in improving the knowledge of the mothers. Ms. Divya Singh | Ms. Sunita Singh "A Study to Assess the Effectiveness of Structured Teaching Programme on Knowledge Regarding Management of Low Birth Weight (LBW) Babies among Postnatal Mothers in Selected Community at Gwalior" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-4 , June 2021, URL: https://www.ijtsrd.compapers/ijtsrd42452.pdf Paper URL: https://www.ijtsrd.commedicine/nursing/42452/a-study-to-assess-the-effectiveness-of-structured-teaching-programme-on-knowledge-regarding-management-of-low-birth-weight-lbw-babies-among-postnatal-mothers-in-selected-community-at-gwalior/ms-divya-singh
Patterns and determinants of breast feeding among mother infant pairs in dera...Zubia Qureshi
Background: Proper breastfeeding practices are effective ways for reducing childhood morbidity and mortality. The objective of the present study was to determine the patterns and explore the determinants associated with breast feeding practices among the nursing women in Dera Ghazi Khan. Methods: A cross sectional study was conducted on randomly selected lactating mother infant pairs in Dera Ghazi Khan. Structured questionnaire was used for data collection. Analysis was done by using SPSS, chi square test was applied to see the association between breast feeding practices and its determinants such as knowledge of breast feeding practices. Results: Majority 372 (93%) of mothers mentioned that they had ever breastfed the youngest child. About 292 (73%) mothers gave colostrum to the child, and 48 (12%) exclusively breastfed. Weaning babies before four month of age was practiced by 84 (21%) of the mothers, 120 (55%) mothers started weaning at 4-6 months of child age, while 72 (18%) started to give additional food after baby turned six months old. Out of total 276 (69%) mothers reported that they had knowledge regarding breast feeding. Significant association was found between knowledge of breastfeeding and initiation and Exclusive Breast Feeding (EBF) practices (p-values <0.05). Income, family type, mode of delivery and assistance for child were significantly associated with initiation of breastfeeding within one hour after birth (p-value <0.001). Conclusion: Breast feeding practices in the studied area were not up to the mark. There is a strong need to improve the breastfeeding practices by Behavior Change Communication. Keywords: Breast feeding; Early initiation; Exclusive Breast Feeding (EBF); Colostrum; Supplementary feeding; Infants
Background: Maternal health remains today, one of the major public health concerns in developing countries. Maternal deaths and newborn deaths usually occur within 48 hours of delivery. In Cameroon, despite all the initiatives set up by the Ministry of Public Health to reduce the mortality rate, the situation remains alarming in terms of postnatal consultation; this is much more felt in the West region of Cameroon, which is one of the most affected regions because 43.1% of women who give birth in hospitals do not return to postnatal consultation and this rate is higher than the national average with a value of 21.5%. Objective:This work aims to determine the factors influencing postnatal follow-up in the Bafang Health District. Methodology: This is a cross-sectional descriptive study for analytical purposes, carried out in the Bafang Health District between January 1 to November 30, 2017. Our study population consisted of all women of childbearing age living in the Bafang Health District during the study period. The variables studied were sociodemographic characteristics, socio-cultural characteristics and the provision of care. Results: Analysis carried out during this study, it appears that, the person who informs the women on the dates of rendez-vous during the CPoN (OR = 2.92; [95%CI = 1.16-7,]; p-value = 0.02), women who think the appropriate period of postnatal follow-up is 6 weeks postpartum (OR = 4.27, [95%CI = 1.47-12.39], p-value = 0.00 ) and those who massage the abdomen after childbirth (OR = 2.62, [95%CI = 1.34 - 5.12], p-value = 0.00) are more likely to have knowledge about follow-up postnatal. While women who have no knowledge of postnatal follow-up (OR = 0.18, 95%CI = 0.07-0.45, p-value = 0.00) are less likely to have more knowledge. Conclusion: Lack of knowledge of the existence and importance of postnatal consultation (CPoN), traditional practices are the factors that influence postnatal follow-up in the Bafang Health District. A good and effective care for women after childbirth requires increased awareness campaigns at the hospital level as well as in community settings.
Annals of Nutritional Disorders & Therapy is a peer-reviewed, open access journal published by Austin Publishers. It provides easy access to high quality Manuscripts in all related aspects of nutritional disorders resulting from either excessive or inadequate intake of food and nutrients leading to various Nutritional diseases including obesity, eating disorders, malnutrition, developmental abnormalities that could be prevented by diet, hereditary metabolic disorders that retort to dietary treatment, food allergies and intolerances, and potential hazards in the food supply. It also focuses upon the chronic diseases caused due to improper nutrition such as cardiovascular disease, hypertension, cancer, and diabetes mellitus.
Austin Publishing Group is a successful host of more than hundred peer reviewed, open access journals in various fields of science and technology with intent to bridge the gap between academia and research access.
Annals of Nutritional Disorders & Therapy journal accepts original research articles, review articles, case reports, mini reviews, rapid communication, opinions and editorials on all related aspects of nutritional disorders resulting from either excessive or inadequate intake of food and nutrients.
Corona is here to stay and it is predicted that over 70% of population will get the infection (fortunately not all will fall sick or very sick). (Recovery rate of over 74% & Death rate around 2%).
A lot of confusion exists regarding testing for covid and what test to do, when and how to interpret these tests.
Compiled by Dr. Narendra Malhotra
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
Navigating the Health Insurance Market_ Understanding Trends and Options.pdfEnterprise Wired
From navigating policy options to staying informed about industry trends, this comprehensive guide explores everything you need to know about the health insurance market.
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
2. Mindful Digital Program–based Interventions and Their Role in Pregnancy and Fetal Outcomes
Journal of South Asian Federation of Obstetrics and Gynaecology, Volume 13 Issue 3 (May–June 2021) 171
The data were collected at 15 and 35 weeks of pregnancy
and then from 1 month until 6 months of postdelivery. Both
quantitative and qualitative data were collected using a descriptive
mixed-methods design. In the first data-gathering touchpoint, the
primigravida milestones were collected from weeks 10 to 12.
In the 15th and 35th weeks, the maternal psychosocial indices
were mapped on three scales, namely the Perceived Stress
Reactivity Scale (PSRS), Pittsburgh Sleep Quality Index Scale (PSQI),
and Cranley’s Maternal–Fetal Attachment Scale (CMFAS).
Participants also responded to a 45-item self-reported
questionnaire on their emotional state, postpartum blues,
breastfeeding, sense of control, and their observations of the baby.
This method of data collection was selected because it not only
provides freedom for participants to express their views but also
helps in validating results. Moreover, this method was the easiest
to conduct during the COVID pandemic.
Results
This study to probe the role of the BCP mindful digital program–
based interventions on pregnancy and fetal outcomes threw up
interesting insights across several dimensions.
The mean gestational age at delivery and the weight of the
baby was significantly more in the study group as compared to the
control group (Table 2). The incidence of preterm deliveries was
significantly lower in the study group as compared to the control
group (Table 2). There was no statistical difference in the normal
vaginal delivery or emergency caesarean section between the two
groups, but the rate of elective caesarean section was much higher
in the control group as compared to the study group though it did
notreachstatisticalsignificance(Table2).Onemustrememberthat
there is still an 8% chance that the null hypothesis is true for the
rate of elective cesarean section being more in the control group.
The data on the birth weight of the babies revealed that the
BCP study group notched a mean of 3.1 kg as against the control
group’s2.4 kg(Table2).Morethan86%ofbabieshadabirthweight
greater than 2500 gm in the study group as against 67% in the
control group (Fig. 1).
When the data were analyzed for preterm deliveries, it was
observed that the incidence was much lower in the BCP group
(12%) as compared to controls (32%) (Fig. 2).
Eighty-two percent of mothers in the BCP group revealed that
theywereabletoadoptdietswithidealnutrition,comparedto46%
in the control group, based on the dietary information and recipes
that were made available to them on the BCP.
The study group of BCP mothers reported better sleep during
pregnancy. On the PSQI scale, there was a significant difference
between mothers using the BCP activities vs those in the control
group (Table 3). Patients reported better sleep (87%) as compared
to their pre-BCP sleep, which was attributed to the in-App activities
of BCP (Fig. 3).
It is a known fact that bonding with and shaping the baby’s
temperament, also known as maternal–fetal attachment (MFA),
begins right from the time of conception.4
The baby can hear and
absorb mother’s emotions and feelings in the womb. Mother is a
powerful engineer in shaping the baby’s traits and personality just
withherstateofmind,calmness,andmentalstability.Herexposure
to good nutrition, music, exercises, and meditation improves her
coping up strategies and reduces stress.
SeveralstudieshaveshownthateducatingmothersonMFAcan
enhancethemother’smentalhealthandattachmenttotheinfant.5
During the past several decades, great strides have been made in
improving the outcomes of pregnant women and their babies.
The Baby Care Program (BCP) digital intervention was designed
and developed to help mothers to improve MFA and help them
to cope with stress. Thus, one can help pregnant women from all
walks of life with the use of technology to experience the benefits
of the age-old practices of maternal well-being.
Simple elements like “music” impacted a mother’s state of
mind and outcomes in pregnancy.6
Chansoria, Konanki, and Tiwari
in a single-center, randomized, open-label controlled trial of
primigravida mothers aged 19 to 29 years concluded that prenatal
musicexposureofthemothersignificantlyandfavorablyinfluenced
neonatal behavior.7
Thebodyofresearchonmindfulinterventionsisthecornerstoneof
theBCPApp,leadingtoitsdigitalframeworkthatinvolvesthefollowing:
• Meditation and sleep guidance
• Harmonizing music
• Talk to baby and storytelling (baby bonding activities)
• Yoga and breathing exercises
• Diet and pregnancy information
The vision of this app, which was established in July 2019, is to
help the expectant mother develop and sustain a healthy, holistic
lifestylethatbeginsinthepreconceptionperiodandcontinuestothe
postpartumperiod.Thisappisamembership-basedplatform,which
has a repository of 800 plus actionable activities under meditation,
music, yoga, and unique baby bonding exercises for women to be
physically and mentally healthy and connect with the baby.
The primary aim of this study was to test the efficacy of
mindfulness activities and maternal bonding with the unborn
baby with regard to postnatal outcomes in primigravidas. The
secondary aim was to determine the influence of ongoing, real-
time consultative mentoring for the primigravida on lowering the
day-to-day maternal stress and other secondary effects.
Materials and Methods
This longitudinal study (panel study) was conducted on 512
primigravidas.Thestudygroupincluded255pregnantwomenwho
opted for a digital holistic health program: “Baby Care Program”
(BCP), while the control group consisted of 257 pregnant women
whoreceivednosuchinterventions.Table1showsthetotalnumber
of women in the study and control groups in different age-groups.
The study group was offered the BCP that included the
following:
• 8 minutes of daily guided mindfulness meditation.
• 3 hours of yoga and breathing practices every week.
• 2 hours of harmonizing music every week.
• 1 hour of baby bonding activities every week.
• 1 hourofpersonalizeddietandpregnancyeducationeveryweek.
Table 1: Subjects as per age-group
Age
Study group
(n = 255)
Control group
(n = 257)
20–30 158 135
30–35 62 78
35–40 23 43
>40 2 1
3. Mindful Digital Program–based Interventions and Their Role in Pregnancy and Fetal Outcomes
Journal of South Asian Federation of Obstetrics and Gynaecology, Volume 13 Issue 3 (May–June 2021)
172
Table 2: Results of the pregnancy outcomes
(Baby Care Program)
Study group (n = 255)
Control group
(n = 257) p
Mean gestational age at
delivery (weeks) 38.5 36 0.02
Mean birth weight (gm) 3130 2490 0.004 (a)
Preterm delivery 30 (12%) 82 (32%) 0.0005 (a)
Mode of delivery
Normal vaginal delivery 141 (55%) 129 (50%) 0.8
Elective cesarean section 40 (16%) 69 (27%) 0.08
Emergency cesarean section 74 (29%) 59 (23%) 0.4
Birth weight
<2500 gm 36 (14%) 80 (31%) 0.01 (a)
≥2500 gm 219 (86%) 177 (67%) 0.01 (a)
a
p <0.05 univariate analysis between groups; p value and significance
Fig. 1: Birth weights for control and study groups
Fig.2:Pretermdeliveryandnormaldeliveryforcontrolandstudygroups
A very important issue of maternal stress was also explored in
this study using the PSRS. The BCP study group also self-reported
significantly lower stress levels (14%) as compared to the control
Table 3: Responses on psychological scales: PSQI, PSRS, and Cranley’s
MFA scale
Control group
(n = 257)
Baby Care Program
Group (n = 255) p
PSQI score
15th week 4.3 4.1
35th week 5.1 2.8 0.018 (a)
PSRS score
15 weeks 1.5 1.4
35 weeks 2.2 0.52 0.032 (a)
Cranley’s MFA scale
15 weeks 76 74
35 weeks 82 108 0.003 (a)
a
p <0.05 univariate analysis between groups; p value and significance
Fig. 3: PSQI scale response for control and study group
group (79%). In the study group, 70% attributed to the reduction
in stress levels to the activities they did under the BCP program.
ThePSRSscorewassignificantlyhigher(2.2)inthecontrolgroup
as compared to 0.52 noted in the BCP study group (Table 3). The
study group performed better (Fig. 4) at 35 weeks of pregnancy.
4. Mindful Digital Program–based Interventions and Their Role in Pregnancy and Fetal Outcomes
Journal of South Asian Federation of Obstetrics and Gynaecology, Volume 13 Issue 3 (May–June 2021) 173
Yoga,breathingexercises,andmeditationshelpedinincreasing
lung capacity, controlling the breathing pattern, and alleviating
labor fears. This helped the pregnant women in having a normal
vaginal delivery and in accepting/tolerating pre- and postpartum
symptoms and body changes.
Moreover, the real-time digital education on widespread
pregnancy-related concerns, such as diet, fetal development,
growth,symptoms,maternalbondingcheckups,andscans,helped
to reduce anxiety and manage nutrition especially during the
pandemic,whenaccesstohealthcareisrestricted.AstheuseofBCP
increased the parental bonding with the baby, it led to exclusive
breastfeeding that has several advantages.
Discussion
The iMumz pregnancy, a baby care and parenting app, has
beautifully amalgamated the treasure of traditional methods
of maternal and fetal wellness, runs past the stringent litmus of
science, and is serving the same methods digitally, via activities
easy for pregnant women to perform in their own comfort zone.
The objective of the digital app is to help the expectant mother
to develop and sustain a healthy, holistic lifestyle right from the
preconception period to postdelivery.
Sleep patterns, ability to perform daily tasks, and quality of
life in the pregnant woman are affected by systematic variations
caused by hormonal, emotional, mental, and physical factors.9
Sleepdeprivationleadstoadecreaseinthefunctionoftheimmune
systemandfunctioningofthehypothalamus,pituitary,andadrenal
glands.10
Even as the pregnant woman tries to cope with this state
during pregnancy, fears related to the upcoming childbirth add to
heranxieties.Inastudy,80%ofpregnantwomenreportedanxieties
around the process of birth.11
The pregnant woman’s state of mind affects the development
of the unborn baby’s cognitive and noncognitive skills: when she
is calm and at peace, the baby reaps significant benefits and she
experiences higher self-esteem and a sense of personal control.12
The opposite leads to increased incidences of intrauterine growth
retardation,pretermlabor,prolongedlabor,fetalheartratedecline,
low birth weight, increased rate of caesarean section, postnatal
neurobehavioralproblems,anddevelopmentaldisorder.Moreover,
itwasalsoobservedthatheightenedmaternalanxietyincreasedthe
This was further validated by the subjective self-reports. With
regardtofearsrelatedtochildbirth,BCPusersreportedsignificantly
lower fear of labor (24%) as compared to the controls (12%).
The BCP study group also reported a higher sense of mastery
in coping with postpartum blues. The control group reported
significantly higher (80%) postpartum blues as compared to 19%
of the BCP users. Moreover, 81.4% of the BCP study group reported
that they felt a sense of control and confidence in managing their
pregnancies, despite the stressful COVID environment.
In the current context of fast-paced urban lives, a raging
pandemic, uncertainty of the future, has multiple stressors on
expectant mothers. In the general population, mothers have
reported that they spend an average of 17 minutes on themselves
while the BCP reported a range of 2 to 4 hours. This, they said,
was despite the increased workload and diminished support due
to the lockdown. The question is how one can expand the use of
scientificallyprovenmindfulness,relaxation,andplannedactivities
for self-care to the entire pregnant population.
On the Cranley’s MFA 24-item scale that has five subscales to
measure the construct of MFA during pregnancy,8
the Cranley’s
MFA scores positively correlated with the amount of available
social support and negatively correlated with the amount of stress
perceived. The BCP study group scored 108 as compared to the
control, which scored 85 (Fig. 5).
The content analysis validated the above in which 97% of the
BCP users reported higher levels of bonding and an understanding
oftheirbaby’sneedscomparedto19%inthecontrolgroup.Ninety-
three percent of BCP users reported a deep understanding of the
importance of MFA compared to 34% of in the control group (the
remaining did not have any knowledge of MFA). In addition, 93%
of BCP users reported a marked increase in attachment with their
babies after regularly practicing BCP baby bonding activities.
Being informed and having easy access to query resolution led to
expectant mothers reporting lower levels of anxiety.
Seventy-four percent of the study group also reported that
the BCP in-App activities helped to stimulate baby’s movements
in the womb. The use of the BCP app resulted in a lower incidence
of postpartum blues and depression and positively correlated with
early childhood development—both mental (brain development,
physiological) and physical (birth weight, motor skills, milestones).
It also helped in improving baby–mother bonding.
Fig. 4: PSRS scale response for control and study group
Fig. 5: Cranley’s MFA score for control and study groups
5. Mindful Digital Program–based Interventions and Their Role in Pregnancy and Fetal Outcomes
Journal of South Asian Federation of Obstetrics and Gynaecology, Volume 13 Issue 3 (May–June 2021)
174
for reducing stress scores, coping with pregnancy, and the overall
well-being of antenatal mothers.17
All these were available in the
interactive BCP app.
Bowlby’s (1951) pivotal work on attachment suggested
that the absence of a close and sustained bond with a mother
(or mother figure) has irreversible mental health consequences on
the child.18
Fowles and Horowitz (2006) support this, describing
infant development to be sensitive to the quality of mother–child
interaction in the first postpartum year.19
Children of mothers with prenatal maternal depression (PMD)
showed cortical thinning, particularly over the frontal lobes and
this may be a risk marker for depression in the future. Another
study found that the microstructure of the amygdala, indexed by
fractional anisotropy, may be altered in newborns of mothers with
PMD.18
ItwasalsoobservedthatPMD-exposedinfantshadincreased
functional connectivity between the amygdala and several frontal
regions.19
TogethertheseresultssuggestthatexposuretoPMDmay
influence the development of the frontal cortex and particularly,
amygdala–prefrontal circuits, with implications for the future as
altered amygdala–prefrontal connectivity has been implicated in
pediatric depression.20–22
Thus prenatal maternal mood and stress
levels have a direct and persisting effect on her child’s psychology
and support an “in utero-programming” hypothesis for depression
in childhood and adolescence.
Today, pregnancy and birth are treated as medical events
rather than as normal life events and the woman is always under
stress between her two prenatal visits that everything is “okay” in a
nuclearfamilysetupwheretheage-oldcultureofsocialandmental
support of joint family is not there. Today with medicolegal issues,
the obstetrician exaggerates the risks of pregnancy and birth and
increases women’s fears for themselves and their babies. This adds
to the stress of the expectant mother that results in an exaggerated
concern for safety, “intervention-intensive” pregnancy, as well as
labor and childbirth. Moreover, the pandemic has increased the
stress of the pregnant woman as her visits to the obstetrician have
also decreased, which makes her worried about the well-being of
her child.
A large number of studies have confirmed that a woman’s
active involvement with the fetus benefits both the woman and
her unborn child.23,24
We have explored how this attachment can
be assisted and facilitated by providing her with well-researched
activities that she can engage in through the BCP. The BCP not only
provides activities but also sets up an engagement framework to
intimate, involve, and continuously encourage the completion of
the same. We must remember that everything that happens once
a baby is born is the outcome of all that has happened during
the pregnancy. One can help pregnant women with the use of
technology to experience the benefits of the age-old practices
of maternal well-being. The iMumz BCP App was designed and
developed for precisely this purpose.
Conclusion
The women’s ability to negotiate this journey of pregnancy and the
postpartum period will determine the well-being of the mother
and child. The physical and emotional changes of pregnancy and
then the experience of labor, birth, and breastfeeding play vital
roles as women make the transition to motherhood. To make this
journeyofpregnancyandlaborfruitfulforthemother,bothphysical
and psychological prenatal care systems contribute in a powerful
associationbetweenplasmaandamnioticcortisollevels,suggesting
thatwomen’sdistressmayaffectchildren’soutcomesviaepigenetic
regulation of glucocorticoid pathway genes in the placenta.13
A recent study found that pregnant women experience more
anxietyantepartumascomparedtopostpartum.14
Astudybasedon
the Avon Longitudinal Study of Parents and Children indicated that
maternal prenatal anxiety predicted persistently higher behavioral
and emotional symptoms across childhood with no decrease of
effect into adolescence. Elevated prenatal anxiety (top 15%) was
associated with a twofold increase in the risk of a probable mental
disorder. Results were similar with prenatal depression that had a
directandpersistingeffectonthechild’spsychiatricsymptomsand
supported an in-utero programming hypothesis.14
Consistent with the Developmental Origins of Health and
Disease model, prenatal distress was found to be associated with
heightened psychiatric risk, suggesting a “third pathway” for the
familial transmission of disease beyond shared genes and the
postnataleffectsofmaternalpsychopathologythatinfluencesfetal
neurobehavioral development.
The woman needs to develop a strong attachment with her
baby in natural and normal ways. She needs to be supported for
this to alleviate her fears about the progress of pregnancy, labor,
and birth so that she takes good care of herself and her baby.
TheBCPhasbeenseentohaveadirectandindirecteffectonthe
mother developing a closer connection with her baby. A milestone
study by Tsao, Hsing, Wang, and Huey-Ming Guo established that
there is a relationship between mindfulness and MFA during
pregnancy.15
A pregnant woman needs to be made aware of the
need for her to connect to the fetus. Furthermore, cultivating an
open and nonjudgmental attitude toward one’s pregnancy stress
is important in addressing the relationship between the mother
and her baby.
Astudyonmaternalbondingthroughpregnancyandpostnatal
life aimed to build a prognostic model of bonding quality based
on sociodemographic factors and postnatal factors (e.g., weeks
of gestation, breastfeeding problems, and crying behavior.).16
It
was hypothesized that both the quality and intensity of maternal–
antenatalbondingwouldincreasethroughthecourseofpregnancy
until the early postnatal period. Furthermore, it was expected that
not only mother–fetal bonding in trimesters 1 through 3 would
predict mother–infant bonding at 8 weeks postpartum.16
It is a known fact that preparation for a safe and easy birth is
determined by what the mother does throughout pregnancy. Thus
preparing for birth needs to start early in pregnancy and childbirth
educationplaysaveryimportantroleinassistingthewomenonthis
journey. This education will help the women manage normal fears
about pregnancy, labor, and childbirth, develop strong bonding
with the baby, and also develop confidence in themselves about
the process of birth. This also helps the women embrace the belief
that she herself is responsible for the health and safety of herself
and her baby.
During the COVID pandemic, it was difficult for face-to-face
talks and counseling, which increased the stress in these pregnant
women.TheBCPapphashelpedtheseanxiousmothersinchanging
their attitude, having a deeper understanding of pregnancy
and childbirth, and becoming stress-free during their journey
of becoming a mother. Moreover, calmness and peace do not
emanate from outside and with momentary pleasures alone but it
isinfluencedbytheinternalstateofbeing.Yoga,music,meditation,
breathingexercise,andcounselinghavebeensignificantlyeffective
6. Mindful Digital Program–based Interventions and Their Role in Pregnancy and Fetal Outcomes
Journal of South Asian Federation of Obstetrics and Gynaecology, Volume 13 Issue 3 (May–June 2021) 175
8. Cranley MS. Development of a tool for the measurement of maternal
attachment during pregnancy. Nurs Res 1981;30(5):281–284.
9. RezaeiE,MoghadamZB,SarayluK.Qualityoflifeinpregnantwomen
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10. Chang JJ, Pien GW, Duntley SP, et al. Sleep deprivation during
pregnancy and maternal and fetal outcomes: is there a relationship?
Sleep Med Rev 2010;14(2):107–114. DOI: 10.1016/j.smrv.2009.05.001.
11. Rondung E, Thomtén J, Sundin Ö. Psychological perspectives on
fear of childbirth. J Anxiety Disord 2016;44:80–91. DOI: 10.1016/j.
janxdis.2016.10.007.
12. Hoseini ES, Rahmati R, Shaghaghi F, et al. The relationship between
hope and happiness with prenatal care. J Educ Health Promot
2020;9:206. DOI: 10.4103/jehp.jehp_141_20.
13. Monk C, Feng T, Lee S, et al. Distress during pregnancy: epigenetic
regulation of placenta glucocorticoid-related genes and fetal
neurobehavior. Am J Psychiatry 2016;173(7):705–713. DOI: 10.1176/
appi.ajp.2015.15091171.
14. Glover V, O’Donnell KJ, O’Connor TG, et al. Prenatal maternal
stress, fetal programming, and mechanisms underlying later
psychopathology—a global perspective. Dev Psychopathol
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15. Tsao CM, Hsing HC, Wang HH, et al. The factors related to maternal-
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17. Deshpande J. The effect of selected aspect of Garbha Sanskar on
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deprivation on attachment: lessons from the Bucharest early
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10.1521/pdps.2017.45.4.441.
19. Rafii F, Alinejad-Naeini M, Peyrovi H. Maternal role attainment in
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21. Rifkin-Graboi A, Bai J, Chen H, et al. Prenatal maternal depression
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way and allow her to negotiate the pregnancy successfully and
ultimately her transition to motherhood.
TheBCPactivities,suchasmeditation,sleepguides,harmonizing
music, talk to baby and baby bonding activities, yoga and breathing
exercise,dietary,andpregnancyinformation, have helped to reduce
stress, educated about MFA, increased a sense of control over diet
and nutrition, and improved the mother’s quality of sleep, which
ultimately has a bearing on the baby’s temperament.
These results have important implications not only for
pregnant women and their unborn children but also for healthcare
professionals working in antenatal and postnatal services,
technologyvisionariesandurbanplanners,andfuturegenerations.
Italsoputsthespotlightonareturntotraditionsthatwereprevalent
forages.Theirrediscoverywithscientificvalidationandtheirbrand-
new method of digital delivery. In these times of social distancing,
isolation, and stress during the pandemic, the BCP has helped
in the remote assistance in pregnancy care. The BCP is one such
contemporary prenatal care app that helps women to accomplish
the tasks of pregnancy, labor, and birth and has the potential to
help women’s transition to motherhood.
Abbreviations
BCP: Baby Care Program
PSQI: Pittsburgh Sleep Quality Index
PSRS: The Perceived Stress Reactivity Scale
CMFAS: Cranley’s Maternal–Fetal Attachment Scale
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