Speaker: Melese Siyoum
Facilitator: Indri Astuti Purwanti
Back ground: Pelvic organ prolapse (POP) is a common condition that can significantly impact a woman’s quality of life. Pelvic floor muscle training (PFMT) is recommended as a first-line conservative treatment for prolapse, but evidence from low-resource settings is limited.
Objectives: This study aimed to assess midwife-led pelvic floor muscle training on prolapse symptoms and health-related quality of life (HRQoL) among women with mild to moderate prolapse in Ethiopia, 2024.
Methods: A community-based, parallel, two-arm cluster randomized controlled trial was conducted in Dale and Wonsho districts of Sidama Region, Ethiopia. Women with symptomatic POP stage I-III were randomized by cluster to receive either midwife-led PFMT plus lifestyle counseling (intervention group) or lifestyle counseling alone (control group). The primary outcomes were change in prolapse symptom score (POP-SS) and prolapse quality of life (P-QoL). Mixed-effects generalized linear model was used to determine the effect size at 99% confidence level.
Results: A total of 187 women were randomized (intervention = 89 and control = 98). At sixth month, the intervention group showed significantly greater improvements with a mean change difference of: -4.1 (99% CI: -5.38, -2.83) in prolapse symptoms; -11.48 (99% CI: -15.9, -7.1) in physical domain, -12.65 (99% CI: -19.3, -6.1) in psychological domain and -9.47 (99% CI: -15.5, -3.5) in personal relationship domain of P-QoL. A significantly higher number of women in the intervention group perceived their condition as ‘better’ after the intervention. Women with earlier stages of prolapse (stage I and II) experienced higher benefits compared to stage III.
Conclusions: A midwife-led PFMT combined with lifestyle counseling significantly improves prolapse symptoms and quality of life in mild to moderate POP. This strategy can be integrated into the existing maternal and reproductive health programs to address POP in low-income settings where access to trained specialist is limited.
Speaker: Mouhtassine Khadija
Facilitator: Linda Wylie
Introduction: Fear of childbirth (tocophobia) is a significant maternal health issue that affects physical and emotional well-being. Tocophobia can lead to complications during pregnancy and childbirth, requiring special attention from midwives. Factors such as maternal age, parity, psychological conditions, lack of social support, history of abuse, and obstetrical complications are strongly associated with this condition. This study aims to assess the prevalence of tocophobia among pregnant women in Settat Province and identify related factors to inform midwifery practices.
Methods: A quantitative study was conducted with 194 pregnant women recruited in Settat Province. Data collection involved a structured questionnaire comprising two sections: the first explored tocophobia-associated factors, and the second evaluated childbirth fear using the EPA scale. Descriptive statistical analysis, mean comparisons of EPA scores, and factor assessments were performed to identify significant correlations.
Results: The average age of participants was 26.31 years, with 59% multiparous and 41% primiparous women. Multiparous women reported higher EPA scores (42.30) than primiparous women (40.63). Significant associations were observed between tocophobia and psychological disorders, experiences of violence, and negative childbirth experiences (p=0.000). These findings suggest that prior trauma and psychological factors are critical determinants of fear of childbirth.
Conclusion: This study underscores the necessity of evaluating tocophobia in pregnant women to improve their well-being and that of their children, thereby preventing complications.
