[show abstract][hide abstract] ABSTRACT: BACKGROUND: Women of reproductive age are vulnerable to psychosocial problems but these have remained largely unexplored in some groups especially amongst Muslims in developing countries. The aim of this study was to explore and describe psychosocial impact and social support following perinatal loss among Muslim women. METHODS: A qualitative study was conducted in specialist centre among Muslim mothers who had experienced perinatal loss. Purposive sampling to achieve maximum variation among Muslims in relation to age, parity and previous perinatal death was used. Data was captured using focus group discussion and in-depth unstructured interview until the saturation point met. RESULTS: Sixteen mothers participated, having had one recent perinatal loss of a wanted pregnancy, had received antenatal follow up from public or private health clinics, and had delivery in our centre. All of them had experienced psychological difficulties including feelings of confusion, emptiness and anxiety over facing another pregnancy. Two of them showed anger and one felt guilt. They reported experiencing a lack of communication and privacy in the hospital during the period of grief. Family members and friends play an important role in providing support was reported. The majority agreed that the decision makers were their husbands and families rather than themselves alone. The respondents felt that repetitive reminder by husband, family or friends that whatever happened was a test from God improved their sense of self-worth. CONCLUSION: Muslim mothers who had experienced perinatal loss showed some level of adverse psychosocial impact which affected their feelings. Health care providers should provide psychosocial support in hospital, and ongoing support should be available where needed. Majority said that their husbands and family members were the main decision makers.
BMC Women s Health 06/2012; 12(1):15. · 1.51 Impact Factor
[show abstract][hide abstract] ABSTRACT: This cross-sectional study assesses factors that contribute to discontinuing breastfeeding among employed mothers in Malaysia.
A structured questionnaire was used in conducting this study involving all government health clinics in Petaling district between July and September 2006. Respondents were Malaysian women with children between the ages of six to twelve months who were formally employed. Factors studied were selected socio-demographic and work-related characteristics.
From a total of 290 respondents, 51% discontinued breastfeeding. The majority (54%) of mothers who discontinued breastfeeding had breastfed their babies for less than three months. Compared to Malay mothers, the risk of breastfeeding discontinuation were higher among Chinese (AOR 3.7, 95% CI: 1.7, 7.8) and Indian mothers (AOR 7.3, 95% CI 1.9, 27.4). Not having adequate breastfeeding facilities at the workplace was also a risk factor for breastfeeding discontinuation (AOR 1.8, 95% CI: 1.05, 3.1).
It is important that workplaces provide adequate breastfeeding facilities such as a room in which to express breast milk and a refrigerator, and allow mothers flexible time to express breast milk.
International Breastfeeding Journal 02/2011; 6(1):4.
[show abstract][hide abstract] ABSTRACT: To evaluate the psychosocial impact among mothers with perinatal loss and its contributing factors.
A cross sectional study was conducted in University Kebangsaan Malaysia Medical Centre (UKMMC) from April 2008 to May 2009 using Edinburgh Postnatal Depression Scale (EPDS) and self administered questionnaire.
Sixty-two respondents were included and most of them were working mothers (77.4%). The mean age of the respondents was (31.0+/-5.6) years and a majority of the subjects aged between 20-34 years (77.4%). According to the EPDS score, 53.2% of the respondents had a psychosocial impact with a total score of >9, out of 30. There was a significant relationship between psychosocial impact after perinatal loss and support from friends (P=0.019). However, there were no significant differences between psychosocial impact and history of previous perinatal loss, ethnicity, occupation, educational level, age or total income.
Mothers with perinatal loss should be screened for psychosocial impact and offered support when needed. Family and friends should continue to provide emotional support. People who have experienced similar problem before will be able to provide better support than those who have not.
Journal of Zhejiang University SCIENCE B 01/2010; 11(3):209-17. · 1.11 Impact Factor
[show abstract][hide abstract] ABSTRACT: To determine the factors contributing to unexplained antepartum stillbirth in Scotland.
A 10-year birth database in Scotland was used to compare the unexplained antepartum stillbirth with other birth outcomes. The sample unit was a pregnant mother with a gestational age of 20 weeks and above and with a fetal birth weight of 200 g and above.
Maternal age of 35 years and above, lower deprivation category, inaccessible area of residence, maternal smoking, maternal height of <160 cm and gestational age of above 39 weeks were significantly associated with unexplained antepartum stillbirth. In multivariable analysis only maternal age (adjusted odds ratio (OR): 1.8, confidence interval (CI): 1.1 to 3.0, P=0.02), smoking during pregnancy (adjusted OR: 2.0, CI: 1.1 to 3.5, P=0.02), and maternal height (adjusted OR: 1.4, CI: 1.1 to 1.8, P=0.01), remain significant. Screening of pregnancies based on these three risk factors had 4.2% sensitivity and 99.4% specificity. The prevalence of stillbirth for this population was 0.2%. A positive predictive value of only 1.2% implies that only 1 in 83 women with these three risk factors will have antepartum stillbirth. The remaining 82 will suffer needless anxiety and potentially diagnostic procedures.
Advanced maternal age, maternal smoking, and shorter maternal height were associated risk for unexplained antepartum stillbirth but screening based on these factors would be of limited value.
Journal of perinatology: official journal of the California Perinatal Association 10/2009; 30(5):311-8. · 1.59 Impact Factor
[show abstract][hide abstract] ABSTRACT: Introduction : Stillbirth is one of the important adverse pregnancy outcomes that has been used as a health indicator for the measurement of the health status of a country especially for its obstetric care management. However, the aetiology of the occurrence of the stillbirth was commonly difficult to identify because of limitations in the classification system. Methods : A review of existing, available information published up to January 2007 on stillbirths in Malaysia was used to obtain the basic background on the determinant factors of stillbirths. Results : Malaysia, which is a fast developing country, reported a stillbirth rate in the range of 4 to 5 per 1000 births. Almost 30-40% were recorded as normally formed macerated stillbirths. This was based on a rapid reporting system of perinatal deaths using the modified version of the Wigglesworth's pathophysiology classification. Those of extreme maternal age (less than 19 years and more than 35 years), those reside in rural areas, of the 'Bumiputera' and Indian ethnic groups were at higher risk of stillbirth. On detailed analysis it was seen that the risks of having a normally formed macerated stillbirth increased among those who had a preterm delivery and hypertension. Stillbirth rates were also higher in those with shorter gestational age and in those with parity between 2 and 5. No other factors related to stillbirth were found in this review. Conclusion : This is a review based on existing published data which has a lot of limitation when it comes to analysing other important factors that might be related with the risk of the stillbirth. However, extreme maternal age and mothers from rural areas are the two factors that were persistently found in almost all literature. When these factors are combined with signs of pre term delivery, they indicate that close monitoring needs to be done.
[show abstract][hide abstract] ABSTRACT: Fieldwork attachment allows student to explore thoughts, feelings, developing self-awareness and fresh insights related to public health knowledge. Practical experience through reflection is as important as theory in fields. Habit of critical reflection prepares students as future health professionals.The aim of this study was to explore learning experience within the fieldwork attachment among the Doctor of Public Health students in achieving stated learning objectives. A qualitative study based on a student's fieldwork, reflection report and supervisor's report on fieldwork attachment in third semester was explored. Descriptive analysis was performed. Students reported that they were in general satisfied with the posting. It helped them to increase their motivation as future health manager. Few have different points of view in achieving learning objectives: the field attachment is tiring or insufficient. Most of the students found it was beneficial and enjoyable. Students have come back with various meaningful learning and positive attitudes. The outcomes were grouped as: (1) student satisfaction and perceived usefulness, (2) ability to practice strategic planning in health programme, (3) length of attachment and (4) availability of field supervisor to coordinate, giving guidance and barrier in communication. In overall, students have benefitted from the fieldwork attachment but the experience gained has not as deep and wide as what had been expected due to time limitation and weakness in coordination.
Procedia - Social and Behavioral Sciences 60:390–396.