Not conceiving, and losing a pregnancy or a newborn.
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151 to 175 of 627The hegemonic role of biomedical discourses in the construction of pregnancy loss.
Background and problem: Pregnancy is constructed as a joy-filled and natural experience with a taken-for-granted expectation that the outcome will be a healthy baby. However, in South Africa approximately 1 in 4 pregnancies end in miscarriage and the stillbirth rate is 24 per 100 live births. Despite the overwhelming statistics, reproductive loss is considered a cultural taboo and continues to be silenced in various ways by the medical fraternity and society in general.
Aim: Our study aimed to demonstrate the role that biomedical discourses play in shaping both women's experiences of reproductive loss as well as how those close to them respond to these losses. The study was located within a social constructionist framework.
Methods: Seven South African women were recruited via snowball sampling to participate in in-depth interviews. A discourse analysis was conducted to deconstruct hegem…
matched on Abortion, Spontaneous (mesh), Stillbirth (mesh), miscarriage (text), pregnancy loss (text)
Grief, traumatic stress, and posttraumatic growth in women who have experienced pregnancy loss.
Objective: Pregnancy loss is common and can be devastating for those who experience it. However, a historical focus on negative outcomes, and grief in particular, has rendered an incomplete portrait of both the gravity of the loss, and the potential for growth in its wake. Consistent with contemporary models of growth following bereavement, this study explored the occurrence of posttraumatic growth following pregnancy loss and further assessed the role of core belief disruptions and common loss context factors across perinatal grief, posttraumatic stress symptoms, and posttraumatic growth.
Method: Women who had experienced a miscarriage or stillbirth (N = 328) were recruited through perinatal loss support groups and completed an online survey that assessed core belief disruption, perinatal grief, posttraumatic stress symptoms, posttraumatic growth, loss context factors, and demographics.…
matched on Abortion, Spontaneous (mesh), Stillbirth (mesh), miscarriage (text), pregnancy loss (text)
Internet message boards for pregnancy loss: who's on-line and why?
Background: Pregnancy loss is common, but its significance is often minimized by family, friends, and the community, leaving bereaved parents with unmet need for support. This study sought to describe demographics, usage patterns, and perceived benefits for women participating in Internet pregnancy loss support groups.
Methods: We requested permission to post an anonymous Internet survey on large and active United States Internet message boards for women with miscarriages and stillbirths. The study purposefully oversampled stillbirth sites and included both closed- and open-ended questions. The University of Michigan Institutional Review Board approved the study. Closed-ended questions were summarized and evaluated with bivariate analysis. We performed a qualitative analysis of open-ended data using an iterative coding process to identify key themes.
Results: Of 62 sites queried, 15 gran…
matched on Abortion, Spontaneous (mesh), Stillbirth (mesh), miscarriage (text), pregnancy loss (text)
Perinatal loss: a qualitative study in Northern Ireland.
This article describes the experiences of women in Northern Ireland who have experienced a miscarriage or stillbirth. Pregnancy loss encompasses several dimensions of loss for women, loss of the future, loss of self-identity, and the loss of anticipated parenthood. The study explored how women emotionally responded to loss and the care they received from medical staff. Burial arrangements for the remains of the baby are also explored. The methodology adopted a narrative approach based upon in-depth interviews with 23 women who attended pregnancy loss self-help groups. The women's narratives highlight their emotional responses to loss, the medicalization of perinatal grief, and burial arrangements. Women felt that their experience was emotionally negative in that they had been subjected to a rationalizing process of medicalization. The primary focus for the women was on the need to recove…
matched on Abortion, Spontaneous (mesh), Stillbirth (mesh), miscarriage (text), pregnancy loss (text)
Intimate partner violence and unwanted pregnancy, miscarriage, induced abortion, and stillbirth among a national sample of Bangladeshi women.
Objective: To estimate (1) lifetime prevalence of physical and sexual victimisation from husbands among a national sample of Bangladeshi women, (2) associations of unwanted pregnancy and experiences of husband violence, and (3) associations of miscarriage, induced abortion, and fetal death/stillbirth and such victimisation.
Design: Cross-sectional, nationally representative study utilizing matched husband-wife data from the 2004 MEASURE Bangladesh Demographic Health Survey.
Setting: Bangladesh.
Population: Married Bangladeshi women ages 13-40 years old (n = 2677).
Methods: Bivariate and multivariate logistic regression analysis.
Main outcome measures: Relations of intimate partner violence to unwanted pregnancy, miscarriage, induced abortion and stillbirth.
Results: Three out of four (75.6%) Bangladeshi women experienced violence from husbands. Less educated, poorer, and Muslim women wer…
matched on Abortion, Spontaneous (mesh), Stillbirth (mesh), miscarriage (text), pregnancy loss (text)
A rapid scoping review of fear of infertility in Africa.
Background: Fear of infertility (FOI) is often reported in studies about reproductive health but this literature not yet mapped. The aim of this rapid scoping review of qualitative studies was to describe the nature of FOI in Africa.
Methods: Eligibility criteria were qualitative data from Africa reporting views of women and men of any age. MEDLINE and CINAHL databases were searched for English language citations to February 2019 using keywords related to fear, infertility and Africa. Two independent reviewers screened texts for inclusion.
Results: Of 248 citations identified, 38 qualitative and six review papers were included. FOI was reported in diverse groups (e.g., men, women, fertile, infertile, married, unmarried, teachers, religious leaders). Two types of fears were identified: (1) fear of triggering infertility due to specific reproductive choices and (2) fear of the dire future …
matched on Infertility (keyword), Infertility, Female (mesh), Infertility, Male (mesh), infertility (text)
Gender differences in experiences with and adjustments to infertility: A literature review.
Background: It has been widely recognized that infertility and its treatment affects a couple as a dyad. Given biomedical differences and differences in socialization processes and gender-role expectations, it is reasonable to suspect that females and males may experience and respond to infertility in different ways.
Objective: To explore gender differences among infertile couples with regard to experiences with and adjustments to infertility.
Design: A literature review.
Data sources: A literature search was performed using the following databases: PubMed, CINAHL, PsycInfo, Web of Science, Scopus, and the China Academic Journal Full-text Database.
Review methods: The studies that were included were those published in English or Chinese from the years 2000 to 2014. The references of all of the studies selected for this review were also searched. An author search was also performed to ret…
matched on Infertility (keyword), Infertility, Female (mesh), Infertility, Male (mesh), infertility (text)
Diagnosis and Management of Infertility: A Review.
Importance: In the US, approximately 12.7% of reproductive age women seek treatment for infertility each year. This review summarizes current evidence regarding diagnosis and treatment of infertility.
Observations: Infertility is defined as the failure to achieve pregnancy after 12 months of regular unprotected sexual intercourse. Approximately 85% of infertile couples have an identifiable cause. The most common causes of infertility are ovulatory dysfunction, male factor infertility, and tubal disease. The remaining 15% of infertile couples have "unexplained infertility." Lifestyle and environmental factors, such as smoking and obesity, can adversely affect fertility. Ovulatory disorders account for approximately 25% of infertility diagnoses; 70% of women with anovulation have polycystic ovary syndrome. Infertility can also be a marker of an underlying chronic disease associated with in…
matched on Infertility, Female (mesh), Reproductive Techniques, Assisted (mesh), Infertility, Male (mesh), infertility (text)
Effect of COVID-19 vaccination and booster on maternal-fetal outcomes: a retrospective cohort study.
Background: COVID-19 in pregnant people increases the risk for poor maternal-fetal outcomes. However, COVID-19 vaccination hesitancy remains due to concerns over the vaccine's potential effects on maternal-fetal outcomes. Here we examine the impact of COVID-19 vaccination and boosters on maternal SARS-CoV-2 infections and birth outcomes.
Methods: This was a retrospective multicentre cohort study on the impact of COVID-19 vaccination on maternal-fetal outcomes for people who delivered (n=106 428) at Providence St Joseph Health across seven western US states from Jan 26, 2021 to Oct 26, 2022. Cohorts were defined by vaccination status at delivery: vaccinated (n=35 926; two or more doses of mRNA-1273 Moderna or BNT162b2 Pfizer-BioNTech), unvaccinated (n=55 878), unvaccinated propensity score matched (n=16 771), boosted (n=10 927; three or more doses), vaccinated unboosted (n=13 243; two dos…
matched on Stillbirth (mesh)
All bereaved parents are entitled to good care after stillbirth: a mixed-methods multicentre study (INSIGHT).
Objective: To understand challenges in care after stillbirth and provide tailored solutions.
Design: Multi-centre case study.
Setting: Three maternity hospitals.
Population: Parents with a stillborn baby, maternity staff.
Methods: Thematic analysis of parent interviews and staff focus groups and service provision investigation.
Outcomes: 1 Themes; 2 Triangulation matrix; 3 Recommendations.
Results: Twenty-one women, 14 partners, and 22 staff participated. Service Provision: Care for parents after stillbirth varies excessively; there are misconceptions; post-mortem does not delay follow-up.
Presentation: Women 'do not feel right' before stillbirth; their management is haphazard and should be standardised.
Diagnosis: Stillbirth is an emergency for parents but not always for staff; communication can seem cold; well-designed bereavement space is critical. Birth: Staff shift priorities to mot…
matched on Stillbirth (mesh)
Factors influencing the uptake of neonatal bereavement support services - Findings from two tertiary neonatal centres in the UK.
Background: Research on perinatal bereavement services is limited. The aim of the study was to compare the uptake of bereavement support services between two tertiary neonatal units (NNU), and to investigate influencing factors.
Method: The medical and bereavement records of all neonatal deaths were studied from January 2006 to December 2011. Data collected included parent and baby characteristics, mode of death, consent for autopsy and bereavement follow-up. The categorical data were compared by chi-square or Fisher's exact test and continuous data by Wilcoxon signed-rank test; a multivariable regression analysis was performed using STATA 12.0.
Results: The neonatal deaths of 297 babies (182 in NNU1 and 115 in NNU2) with full datasets were analysed. Baby characteristics were similar between units except for lower median gestational age in NNU1 (p = 0.03). Significantly more NNU1 parents…
matched on Stillbirth (mesh)
The effect of neighbourhood income and deprivation on pregnancy outcomes in Amsterdam, The Netherlands.
Background: Studies suggest that the neighbourhoods in which people live influence their health. The main objective of this study was to investigate the associations of neighbourhood-level income and unemployment/social security benefit on pregnancy outcomes: preterm delivery, small for gestational age (SGA), pregnancy-induced hypertension (PIH) and miscarriage/perinatal death in Amsterdam.
Methods: A random sample of 7883 from 82 neighbourhoods in Amsterdam. Individual-level data from the Amsterdam Born Children and their Development (ABCD) study were linked to data on neighbourhood-level factors. Multilevel logistic regression was used to estimate odds ratios and neighbourhood-level variance.
Results: After adjustment for individual-level factors, women living in low-income neighbourhoods (third, second and first quartiles) were more likely than women living in high-income neighbourhoo…
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Inhorn MC (2006)cohort or longitudinalMEDLINE-indexed journal, not yet read by usCulture, medicine and psychiatry58 citations Making Muslim babies: IVF and gamete donation in Sunni versus Shi'a Islam.
Medical anthropological research on science, biotechnology, and religion has focused on the "local moral worlds" of men and women as they make difficult decisions regarding their health and the beginnings and endings of human life. This paper focuses on the local moral worlds of infertile Muslims as they attempt to make, in the religiously correct fashion, Muslim babies at in vitro fertilization (IVF) clinics in Egypt and Lebanon. As early as 1980, authoritative fatwas issued from Egypt's famed Al-Azhar University suggested that IVF and similar technologies are permissible as long as they do not involve any form of third-party donation (of sperm, eggs, embryos, or uteruses). Since the late 1990s, however, divergences in opinion over third-party gamete donation have occurred between Sunni and Shi'ite Muslims, with Iran's leading ayatollah permitting gamete donation under certain condition…
matched on Fertilization in Vitro (mesh), infertility (text)
Hofmeyr GJ, Black RE, Rogozińska E, Heuer A, Walker N, Ashorn P, Ashorn U, Bhandari N, Bhutta ZA, Koivu A, Kumar S, Lawn JE, Munjanja S, Näsänen-Gilmore P, Ramogola-Masire D, Temmerman M, Lancet Small Vulnerable Newborn Steering Committee (2023)reviewMEDLINE-indexed journal, not yet read by usLancet (London, England)78 citations Evidence-based antenatal interventions to reduce the incidence of small vulnerable newborns and their associated poor outcomes.
A package of care for all pregnant women within eight scheduled antenatal care contacts is recommended by WHO. Some interventions for reducing and managing the outcomes for small vulnerable newborns (SVNs) exist within the WHO package and need to be more fully implemented, but additional effective measures are needed. We summarise evidence-based antenatal and intrapartum interventions (up to and including clamping the umbilical cord) to prevent vulnerable births or improve outcomes, informed by systematic reviews. We estimate, using the Lives Saved Tool, that eight proven preventive interventions (multiple micronutrient supplementation, balanced protein and energy supplementation, low-dose aspirin, progesterone provided vaginally, education for smoking cessation, malaria prevention, treatment of asymptomatic bacteriuria, and treatment of syphilis), if fully implemented in 81 low-income a…
matched on Stillbirth (mesh), Perinatal Death (mesh)
Male fertility as a marker for health.
Male reproduction is a complex biological process, and male factor infertility is increasingly recognized as a biomarker for overall male health. Emerging data suggest associations between male reproduction and medical disease (genetic, infectious, chronic comorbid conditions), psychological disease, environmental exposures, dietary habits, medications and substances of abuse, and even socioeconomic factors. There is also evidence that a diagnosis of male fertility is associated with future disease risk including cancer, metabolic disease and mortality. As such, there is a growing view that the male fertility evaluation is an opportunity to improve a man's health beyond his immediate reproductive goals, and also highlights the necessity of a multidisciplinary approach.
matched on Infertility (keyword), Fertility (mesh), Infertility, Male (mesh), infertility (text)
The effects of human immunodeficiency virus, human papillomavirus, herpes simplex virus-1 and -2, human herpesvirus-6 and -8, cytomegalovirus, and hepatitis B and C virus on female fertility and pregnancy.
Female infertility may be defined as a woman of reproductive age being unable to become pregnant after a year of regular unprotected sexual intercourse. Social, genetic, endocrine, physiological, and psychological factors as well as lifestyle habits (i.e., smoking and alcohol consumption), either alone or in combination with male factors, are major causes. However, approximately 15-30% of cases of female infertility remain unexplained. Numerous investigations have also indicated that microbiomes play an important role in human reproduction. All parts of the female reproductive system may be influenced by infectious and pathological agents, especially viruses, and these may interfere with reproductive function and so are risk factors for infertility, although in many cases an exact role is unclear. We present an overview of the impact of common viral infections on female reproduction, sea…
matched on Infertility, Female (mesh), miscarriage (text), Fertility (mesh), infertility (text)
Ferreux L, Sallem A, Chargui A, Gille AS, Bourdon M, Maignien C, Santulli P, Wolf JP, Patrat C, Pocate-Cheriet K (2019)reviewMEDLINE-indexed journal, not yet read by usHuman reproduction (Oxford, England)16 citations Is it time to reconsider how to manage oocytes affected by smooth endoplasmic reticulum aggregates?
Study question: Did the revised Alpha/ESHRE consensus (Vienna, 2017) bring a real answer on managing oocytes with aggregates of smooth endoplasmic reticulum (SERa)?
Summary answer: According to the currently available literature, a case by case approach on the time of injecting/inseminating SERa+ oocytes may be not helpful for embryologists making a decision, so we suggest fertilizing both SERa+ and SERa- oocytes and prioritizing embryos derived from SERa- oocytes.
What is known already?: In 2011, the Istanbul consensus recommended not to inject/inseminate SER+ oocytes due to adverse foetal outcomes reported in literature. At the end of 2017, a panel of experts reconsidered this recommendation and advised a case by case approach. Hence, with a lack of clear recommendations, in-vitro fertilization practitioners still have heterogeneous attitudes when managing SERa+ oocytes. In this contex…
matched on Fertilization in Vitro (mesh), Pregnancy Rate (mesh), infertility (text)
Grief and Bereavement Training in OB/GYN: A Review and Survey of Canadian Residents and Programs.
Objectives: Stillbirth and pregnancy loss is common and can be emotionally distressing for health care providers. Although limited, some studies suggest an ameliorating effect of grief and bereavement training (GBT) for some of these difficult clinical situations. Here, we aim to describe the current landscape of GBT and assess whether trainees feel equipped to manage difficult losses.
Methods: This study included a review of the published literature in addition to surveys delivered to Canadian obstetrics and gynecology residents and residency programs.
Results: Literature review demonstrated a positive association between GBT and patient care overall, whereas results of our survey emphasize that caring for patients experiencing pregnancy loss and stillbirth impacts health care providers and support increased GBT.
Conclusions: Findings broadly support increased need for GBT for trainees,…
matched on Stillbirth (mesh), pregnancy loss (text)
A scoping review of therapies used to treat psychological trauma post perinatal bereavement.
Background: Up to 39% of women who experience perinatal bereavement proceed to develop Post-Traumatic-Stress-Disorder (PTSD), with this large proportion meriting treatment. Before setting-up a treatment service for postnatal women who are experiencing psychological trauma, it is important to identify what therapies have been used in-the-past to address this problem.
Aim: To scope for research that has implemented therapies to treat psychological trauma post perinatal bereavement, for potential inclusion in a flexible treatment package.
Method: A scoping review mapped coverage, range, and type of research that has reported on prior therapies used to treat psychological trauma post perinatal bereavement.
Findings: Due to the dearth of papers that directly addressed perinatal bereavement, we widened the scope of the review to view what treatments had been used to treat psychological trauma …
matched on Stillbirth (mesh), miscarriage (text)
Toward Optimal Emotional Care During the Experience of Miscarriage: An Integrative Review of the Perspectives of Women, Partners, and Health Care Providers.
Introduction: Miscarriage is frequently associated with significant emotional impact, causing psychological distress, trauma, and grief. Unfortunately, women and partners frequently report dissatisfaction with care around miscarriage, and health care providers report feeling ill-prepared and underequipped to provide emotional support. This integrative review synthesizes the individual perspectives of the woman experiencing the miscarriage, the partner, and the different health care provider roles involved in the care to better understand what future research is necessary to improve the experiences of bereaved parents and their health care providers.
Methods: Electronic databases were searched for studies that covered emotional care around miscarriage from the perspective of women, partners, or health care providers. The review included studies published in English between 2015 and 2022, …
matched on Abortion, Spontaneous (mesh), miscarriage (text)
Factors affecting the emotional wellbeing of women and men who experience miscarriage in hospital settings: a scoping review.
Background: Miscarriage can be a devastating event for women and men that can lead to short- and long-term emotional distress. Studies have reported associations between miscarriage and depression, anxiety, and post-traumatic stress disorder in women. Men can also experience intense grief and sadness following their partner's miscarriage. While numerous studies have reported hospital-related factors impacting the emotional wellbeing of parents experiencing miscarriage, there is a lack of review evidence which synthesises the findings of current research.
Aims: The aim of this review was to synthesise the findings of studies of emotional distress and wellbeing among women and men experiencing miscarriage in hospital settings.
Methods: A systematic search of the literature was conducted in October 2020 across three different databases (CINAHL, MEDLINE and PsycInfo) and relevant charity org…
matched on Abortion, Spontaneous (mesh), miscarriage (text)
Adverse obstetric and neonatal outcomes in women with mental disorders.
The brain and the placenta synthesize identical peptides and proteins, such as brain-derived neurotrophic factor, oxytocin, vascular endothelial growth factor, cortisol, and matrix metalloproteinases. Given the promiscuity between neurochemistry and the mechanism of placentation, it would be expected that mental disorders occurring during pregnancy would increase the risk of adverse obstetric and neonatal outcomes. Indeed, expectant mothers with anxiety disorders, post-traumatic stress disorder, schizophrenia, or depressive disorders are at higher risk of preterm birth, low-birth-weight and small-for-gestational-age infants than controls. These mental illnesses are accompanied by a procoagulant phenotype and low activity of tissue plasminogen activator, which may contribute to placental insufficiency. Another risk factor for pregnancy complications is hyperemesis gravidarum, more common …
matched on Abortion, Spontaneous (mesh), miscarriage (text)
Brier N (2008)reviewMEDLINE-indexed journal, not yet read by usJournal of women's health (2002)110 citations Grief following miscarriage: a comprehensive review of the literature.
Objective: The literature exploring the relationship between miscarriage and grief is sparse. This paper summarizes the literature on grief subsequent to an early miscarriage to elucidate the nature, incidence, intensity, and duration of grief at this time and to identify potential moderators.
Methods: An electronic search of the Medline and Psych Info databases was conducted. Studies were selected for inclusion if they related to early miscarriage, used a standardized measure to assess perinatal grief, and specified the assessment intervals employed. Qualitative studies were included when helpful to develop hypotheses.
Results: Descriptions of grief following miscarriage are highly variable but tend to match descriptions of grief used to characterize other types of significant losses. A sizable percentage of women seem to experience a grief reaction, with the actual incidence of grief u…
matched on Abortion, Spontaneous (mesh), miscarriage (text)
The effects of an expressive writing intervention on pregnancy rates, alexithymia and psychophysical health during an assisted reproductive treatment.
Objective: World Health Organization reported that in developed countries one in four couples experience infertility with serious implications for the psychophysical well-being. Aim of this study was to evaluate the effects of Pennebaker's writing technique on pregnancy rates, alexithymia and psychophysical health during an assisted reproductive treatment (ART).Method: 91 women admitted for an ART were randomly divided into two groups: an experimental one (n = 46), where women wrote about their thoughts and emotions concerning the infertility experience, and a control group (n = 45) where women did not write. All subjects completed a socio-demographic questionnaire, the 20-item Toronto Alexithymia Scale and the Symptoms Checklist-90-R before and after the writing sessions. Results: A significant difference in pregnancy rates between the experimental group (n = 13) and the control group (…
matched on Infertility (mesh), Pregnancy Rate (mesh), Reproductive Techniques, Assisted (mesh), infertility (text), Pregnancy Rate (keyword)
Hutti MH, Myers JA, Hall LA, Polivka BJ, White S, Hill J, Grisanti M, Hayden J, Kloenne E (2018)MEDLINE-indexed journal, not yet read by usJournal of obstetric, gynecologic, and neonatal nursing : JOGNN16 citations Predicting Need for Follow-Up Due to Severe Anxiety and Depression Symptoms After Perinatal Loss.
Objective: To evaluate the ability of the Perinatal Grief Intensity Scale (PGIS) when used within 8 weeks of perinatal loss to predict intense anxiety and severe depression symptoms in women 3 months later (Time 2 [T2]).
Design: Prospective survey.
Setting: Participants were recruited from hospitals in Louisville, KY and via the Internet.
Participants: Women (N = 103) who experienced perinatal loss.
Methods: Data were collected using the PGIS, Beck Anxiety Inventory, and the Center for Epidemiologic Studies Depression Scale. We used logistic regression, odds ratios, and receiver operating characteristic curve analysis.
Results: The PGIS had 97.9% sensitivity and 29.6% specificity to predict severe depression symptoms and 95.2% sensitivity and 56.2% specificity to predict intense anxiety at T2. A baseline PGIS score greater than or equal to 3.53 predicted severe depression symptoms (odds …
matched on Abortion, Spontaneous (mesh), Stillbirth (mesh), Perinatal Death (mesh)