Purpose

The purpose of this study is to review intervention studies on preconception care for women in order to clarify the effectiveness of interventions and outcome measures, and thereby open doors to further investigations that will contribute to the advancement of research in the field of preconception care in Japan.

Methods

PubMed, Cochrane Library/ CENTRAL, EMBASE, and the NPO Japan Medical Abstracts Society database (Ichushi-Web) were searched in October 2020 to gather relevant studies in order to outline the main concepts and evidence underlying health behavior changes of preconception care in women.

Results

From the results of this study, 38 overseas studies, and three studies in Japan were retrieved. In terms of the range of effects of interventions/programs, the overseas studies included the following 10 areas: 1. nutrition and diet, 2. knowledge of fertility and health, 3. contraceptive methods, 4. physical activity, 5. physical and physiological indicators, 6. prevention of alcohol and tobacco exposure pregnancy, 7. folic acid supplementation, 8. mental and psychological changes, 9. pregnancy, childbirth, and birth outcomes, and 10. other areas. In the domestic studies, four areas were categorized: 1. knowledge about health and preconception care, 2. awareness related to preconception care, 3. nutrition and diet, and 4. other areas.

Conclusion

This scoping review revealed that research on preconception care in Japan is limited only to the areas of knowledge, awareness, and nutrition related to preconception care. As there is still limited research on this topic, this study suggests that certain areas of research that are lacking should be investigated. In particular, further studies on folic acid supplementation in preconception, physical activity, prevention of alcohol and tobacco exposure pregnancy, mental and psychological changes, physical and physiological indicators, and pregnancy and birth outcomes were suggested.

Purpose

This study aimed to examine the relationship between lower limb muscle mass in pregnant women and factors affecting it, such as physical activity, weight gain during pregnancy, and body mass index (BMI) prior to pregnancy.

Subjects and Methods

Five hundred and twenty pregnant women were asked to answer a self-administered questionnaire, which included questions regarding their prior to pregnant weight, height, and level of physical activity. Their weight and lower limb muscle mass were measured using a body composition analyzer (InBody270). Physical activity pertained to the presence or absence of exercise habits and daily activity levels (NEAT questionnaire). A t-test was performed separately for each of the primipara and multipara groups, and multiple regression analysis was performed to examine the relationship between lower limb muscle mass and factors associated with it.

Results

A total of 484 respondents (229 primiparas and 255 multiparas, aged 18–44 years at 5–40 weeks of gestation) with an average lower limb muscle mass of 11.53±1.68kg were included in this study. The muscle mass of both primiparas and multiparas was significantly higher in the high group (primiparas: 11.76±1.49kg and multiparas: 12.41±1.72kg) than in the low group (10.97±1.70kg and 11.24±1.63kg). BMI at non-pregnancy was significantly higher in the high group (11.98±1.60kg and 12.17±1.56kg) than in the low group (10.71±1.60kg and 11.46±1.85kg). Among primiparas, lower limb muscle mass was associated with factors, such as prior to pregnant BMI and weight gain and pre-pregnancy exercise habits (β=0.339, 0.227, 0.136, respectively), with a contribution ratio of 18.8%. Among multiparas, lower limb muscle mass was associated with, weight gain, prior to pregnant BMI and daily activity levels (β=0.258, 0.245, 0.169, respectively), with a contribution ratio of 15.6%. Among pregnant women who had normal BMI prior to pregnancy, the lower limb muscle mass was higher in women with weight gain ranging from 4.9kg to >8.5kg at 16–27 weeks and 28–37 weeks of gestation than in those who did not experience weight gain.

Conclusion

Prior to pregnant BMI and weight gain affected the muscle mass of the lower limbs of pregnant women. Pre-pregnancy exercise habit affected the lower limb muscle mass of primiparas, while the level of daily activity affected the lower limb muscle mass of multiparas.

Purpose

This study aimed to clarify the emotional changes that occur in couples immediately after the birth of their first child.

Methods

A qualitative descriptive analysis using semistructured interviews was performed on five couples immediately after the birth of their first child. The interviews were conducted 3–7 days after delivery and 1 month after delivery.

Results

The common change was that the wives became more thankful to their husbands and trusted them, and the husbands became more respectful of their wives and continued to care for them. Couples became grateful and satisfied when “the couple's role recognition was the same,” “the couple acquired parental roles,” and “the couple could understand each other's private life.” Couples showed dissatisfaction and patience with their partners when “the wife was anxious about her husband immediately after giving birth” and “the couples had different views about childcare.”

Conclusion

Although all couples shared some feelings, the specific emotions varied. When a wife is in the hospital, clinical midwives should pay attention to concrete emotions, such as what couples desire from their partner, anxiety about the marital relationship, concerns for the future, and level of acceptance as parents. It is necessary to assess whether a couple will collaborate in childcare in the future, whether there is a possibility of problems, and whether they will provide support tailored to each other.

Purpose

The coronavirus disease 2019 (COVID-19) pandemic has significantly affected outings associated with work, shopping, eating out, exercising, and entertainment. Reportedly, COVID-19 induced restrictions in social activities and outings are associated with physical and mental health issues. However, adjustments in outings during pregnancy remain unclear. This study aimed to investigate the adjustment strategies adopted by Japanese primiparas for outings during the COVID-19 pandemic and women's attitudes toward these adjustments during pregnancy.

Methods

A qualitative descriptive study involving semi-structured interviews with 11 Japanese primiparas 2–3 months postpartum was conducted between July and November 2021. The participants were recruited from a prospective cohort study performed at a university hospital in Tokyo. Data were analyzed inductively, using a qualitative descriptive approach. The study protocol was approved by the Research Ethics Committee of Graduate School of Medicine, The University of Tokyo.

Results

A total of 21 codes, 13 subcategories, and 5 categories were extracted from the data. Some women implemented “restrictions on outings to reduce the infection risk during pregnancy” owing to concerns regarding the effects of COVID-19 infection on the health of the fetus. Pregnancy led to “increased outings with little social contact considering healthy pregnancy and postpartum life.” On the other hand, some women freely stepped out during the COVID-19 pandemic, similar to their pre-pregnancy behavior. They “continued high-priority outings throughout pregnancy while implementing infection prevention measures” to maintain the status of their pre-pregnancy lives, “continued social outings even during the pandemic, without being overly concerned regarding the risk of infection during pregnancy,” and “continued their pre-pregnancy lifestyle with the lowest risk of infection.”

Conclusion

During the COVID-19 pandemic, Japanese primiparas adjusted their outings based on perceived infection risk during pregnancy, perceived health risks to themselves and their fetus related to daily activities, priorities for outing behaviors during pregnancy, and living condition before pregnancy. Healthcare professionals should provide health guidance that takes into account adjustments in outing behaviors of pregnant women during infectious disease pandemics.

Objective

To elucidate the experience of fathers who have lost a child and the support that they desire from nurses.

Subjects and Methods

The study participants included 9 Japanese fathers who, 1–7 years before the initiation of this study, had experienced the loss of a child aged between ≥20 weeks of pregnancy and <10 years. Upon performing data collection and semi-structured interviews, we performed an analysis using the KJ method.

Results

The fathers were divided into the following three categories according to their experience upon being bereaved.

Those in the first category expressed the conviction that “the death has not affected me” and “I was prepared to part with my child.” However, and as a consequence of physically touching their child, the fathers had concurrently experienced and greater appreciation of the significance of “birth and death.” They were aware of a gap between the depth of their own grief and that of the child's mothers, Furthermore, the fathers were inclined tended to try to conceal their grief by devoting themselves to their paternal roles. Their grief did, however, manifest itself in their heartfelt farewells and their continuing recognition of the child as a member of their family.

The fathers in the second category commonly wanted those around them to understand their “inability to cry despite their desire to do so”, and their decision to attempt to return to normality by resuming work. These fathers did, however, want their feelings as a bereaved father to be better understood. Furthermore, they expressed a desire to remain strong and to maintain the illusion of their child still being alive despite their absence from their daily lives. However, they also felt that the death of their child had caused their daily lives and family lives to stagnate and even stop. These fathers also expressed confusion regarding the disparity between their own feelings and those of the mothers.

Despite simultaneously expressing their gratitude to nurses, the fathers in the third category were also resentful due to the pain caused them by what they perceived as a lack of consideration on the part of nurses. These fathers would have preferred to express their feelings to male nurses who, they felt, would have been more empathic in terms of understanding male grief and to whom they would have been able to express themselves more easily. They also conveyed their belief that only similarly bereaved people can fully understand the experience of losing one's child.

Conclusion

Even after having lost their child, fathers felt the presence of their child in the family, and felt that the child continued to live in the fathers. However, the fathers felt that there was a gap with the mothers in terms of the depth of their grief over the death of their child arising from a difference in the physical sensation with the mother. Moreover, fathers were negatively impacted by the gender-defined roles and expectations of the society and experienced an alienation from reality; they desired to be understood. Nurses in perinatal settings are typically female, and thus support is needed to provide fathers with the opportunity to be able to comfortably speak with male nurses as they desire.

Purpose

This study reveals the decision-making process of women identifying as a lesbian to have children with a biological connection to them or their same-sex partners.

Method

The study recruited four Japanese lesbians raising or wishing to have children with a biological connection to them or their same-sex partners. Narratives during interviews were used as data. Analysis used the trajectory equifinality model to describe the process of making a decision to have a child.

Results

Despite facing various challenges in having children as lesbians, they decided to have children in a stable relationship with their partner. Decisions regarding which methods to use for having children, who will give birth, and the choice of sperm donor, among others, were made according to individual values.

Conclusion

The study observed that the decision-making process of lesbians in having children with same-sex partners undergoes a period of conflict about whether or not to have children and of discussions regarding methods for having children.

Several decisions were made on how to have children, according to individual values.

Thus, accumulating basic data is necessary for future studies to consider the acceptance of healthcare providers of the needs of lesbian couples who intend to have biological children.

Purpose

To explore the association between physical activity (PA) and low mood during pregnancy.

Methods

Secondary analyses were conducted on data from a quasi-experimental study of 58 healthy primigravida women without PA limitations. PA was measured using an accelerometer (Polar Loop 2, Polar Electro Oy) at T1 (5 months), T2 (7 months), and T3 (9 months). The indicators of PA were cumulative time spent at each PA intensity level (sedentary behavior [SB], light PA, and moderate-to-vigorous PA [MVPA]) time in minutes/day, and the cumulative time by the duration of PA (minutes/day). Based on the data acquired from the low mood frequency and symptoms through a questionnaire in the T3 interval, women with a high frequency and severe symptoms were considered as having low mood.

Results

Eleven women (18.9%) with low mood had significantly shorter wake period (p=0.002), cumulative SB time < 30 min (p=0.020), cumulative MVPA time (p=0.035), and cumulative MVPA time < 10 min (p=0.018) than women without a low mood. In the receiver-operating characteristic analysis for the low-mood group, the area under the curve values for cumulative MVPA time < 10 min at T1 and cumulative SB time < 30 min at T3 were 0.723 (95% CI: 0.555–0.892, p=0.022) and 0.724 (95% CI: 0.565–0.883, p=0.029), respectively; the cut-off values were 19.43 min (sensitivity 0.702, specificity 0.818) and 258.05 min (sensitivity 0.786, specificity 0.500), respectively.

Conclusion

Cumulative MVPA time < 10 min and cumulative SB time < 30 min were predictors of low mood in the third trimester of pregnancy. Moreover, frequent PA and less time spent in SB may improve the mental health during pregnancy.

Purpose

To develop a “midwives' emotion scale in second-trimester abortion care,” to measure midwives’ emotions and examine its reliability and validity.

Methods

We created a scale based on the literature and previous studies that elucidated the emotions of nurses in abortion care and examined the content as well as face validity. We requested cooperation from 300 medical institutions that handle childbirth in the Tokyo metropolitan area, distributed 511 copies of research cooperation request documents to the midwives working at these facilities, and conducted an online survey. Item and exploratory factor analyses examined reliability and validity. Statistical package for social sciences (SPSS Ver.28) was used for analysis.

Results

A total of 240 valid responses were analyzed. As a result, a scale consisting of 6 subscales and 25 items was completed: factor I (positive perception of care), II (negative feelings towards fetus), III (anger towards women), IV (negative perception of care), V (self-evaluation of care techniques) and VI (frustration with women's surroundings). Cronbach's alpha for the scale was 0.88 and that for the subscales ranged from 0.72–0.83. The correlation coefficient between the total scale score and the total score of the Japanese version of SABAS (stigmatizing attitudes, beliefs, and actions scale) was 0.41. Using the known groups method, the data were classified into groups having negative and positive values for abortion and compared, and it was observed that the total scale score was significantly higher in the group having negative values.

Conclusion

We developed a midwives' emotion scale in second-trimester abortion care and evaluated its reliability as well as construct validity. We believe that this scale can to self-evaluate emotions in second-trimester abortion care and contribute to its improvement.

Purpose

The purpose of this study was to review the trends and findings of previous domestic and international studies on midwifery during the COVID-19 pandemic.

Methods

A literature search in the Japan Medical Abstracts Society (Ichushi-Web) and PubMed, using “COVID-19,” “JYOSAN (midwifery in Japanese)” and “midwifery,” as keywords, identified 96 articles (six in Japanese and 90 in English). The following information was extracted and classified: research topic, country of origin, study design, subjects, data collection method, type of data analysed, and ethical considerations.

Results

The most common research topics were maternity care services provided by healthcare professionals (30 articles), the use of maternity care services by pregnant and postpartum women and their families (24 articles), infection management (17 articles), and mental health of healthcare providers (16 articles). The most frequent country of origin was Turkey (11 articles), followed by the United Kingdom (10 articles), Japan, and Australia (nine articles each). The most common study designs were cross-sectional studies (71 articles), literature reviews (nine articles), cohort studies (six articles), and case reports (four articles). The subjects analysed most were medical personnel or medical students (64 articles), non-medical personnel (e.g., pregnant and postpartum women, their families, and neonates, 37 articles), and documents, including medical records, government documents, and academic papers (13 articles). The data collection methods more frequently used were online survey, internet search, phone, email, or mailing method (58 articles), and literature search (14 articles). The data analysed were quantitative (62 articles), qualitative (25 articles), and existing documents (16 articles). Seventy-six articles included a description of ethical considerations, whereas 18 did not.

Conclusion

The three most common topics (74.0%) of articles published during the COVID-19 pandemic were maternity care services provided by healthcare professionals, the use of maternity care services by pregnant and postpartum women and their families, and infection management. The number of studies analysing medical personnel or medical students was 1.7 times higher than those on different subjects. Therefore, the studies possibly contributing to healthcare professionals’ infection control may have been prioritized during the pandemic. The majority were cross-sectional studies on data collected indirectly through online surveys, internet searches, phone, or email (60.4%) and from existing documents (16 articles), possibly due to the concern about conducting studies targeting care receivers directly, such as pregnant and postpartum women and their families. This study identified concrete strategies for maintaining and developing research activities during the pandemic.