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      Nine centuries waiting: The experiences of Iranians surrogacy commissioning mothers

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          Abstract

          Background:

          There are a few studies about commissioning mothers’ understanding from the surrogacy during 9 months of waiting for delivery in Iran and other countries. This study was conducted with an aim to explore and explain the nature of concerns (experiences) of commissioning mothers.

          Materials and Methods:

          A qualitative design with a conventional content analysis approach was used to gather and analyze the experiences of commissioning mothers. They were selected from Royan Research Centre and other infertility centers in Iran. After purposive sampling for the selection of the participants, unstructured interviews were held for data collection. Twenty-four unstructured interviews were conducted with 12 commissioning mothers, 2 surrogate mothers, and 2 infertility center social workers who directly and continuously dealt with these mothers.

          Results:

          Two main themes emerged from the data analysis: 1. cultural dilemma (consisting of three subthemes: Social taboo, concerns about disclosure to others and the child, concerns about altering maternal and child's identity, and 2. uncertain waiting (consisting of three subthemes: Concerns about health of fetus and surrogate, concerns about an unfamiliar surrogate, and concerns about lack of preparation for maternal role).

          Conclusions:

          The study reveals the importance of maternal emotional care in this group and introduces a new arena for nurses’ activity. These findings help the mothers by nurses’ activities in health care clinics and anywhere they deliver nursing care.

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          Most cited references40

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          A national study of the prevalence and correlates of domestic violence among women in India.

          This article estimates the national prevalence rate of domestic violence in India and examines the demographic and socioeconomic status of the victims of domestic violence. The study used the Indian National Family Health Survey 3, a cross-sectional national survey of 124 385 ever-married women of reproductive age from all the 29 member states. χ(2) Analysis and logistic regression were used. Lifetime experiences of violence among respondents were as follows: emotional violence, 14%; less severe physical violence, 31%; severe physical violence, 10%; and sexual violence, 8%. Women of scheduled castes and Muslim religion were most often exposed to domestic violence. Women's poorer economic background, working status, and husband's controlling behavior emerged as strong predictors for domestic violence in India. Elimination of structural inequalities inherent in the indigenous oppressive institutions of religion, caste, and the traditional male hierarchy in society could prevent domestic violence.
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            Psychological and social aspects of pregnancy, childbirth and early parenting after assisted conception: a systematic review.

            It is known that infertility affects emotional well-being, satisfaction with life and self-esteem and that failed assisted reproductive technology (ART) treatment is associated with diminished life satisfaction, reduced self-confidence and substantial psychological distress. Investigations of whether these persist when treatment results in a pregnancy and live birth have been undertaken. A systematic search for English-language research articles on psychological and social aspects of pregnancy, childbirth and the first post-partum year after ART conception. Of 466 retrieved papers, 46 met inclusion criteria. These reported data from 28 studies. There is consistent evidence that marital satisfaction, emotional well-being and self-regard in pregnancy, attachment to the fetus and parent-infant relationship in ART groups are similar to comparison groups. Anxiety about the survival of the fetus and early parenting difficulties appear to be higher and post-natal self-confidence lower. Evidence about adjustment to pregnancy and parenthood and the experience of childbirth is inconclusive and reports of parental perceptions of infant temperament and behaviour are contradictory. Between-study methodological differences may explain the lack of consistency in findings of the influence of infertility and ART on some aspects of the transition to parenthood. Overall, this body of evidence is best described as emergent. It is possible that in pregnancy after ART, parenthood might be idealized and this might then hinder adjustment and the development of a confident parental identity.
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              Prevalence of primary infertility in the Islamic Republic of Iran in 2004-2005.

              This study aimed to determine the prevalence of lifetime and current primary infertility in Iran. The study was conducted in 2004-5 in all the 28 provinces of Iran. A cluster sampling method was used to select 10 783 women aged 19 to 49 years for the survey. Lifetime primary infertility was defined based on 1 of 2 contraception scenarios immediately after marriage to find experience of infertility despite 1 year of unprotected intercourse. The term "current primary infertility" designated a woman who, in addition to meeting the definition of lifetime infertility, had been unable to conceive up to the study time. A complex sampling design and SVY commands in the software package STATA 8.0 were used to derive 95% confidence intervals. A history of lifetime primary infertility was present in 24.9% of the subjects (95% CI: 23.5-26.2), and the prevalence of current primary infertility was 3.4% (95% CI: 3.0-3.8). As for age trends in lifetime primary infertility, the highest prevalence rates were observed in individuals with the lowest age at marriage. Minimum prevalence (17.2%) occurred with marriage age of 21 to 26 years, and the rates rose with higher age at marriage. About one fourth of the Iranian couples experience primary infertility at some point in their lives and 3.4% suffer from this problem at any time. For a correct interpretation of prevalence rates and the implications in terms of health care and service delivery, factors such as age at marriage and the couple's fertility potential must be taken into consideration.
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                Author and article information

                Journal
                Iran J Nurs Midwifery Res
                Iran J Nurs Midwifery Res
                IJNMR
                Iranian Journal of Nursing and Midwifery Research
                Medknow Publications & Media Pvt Ltd (India )
                1735-9066
                2228-5504
                May-Jun 2014
                : 19
                : 3
                : 224-232
                Affiliations
                [1 ]Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
                [2 ]Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
                Author notes
                Address for correspondence: Dr. Zohreh Vanaki, Department or Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. E-mail: vanaki_z@ 123456modares.ac.ir Dr. Marziyeh Shiva, Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran. E-mail: shivamarzieh@ 123456yahoo.com
                Article
                IJNMR-19-224
                4061620
                24949058
                7cd3d8c8-79e6-4098-881c-520ae6c19401
                Copyright: © Iranian Journal of Nursing and Midwifery Research

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Original Article

                Nursing
                iran,nursing,reproductive techniques,surrogacy
                Nursing
                iran, nursing, reproductive techniques, surrogacy

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