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Obstetrics, Gynecology, & Women's Health

Menstrual Problems of Women in Bangladesh

Menstrual Problems of Women in Bangladesh
Bangladeshi women suffer from menstrual problems such as dysmenorrhoea, menorrhagia, light and heavy bleeding during menstruation, and irregular period and are constantly worried if they menstrual flow is not a “normal” amount. They believe that a good menstrual flow is needed to stay healthy. If the flow decreases, they think that they’re must be “bad blood” trapped within their bodies, and if it stops altogether, they are concerned that they may have become infertile. Inability to conceive is viewed negatively in Bangladeshi society and women are subjected to psychological distress by society if they are perceived as infertile. Also, there are many social, cultural and religious taboos surrounding menstruation such as staying away from food such as fish, eggs, meat, sour fruits, etc during menstruation. Moreover, they are often advised to stay indoors as menstrual blood may attract evil spirits. Furthermore, these women also experience menstrual problems as side effects of contraceptives such as Norplant, IUD, and the pill, and sometimes discontinue its use as a result which may lead to unplanned pregnancies. Gynaecological problems such as those related to menstruation are a major concern among Bangladeshi women, but social stigma and shame stand as a barrier against seeking proper healthcare. Often, they seek health advice from female relatives and unqualified health providers which in turn often leads to incorrect treatment and chronic menstrual related illnesses. Only a few studies have been carried out on menstrual problems in Bangladesh and most of them are either part of larger studies on side effects of contraceptives or a few small-scale exploratory studies.

Prevention of Postpartum Hemorrhage at Home Birth in Afghanistan

Prevention of Postpartum Hemorrhage at Home Birth in Afghanistan
Objective: To test the safety, acceptability, feasibility, and effectiveness of community-based education and distribution of misoprostol for prevention of postpartum hemorrhage at home birth in Afghanistan. Methods: A nonrandomized experimental control design in rural Afghanistan. Results: A total of 3187 women participated: 2039 in the intervention group and 1148 in the control group. Of the 1421 women in the intervention group who took misoprostol, 100% correctly took it after birth, including 20 women with twin pregnancies. Adverse effect rates were unexpectedly lower in the intervention group than in the comparison group. Among women in the intervention group, 92% said they would use misoprostol in their next pregnancy. In the intervention area where community-based distribution ofmisoprostol was introduced, near-universal uterotonic coverage (92%) was achieved compared with 25% coverage in the control areas. Conclusion: In Afghanistan, communitybased education and distribution of misoprostol is safe, acceptable, feasible, and effective. This strategy should be considered for other countries where access to skilled attendance is limited.

Sponsored by the Afghanistan Higher Education Project and Kabul Medical University.
Sponsored by the Afghanistan Higher Education Project
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