Background: A considerable amount of research demonstrates how breastfeeding self-efficacy significantly influences breastfeeding outcomes. The aim of this study was to evaluate the role of nursing intervention on mother's breastfeeding self-efficacy. Methods: In this experimental investigation, 130 pregnant women who attended a primary health care centre were randomly assigned to the experimental (n = 65) or control (n = 65) groups. The experimental group received two 60-90 min group breastfeeding educational sessions based on the breastfeeding self-efficacy theory along with routine care. Mothers' knowledge, attitudes, prenatal and postnatal self-efficacy towards the breastfeeding were compared between both groups. The Iowa Infant Feeding Attitude Scale measured the attitudes. Prenatal Breastfeeding Self-Efficacy Scale measured the self-efficacy during pregnancy and Breastfeeding Self-Efficacy-Short Form measured the self-efficacy in postnatal period. Results: Breastfeeding self-efficacy during pregnancy and following two months of delivery in the experimental group was significantly higher. The experimental group had a higher level of knowledge and attitude in comparison with subjects in the control group. In addition, the mothers who breastfed exclusively had higher levels of postnatal selfefficacy in both experimental and control groups compared to formula feeding women (52.00 vs. 39.45 in the control and 57.69 vs. 36.00 in the experimental subjects; P < 0.001). Conclusion: The present investigation suggests that antenatal breastfeeding education is an effective way to increase the level of breastfeeding self-efficacy, which increases exclusive breastfeeding practice.

Background Female genital mutilation (FGM) is prevalent in Iraqi Kurdistan Region, but there is a lack of adequate knowledge about how the practice is perceived by the women population who are the direct victims of the practice. This study aimed to assess the knowledge, beliefs, and attitude of a sample of Kurdish women of FGM and identify the main enabling factors for performing this practice and the barriers to ending it. Methods This qualitative study was based on six focus groups involving a sample of 51 women. We used a topic guide to lead discussions, which included questions on women’s perspectives of different aspects of FGM such as the reasons for practicing it, the positive and negative consequences, the continuation of the practice and tackling this problem in the community. Content analysis was used for the qualitative analysis of the data. Results The women had poor knowledge about different aspects of FGM particularly concerning the procedure and the consequences. The mutilated participants revealed the devastating experience of the pain and the psychological effects they have experienced. Reducing sexual desire, having halal (permissible by Allah ) hands, and religious requirement were the main reasons for practicing FGM. Reduction in women’s sexual desire and the related social problems with the husband were the main problems identified to be associated with FGM. Most women did not support the continuation of FGM practice, but some women still think that FGM should be left to the people’s preference. The participants identified raising people’s awareness, active involvement of religious leaders in prevention efforts and the issuance and enforcement of legislation against FGM as the primary measures to reduce FGM practice. Conclusion Passing through FGM at childhood is an overwhelming experience with long-term effects for women. There is still a significant segment among the women population that do not oppose the continuations of FGM and need religious and scientific evidence against FGM. Some reasons for practicing FGM are deeply embedded in the culture and traditions, and there is a need for extensive efforts to raise the awareness of the population and change their thoughts and behavior about FGM. Electronic supplementary material The online version of this article (10.1186/s12905-019-0765-7) contains supplementary material, which is available to authorized users.

Background There are controversies over the effects of Ramadan fasting on pregnancy outcomes, and women’s perspectives of fasting are diverse. This study aimed to assess the perspectives and pregnancy outcomes of maternal Ramadan fasting in the second trimester of pregnancy. Methods A case-control study was conducted at Hawler Maternity Teaching Hospital of Erbil, Iraq from October 2017 to January 2018. Out of 301 participating women, 155 fasted during the second trimester of their current pregnancy, while the remaining 146 did not. Mothers were asked concerning their fasting behaviors and perception of fasting during pregnancy. The main outcomes of this study were gestational diabetes, preterm labour, preeclampsia, low birth weight, Apgar score, height, weight, and head circumference of the newborn. Results About 80% of the women in the fasting group fasted for 21–29 days during Ramadan, out of whom 38.7% completed fasting for the entire Ramadan period. The results revealed that the decision to fast during pregnancy was negatively associated with the mother’s educational level and occupation. Weight gain during pregnancy in the fasting women was approximately 0.4 kg less than those who did not fast. The incidence of gestational diabetes was 2.6% in the fasting women, while it was 8.3% in the non-fasting mothers ( P = 0.02). Regression analysis showed that women who did not fast during the second trimester of pregnancy were 1.51 times more likely to develop gestational diabetes [odd ratio (OR) 1.51; 95% confidence intervals (CI) 0.06, 0.74, P = 0.01]. It was also found that among the women in the fasting categories, those who fasted for 21–29 days during pregnancy had a lower risk of gestational diabetes compared to the other groups. More than half of the mothers in the fasting group (60%) perceived that fasting during pregnancy was compulsory for healthy and non-healthy women, comparing with those who did not fast. Conclusion It was found that fasting during the second trimester of the pregnancy decreased the risk of gestational diabetes and excessive weight gain during pregnancy. Most of Iraqi women did not fully recognize their right to be exempted from fasting during pregnancy by the Islamic law. Electronic supplementary material The online version of this article (10.1186/s12884-019-2275-x) contains supplementary material, which is available to authorized users.

BackgroundUnderstanding women’s experiences and perspectives of antenatal care services is particularly critical for enhancing effectiveness of services delivery and addressing women’s needs and expectations. As part of a comprehensive assessment of the maternity care services in Iraq, this study aimed to explore the views and experiences of antenatal care in a sample of women.MethodsThis explorative study was conducted in Erbil governorate, Iraq. Data were collected using Q methodology, a technique for eliciting subjective views and identifying shared patterns among individuals. A sample of 38 women of different educational and socioeconomic statuses were invited to sort a set of 39 statements reflecting different aspects of the available antenatal care services and issues related to their last pregnancies into a distribution on a scale of nine from “disagree most” to “agree most”. By-person factor analysis was used to derive latent views through centroid factor extraction and varimax rotation of factors.ResultsAnalysis of the participants’ Q sorts resulted in identifying four distinct views and experiences of pregnancy and antenatal care services: (i) public maternity services second best: preference for, and ability to afford, private care, (ii) dissatisfaction with public maternity services: poor information sharing and lack of health promotion, (iii) satisfaction with public maternity service but information gaps perceived and (iv) public maternity services second best: preference for private care but unaffordable. The typical characterizations that were associated with each view were highlighted.ConclusionsThis study revealed different patterns of views and experiences of women of pregnancy and antenatal care services and recognized the particular issues related to each pattern. Different patterns and types of problems and concerns related mainly to inadequate provision of information and poor interpersonal communication, poor utilization of public services and a general preference to use private services were identified in the different groups of women.

The Kurdish version of the EPDS can be successfully used to screen depression in a Kurdish population of puerperal women.