The childbearing experience of women with spinal cord injury in Iran: a phenomenological study (original) (raw)
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Topics in Spinal Cord Injury Rehabilitation, 2017
Background: In North America, there are currently no clearly defined standards of care for women with spinal cord injury (SCI) during the perinatal periods of preconception, pregnancy, labour/delivery, and postpartum. Women with SCI and their partners say resources specific to their needs are hard to find. Little evidence-informed research exists to guide clinicians in the care of women with SCI during pregnancy. Objectives: To further explore these gaps in knowledge and practices for perinatal care for women with SCI, a 1-day workshop was held in Vancouver, British Columbia (BC), Canada in November 2013. Methods: Twenty-nine attendees included women with SCI, SCI-community service providers, researchers, and health care providers from maternal/fetal medicine, rehabilitation, anesthesiology, and psychiatry. A pre-meeting online survey of stakeholders elucidated 3 themes: lack of knowledge for both consumers and care providers, gaps in access to services and information, and a need for collaboration throughout the perinatal journey. The workshop addressed issues of care providers' lack of knowledge of nonmedical issues during the perinatal period, physical and attitudinal barriers to access to care for women with SCI, and the need for better collaboration and communication between care providers, the latter potentially initiated by providing information to care providers through the women with SCI themselves. Results: Content experts attending the workshop collectively made recommendations for knowledge generation and research priorities, clinical application priorities, and the need for policy and guideline development in this field. Conclusion: Two information sources for women have since been developed and are available online.
Sexual Health of Women with Spinal Cord Injury in Bangladesh
Disability, CBR & Inclusive Development, 2012
Methods: This study used both qualitative and quantitative methods. The quantitative part used a case-control design. Cases were women with SCI and controls were age-matched women without SCI. Questionnaires were used to collect data concerning the sexual health status of women. Multivariate logistic regression was done to determine which factors had an independent effect on sexual health. In-depth interviews were held with a sub-group of women from both groups, and interview guides were used. The in-depth interview data was subjected to content analysis.
BMC Pregnancy and Childbirth
Background Psychological birth trauma (PBT), mainly due to overlooking maternal mental health, is a common and high prevalence public health problem in low-resource settings. Preventing PBT is a good indicator of the realization of human rights in healthcare. This work reports the results of a qualitative study that aimed to identify perceived strategies of PBT prevention among childbearing women in Iran. Methods We conducted semi-structured in-depth interviews with 22 mothers with history of traumatic childbirth, two mothers with positive childbirth experience, two spouses, and eight health professionals between April and June 2017. We used purposive sampling method to recruit traumatized mothers, while health experts were selected based on their relevant expertise and experience. Our initial literature review identified eight categories, using which we developed our interview guide and conducted the content analysis approach. Results With the maximum possible purification, we reac...
International Journal of Research in Medical Sciences, 2023
Background: Our objective was to find out the reproductive health related complications among spinal cord injury patients. Methods: A cross sectional study was conducted at the Center for the Rehabilitation of the Paralyzed (CRP) in Savar, Dhaka, Bangladesh from August 2017 to July 2018. A total of 289 patients, both indoor and outdoor, with spinal cord injury were randomly selected. The study aimed to examine reproductive health complications associated with spinal cord injury. Data was collected using a questionnaire and analyzed using SPSS version 20. Results: Among 220 (76.1%) were male and 69 (23.9%) were female. In 15-35 (68.1% and 91.2%), 47 (68.1%) participants had menstruation problem. 42.1% had autonomic dysreflexia and 57.9% had UTI as pregnancy related complications. In sexual activity 52% had difficulties having intercourse, 20% had difficulties to reach orgasm and 28% had dry sex. In male participants after SCI 70.5% had erection problem and 78.6% had ejaculation problem. Participants who had erection problem, most of their neurological level was thoracic level 84.51% and in case of ejaculation also their neurological level was thoracic level 81.50%. Conclusions: Awareness of sexuality and reproductive health after SCI has grown among healthcare professionals and individuals with spinal cord injuries. This recognition emphasizes the importance of open discussions, active listening, and education to enhance the quality of life for those affected by spinal cord injury.
Maternity Care Experiences of Women with Disability: A Phenomenological Study
Women with disability are those women with impairment which can be either physical, sensory, cognitive or mental which can affect everyday life activities. Pregnant women with disability, for instance, experience challenges during the course of pregnancy. Their voices of being a mother are heard on different perspective. This study aimed to explore the maternity care experiences of women with disability. The objective of the study was to explore the women with disability lived experiences on pregnancy, their challenges and the possible barriers and facilitator where the women faced during pregnancy. A qualitative phenomenological study was used to conduct this study by using semi-structured, in-depth individual interviews, observation and recorded voices were transcribed into codes and key themes. A guide questions for interview was designed for the purpose of this research. 16 pregnant women with disability were selected as the participants of the study through purposive sampling technique. With the two-part interview, the women with disability interview were conducted during the last trimester to delivery and followed by verification and interpreting the texts and recorded voices on the personal interview. Findings revealed that women with disability encountered positive and negative maternity care experiences.
Consequences of traumatic spinal cord injury during pregnancy in Pakistan
Spinal Cord Series and Cases, 2017
INTRODUCTION: Traumatic spinal cord injury (SCI) is one of the major causes for poor outcomes of pregnancy. Injury during pregnancy is uncommon; therefore, outcome data are scarce. This case series presents outcomes of pregnancy in five women who sustained SCI during their pregnancies. CASE PRESENTATION: Five women who sustained SCIs during pregnancy (age range: 24-38 years) were identified and included in this case series. The causes of SCI in this population were fall from heights (cases 1 and 2), road traffic accidents (cases 3 and 4) and firearm injury (case 5). Two of the females were managed conservatively (cases 1 and 5) and the rest underwent surgical procedures for fixing their spine. Out of these patients, four patients delivered normal healthy babies, while the baby of one patient died within 1 hour after delivery. DISCUSSION: Limited data about the outcomes of pregnancy in women who sustained SCIs during pregnancy are available in the literature. The outcomes of pregnancy in women who sustained SCIs during the first trimester are not satisfactory, and special attention may be needed to improve the expected outcomes. Data from our study show similar findings to developed countries.
Iranian mothers' perception of the psychological birth trauma: A qualitative study
Iranian journal of psychiatry, 2014
Childbirth is one of the most vulnerable moments and the most important and memorable events in the lives of women that despite of bringing happiness, it can be associated with psychological trauma and endanger the mother and neonate health. Mothers' perception of the psychological birth trauma is a highly subjective process that depends on the cultural, social and biological conditions of mothers that is not achievable except with examination of their views. This study aimed to understand psychological birth trauma from the perceptions of Iranian mothers. A qualitative research design using in-depth interviews of 23 Iranian mothers was conducted from Tehran and Isfahan health centers. The interviews were transcribed and analyzed using conventional content analysis. Two themes were extracted from the data: impact of psychological birth trauma and trends of psychological birth trauma. Several categories and sub-categories also emerged from the data. Feelings of fear, anxiety, hel...
Neurosciences, 2018
Objectives: To explore individuals' perception of the personal, family and societal educational needs following a spinal cord injury)SCI(. Methods: Sixty-one patients who sustained a traumatic SCI between March 2015 and June 2016 referred to Brain and Spinal Cord Injury Research Center)BASIR(were included in a cross sectional study and completed an online survey containing open-and closed-ended questions, in Iran. Participants' responses were analyzed i using a qualitative approach with a thematic analysis. Results: Following a thematic analysis of the patient's perceived educational needs, 3 themes and 14 subthemes were identified. The 3 themes included personal, family, and societal educational perceived needs. Within personal educational needs, there were 7 subthemes which included personal independence and transportation, financial independence, life skills modification, knowledge about SCI, prevention of SCI complications, relationships and sexual function, and psychological adjustments. Among family educational needs, the 3 subthemes were caregiver skills and communication, first aid and emergency skills, and emotional and psychological support. For societal educational needs, the 4 subthemes described were social integration, interpersonal communication skills, SCI awareness and injury prevention, sympathize while avoiding pity. Conclusion: According to our findings, people with SCI have various needs that need to be addressed. Educational support should be a part of a comprehensive rehabilitation program and geared towards addressing the patients' personal and family needs, while educating the community about SCI in order to allow for reintegration into society.
Pregnancy, labor and delivery post spinal cord injury
Paraplegia, 1992
There are approximately 3,000 women of childbearing age who become spinal cord injured each year in the United States. There are few reports in the literature that address pregnancy, labor and delivery in this patient population. We are reporting on 22 women post spinal cord injury who had 33 pregnancies. There were equal numbers of paraplegic and quadriplegic women. Three pregnancies aborted, one spontaneously. The babies were near normal or normal weight with one exception. The mothers waited 5 years on average to become pregnant. Cesarean section was performed on 43% of pregnancies. Abnormal presentations occurred in over 10% of pregnancies. Indications for cesarean section included 5 that were repeats; the remainder were necessary due to bleeding (1), breech presentation (1), transverse presentation , lack of progress (2), onset of labor 1 day post spinal fusion, and a mother's request to have tubal ligation. Epidural anesthesia was selected for 9 deliveries; 6 of these patients had controlled autonomic hyperreflexia. Five general and 4 local anesthetics were used, and 12 patients received no anesthesia. Diagnostic ultrasound and amniocentesis were used selectively. Complications included autonomic hyperreflexia (9), frequent urinary tract infections, infected pressure sores (3, 2 resulting in below-knee amputations), seizures during and after delivery, pneumonia, bladder stones (2), episiotomy dehiscence (1), and break down of spinal fusion. The newborns were healthy, although one double footling breech vaginal delivery had an AP GAR of 1 at 1 min, 7 at 5 min and 9 at 10 min. One premature baby, who weighed only 1600 g, was a precipitate birth at home unattended. Implications for the care of pregnant SCI women are discussed.