BACKGROUND

Despite policies promoting facility births, home deliveries attended by traditional birth attendants (TBAs/hilot) persist in rural Philippines. We examined determinants of home delivery and the continuing role of TBAs in Palawan.

We used a convergent mixed-methods design: a survey of 48 postpartum mothers and 48 in-depth interviews (45–90 minutes). The survey captured socio-demographics, delivery histories, and preferences; interviews explored decision-making, experiences with TBAs and facilities, and barriers to care. Descriptive statistics summarized quantitative patterns; inductive thematic analysis generated qualitative themes. Findings were integrated via a joint-display matrix to produce meta-inferences.

Respondents reported 141 lifetime deliveries; 85.8% (121/141) occurred at home and 81.0% (98/121) of home births were TBA-attended. Three-quarters lived >1 km from the nearest facility, and 89.6% had monthly household income below the provincial poverty threshold. Over half (54.2%) planned their most recent birth at home and 81.3% intended to deliver at home again. Qualitatively, mothers valued TBAs' accessibility, flexible/low payment, and relational care. Facilities were associated with indirect costs, distance, scolding, invasive procedures, and loss of dignity; decisions were commonly joint with partners/elders, reflecting relational autonomy.

Home birth in Palawan represents a constrained preference shaped by structural barriers (poverty, distance), cultural trust in TBAs, and relational decision-making. Safety messaging alone is insufficient without respectful, affordable, and accessible facility care. Policy actions should: (1) reduce non-fee costs (transport/food; maternity waiting homes), (2) institutionalize Respectful Maternity Care, and (3) integrate TBAs as trained community referral partners within UHC.

Sacrococcygeal teratoma is one of the most common pediatric tumors. In contrast, its highly developed variant known as Fetiform Teratoma is an extremely rare elusive subtype with overall incidence of 0.01% and reported in only 35 cases worldwide.

This is a case report of a large sacrococcygeal fetiform teratoma in a 3-year-old female from the Philippines seen at the Outpatient Department presenting with history of sacrococcygeal mass initially noted since birth. Work-ups revealed normal tumor markers and a large multi-lobulated, heterogenous and hypervascular Altmann type I sacrococcygeal teratoma on imaging. Preoperative endovascular angioembolization with subsequent En Bloc Excision and coccygectomy was performed. The tumor was confirmed to be fully excised, and no malignant or immature features were found on histopathological examination. Early diagnosis, meticulous preoperative preparation, complete surgical excision, involvement of multidisciplinary team, active surveillance and long-term follow-up are key in the management of sacrococcygeal tumors. Utilization of preoperative endovascular angioembolization is an innovative, safe, feasible, and beneficial in minimizing perioperative blood loss and improving outcomes for large pediatric sacrococcygeal tumors.

Lymphangioma is a rare developmental anomaly of the lymphatic system, commonly arising at birth, in infancy, or early childhood. Treatment is rarely curative. We report a case of macrocystic lymphangioma treated with sildenafil in a 16-year-old Filipino child diagnosed clinically, radiologically and histologically. The patient presented with grouped papulovesicles on the left lower extremity, associated with limb length discrepancy, unilateral leg pain and difficulty in ambulation. Given the recurrent course of this condition, even with surgical management, the use of a non-invasive approach such as sildenafil as a potential treatment option for lymphangioma is an important emerging area of study.

The options for prenatal genetic testing have evolved rapidly in the past decade, and advances in sequencing technology now allow genetic diagnoses to be made down to the single-base-pair level, even before the birth of the child. This offers women the opportunity to obtain information regarding the foetus, thereby empowering them to make informed decisions about their pregnancy. As genetic testing becomes increasingly available to women, clinician knowledge and awareness of the options available to women is of great importance. Additionally, comprehensive pretest and posttest genetic counselling about the advantages, pitfalls and limitations of genetic testing should be provided to all women. This review article aims to cover the range of genetic tests currently available in prenatal screening and diagnosis, their current applications and limitations in clinical practice as well as what the future holds for prenatal genetics.
Child ; Pregnancy ; Female ; Humans ; Prenatal Diagnosis ; Knowledge ; Parturition

Pregnancy ; Female ; Humans ; COVID-19/epidemiology* ; Singapore ; Telemedicine ; SARS-CoV-2 ; Parturition

Objective: This research aims to unravel the local knowledge, practices, and experiences of care during pregnancy and childbirth in one community in Batangas. Methods: Qualitative interviews with two hilots and a mother, two focus group discussions with mothers from different generations, and indigenous research methods – pakikipagkwentuhan (story-telling or informal discussions with the locals) and pagmamasid (observations of the local practices in the community) were used in this ethnographic study. The data gathered through these methods were analyzed using an interpretive approach. Results: Data showed that knowledge and practices related to pregnancy and childbirth which were viewed as rituals remain to be significant in the community because they are sources of psychological support in a highly intimate situation. These practices also help in creating a feeling of security and safety during this very uncertain period. The data also showed the different ways of making sense of risks associated with pregnancy and childbirth and this affects the decisions made by mothers, midwives and hilots during birthing. Lastly, we saw the effects of the implementation of the no home birthing policy on the hilots and the life and well-being of the pregnant women in the community. Conclusions Local practices of care during pregnancy and childbirth remain significant today because these cater to the overall well-being of women giving birth. For these women, the implementation of the no home birthing policy that changed the status of the hilots (TBAs) in the community does not address the real issues on maternal healthcare. For them, the government should have focused on continuing to address the structural and institutional problems that they have encountered in their experiences of birthing. This can be done by providing more facilities that would readily cater to the needs of birthing women and by creating a more holistic healthcare system.
Pregnancy ; Parturition ; Midwifery

OBJECTIVE: This study estimated the effects of weekend and off-hour childbirth and the size of perinatal medical care center on the incidence of cerebral palsy. METHODS: The cases were all children with severe cerebral palsy born in Japan from 2009 to 2012 whose data were stored at the Japan Obstetric Compensation System for Cerebral Palsy database, a nationally representative database. The inclusion criteria were the following: neonates born between January 2009 and December 2012 who had a birth weight of at least 2000 g and gestational age of at least 33 weeks and who had severe disability resulting from cerebral palsy independent of congenital causes or factors during the neonatal period or thereafter. Study participants were restricted to singletons and controls without report of death, scheduled cesarean section, or ambulance transportation. The controls were newborns, randomly selected by year and type of delivery (normal spontaneous delivery without cesarean section and emergency cesarean section) using a 1:10 case to control ratio sampled from the nationwide Japan Society of Obstetrics and Gynecology database. RESULTS: A total of 90 cerebral palsy cases and 900 controls having normal spontaneous delivery without cesarean section were selected, as were 92 cerebral palsy cases and 920 controls with emergent cesarean section. A significantly higher risk for cerebral palsy was found among cases that underwent emergent cesarean section on weekends (odds ratio [OR] 1.72, 95% confidence interval [CI] 1.06-2.81) and during the night shift (OR 2.29, 95% CI 1.30-4.02). No significant risk was found among normal spontaneous deliveries on weekends (OR 1.63, 95% CI 0.97-2.73) or during the quasi-night shift (OR 1.26, 95% CI 0.70-2.27). Regional perinatal care centers showed significantly higher risk for cerebral palsy in both emergent cesarean section (OR 2.35, 95% CI 1.47-3.77) and normal spontaneous delivery (OR 2.92, 95% CI 1.76-4.84). CONCLUSION Labor on weekends, during the night shift, and at regional perinatal medical care centers was associated with significantly elevated risk for cerebral palsy in emergency cesarean section.
Case-Control Studies ; Cerebral Palsy ; epidemiology ; etiology ; Delivery, Obstetric ; statistics & numerical data ; Health Facilities ; statistics & numerical data ; Humans ; Incidence ; Infant, Newborn ; Japan ; epidemiology ; Parturition ; Perinatal Care ; statistics & numerical data ; Retrospective Studies ; Time Factors

childbirth, and puerperium outcomes (PCPOs) in female firefighters.METHODS: The present study compared hospital admissions for PCPOs, based on 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) codes, among Korean female firefighters with those of the general Korean population. Standardized admission ratios (SARs) and their 95% confidence intervals (CIs) were calculated.RESULTS: The study population included 1,766 female firefighters. Total follow-up duration was 9,659 person-years. Compared to the general female population, the female firefighters' SARs were higher in all admissions for PCPOs (SAR, 1.92; 95% CI: 1.79–2.05); pregnancy and abortive outcomes (SAR, 1.56; 95% CI: 1.12–2.12); other maternal disorders predominantly related to pregnancy (SAR, 2.65; 95% CI: 1.99–3.46); maternal care related to the fetus, amniotic cavity, and possible delivery problems (SAR, 2.13; 95% CI: 1.74–2.57); labor and delivery complications (SAR, 1.55; 95% CI: 1.15–2.06); delivery (SAR, 1.94; 95% CI: 1.80–2.08); and complications predominantly related to puerperium (SAR, 4.68; 95% CI: 2.02–9.23).CONCLUSION: The results of this study showed high SARs in all and specific subcategories of PCPOs in female firefighters.]]>
Female ; Fetus ; Firefighters ; Follow-Up Studies ; Humans ; International Classification of Diseases ; Korea ; Parturition ; Postpartum Period ; Pregnancy ; Reproductive Health

birth weight, birth height, and birth head circumference were also determined as the pregnancy-outcomes. There was a significant association between total iron consumption and infant head circumference (p = 0.01). Total maternal iron (the sum of heme and non-heme iron) was negatively associated with both infant's birth height (p = 0.006) and birth weight (p = 0.02). Non-heme iron consumption is positively associated with high-risk of IUGR (p = 0.004). Heme intake was associated with an increased risk of maternal fasting blood sugar (FBS) (p = 0.04). Higher heme, non-heme, and total iron intake were associated with lower risk of pre-eclampsia (heme: crude p = 0.05; non-heme iron: adjusted p = 0.02; total iron: adjusted p = 0.05). Maternal total iron intake was directly associated with infant head circumference, whereas, negatively associated with both birth weight and birth height. High non-heme iron intake may increase the risk of IUGR, and a high intake of heme iron may increase FBS.]]>
Birth Weight ; Blood Glucose ; Diabetes, Gestational ; Fasting ; Female ; Fetal Growth Retardation ; Head ; Heme ; Humans ; Hypertension, Pregnancy-Induced ; Infant ; Iran ; Iron ; Iron, Dietary ; Nausea ; Parturition ; Pre-Eclampsia ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, First ; Pregnancy ; Pregnant Women ; Prospective Studies ; Vomiting

birth year. The HBV co-infection prevalence rate was the highest (8.8%) in patients born between 1960 and 1964 and the lowest (0%) among those born between 1995 and 1999. A decreasing linear trend of HBV co-infection rate was observed according to the 5-year interval changes. HBsAb-positive rate was only 58.1% in our study. The national HBV vaccination programs have effectively lowered the HBV co-infection rate in HIV population. However, it is identified that the HIV population has low HBsAb positive rate. Further evidences supporting efficacy of booster immunization for HBsAb negative HIV patients are required and efforts should be made to increase HBsAb positive rates among HIV patients to prevent horizontal transmission.]]>
Cohort Studies ; Coinfection ; Hepatitis B virus ; HIV Infections ; HIV ; Humans ; Immunization, Secondary ; Korea ; Parturition ; Prevalence ; Vaccination