Purpose

This study clarifies the role of midwifery care in achieving childbirth autonomy in pregnant women scheduled to deliver elective epidural labor. By comparing epidural labor with natural birth, it offers suggestions for midwifery care that are necessary to elicit the autonomy of childbirth for pregnant women who wish to have the same.

Methods

A total of 146 midwives who work at facilities in the Tokyo metropolitan area that handle natural birth and epidural labor, are currently involved in antenatal checkups, and have at least three years of experience as a midwife were selected for this study. An anonymous self-administered questionnaire survey was administered. The primary analysis calculated the basic statistics for midwifery care leading to maternal autonomy in childbirth, followed by Mann-Whitney U tests of differences between variables. The study was approved by the Ethical Review Committee of Yokohama City University, which took into account all relevant ethical considerations (approval number: F230800034).

Results

A total of 97 valid responses were obtained from the questionnaire (collection rate: 69.1%; valid response rate: 96.0%). Midwifery care that encourages pregnant women to take the autonomy in childbirth achieves high implementation rates of care elements in both natural birth and epidural labor and includes “giving encouraging words to recognize the pregnant woman's efforts (natural birth 99.0%, epidural labor 96.9%)”, “during the preventive examination, in addition to the essential examination points, listen to the pregnant woman's concerns and questions (natural birth 97.9%, epidural labor 98.9%),” and “acknowledge and respect what the pregnant woman has to say (natural birth 97.9%, epidural labor 96.9%).” In contrast, “encouraging interaction with other pregnant women received low implementation rates (natural birth 28.9%, epidural labor 32.0%)”. Concerning the awareness of midwifery care to take autonomy in childbirth for pregnant women planning to give birth through epidural labor, the highest percentage of respondents chose “the same as natural birth” for most of the items. The implementation rates of midwifery care in epidural labor showed differences in the availability of midwifery care education/training for autonomy in childbirth.

Conclusion

Midwifery care during the gestational period to promote autonomy in childbirth is the same for both natural birth and epidural labor and is based on the same awareness. However, there were differences in the availability of midwifery care education/training in epidural labor, suggesting that improved education/training for midwives could support the autonomy of pregnant women who wanted to have epidural labor.

Purpose

The impact of teleworking on physical activity (PA) during pregnancy has not been fully elucidated. This study aimed to describe the PA level of pregnant women according to their employment and teleworking availability and evaluate the magnitude of the association between PA and these working availability in the second trimester.

Methods

This cross-sectional study was part of The Japan Pregnancy Eating and Activity Cohort Study conducted in four prefectures. Participants were recruited from March 2020 to October 2022, including the coronavirus disease 2019 pandemic. PA was assessed using the Japanese version of the self-administered Pregnancy Physical Activity Questionnaire 2020. Participants were classified as non-workers, teleworkers, and on-site workers. The data of 864 participants were stratified by parity, and analyzed via analysis of covariance.

Results

Teleworkers performed significantly more total PA than non-workers, regardless of parity. In terms of intensity and PA type, teleworkers and on-site workers were more sedentary and performed significantly more occupational PA and less household/caregiving PA than non-workers among primiparas. Only primiparous teleworkers performed significantly less light PA, with no significant difference in moderate PA, than non-workers. Among multiparas, teleworkers and on-site workers were more sedentary and performed significantly more occupational PA and less light PA and household/caregiving PA. Compared to non-workers, only multipara teleworkers showed no significant difference in moderate PA.

Conclusion

Teleworkers performed more total PA, sedentary activity, and less light PA than non-workers, like on-site workers. Increased sedentary time is related to higher risk of pregnancy complications and unfavorable birth outcomes. Therefore, healthcare professionals may need to encourage pregnant teleworkers to replace sedentary with PA of any intensity as much as possible.

Purpose

A scoping review on the use of peripheral intravenous catheters (PIVCs) in neonatal intensive care unit was performed to determine (1) the incidence of PIVC-related complications, (2) risk factors for these complications, and (3) measures to prevent them.

Methods

We searched the MEDLINE database through PubMed, CINAHL, and Ichushi-Web version 5 (from the Japan Medical Abstracts Society) for articles published from inception until January 2022. The inclusion criteria were as follows: (1) articles reporting the incidence of neonatal PIVC complications; (2) articles identifying the risk factors for neonatal PIVC complications or measures to prevent these complications; (3) article types including original observational studies, randomized controlled trials, reviews, case reports, symposia, conference proceedings, guidelines, and commentaries ; and (4) articles published in English or Japanese. We excluded articles that included non-neonatal patients and those that evaluated catheters other than PIVCs. We screened data on the incidence of PIVC-related complications, risk factors associated with these complications, and their preventive measures and extracted them.

Results

We analyzed 47 articles. The incidence of complications of PIVC was 45.6–94.6%. The incidence of infiltration, extravasation, and occlusion was 1.0–78.0%, 2.4–84.0%, and 1.4–77.3%, respectively. Risk factors for PIVC complications included gestational age, body weight, antibiotic use, intravenous nutrition, total number of insertion attempts, insertion site, and type of infusion to maintain the patency of PIVCs (intermittent or continuous). The most essential preventive measures identified were enhancing nurse education and implementing specific PIVC management interventions.

Conclusion

The incidence of PIVC complications was high, and the most common complications were infiltration, extravasation, and occlusion; thus, attention should be paid to these. Certain factors associated with PIVC complications are difficult to address, while others are amenable to intervention. Improving nurse education and implementing specific management interventions are essential measures for preventing PIVC complications.

Purpose

The purpose of this study was to develop a linguistically valid Japanese version of the London Measure of Unplanned Pregnancy (LMUP), a screening tool for assessing unplanned pregnancy.

Methods

The Japanese version of the LMUP was prepared through the following stages: (1) Forward translation into Japanese by two researchers; (2) Researcher consultation and integration of forward translation; (3) Back translation into English by two researchers; (4) Researcher consultation (creation of a tentative Japanese version); and (5) Reexamination.

Results

In the process of creating the Japanese version of the LMUP, the version was finalized after linguistic validity was examined in the fifth stage, which consisted of researcher consultation and review with the author who developed the original LMUP questionnaire. The main points that required consideration in the translation process included the minimization of differences in meaning and nuances between the two languages as perceived by respondents due to varying temporal perspectives, such as “In the month that I became pregnant” and “Just before I became pregnant.”

Conclusion

Through a formalized translation process, a linguistically valid Japanese version of the LMUP was developed. The next steps will be to pilot test the translated version and perform an assessment of reliability and validity.

Purpose

To develop a “Fertility Literacy Scale” in male and female reproductive generations, and to examine its reliability and validity.

Methods

Based on data obtained from previous research and a literature review of existing measures of fertility knowledge and factors affecting fertility, a 60-item draft questionnaire was developed to measure fertility literacy. A web-based survey was administered to 648 men and women of reproductive age to test the scale's reliability and validity.

Results

In an exploratory factor analysis, 7 factors and 31 items were selected for the [knowledge of age and health conditions affecting female fertility], [knowledge of physical risks affecting male fertility], [knowledge of lifestyle affecting male fertility], and [knowledge of male sexual function and fertility], [ability to judge the risk of one's own situation based on obtained information], [ability to make decisions and take action for the future], and [ability to seek support and communicate]. Discriminative and convergent validity were ensured, and the scaling success rate was 100%. The known group validity of the “Fertility Literacy Scale” was significantly higher in the group with infertility treatment than in the group without infertility treatment (p<.001~.039). A moderately significant correlation was also found between general health literacy and the factors of Self-care Behaviors Ability and its total score (r=.420–.596, p<.01). The reliability coefficients was .911 for the overall scale and .794–.881 for the subscales.

Conclusion

The validity and reliability of the Fertility Literacy Scale for men and women of reproductive age were confirmed. The scale is expected to be applied to interventions that promote reproductive life planning in the future.