Objective
The purpose of this study is to investigate the influence of sleep-disordered breathing (SDB) in pregnant women on birth outcomes.
Methods
The subjects were 179 females after Week 28 of pregnancy who had undergone pregnancy checkups in one obstetric hospital. We calculated the peripheral arterial blood ODI per hour during sleep at night by dividing the frequency at which the oxygen saturation did not reach the reference value by the duration of examination using a pulse oximeter.
Concerning the criteria, patients with a 3%ODI of less than 0.5 were regarded as showing the absence of SDB, those with values ranging from 0.5 to 4.9 as showing the normal range, those with values ranging from 5 to 14.9 as having mild SDB, those with values ranging from 15 to 29.9 as having moderate SDB, and those with a 3%ODI of 30 or more as having severe SDB.
Multiple logistic regression analysis was performed to assess the birth outcomes associated with SDB.
Results
The 3%ODI was less than 0.5 in 38 (21.2%), 0.5 to 4.9 in 119 (66.5%), and 5 to 14.9 in 22 (12.3%). Therefore, we compared a mild SDB group (3%ODI≥5, n=22) with a normal group (3%ODI<5, n=157).
We calculated the adjusted odds ratio (OR), regarding parity and obesity as confounding variables. Regarding spontaneous vaginal birth as the baseline, the adjusted OR of elective or emergency cesarean birth (CB)/vacuum extraction was 3.03 (95% Confidence Interval (CI): 1.10-8.33). Regarding elective CB/spontaneous vaginal birth as the baseline, the adjusted OR of emergency CB/vacuum extraction was 5.18 (95%CI: 1.44-18.65).
Conclusion
Mild SDB in pregnant women suggested that influence to the birth outcomes. Therefore, screening with a pulse-oximeter should be effectively utilized in multiparas with a history of spontaneous abortion and pregnant women complaining of frequent awakening at night or sleep disturbance. In addition, early intervention to improve the state of sleep and treat sleep disturbance may be necessary to promote a safer pregnancy.

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Aim
To assess the outcome of providing Japanese mothers and family who have experienced a perinatal loss with a booklet called Living with Grief, and the Angel Kit, which included keepsakes and preparations for parting with their baby.
Methods
A descriptive exploratory study design was used to translate research from the trial kit into feasible materials. Participants were mothers from five Tokyo maternity hospitals who experienced perinatal loss (such as abortion, intra-uterus fetal death, stillbirth, death of a newborn) between mid-May 2006 and May 2007. The main outcome measures were self-administered questionnaires developed by the authors which each mother completed. A content analysis approach was applied to the evaluation comments.
Results
Eligible mothers were hospitalized: 84 mothers trial-used the Booklet and Angel Kit, and 43 mothers returned the questionnaire. Forty-two mothers (97.6%) thought the booklet was helpful and very helpful. All mothers expressed appreciation and favorable comments about the Angel Kit. Five themes emerged for the Booklet: 1. To help relief and acceptance, 2. Understanding the experience of loss, 3. No feeling of loneliness, and sense of linkage to somebody, 4. Assurance of one's grieving pace, and that it takes a long time, 5. Knowing about personal differences in expression of grief. Five themes emerged for the Angel Kit: 1. The Kit was one of the few keepsakes, 2. Timely assistance and help in case of need, 3. Appropriate guide for memory-keeping and support to make decisions, 4. Treated the dead baby carefully like a valuable human being, 5. Made it easier to communicate with nursing/midwifery staff.
Conclusion
Both Living with Grief and the Angel Kit were evaluated well by mothers. The Booklet helped mothers recognize their grief and understand their cognitive and emotional processes. The Angel Kit helped with cognitive, emotional and behavioral activities of grief. They would be a good guide to the grieving process, therefore they can be of practical use.

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Purpose
The purpose of this study was to clarify the relationship between the recognition of postpartum mothers of their birth plan and the degree of satisfaction with their delivery, as well as to examine the role of the midwife in giving satisfaction with the delivery.
Methods
The subjects were 442 mothers who had delivered 2-7 days earlier. The data was collected using a self-reported questionnaire. The questionnaire consisted of the attributes, the situation during the delivery, the situation when writing the birth plan, recognition of the birth plan (10 item 5 case law), and the Design of Self-evaluation Scale for Experience of Delivery (Tokiwa 2001, 18 item 5 case law). Data analysis was conducted using SPSSver.16.0. The significant level was set to 5%.
Results
The responses were 416 (94.1% of rate of collection), and the effective number of answers were 370 (88.9% of the effective answering rate). By using multi regression analysis (R²=0.361, p<0.01), the satisfaction with delivery was evaluated related to the following factors: number deliveries, delivery style, delivery time, the state of the newborn, correspondence between the medical staff's understanding and respect, and the recognition of the postpartum mother's birth plan. According to the delivery experience with no problem during the delivery progression, the recognition of birth the birth plans of both primipara 0.326 (p<0.01) and multipara 0.442 (p<0.01) had a significantly positive correlation with satisfaction with the delivery. The recognition of the birth plans of postpartum mothers became significantly higher by consulting about the birth plan, by gathering information about the birth plan, and by having expectations and desires for the birth plan (p<0.01).
Conclusion
The recognition of birth plans by postpartum mothers is related to the satisfaction with their delivery. The process of making the birth plan is one of the effective approaches that raises the degree of satisfaction with the delivery, and reconfirms that it is important to give mothers satisfaction with their delivery.

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Object
This study investigated ultrasonography examinations during prenatal checkups, the emotional impact of these examinations on pregnant women, and differences between the psychological effects of examinations performed by midwives and by doctors.
Subjects and Methods
The subjects were 215 pregnant women showing normal gestational progress to three hospitals and two maternity centers. After consenting to participate in this survey, questionnaires were completed and returned anonymously. Before and after prenatal checkups, their heartbeats, saliva amylase and the State Trait Anxiety Inventory (STAI) were measured and recorded. The pregnant women who received prenatal checkup by doctors were defined as the "doctors group" and those who received checkups by midwives were defined as "midwives group".
Results
Regarding the duration of the ultrasonography examination, midwives took 8.3±4.2 (mean±SD) minutes and the doctors took 3.7±1.6 minutes on average (P<.001). However, more than 90% of both the midwives group and doctors group were satisfied with the length of time for testing and also understood the ultrasonographic images. Regarding the frequency of using a part or whole image of the fetus, midwives frequently used the image to explain the movement of the heart (χ²=5.792, P=.016), stomach (χ²=15.669, P<.001), bladder (χ²=49.602, P<.001), brain (χ²=5.785, P=.021), umbilical cord position (χ²=8.605, P=.003). The margin of error in measuring the fetus was 9.8 ±8.1% for midwives and 10.4±6.9% for doctors on average. It was also shown that 100% of midwives group and 95.5% of doctors the group considered that having ultrasonography examination performed by midwives is highly acceptable. In both groups, the heartbeat counts and STAI scores were significantly decreased after prenatal checkups (both P<.001). As for saliva amylase, it showed a slight decrease in the midwives group after prenatal checkups, while there was an increase in the doctors group. In addition, there were no significant differences between the two groups in the variability rate of each index before and after the examination.
Conclusion
Although details of ultrasonography differed between midwives and physicians, no differences in the skills for assessing the fetal body weight, pregnant women's attitudes, and psychological effects were observed, suggesting that midwives can effectively provide medical checkups involving ultrasonography on comparison with physicians.

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Purpose
The purpose of this study was to clarify similarities and differences of couples' awareness about husbands' support for their wives' satisfaction during the early phase of pregnancy, and discuss the effect of nursing activities that enhance husbands' support for their wives' satisfaction.
Method
Semi-structured interviews were conducted on eight couples during the early phase of pregnancy. All interviews were transcribed, and a qualitative inductive analysis was performed using the methods of Berelson. Ratios of agreement obtained by the Scott's equation in categories were 88.0% for similarities of couples' awareness, 87.0% for differences of couples' awareness on wives side and 89.0% for differences of couples' awareness on husbands side. These results confirmed the reliability.
Results
The following three categories were identified about husbands' support for their wives' satisfaction during the early phase of pregnancy: 'Empathy for wives' feelings and health', 'Support with housework', and 'Preparation for parenthood'. Similarities and differences of couples' awareness about husbands' support for their wives' satisfaction were clarified.
Conclusion
The three categories were identified from the view point of similarities and differences of couples' awareness about husbands' support for their wives' satisfaction during the early phase of pregnancy. From the discussion about the similarities and differences of couples' awareness, it has been suggested that nursing activities to improve husbands' support for their wives satisfaction during the early phase of pregnancy should focus on enough communication and sharing mind within a couple.

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Purpose
In the present study, the focus is applied to twin in multi embryo, and it actually attaches and feelings and the child care of father are understood, after that, it aims to clarify the support requested from father's aspect.
Subject and method
Half structural interview method was done for father who brought up the twin for months of 4,5 after one's birth. The detailed minutes of acquired data was analyzed in the qualitative induction.
Results
Three categories of {feelings when hearing the twin for the first time}, {feelings at the birth period from the pregnancy period}, and {feelings when meeting for the first time} are extracted from the pregnancy period as father's feelings at the birth period, and nine subcategories to be positional have been extracted respectively. Six categories of {happiness of the child care}, {Of a child is taken care very much}, {tiredness of the child care}, {uneasy child care and stress}, {It is puzzled}, and {worry of the child care} have been extracted as feelings of father who can put the child care period. Moreover, the subcategory of 15 has been extracted. Five categories of {reason to work on the child care}, {attitude by the child care and device}, {action method to worry and uneasiness}, {wife and husband's mutual coverages}, and {use situation of the child-rearing manual and the child care magazine} are extracted as a current state of the child care of father, and the subcategory of 17 has been extracted respectively. Three categories of {polite action on a family in hospital}, {device to the legend for which the object hoped}, and {device of the dissemination for the child care support system enhancement} were clarified as necessary support to father. Moreover, the subcategory of 13 has been extracted respectively.
Conclusion
On the other hand, negative feelings such as serious of the child care and puzzled were expressed though father felt the happiness of the child care. Feelings and the current state of twin father were especially understood as necessary support to father, and the importance of nursing that considered the legend, transmission, and the offer was suggested in polite correspondence.

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