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Introduction: Diagnosing parturients in risk of cesarean section early in the beginning of active phase of labor, is very important. This may let take necessary action to accelernate labor (delivery) and prevent maternal mortality and morbidity due to late cesarean section. Materials and Methods: During a period of 8 months from July 2004 to March 2005, 216 primiparous women, with term pregnancy and cephalic single fetus, referred to Imam Reza hospital in (during) active phase of labor, were studied. Changes of cervical dilatation and descent of the conceptus were observed. Parturients were devided to two groups, vaginal delivery and cesurean section. Protraction or arrest disorders were the indications of cesarean deliveries. Findings were analysed through using T-Test, unilateral variance and Chi square test. Results: The more changes in cervical dilatation in the first 2 hours of active phase of labor, the less possibility of cesarean delivery (p<0.001). Also the more rate of the conceptus descent in the first 2 hours of active phase of labor, the less rate of cesarean section (p<0.001). There was no significant statistical relationship between condition of membranes at the onset of active labor and method of delivery, however there was a significant relationship between oxytocin augmentation and method of delivery (p<0.001). Conclusion: In primiparous women with term pregnancy, vaginal delivery would be fairly predictable by observing changes of cervical dilatation and conceptus descent during the first 2 hours of active phase of labor.

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Background: There has been an increase in the number of women willing to have a caesarean birth because of their fear of childbirth. It seems the childbirth preparation educational class is a good way to remove or alleviate fears associated with pregnancy and childbirth.This research designed to identify the effect of childbirth preparation classes on childbirth fear on the primiparous women. Methods and Materials: The present study is a clinical trial which was carried out in 2007 at Milad Hospital, with 100 nulliparous pregnant women. Childbirth fear was measured by childbirth attitudes questionnaire. Normal pregnant women in the second trimester with childbirth fear score was 28 or more were randomly selected and dirided into experimental and control group with 50 subject in each qroup. The experimental group attended nine childbirth preparation class sessions and control group received routine antennal care. Results: The mean scored fear of childbirth in case and control group were 39.35±6.96 and 40.71±6.23 respectively. There was not significant difference between two groups. After the sessions, comparing childbirth fear score between two groups in third trimester showed the mean score of childbirth fear among experimental group was lower than control group (29.82+/- 7.18 compare to 38.03+/-9.27), and the differences statistically was significant (p<0.001). Mode of delivery was significantly different between the two groups. Conclusion: Primiparous women attended childbirth preparation classes acquired lower score of childbirth fear in compare to women received routine prenatal care. The results of this research showed relaxation training decreased childbirth fear and increased normal vaginal delivery.

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Introduction: The postpartum period is a dangerous potential time for postpartum depression. Postpartum depression is the reducer instrument for postpartum support. The purpose of the current study is to determine the effectiveness of postpartum supports on the postnatal women depression after childbirth.
Methods: This study a semi experimental study was conducted in Marand hospital. Two hundred sixty mothers agreed to take part and were randomly allocated to an intervention group
(n = 130) or control group (n = 130). The intervention group received telephone counseling for 20- minute at the first week twice, second week till 6^th weeks once at week plus routine care. The control group received only the routine care. Also for evaluation of the unanticipated mother’s needs, 24-hour telephone access to researcher was provided. The main outcome measure was recording demographics data sheet, postpartum problem’s checklist and the Edinburgh Postnatal Depression Scale (EPDS) administered by presence interview questionnaire at six weeks after delivery. Control group received general postpartum education. The data were analyzed by χ², Fisher test and T test.
Results: At 6 week postpartum, mean of depression was obtained in the intervention group (15/80 ± 5/12) and in the control group (18/43 ± 5/90). On the EPDS scale, in the intervention group was significantly decrease to control group (P < 0.0001).
Conclusions: The result of this research showed that Postpartum Fallow Up by midwife could effective to decrease women’s postpartum depression in the pureperium.