<p>Until 1976, women in Alabama could choose to make use of a midwife when they gave birth. In that year, the Alabama state legislature outlawed the practice. This dissertation explores the consequences of that decision as well as the efforts of contemporary non-nurse midwives, also known as Certified Professional Midwives (CPM’s), to re-establish the practice as an option available to birthing women in the state.</p><p> In order to address the consequences of outlawing non-nurse midwives in the state of Alabama a mixed methodology approach is applied. Two years of ethnographic data collection approached with a feminist and cultural anthropology lens, reveal that the lack of medical infrastructure within the state of Alabama prohibits the ability for CPM’s to practice safely. This is owed to historically grounded stigma in racism and classism. As a result, the current CPM community within the state of Alabama, along with their clientele, is predominantly white. This is reflected in the case studies within the dissertation as all the families and care providers, regardless of clinical expertise, are all white. An examination of cesarean rates via quantitative analysis supports the historical and ethnographic findings. Cesarean rates are highest within counties that have a low median household income, and a population that is predominately African American.</p><p> The dissertation features five case studies of women who gave birth attended by a CPM. By relating the experiences of the birthing mothers, a CPM, and certified medical professionals, the dissertation offers evidence of the kind of supplemental medical care and knowledge that can be offered by practitioners of midwifery. At the same time, while contemporary midwives such as the one featured here offer important medical service to their clients, they are not equipped to or knowledgeable about political work necessary to push for the re-legalization of midwifery. This dissertation thus sheds light on the challenges facing midwives who would prefer to work openly and legally in the state.</p><p> Ultimately what is revealed is the value of supplementary healthcare networks within the state. While care and birth services provided by CPM’s is not readily accessible to all, those giving birth in Alabama can find support within the current system through supplementary healthcare networks. These networks include doulas, lactation support groups, babywearing groups, etc. It is a piecemeal system to be sure, but it is a piecemeal system that is working diligently to unlearn biases, and support women and birthing families. However, it is important to understand that the supplemental networks cannot fully address the larger structural crisis that is a lack of infrastructure within the state’s medical system. Ideally, a system that utilizes Obstetricians, Nurse Midwives, and Non-nurse Midwives, all with mutual respect for their own expertise, would exist to provide quality care to women throughout the state.</p>

Thesis (M. A. (Nursing)) -- University of Limpopo, 2021 / Indigenous practices are performances that occur naturally in a region or a growing living environment. Most women believe in indigenous practices because of their cultures and social structure. In South Africa regardless of the availability and accessibility of maternal and child health services, 50% of women were found that they still consult traditional birth attendants as their first choice during pregnancy, labour, delivery, and postnatal care. The purpose of the study was to determine the indigenous practices of women during pregnancy, labour and puerperium amongst cultural groupings at selected hospitals in Limpopo Province, South Africa. A Convergent parallel mixed method design was used in the study to collect both qualitative and quantitative data at the same time. Non-probability purposive sampling was used to select 15 participants and Probability simple random sampling was used to select 125 women who were pregnant, in labour and puerperium using slovin’s formula. Data were collected through a semi-structured interview with a guide for qualitative strand and a self-administered structured questionnaire for quantitative srtand. Data were analysed qualitatively using tech’s open coding method and quantitatively using Statistical Package for the Social Sciences (SPSS) Version 25 with the assistance of the University of Limpopo’s Bio-statistician. The results of the study showed that most women use indigeneous practices for protection against witchcraft, fear of giving birth in caesarian section and many other reasons.THPs and church leaders are regarded as the most principled people in their community. Indigenous women are aware of the sign and symptoms during pregnancy, labour, and puerperium which may determine consultation to healthcare practitioners, but they choose THPs and church leaders. Most women still rely on their religious beliefs to assist during their labour. Pregnant women, those in labour and puerperium should be supported to practice their religious beliefs and practices. THPs and church leaders are obliged to teach their clients and ensure that they know the names and components of the traditional medicines and church rituals they use.The nursing education should include indigenous practices in the curriculum so, that healthcare practitioners know about the indigenous practices and can serve as assistance in the training and development of health practitioners who continuously care for women during pregnancy, labour, and puerperium and as a result, may reduce maternal and child morbidity and mortality in Limpopo Province, South Africa.

Trots att det i sjukvården betraktas som normalt att föda barn vaginalt väljer en del kvinnor att föda sina barn med hjälp av kejsarsnitt utan att det föreligger någon medicinsk indikation, varken för mor eller barn (elektivt sectio). Den medicinska vetenskapen visar att det både är säkrare och bättre i de flesta fall att föda vaginalt, men antalet elektiva kejsarsnitt ökar årligen. Kunskap om vad som driver kvinnor att önska elektivt kejsarsnitt kan öka möjligheten att minska kejsarsnitt som görs utan medicinsk indikation. Kunskapen är viktig för barnmorskor som kan hjälpa gravida kvinnor att i högre grad välja att föda sitt barn vaginalt då det inte föreligger indikation för kejsarsnitt. Syftet med arbetet var att beskriva kvinnors önskan om att föda sitt barn med hjälp av  elektivt kejsarsnitt utan att det föreligger någon medicinsk indikation för kejsarsnitt. En litteraturstudie har genomförts där sökningar efter artiklar gjorts i databaserna PubMed, CINAHL och APA PsychInfo. Till studiens resultat har 20 vetenskapliga artiklar, både kvalitativa och kvantitativa artiklar använts. De publicerade studierna är genomförda i  olika länder, en del i höginkomstländer och en del i medelinkomstländer enligt måttet bruttonationalprodukt per person och år, vilken beskriver ett lands produktion utifrån dess befolkningsutveckling (BNP per capita). Samtliga artiklar är publicerade mellan åren 2009-2019, och är etiskt godkända.  Kvinnors anledning att önska elektivt kejsarsnitt utan medicinsk indikation sammanfattas i detta arbete med två övergripande teman: Vaginal förlossning ett hot och Kejsarsnitt garanterar hälsa och trygghet. Kvinnornas rädsla för vaginal förlossning var en framträdande anledning till att önska kejsarsnitt. Rädslan hade sitt ursprung i egna eller andras negativa erfarenheter av vaginal förlossning. Rädslan grundades också i en oro för att kvinnans utseende och hennes relation skulle påverkas av en vaginal förlossning. Önskan om kejsarsnitt utan medicinsk indikation grundades i en tro om att ingreppet skulle garantera hälsa och trygghet för mor och barn, något som vaginal förlossning inte kunde erbjuda.  Den mest framträdande anledningen till att kvinnor önskade kejsarsnitt utan medicinsk indikation var en intensiv rädsla för en vaginal förlossning. Kvinnorna hade uppfattningen att ett kejsarsnitt skulle garantera säkerhet för mor och barn. Det kan inte uteslutas att önskan om elektivt kejsarsnitt kan bero på brist på kunskap.  Det finns ytterligare behov av forskning på ämnet, förslagsvis på interventioner från sjukvården som fokuserar på att utbilda födande kvinnor om vinsterna med vaginal förlossning.

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Survey on maternal satisfaction in receiving spinal anesthesia for Cesarean section / A quantitative descriptive and cross-sectional study was conducted. The purpose of the study was to evaluate the maternal satisfaction after the experience of spinal anaesthesia for Caesarean section in one public hospital of Gauteng Province in South Africa. Data were collected by administering a questionnaire which included the demographic profile and satisfaction score in terms of perioperative elements to 82 women in their postoperative period. Analysis of data was performed by The Statistical Package for the Social Sciences (SPSS) version 13 and Excel 2010 was used for tabular and graphical illustrations. The findings revealed that the majority of women studied were black (95,1%), not married (73,2%) and unemployed (64,6%). The levels of maternal satisfaction in terms of intraoperative, postoperative and other perioperative elements were high, at 94,4%, 90,3% and 85,4% respectively. The lowest percentage (76,8%) was found for the maternal satisfaction about the preoperative explanation. The overall level of maternal satisfaction in this study was 86,7%. The majority of women (82,9%) would opt for spinal anaesthesia in future, while 6,1% would not accept it and 11,0% were not sure if they would opt for it or not. / Health Studies / M.A. (Public Health)

Survey on maternal satisfaction in receiving spinal anesthesia for Cesarean section / A quantitative descriptive and cross-sectional study was conducted. The purpose of the study was to evaluate the maternal satisfaction after the experience of spinal anaesthesia for Caesarean section in one public hospital of Gauteng Province in South Africa. Data were collected by administering a questionnaire which included the demographic profile and satisfaction score in terms of perioperative elements to 82 women in their postoperative period. Analysis of data was performed by The Statistical Package for the Social Sciences (SPSS) version 13 and Excel 2010 was used for tabular and graphical illustrations. The findings revealed that the majority of women studied were black (95,1%), not married (73,2%) and unemployed (64,6%). The levels of maternal satisfaction in terms of intraoperative, postoperative and other perioperative elements were high, at 94,4%, 90,3% and 85,4% respectively. The lowest percentage (76,8%) was found for the maternal satisfaction about the preoperative explanation. The overall level of maternal satisfaction in this study was 86,7%. The majority of women (82,9%) would opt for spinal anaesthesia in future, while 6,1% would not accept it and 11,0% were not sure if they would opt for it or not. / Health Studies / M. A. (Public Health)

Introdução - No Brasil mais da metade dos nascimentos ocorrem por meio de cesariana. As pacientes atendidas pelos planos e seguros saúde têm maior chance de passar por uma cirurgia. Embora seja um recurso que salva vidas, a cesárea sem indicação clínica acarreta riscos de saúde imediatos e de longo prazo. Objetivo - Analisar a regulação orientada à redução das cesarianas sem indicação clínica expedida pela Agência Nacional de Saúde Suplementar (ANS) através das Resoluções Normativas RN 368/2015, RN 387/2015 e RN 398/2016 da ANS. Esta tese é uma pesquisa qualitativa com base documental e entrevistas com representantes de entidades relevantes para a formulação de políticas de saúde materna e para a regulamentação dos planos e seguros de saúde. Resultados - Questões relacionadas à regulação das profissões, do modelo assistencial e da relação entre os agentes estão presentes nas causas do problema e não são suficientemente atendidas pelas resoluções normativas. Conclusão - A regulação da assistência obstétrica na saúde suplementar exige ação coordenada de agentes, instituições e entidades que atuam no mercado e na regulação dos planos de saúde, estabelecimentos hospitalares e profissões de saúde, de modo a promover o desenvolvimento de um plano de ação integrado / In Brazil, more then a half of childbirths are delivered by cesarean section. Healthcare insurance system\'s patients have a higher chance to experience surgery. Although an important resource to save lives, cesareans without clinical justifications may cause immediate and in long-term health risks. Objective - Analyse ANS obstetric regulation focused on reducing no clinical indicated cesareans as issued in RN 368/2015, RN 387/2015 and RN 398/2016. The present thesis is qualitative research based on documents and maternal health policies stakeholders interviews. Results - Professional rules and standards, the maternal health assistance model and the relationship between obstetric actors and entities are issues related to the problem causes and not efficiently developed and solved by ANS normative resolutions. Conclusion - Obstetric assistance regulation in Brazilian private health insurance and plans demands action by the Health Ministry coordinating all authorities responsible for healthcare plans, hospitals, and professionals in obstetric assistance as a means of developing an integrated solution plan

In the diploma thesis, objectives were set that were intended to find out medical, mental and social problems of women after complicated childbirth and to compare the problems with those of women after physiological childbirth. The other objective was to find out what kinds of complicated deliveries occur in Nemocnice Písek, a.s. /Písek Hospital/ the most. Hypotheses were set for the objectives. The first hypothesis was to confirm that birth injuries after complicated childbirth are healed per secundam. The second hypothesis was to confirm that women after complicated childbirth feel that they will not manage care for their family. The third hypothesis was to confirm problems with economic support of a family in the cases of single mothers after complicated childbirth. The fourth hypothesis was to confirm that women after complicated childbirth do not have enough information about social security. The fifth hypothesis was to confirm that in Písek Hospital, the most frequent complicated deliveries include Cesarean sections.

Le déclenchement du travail est une procédure obstétricale qui consiste à provoquer le travail afin que la femme puisse vivre un accouchement vaginal dans les 24 à 48 heures suivant l’initiation de la procédure (Leduc et al., 2013). Cependant, le déclenchement du travail peut ne pas fonctionner entraînant la nécessité de procéder à un accouchement par césarienne après un travail d’une durée de plus de 24 heures. Cette étude qualitative visait à explorer l’expérience de femmes qui ont vécu un échec du déclenchement du travail résultant en une césarienne non planifiée. Cette étude a été menée auprès de 6 femmes durant leur séjour hospitalier post-partum. Les données ont été obtenues à l’aide d’un questionnaire sociodémographique, du dossier médical des participantes et d’un entretien semi-dirigé. Les entretiens semi-dirigés ont été enregistrés, avec l’accord des participantes, puis transcrits et analysés selon l’approche d’analyse thématique de Braun, Clarke, Hayfield et Terry (2019). Cinq thèmes et 12 sous-thèmes ont émergé de l’analyse thématique permettant de mieux saisir l’expérience des femmes vivant un échec du déclenchement du travail résultant en une césarienne. Les thèmes : Les attentes envers l’expérience, Le soutien reçu, La qualité et quantité de l’information reçue ainsi que Le sentiment de contrôle envers l’expérience semblent influencer la satisfaction ou l’insatisfaction de la participante envers son expérience et contribuent au thème global de l’Expérience globale de l’échec du déclenchement du travail résultant en une césarienne. Les infirmières ont un rôle important afin de communiquer l’information aux patientes et de les soutenir quant au déclenchement du travail leur permettant de mieux gérer leurs attentes et exercer le contrôle désiré envers leur expérience. / Induction of labor is an obstetric procedure which consists of inducing labor so that women can experience a vaginal birth within 24 to 48 hours after the initiation of the procedure (Leduc et al., 2013). The induction of labor may not work resulting in the need for a caesarean delivery after lasting more than 24 hours. This qualitative study aimed to explore the experience of women who had experienced labor induction failure resulting in an unplanned caesarean section. This study was conducted with 6 women in the postpartum unit during their hospitalisation. Data were collected from a socio-demographic questionnaire, the participants’ medical chart as well as a semi-structured interview. After participants’ consent, the semi-structured interviews were recorded, transcribed, then analysed using the Braun, Clarke, Hayfield and Terry (2019) thematic analysis approach. Five themes and 12 sub-themes emerged to better capture the experience of women experiencing labor induction failure resulting in a caesarean. Four themes: Expectation of Labor and Delivery: Managing Expectations, Antepartum and Intrapartum Support Received, Comprehensive Information Needed, and Feeling in Control of the Experience emerged as influencing the participant's satisfaction or dissatisfaction towards their Global Experience of a Failed Induction of Labor Resulting in a Ceserean Section. Nurses have a strategic role and are key support professionals in communicating information and supporting women during induction of labor, allowing them to better manage their expectations and have the desired level of control over their experience.

<p>Uprkos op&scaron;te prihvaćenom stavu da u trudnoći lekove treba izbegavati, veliki broj trudnica tokom trudnoće uzima lekove sa manje ili vi&scaron;e opravdanja. Primena lekova u trudnoći zahteva dodatnu patnju, jer se mora voditi računa o zdravlju majke i zdravlju jo&scaron; nerođenog&nbsp; deteta. Većina lekova koji nalaze primenu u trudnoći, nisu ispitani u kontrolisanim studijama na trudnicama, već se njihov uticaj naljudski fetus, bazira na predpostavkama i kliničkim istraživanjima na životinjama. Odsustvo studija dovodi do toga da se trudnicama obično prepisuju lekovi u dozi za odrasle osobe, koje ne prate fiziolo&scaron;ke promene u trudnoći. Tokom trudnoće u telu trudnica dolazi do promena u funkciji organa i organskih sistema, a zbog nastalih promena menja se i sudbina leka u organizmu. Sistemske bolesti trudnice poput hipertenzije i dijabetesa dovode do hemodinamskih promena i utiču na nastanak patolo&scaron;kih promena posteljice, &scaron;to sve zajedno menja farmakokinetiku lekova i njihov transplacentrarni transport. Ukupno 75 trudnica je uključeno u studiju i podeljeno u tri grupe: zdrave trudnice-kontrolna grupa (n=31), trudnice sa hipertenzijom (n=30) i trudnice sa dijabetesom (n=14). Sve trudnice su u premedikaciji primile iste lekove koji su deo standardne kliničke&nbsp; procedure. Trudnice su primile jednu dozu diazepama intramuskularnom injekcijom (10mg/2ml), a intravenski su primile pojedinačne doze cefuroksima (1,5g), metoklopramida (10mg/2ml) i ranitidina (50mg/2ml). Od svakog para majka-dete ukupno je analizirano po 5 uzoraka. Uzorci krvi od majke uzimani su u tri vremenske tačke: nakon davanja leka, u momentu ekstrakcije deteta i nakon porođaja. Uzorci&nbsp; krvi&nbsp; deteta&nbsp; uzimani su&nbsp; nakon&nbsp; porođaja iz pupčane vene i arterije. Prikupljeni uzorci plazme analizirani su metodom tečne hromatografije visokih performansi (HPLC). Istraživanje je pokazalo da lekovi&nbsp; primenjeni u premedikaciji&nbsp; carskog reza prolaze transplacentarnu membranu i da se ni jedan&nbsp; od&nbsp; lekova&nbsp; primenjenih&nbsp; u studiji nije akumulirao u fetusu i nije imao neželjeno dejsvo na novorođenče. Cefuroksim, ranitidin i metoklopramid pokazali su nizak feto-maternalni transfer, dok je diazepam pokazao visok&nbsp; feto-maternalni transfer. Izmerene koncentracije cefuroksima u plazmi trudnica u momentu porođaja bile su &ge;8 &mu;g/ml, &scaron;to je koncentracija veća od MIC za većinu patogena odgovornih za nastavak infekcija u aku&scaron;erstvu. Koncentracije cefuroksima u fetalnoj plazmi bile su &ge;4&mu;g/ml &scaron;to je veće od&nbsp; MIC koncentracija za veliki broj patogena. Gestacijska starost trudnoće nije uticala na obim prolaska cefuroksima&nbsp; kroz placentu, koji je prolazi uglavnom pasivnom difuzijom. Farmakokinetski parametri cefuroksima razlikovali su se kod hipertenzivnih i dijabetičnih trudnica, u odnosu kontrolnu grupu, ali ove bolesti nisu imale značajan uticaj na smanjenje terapijske efikasnosti cefuroksima. Farmakokinetika cefuroksima kod hipertenzivnih&nbsp; trudnica&nbsp; ukazala je na bržu eliminaciju cefuroksima iz krvi majke i na veću distribuciju leka u okolna tkiva. U dijabetičnoj grupi trudnica i novorođenčadi koncentracije cefuroksima su bile vi&scaron;e u odnosu na druge ispitivane grupe, dok je feto-maternalni odnos bio niži, &scaron;to ukazuje na postojanje strukturalne i funkcionalne pomenu posteljice u dijabetesu. Hipertenzija i dijabetes trudnica nisu imali uticaj na prodor ranitidina kroz placentu. Hipertenzija i dijabetes trudnica nisu uticali na većinu farmakokinetskih parametara ranitidina, mada je zabeleženo smanjenje volumena distribucije u ovim grupama trudnica, &scaron;to bi moglo da ukazuje na njihovu hemodinamsku nestabilnost i povećanje slobodne frakcije ranitidina. Koncentracija metoklopramida bila veća u krvi majki u odnosu na krv fetusa. Transport metoklopramida iz fetusa ka majci bio je dominantniji, a naročito u hipertenzivnoj i dijabetičnoj grupi trudnica. Hipertenzija i dijabetes trudnica uticali su na zadržavanje metoklopramida u fetusu. Koncentracije dijazepama u majčinoj i fetalnoj krvi bile su vi&scaron;e u kontrolnoj i hipertenzivnoj grupi trudnica. Hipertenzija i dijabetes trudnica povećavaju&nbsp; transfer diazepama kroz placentu, povećanjem koncentracije slobodnih masnih kiselina, steroidnih hormona, smanjenjem vezivnog kapaciteta potencijalna opasnost od neželjenog dejstva diazepama i njegovih metabolita na fetus i novorođenče. Ova doktorska studija ukazuju na potrebu obimnijih farmakokinetskih istraživanja kako na zdravim tako i na bolesnim trudnicama, koja će dati zaključke utvrđene na dokazima i pomoći u individualnom terapijskom pristupu svakoj trudnici.</p> / <p>In spite of&nbsp; the widespread opinion&nbsp; that&nbsp; drugs should be avoided in pregnancy, a great number of&nbsp; pregnant&nbsp; women&nbsp; take drugs with more or less justification.&nbsp; Administration of drugs in pregnancy requires additional attention because the health of&nbsp; both the mother and&nbsp; her unborn child must be protected. Majority of drugs administered in pregnancy have not been tested&nbsp; within the controlled studies performed on pregnant women, but&nbsp; their effect on the human foetus is based on assumptions and clinical trials performed on animals. This absence of studies results in the situation that pregnant&nbsp; women are usually prescribed drugs in a dose&nbsp; for adults, which does not take into account the physiological changes happening in pregnancy. During pregnancy, the pregnant woman&rsquo;s body undergoes changes in the<br />functions of organs and organ systems. These changes further affect the destiny of a&nbsp; drug in the organism. In pregnant women, systemic diseases such as hypertension&nbsp;&nbsp; and diabetes mellitus lead to hemodynamic changes and cause pathological&nbsp; changes in placenta, thus changing the pharmacokinetics of drugs and their transplacental transport. The study sample consisted of 75 pregnant women, who were divided into three groups as follows: the control group included healthy pregnant&nbsp; women (n=31), a group of pregnant women&nbsp; with&nbsp; hypertension (n=30) and&nbsp; a group of&nbsp; those&nbsp; with&nbsp; diabetes mellitus (n=14). All of them were administered the same drugs as a part of standard clinical procedure in premedication. The pregnant women received a single dose of diazepam by intramuscular injection (10mg/ml), and individual doses of cefuroxime (1.5mg), metoclopramide (10mg/2ml) and ranitidine (50mg/2ml). Five samples taken from each mother-infant pair were analyzed. Blood samples were taken from the mother three times: after drug administration, at the moment of extraction of baby and after delivery. Baby&rsquo;s blood samples were taken from the umbilical cord vein and artery after delivery. Plasma samples were analyzed by the method of high-performance liquid chromatography (HPLC). The research has shown that drugs administered in premedication of caesarean section went through the transplacental membrane and that none of the tested drugs accumulated in the foetus and had an adverse effect on the newborn. Cefuroxime, ranitidine and metoclopramide were shown to have a low transfer between the mother and her foetus, whereas diazepam showed a high foetal-maternal transfer. Cefuroxime concentrations measured in the pregnant woman&rsquo;s and foetal plasma at the moment of delivery were &ge;8&mu;g/ml and &ge;4&mu;g/ml, respectively, that&nbsp; being above the minimum inhibitory concentration (MIC) for most pathogens responsible for the development of infection in obstetrics. Gestational age had no effect on the range of cefuroxime flow through the placenta, which happens mostly by&nbsp; passive diffusion. Pharmacokinetic parameters of cefuroxime differed in the pregnant&nbsp; women having hypertension and diabetes mellitus from the controls; however, these diseases did not significantly reduce the therapeutic efficacy of cefuroxime. Pharmacokinetics of cefuroxime indicated faster elimination of&nbsp; cefuroxime into the maternal blood and greater distribution of the drug into the surrounding tissues in the hypertensive pregnant women. In the group consisting of pregnant women and newborns having diabetes, the cefuroxime concentrations were higher than in other groups, whereas foetal-maternal relation was lower, which suggests the presence of structural and functional change in the placenta in diabetes. Hypertension and diabetes mellitus had no affect either on the flow of ranitidine through the placenta in the pregnant women or on&nbsp; the&nbsp; majority of pharmacokinetic parameters of ranitidine, although a certain reduction in the volume&nbsp; of distribution was recorded in these groups of pregnant women, which could suggest their hemodynamic instability and increased free fractions of ranitidine. The concentration of metocloporamide was higher in the maternal blood than in the&nbsp; foetal blood, and&nbsp; the transport of metocloporamide from the foetus towards the mother was more dominant, particularly in&nbsp; the&nbsp; group of&nbsp; hypertensive and diabetic&nbsp;&nbsp;&nbsp; pregnant women. Metoclopramide tended to retain in the foetuses of mothers having&nbsp; hypertension and diabetes. The concentrations of diazepam in maternal and foetal blood were higher in the controls&nbsp; and hypertensive&nbsp; pregnant&nbsp; women. Hypertension and diabetes in pregnant&nbsp; women increase the transfer of diazepam through the placenta by increasing the concentration of free fatty acids and steroid hormones and by reducing the binding capacity of carrier proteins and the concentration of plasma&nbsp;&nbsp; proteins, thus increasing the potential danger of adverse effects of diazepam and its metabolites on the foetus and the newborn. This doctoral study suggests the necessity for more extensive pharmacokinetic research including both healthy and affected pregnant women that would lead to conclusions based on evidence and help to develop individual therapeutic approach to each pregnant woman.</p>