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Influence of stress on women during pregnancy, childbirth and puerperium
HAVLÍČKOVÁ, Karolína
The subject of interest of this bachelor thesis is the impact of stress factors to women's health during pregnancy, childbirth and puerperium. The first aim of this bachelor thesis was to find out what is the most common stress cause for women during upmentioned periods. The second aim was to explore the women's ability to cope with stress. This thesis is divided into two parts - teoretical and practical. The theoretical part provides information about pregnancy characteristics (its duration, symptoms, signs and changes in the female body and organs during pregnancy). In subchapters related to pregnancy is the attention paid to prenatal diagnosis and stress factors during graviditas. The theoretical part also includes information about childbirth and its detailed periods. The subchapters considering childbirth provide summary of preparations for a delivery and the stress sources during the act itselves. The theoretical part also deals with the information about puerperium. This part is devided into subchapters which také into account breastfeeding difficulties, newborn care, stress factors affecting women in the puerperium, and psychological changes of women during puerperium. The final passage of the theoretical chapter discusses the definition of stress. The description of midwife role is possible to be found in each subchapter. The practical part of the bachelor's thesis founds its basis on a qualitative research in the form of individual semi-structured interviews. The survey was held from February to April 2021 and the group of analysed specimens consisted of 11 women not earlier than two months after they gave birth. To make the research anonymous the women were marked Ž1 - Ž11. All the interviews were held at the women's household with their approval. The research was going on in a covid-19 epidemic era, therefore all the restrictions such as face mask wearing and two meter distancing must have been kept during the visits. All the dialogues have been recorded, literally rewritten and analysed with women's assent. All the reached data have been treated by open coding, "pencil and paper" method (Švaříček et al., 2014). As the main categories for purpose of data evaluation have been marked: Pregnancy stress, birth stress, post-partum stress and their appropriate subcategories. The topics mentioned in "Pregnancy stress" are Covid-19 pandemic, partner's support, maternity clinic attendance and antenatal course. Aspects affecting the birth itselves are maternity hospital staff behaviour and partner's presence in the delivery room. The last category includes themes of breastfeeding and newborn care. On basis of the first, previously discussed, goal of this bachelor thesis was established the question which considers what is the most common stress cause during pregnancy, birth and six weeks post-partum. The result of this research indicates, that the women are most often stressed out because of the current coronavirus pandemic situation and prenatal diagnosis. The women are also worried about miscarriage or preterm birth. As the reasons of stress during the delivery were indicated hospital staff bad behaviour or a fear of being lonely and experiencing the feelings without partners. The investigation on the last category displays that over the post-partum period the women are worried about breastfeeding difficulties and insufficient childcare skills.The second question of the research followed up in what ways the stress impacts the women. From the survey it is possible to ascertain that all the involved women, except Ž1 were not affected by the stress in a long-term run. The specimen "Ž1" stated that her postnatal feelings and stresses had made her to shut herself off from her surroundings.The results of this bachelor thesis could be possibly used for scholar seminar purposes as a source of information for midwives. The other possible usage for this document would be a provision of needed information for pregnant women.
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Knowledge of adolescent girls about pregnancy, childbirth and contraception.
KUNTEOVÁ, Pavlína
The bachelor's thesis entitled Knowledge of adolescent girls about pregnancy, childbirth, contraception, focuses on the level of awareness of adolescent girls about pregnancy, childbirth and contraception. The theoretical part of the bachelor's thesis deals with the developmental stages of man from conception to old age. A special chapter is devoted to the period of adolescence and risky behavior of adolescents - at this stage of their lives, because the respondents are adolescent girls. Furthermore, the theoretical part contains the period of pregnancy, the stage of childbirth and types of contraception. Because it is very important for adolescent girls to receive information about contraception, pregnancy and childbirth, the last chapter mentions the importance of educating adolescent girls by midwives and their communication together. In the research survey, a quantitative method was chosen and data collection took place in the form of a non-standardized questionnaire, which was published on social networks. The questionnaire consisted of 28 questions, of which 19 were closed and 9 semi-closed. The data obtained by the research survey were processed and evaluated using a computer program Microsoft Excel. Graphs were created for each questionnaire, which shows the answers of adolescent girls. The research group consisted of 71 respondents aged 16 to 20 years. The aim of this work was to find out whether adolescent girls have knowledge about pregnancy, childbirth and contraception. Six hypotheses were established for the research part. The first hypothesis was to find out whether adolescent girls aged 18-20 have more information about pregnancy than girls aged 16-17. This hypothesis was refuted. The second hypothesis was: Adolescent girls aged 18-20 have more information about childbirth than girls aged 16-17. The sec- ond hypothesis was also refuted. Third hypothesis: Adolescent girls aged 18-20 have more information about contraception than girls aged 16-17. This hypothesis was con- firmed. Fourth hypothesis: Teenage girls in secondary medical schools have more knowledge about pregnancy than teenage girls in grammar schools and high schools with- out a high school diploma. The fourth hypothesis was confirmed in the research. The fifth hypothesis was to find out whether adolescent girls in secondary medical schools have more knowledge about childbirth than adolescent girls in high schools and high schools without a high school diploma. This hypothesis was refuted. The last, sixth hypothesis was: Teenage girls in secondary medical schools have more knowledge about contracep- tion than teenage girls in grammar schools and high schools without a high school di- ploma. This hypothesis was refuted.
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A midwife's personal experience with pregnancy and labor
JAREŠOVÁ, Natálie
A midwife's personal experience with pregnancy and labor Bachelor theses is focused on personal experience with pregnancy and labor of midwife. Defined in the theoretical part of the Bachelor theses is the profession of a midwife, her competencies and role in prenatal counselling and during labor. Subsequently, the theoretical part contains the characteristics of pregnancy and physical and mental changes that are closely related to pregnancy. Last but not least, the theoretical section describes childbirth and all periods of childbirth. For Bachelor theses there were two goals, the first goal was to identify if professes of midwife affect their own pregnancy and labor experience. The second goal was to identify if their own pregnancy and labor experience affects a midwifes approach to pregnant women and women after childbirth. Based on set goals, the research questions were created. The first research question focused on how the midwifes profession affected the experience of her own pregnancy and labor. The second question examined how the midwife's own pregnancy and labor affect her approach to providing care to a women within her competencies. To obtain the results of a qualitative research survey, two research sets were created. The first research group consisted of midwives who practiced the profession of a midwife in primary care and had been pregnant and gave birth at least once. For the second research group, which consisted of midwives, the criterion of performing the profession of midwife in the delivery room was determined, as well as at least one experienced pregnancy and childbirth. The survey itself took the form of individual semi-structured interviews, which took place during a personal meeting in the period from March to May 2021. Before the start, all informants gave their approval to the interviews and their recording to the mobile phone and also their data processing. The obtained data was analyzed and the main categories and subcategories were created based on the results. After evaluating the data with midwives working in primary care, 3 main categories were set (Perception of own pregnancy, Prenatal counseling, Return to work) and 6 subcategories (Own experience with pregnancy, Influence of own pregnancy on the profession of midwife, Prenatal preparation, Course of care in prenatal counseling, Access of medical staff, Changes in the care of pregnant women). After evaluating the data with the midwives who worked in the delivery room, 3 main categories were set (Perception of own childbirth, Provision of health care, Return to work) and 5 subcategories (Course of own childbirth, Experience of own childbirth, Place of childbirth, Access of medical staff, Changes in the care of women in labor). The first research question was devoted to how the profession of midwife influenced their pregnancy and labor. The research found that midwives during own pregnancy were influenced by their profession mainly in the perception of care for themselves in the prenatal counseling and in the perception of the approach of medical staff for themselves. The second research question dealt with the influence of their own pregnancy and labor on the approach to pregnant women and childbirth after returning to work within their competencies. It was found that after returning to work, midwives were affected by their pregnancy and thus perceived certain changes in the approach to pregnant women. The experience of giving birth also had an effect on the performance of their profession after returning to work.
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Epidural analgesia during childbirth
MAŘÍKOVÁ, Tereza
This thesis focuses on the topic of epidural analgesia during childbirth. The work consists of two main parts-theoretical and practical. The theoretical section first and foremost defines the concept of childbirth and describes all birth times. Last but not least, it is also dedicated to the role of midwife in childbirth. Another topic is obstetric pain, which is followed by the theme of pharmacological methods to labor pain relief. The issue of epidural analgesia is described in detail and divided into additional subchapters. These are devoted to the description of the procedure for administering epidural analgesia in childbirth, it's indications and contraindications, the advantages and disadvantages, the complications of epidural analgesia in childbirth and, last but not least, the role of the midwife in the care of the woman with epidural analgesia. The theoretical section concludes with a chapter on non-pharmacological methods of controlling birth pain. The first objective of the work was to determine whether women use epidural analgesia during childbirth. The second goal was to map women's satisfaction with the effects of epidural analgesia in childbirth. The third and final goal was to see if women worked better with midwives after receiving epidural analgesia. Three hypotheses have been set for the objectives. H1: First-time mothers are more likely to use epidural analgesia than multi-parents. H2: Younger women (under 30) are more satisfied with the effects of epidural analgesia in childbirth than older women (over 30). H3: Women with epidural analgesia at birth cooperate better with midwives than women without epidural analgesia. The objectives were achieved by a quantitative research investigation in the form of own design questionnaires, which consisted of both open and closed questions. The assessment of the questionnaires was carried out using a statistical chi-square test which determined the significance or insignificance of the results. The first research set consisted of 205 women active on the Facebook social network. Of the total number of respondents, women in the 26-30 age range had the highest representation. The second research set included 102 midwives working in the delivery room. Midwives in the 20 to 30 age range had the highest representation of total respondents. The research investigation revealed that more than half of the respondents had used epidural analgesia during childbirth. However, only a third of women are certain that they would also use epidural analgesia for their next birth. The other two-thirds of women do not know whether they would use the epidural analgesia method or are certain that they do not want epidural analgesia in their next childbirth. We also wanted to find out whether younger women (under 30) are more satisfied with the effects of epidural analgesia in childbirth than older women (over 30). This hypothesis has not been confirmed. This was due to the low representation of the group of women over 30. We also wanted to find out whether first-time mothers use epidural analgesia more often than multi-time mothers. The result of the research showed that the largest representation of our female respondents who took advantage of epidural analgesia was just 7 % more first-time mothers. However, the difference is not statistically significant. We also wondered if women with epidural analgesia at birth cooperate better with midwives than women without epidural analgesia. According to the research investigation, the vast majority of midwives think that women with epidural analgesia cooperate better during childbirth than women without epidural analgesia.
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Reducing labour pain using non-pharmacological methods
KOPKOVÁ, Iva
This bachelor thesis monitors non-pharmacological methods during labour, evaluates their efficiency on the visual analogue scale, and finds how women view them after childbirth. The theoretical part describes phases of delivery seen by a woman in labour and a midwife, and the matter of pain and specifically the labour pain. The last section of the theoretical part characterizes the non-pharmacological methods of easing labour pain. The empirical part contents qualitative observational research and a semi-structured interview. During labour, midwives observed women fighting the pain without any help of non-pharmacological methods and then with them. They wrote all findings into a record sheet. To be a part of this research, women in labour must not have used any pharmacological methods. Women, while being recorded, answered twelve questions in the interview no more than three days after their childbirth. The research from May 2021 shows which non-pharmacological methods women in the delivery room in the hospital in České Budějovice and Český Krumlov chose to use to ease their pain. The bachelor thesis refers to the importance of non-pharmacological methods in labour, although they cannot be equal to the efficiency of pharmacological approaches. The midwives and doctors may speak about the conclusion of this thesis at professional conferences or antenatal classes.
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Awareness of pregnant women about cord blood donation
KOLMANOVÁ, Michaela
This bachelor's thesis is dedicated to donating umbilical cord blood. The thesis consists of a theoretical and practical part. The theoretical part contains a description of the placenta and its functions, umbilical cord blood, stem cells. Furthermore, the theoretical part contains a description of the technique of cord blood collection, contraindications of the collection and processing of umbilical cord blood. It also describes the education of midwives on this issue. Umbilical cord blood banks and legislative provisions are listed here. The aim of the bachelor's thesis was to find out how knowledgeable pregnant women are about this issue. A quantitative research survey was used in the practical part of this work. The questionnaire created contained 18 closed questions. The research team was pregnant women. This set consisted of 244 respondents. Of these, 155 (64%) first-time parents 89 (36%) multi-parents. Of these, 41.39% of respondents know the use of umbilical cord blood. Only 18.03% of respondents know what they need to do to be able to take umbilical cord blood. 19.67% of respondents reported the correct time of collection of umbilical cord blood. 13.52% of respondents reported that the maximum storage period of donated umbilical cord blood is 20 years. Two hypotheses were established in this work. The first hypothesis focused on whether pregnant women are given more information about this issue by a midwife or gynecologist. 5.70% of respondents received information from a midwife. 3.70% of respondents received information from a gynecologist. Statistical processing of the hypothesis has shown us that there is no difference in who gives information. Women are informed from the midwife as well as from the gynecologist. The second hypothesis was whether multi-parents are more informed about umbilical cord blood donation than first-time parents. Multi-parents accounted for 36%, and first-time parents 64%. 46.06% of multi-parents and 38.71% of first-time parents said they knew the use of umbilical cord blood. 20.22% of multi-parents and 19.35% of first-time parents know the time of collection of umbilical cord blood. 50.56% of multi-parents and 39.35% of first-time parents reported that the donation was not risky for newborns. We confirmed the second hypothesis. The results of this work show that women have very little information on the issue of umbilical cord blood donation. The midwife is a competent person, so women could be more education about this issue. This work can be used in seminars for midwives.
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Průběh porodu a puerperia u klisen
STAROBOVÁ, Hana
The subject of the bachelor's thesis is the course of childbirth and puerperium in mares. First, it deals with sexual activity in mares, including an analysis of indivi-dual important factors that affect it. Furthermore, the work focuses on fertilization and pregnancy of mares and their disorders. It outlines both the causes and the course and treatment options. The main part focuses on the birth itself, its complica-tions and subsequently the postpartum period. A survey of the course of parturition and puerperium was carried out as part of the work, which was to find out the characteristics of pregnant mares, the course of pregnancy and parturition, complications during and after parturition and basic in-formation about the foal born. The survey found that the most popular breed of horse among Czech respon-dents is the Czech Warmblood and they are mostly used for hobby riding. Mares are usually older than 8 years and it is their 3rd or subsequent pregnancy. The course of the birth was mostly problem-free and completed within one hour. Subsequently, the survey addressed the postpartum period, when it was found that the mares did not suffer from clinical signs or inflammation to a greater extent. The foals born were mostly stallions, who were largely independent, so they did not need help with the first drink and the departure of the pitch took place within a maximum of 4 hours.
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Birth plan from a midwife' s perspective
TOMÁŠKOVÁ, Barbora
The bachelor's thesis deals with the birth plan from a midwife's perspective. Two goals were established advance. The first goal was to find out the attitudes od midwives to the birth plan and the second goal was to find out what is the approach of midwives to mothers with a birth plan. The bachelor thesis is divided into two parts. The theoretical part and the practical part. The theoretical part introduces the profession of midwife and profession competencies. Furthermore, the theoretical part presents the importance of the birth plan, which women usually create a birth plan and the wishes that women can state in their birth plan. One of the chapters describes a childbirth and all his periods of birth (first, second, third and fourth). The end of the theoretical part is described the characteristic of the puerperium. The practical part of the bachelor thesis was based of a qualitative research survey. One research group was created with the help of semi-structured interviews, which was carried out with midwives working in the delivery room at Český Krumlov Hospital, a.s. and at the Hospital of České Budějovice, a.s. There were total an eleven midwives. The main criterion for the research survey was requirement for midwives to work in the delivery room and have experience with the birth plan. Before the interviews began, the topic of the bachelor's thesis was explained to all midwives and it was pointed out that the information obtained would remain anonymous. Interviews were conducted with the consent of the midwives. The individual interviews were recorded on a dictaphone and then literally transcribed. This was followed by data analysis and processing. To evaluate the data, two main categories and ten subcategories were identified.
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Problematics of cord blood collection.
VAŇKOVÁ, Barbora
This bachelor's thesis deals with the issue of umbilical cord blood collection. Due to the focus of the work, the theoretical part describes childbirth and all periods of childbirth, the procedure of collecting umbilical cord blood after a spontaneous delivery and after delivery per sectio caesarea and possible contraindications of umbilical cord blood collection. My thesis also describes the role of a midwife as a women's educator about the possibility of collecting umbilical cord blood and the role of a midwife during childbirth, including the collection of umbilical cord blood. Last but not least, the theoretical part mentions the importance of umbilical cord blood banks and their legislation concerning and stem cell transplantation. In total, three goals were set. The first goal was to find out if midwives have knowledge about the collection of umbilical cord blood. The second goal was set to reveal whether pregnant women have enough information about umbilical cord blood collection, and the third goal was to see whether pregnant women are interested in umbilical cord blood collection. Based on the goals set, research questions were assigned to each goal. The first research question asked about the knowledge of midwives about the collection of umbilical cord blood, the second question dealt with the pregnant women's knowledge of umbilical cord blood collection and the last question examined the attitude of pregnant women to the collection of umbilical cord blood. Two research files were identified in the research survey. The first group consisted of six midwives, labeled PA1 to PA6, who worked in the delivery room for at least one year. In the second research group there were six pregnant women, marked T1 to T6, who regularly attended an antenatal clinic. The research was conducted using web programs Skype or Teams in May 2020. A qualitative method was chosen to carry out the research part, which was implemented using individual semi-structured interviews. Before the interviews began, the informants gave oral consent to data processing. The data was later analyzed and main categories and subcategories were created based on the results. After evaluating data with the midwives, 2 categories and 8 subcategories were determined. After evaluating data with pregnant women, one category and 3 subcategories were determined. The first research question examined the knowledge of midwives about the collection of umbilical cord blood. Research has shown that midwives PA2 to PA6 have sufficient information on the procedure for collecting umbilical cord blood. Midwife PA1 stated that she had never seen the collection and did not know how such a collection would be performed. On the other hand, midwife PA5 stated that earlier, up to 15 samples per month were performed at her workplace. Therefore, she was the most informed of all the midwives interviewed. The second research question examined the pregnant woman's knowledge about the collection of umbilical cord blood. Research has shown that all pregnant women knew what umbilical cord blood is, but most (T1, T2, T3 and T5) do not know how it is collected and used. The third research question was aimed at the attitude of pregnant women towards the collection of umbilical cord blood. The research found that due to the lack of information, high financial cost and storage of umbilical cord blood, women are not interested in commercial collection of umbilical cord blood. The reason why women are not interested in umbilical cord blood donation was that women would have to choose to give birth at a hospital that allows this type of collection, namely maternity hospitals in Slaný, Česká Lípa and Thomayer Hospital in Prague. Pregnant women state that these hospitals are very distant from their family and place of residence, and that is the reason why not choose these hospitals for childbirth. Only pregnant woman T2 stated that she would consider collecting blood for her own purposes.
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Person accompanying during childbirth
BISKUPOVÁ, Iveta
This bachelor thesis deals with the issue of accompanying person during childbirth. Due to the topic of the bachelor thesis, there are introduced persons that a woman can choose to childbirth, including their specifics and differences, in the theoretical part. The individual stages of childbirth, the role of a midwife during childbirth and the communication of the midwife with the woman and her accompaniment are also described. There were established two goals of the thesis. The first goal was to find out how the woman perceived the presence of the accompanying person during childbirth, and the second was to find out what influenced the woman in choosing the accompanying person to childbirth. The research investigation was conducted through an individual semi-structured interview, so it was processed using a qualitative method. The data was collected from postpartum women who had already been released from the puerperium department for home treatment. However, the condition was that the women gave childbirth in 2020 and had an accompanying person during childbirth. The data collection took place in March and May 2020. In March, there was an increase in the number of infected people with coronavirus in the Czech Republic. There were put in place measures to prevent the spread of the disease, including a ban on accompaniment in the birth room. The interviews took place in a pre-arranged, calm and pleasant environment for the women. The obtained data recorded on a dictaphone was evaluated manually, using the "paper - pencil" method. There were created three main categories and their subcategories. The first category is called Accompanying Person and contains five subcategories - Accompanying person during childbirth, Factors influencing the choice of the accompanying person, Proposal for presence at childbirth, Satisfaction and Recommendation of the accompaniment. The second main category Childbirth has four subcategories - Preparation for childbirth, Coming to childbirth, Perception of the accompaniment during childbirth by a woman, and Process of the fourth stage of childbirth. The last category is Communication with three subcategories - Behavior and communication of the accompaniment with a woman, Communication with staff and Behavior of staff. The research revealed that women I1 - I9 chose their partner as their 7 accompanying person and woman I10 chose a dula. For women, the partner is the closest person they want to experience the most important moments. Woman I10 chose the doula on the base of recommendation of her colleague. Furthermore, it was found that women perceived their accompaniment primarily as psychological support, which calms them verbally or by their presence, but women I1, I4 and I7 considered their partners as an auxiliary person who assisted them in the shower, in moving or giving things. All the women were ultimately satisfied with their choice, despite flaws such as playing on the phone or too much effort.
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