• Women's Health Nursing
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• v.17 no.3
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• pp.225-242
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• 2011

Purpose: The purpose of this study was to identify students' experiences of performance and their satisfaction with clinical nursing practice in Women's health nursing. Methods: Data was collected using questionnaire consisting of 104; 89,; and 82 nursing activities with 12; 10; and 7 domains for delivery floor, obstetric, and gynecologic wards retrospectively. Five hundred ninety nursing students from 10 four year and one three year colleges, were recruited and selected for data collection. Results: Site specific core nursing activities among top 15 items of performed experience were: interpreting fetal monitoring; massage for pain reduction; breathing technique; perineal pad change; non stress test; manual check for uterine contraction; and position change for the delivery floor. Experiences of clinical nursing practice for the obstetric ward and the gynecologic ward were identified and ranked as well. Observation of delivery, measurement & test during labor and observation of anesthesia and operation were the highest ranked activity domains of satisfaction for delivery floor, obstetric and gynecologic wards retrospectively. Conclusion: Discussions are needed to standardize curriculum for clinical practice in women's health nursing initiated at the level of Korean Society of Womens' Health Nursing by reflecting this result. Strategic approaches are emphasized in order to enhance a collaboration between clinical fields and colleges.

• Clinical and Experimental Pediatrics
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• v.46 no.3
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• pp.224-229
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• 2003

Purpose : To examine various neonatal outcomes and perinatal factors resulting from assisted reproduction compared to that of spontaneous conception. Methods : This is a retrospective study. The control cases were all twins of spontaneous conception born between periods from January 1995 to June 2000. The study cases were identified from twins conceived by assisted reproduction in the same time peried. A total of 460 sets of twins consisted of 250 twins of spontaneous conception and 156 twins of assisted reproduction were studied. The primary outcomes were neonatal morbidity and mortality and the secondary outcomes were perinatal factors including number, length and cost of hospitalization for the delivery. Results : No differences were seen in various neonatal factors including gestational age, birth weight and incidences of respiratory distress syndrome, patent ductus arteriosus, necrotizing enterocolitis, hyperbilirubinemia, sepsis, intraventricular hemorrhage and the length of hospitalizations. Lower one minute and five minute Apgar scores and frequently encountered electrolyte abnormalities were observed in neonates of assisted reproduction. In general, the second twin of assisted reproduction had increased incidences of respiratory distress syndrome, sepsis and necrotizing enterocolitis than the first twin. Increased frequencies of preterm labor, hospitalization and elective cesarean section were seen among mothers who underwent artifical conception. However, overall hospital costs in terms of mothers hospitalization for the delivery and neonates hospitalization did not show differences. Conclusion : Assisted reproduction twins had similar neonatal morbidities, mortalities and perinatal morbidities compared to those born by spontaneous conception.

• Journal of Korean Academy of Nursing
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• v.10 no.2
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• pp.1-12
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• 1980

The process of having baby including pregnancy, labor and birth; is considered as crises of life cycle. It is noted that most pregnat women experience fear and anxiety through the gestational period and this may effect to the health of the baby and the mother. Therefore, we, nurses must focuse on this fear and anxiety of pregnant women and make an effort to relieve their emotional discomfort. This study was conducted to determine the pregnant women's intensity of fear and anxiety during pregnancy thus to provide some information for maternal care in terms of antenatal care. The specific objectives of this study are : 1. to determine what are the most frequently experienced fear and anxiety and how frequently the pregnant women perceive them as a fearful and anxious experience. 2. to find out the relations between the intensity of fear and anxiety of pregnancy and the demographic characteristics of the subjected women During the period May 15,1980 to June 4,1980,212 pregnant were asked to question are by trained student mures who visited to 4 obstetric clinic for antenatal care in C-city. The questionare were designed and and scheduled by author which covers 38 items about fears and anxiety during pregnancy and each item was answered by 5 seales according to it's intensity. The result analysed as percentile , mean and S.D. statistically and obtained as rollows 1) The mean age was 27,4 years, the proportion of women completed high school are 45.3%, and 51.4% has no religion 2）68.6% seplied“positive”response about fears and anxiety during pregnancy. 3) Fear relevant to pain, particularly during labor noted most frequent rate. 4) Social factors may relate to the intensity of the fears or anxiety further more socioeconomic problem take important role and affects to the expectant women, 5) Primigravida noted more fears and anxiety about pregnancy compared to multigravida and more in-tensity during aerly half gestational period than late. Majority of pregnant women have experienced fear and anxiety attendant upon pregnancy and so nurse can help the patient to be able experience 1ha difficult adjustment to be course of pregnancy and be able to get good result both fetus and mother through antenatal care.

• Women's Health Nursing
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• v.6 no.1
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• pp.34-45
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• 2000

The study was to find whether the educational program contributed to increase of knowledge and self-efficacy of the postpartal primiparas. This study aimed at improvement of the educational effect for postpartal primiparas. The Subjects were 34 primiparas who were admitted to the obstetric ward in a University hospital from November 15th to December 9th, 1999. The Subjects were those who had no labor pain at the admission time, had no complications during labor and delivery and, gave birth to a healthy baby. They were tested on knowledge and self-efficacy two times, one at the admission time and prior to discharge. After the first test nurses in a maternity ward taught them on postpartal care. Two tools were developed by authors based on literature review. The test tool fr knowledge of postpartal car consisted of 23 items. The test tool for self-efficacy of postpartal care consisted of 16 items. Analysis of demographic data were analyzed with calculation of percentage. Score differences between the first test and the second test were analyzed with paired t-test. The Spss (Win 8.0) program was used for data analysis. The results are as follows. 1. There were not significant influencing general characteristics of primiparous to pre-educational knowledge. There were significant influencing general characteristics of primiparous to post-educational knowledge : occupation(t=13.04, p=0.00), postpartal education(t=5.51, p=0.02). 2. There were not significant influencing general characteristics of primiparous to pre-educational self-efficacy. There were significant influencing general characteristics of primiparous to post-educational self-efficacy : antenatal education(t=5.53, p=0.02) 3. Primiparas' knowledge of postpartal care increased significantly after education(t=13.04, p=0.00). 4. Primiparas' self-efficacy of postpartal care increased significantly after education(t=5.51, p=0.02). 5. Correlation between knowledge and self-efficacy was r=.360(p=0.03). We suggest follow-up studies to find whether primiparas' self-efficacy will last after discharge or not.

• Women's Health Nursing
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• v.17 no.4
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• pp.369-377
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• 2011

Purpose: Childbirth self-efficacy plays an important role in women's ability to cope with labor and delivery. Coaching has been gaining popularity as a way to promote cognitive, emotional and behavioral change. This study aimed to test the effects of a Coaching-based childbirth program on anxiety and childbirth self-efficacy among primigravida women. Methods: The study design was a quasi-experimental pre-post design. A coaching-based childbirth program was developed synthesizing concepts and techniques from the literature on coaching and was verified by an expert panel. It consisted of four weekly 2-hour small group sessions. Pregnant women were recruited from H hospital in Seoul. Childbirth self-efficacy and state anxiety were measured before and after the program. Results: Although there was a no significant reduction in anxiety, there were statistically significant increase for childbirth self-efficacy in the experimental group when compared to the control group. Conclusion: The program appears to increase childbirth self-efficacy for pregnant women. Future studies may benefit from using mixed coaching modalities and consider measuring health behaviors and obstetric outcomes to gain insights on its long-term impact.

• Clinical and Experimental Reproductive Medicine
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• v.30 no.1
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• pp.85-93
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• 2003

Objective : To evaluate the safety and efficacy of selective fetal reduction (SFR) and compare the outcome of twin pregnancy after SFR in multiple pregnancy induced by assisted reproductive technology (ART) with that of natural twin pregnancy. Methods : From September 1995 to March 2002 in Ajou University Hospital, SFR was performed in 79 patients whose gestational sacs were more than 3. Of these 79 patients, 47 patents resulted in twin pregnancy after SFR. SFR was performed using transvaginal intracardiac KCl injection at gestational age of $6{\sim}9$ weeks. Control group was composed of 264 patients with natural twin pregnancy, who delivered after intrauterine pregnancy at 24 weeks, from June 1994 through December 2002. We compared Obstetric and perinatal outcomes between SFR group and natural twin group. Results: Among 47 patients with twin pregnancy after SFR, 2 spontaneous abortion were occurred at intrauterine pregnancy at 8 and 19 weeks. Obstetrical and perinatal outcomes were available in 43 patients. Single intrauterine fetal death was occurred in 1 of 43 (2.3%) patients in SFR group. Incidence of preterm labor, premature rupture of membrane, preeclampsia and placenta previa were similar, but gestational diabetes mellitus (GDM) was occurred more frequently in SFR group (3 (7.0%) vs 4 (1.5%), p=0.02). Mean gestational age, mean birth weight, incidence of discordancy, use of intubation and ventilation, incidence of fetal anomaly, low (<7) Apgar score and intrauterine growth restriction were similar in both groups. Conclusion: Twin pregnancy after SFR has the increased incidence for GDM but other obstetric and perinatal outcome was similar compared with natural twin pregnancy. So SFR is a safe and effective procedure, so we suggest SFR is needed in multifetal pregnancy more than triplet.

• Journal of Preventive Medicine and Public Health
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• v.31 no.4 s.63
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• pp.751-769
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• 1998

This study was conducted to assess the attitude of pregnant women toward delivery method, understanding of the reason for determining her own delivery method, participation in decision-making process and satisfaction with delivery method after labor. Study subjects were 693 pregnant women who had visited obstetric clinic for prenatal care in the last month of pregnancy in one general hospital and one obstetrics-gynecology specialty hospital in Taegu city from February 1 to March 31 in 1998. A questionnaire was administered before and after labor and a telephone interview was done one month after labor. Proportion of women who had health education and/or counselling about delivery method during prenatal care was 24.0% and this proportion was higher for women who had previous c-section(35.5%) than others. Women thought vaginal delivery is better than c-section for both maternal and baby's health regardless of previous delivery method. About 90% of primipara and multiparous women who had previous vaginal delivery wanted vaginal delivery for the index birth, while 85.6% of multiparous women who had previous c-section wanted repeat c-section. Reasons for choosing c-section in pregnant women who preferred vaginal delivery before labor were recommendation of doctors(81.9%), recommendation of husband (0.8%), agreement between doctor and pregnant woman(4.7%), and mother's demand (12.6%). Reasons for choosing vaginal delivery were mother's demand(30.6%) and no indication for c-section(67.2%). Reasons for choosing c-section in pregnant women who preferred c-section before labor were recommendation of doctors(76.2%), mother's demand(20.0%), recommendation of husband(1.3%), and agreement between doctor and pregnant woman(2.5%). Of the pregnant women who had c-section, by doctor's recommendation, the proportion of women who had heard detailed explanation about reason for c-section by doctor was 55.1%. Mother's statement about the reason for c-section was consistent with the medical record in 75.9% . However, over 5% points disparities were shown between mother's statement and medical record in cases of the repeat c-section and mother's demand. In primipara and multiparous women who had previous vaginal delivery, the delivery method for index birth had statistically significant association with the preference of delivery method before labor(p<0.05). All of the women who had previous c-section had delivered the index baby by c-section. Among mothers who had delivered the index baby vaginally, 84.9% of them were satisfied with their delivery method immediately after labor and 85.1% at 1 month after labor. However, mothers who had c-section stated that they are satisfied with c-section in 44.6% immediately after labor and 42.0% at 1 month after labor. Preferred delivery method for the next birth had statistically significant association with delivery method for the index birth both immediately after labor and in 1 month after labor. The proportion of mothers who prefer vaginal delivery for the next birth increased with the degree of satisfaction with the vaginal delivery for the index birth but the proportion of mothers who prefer c-section for the next birth was high and they did not change significantly with the degree of satisfaction with the c-section for the index birth. These results suggest that the current high technology-based, physician-centered prenatal and partritional cares need to be reoriented to the basic preventive and promotive technology-based, and mother-fetus-centered care. It is also suggested that active involvement of pregnant woman in decision-making process for the delivery method will increase the rate of vaginal birth after c-section and decrease c-section rate and improve the degree of maternal satisfaction after delivery.

• Women's Health Nursing
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• v.5 no.2
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• pp.191-203
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• 1999

A clinical study was made on 365 low birth weight infant and 406 normal birth weight infant who had been born at Kangnam St. mary's Hospital during past 3 years from Jan. 1, 1995 to Dec. 31, 1997. the data of this study were gathered through reviewing of medical records. 1. Comparison of general characteristic with of obstetric characteristic 1) Old maternal age, previous abortion and previous LBWI delivery in the group of low birth weight infant(LBWI) mother were more prevalent than those in the group of normal birth weight infant(NBWI)mother 2) Cesarean section, abnormal presentation and multiple pregnancy in the group of LBWI mother were prevalent than those in the group of NBWI mother. 3) regular antenartal care and visiting rate of tertiary hospital in the group of LBWI mother were more prevalent than those in the group of NBWI mother. 2. Frequency of low birth weight infant 1) Anmual average frequency of LBWI was 6.5% and monthly frequency was the highest in January and december. 2) The frequency of LBWI was the highest in 37-40wks of gestational age and was the highest in 2251-2500 gm of birth weight. 3) The frequency of congenital anomaly in the group of LBWI was more prevalent than that of NBWI. 3. Mortality rate of LBWI The mortality rate of LBWI was 9.2%. The highest mortality rate was noted before 27wks of gestational age, less than 1000gm of birth weight and within 12hrs of delivery. 4. The most common complication of pregnant women was pre-term labor, the most complication relating to placenta was premature rupture of membrane(PROM) and the most fetal complication was fetal distress in delivered LBWI. 5. Significant relating factors of low birth weight infant delivery were associated with maternal age, previous delivery, previous low birth weight delivery, pre-eclampsia, anemia, oligohydramnios, PROM, placenta previa, abruptio placenta, fetal sex, fetal distress and congenital anomaly.

• Women's Health Nursing
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• v.27 no.4
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• pp.379-387
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• 2021

Purpose: This study aimed to determine the actual state of childbirth in Korean women with natural childbirth and the degree of damage to the perineum during childbirth. Methods: This retrospective study analyzed the medical records of mothers who had natural childbirth at a hospital in Seoul, Korea in 2018. Data from 358 women with cephalic births at greater than 37 gestational weeks were analyzed. To determine natural childbirth characteristics and the degree of damage to the perineum, descriptive statistics were done. The difference in the degree of perineal injury according to obstetric characteristics was analyzed using independent t-test and one-way analysis of variance. Results: The mean age was 33.18±3.68 years, and 49.2% were primiparas, while 39% gave birth with a doula. The degree of perineal damage differed by age (F=9.15, p<.001), parity (t=19.13, p<.001), number of births in multiparity (F=3.68, p=.027), previous vaginal delivery in multiparity (F=3.00, p=.032) and birthing posture (F=7.44, p<.001). Having received therapeutic procedures (t=-4.62, p<.001), specifically fluid administration (t=-2.72, p=.007), oxygen supply (t=-2.76, p=.006) and epidural anesthesia (t=-2.77, p=.006) were statistically significant for perineal damage. There were no differences, however, by gestational period, doula use, water room use in labor, baby head circumference, or birth weight. Conclusion: Study findings suggest that support for older women, primiparas, and those who require therapeutic procedures may help to decrease the possibility of perineal damage during childbirth. As perineal damage was also associated with birthing posture, this should be considered when providing intrapartum nursing care.

• The Korean Journal of Pain
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• v.35 no.1
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• pp.86-96
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• 2022

Background: To explore the association between low back pain (LBP) and pelvic pain (PP) and rectus abdominis diastasis (RAD) in postpartum women and identify the characteristics and risk factors. Methods: Women diagnosed with RAD and a history of labor and delivery, between 2009 and 2018, were identified from six hospitals within the Partners Healthcare System. Univariate and multivariable binary logistic regression analyses were used to identify the risk factors associated with pain. Results: Age at onset of RAD in the non-cesarean delivery group was earlier than those in cesarean delivery (CD) group (P = 0.017). Women who underwent CD demonstrated 4.5 times greater risk of RAD than those who had no CD exposure. The cumulative composition ratio of LBP at every age stage of the period from 8 years pre-first delivery to 8 years post-first delivery was significantly higher than the other five conditions (RAD, umbilical hernia, PP, depressive disorder [DD], and strain of muscle, fascia, and tendon [SMFT]) (P for trend < 0.001). Women with DD, SMFT, and PP were more likely to have LBP (odds ratio [OR] = 1.91, 95% confidence interval [CI] 1.06 to 3.47, P = 0.032; OR = 4.50, 95% CI 1.64 to 12.36, P = 0.003; OR = 2.14, 95% CI 1.17 to 3.89, P = 0.013; respectively). Conclusions: In postpartum women with RAD, DD, SMFT, and PP were found to be risk factors contributing to the development of LBP. Race and LBP also played roles in the development of PP.