Tesis: "Postnatal care"

1

Healy, Maria Isobel. "Rethinking postnatal care : a Heideggerian hermeneutic phenomenological study of postnatal care in Ireland." Thesis, University of Central Lancashire, 2012. http://clok.uclan.ac.uk/6654/.

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The postnatal period is an important and extremely vulnerable time for new mothers and their infants. Research has outlined the considerable extent of maternal physiological and psychological morbidity following childbirth. The underreporting and undiagnosed aspect of this morbidity has also been highlighted. Newborn infants are totally dependent on their needs being met and are also at risk of newborn conditions particularly if they are undiagnosed, for example neonatal jaundice. There is however, mounting evidence regarding the lack of postnatal support from health professionals, with women continuing to report their dissatisfaction with postnatal care. Research into postnatal care is pre-dominantly quantitative and clinically focused. Few empirical studies have examined the meaning women give to their postnatal care experiences. This research aims to generate a deeper understanding of the meanings, and lived experiences of postnatal care. In addition, it aims to reveal future possibilities to enhance women’s postnatal care experiences. Initially, an in-depth examination of relevant literature is undertaken followed by a presentation of the process and findings from a qualitative meta-synthesis. An in-depth exploration of Martin Heidegger’s biography and explication of his philosophy is then outlined. This research is a Heideggerian hermeneutical phenomenological study of Irish women’s aspirations for, and experiences of, postnatal care. Purposive sampling is utilised in this research, which was undertaken in two phases. Phase one involved group interviews over three different time periods (between 28-38 weeks gestation, 2-8 weeks and 3-4 months postnatally), with a cohort of primigravid women and a cohort of multigravid women. The second phase involved recruiting two further cohorts of primigravid and multigravid women who participated in individual in-depth interviews over the same longitudinal period. In total nineteen women completed the study. Thirty-three interviews were held in total. The data analysis is guided by Crist and Tanner’s (2003) interpretative hermeneutic framework. The women’s aspirations/expectations for their postnatal care are represented through three interpretive themes: ‘Presencing’, ‘Breastfeeding help and support’ and ‘Dispirited perception of postnatal care’. In addition, five main themes emerged from the data and capture the meanings the women gave to their lived experiences of postnatal care: ‘Becoming Family’, ‘Seen or not seen’, ‘Saying what matters’, ‘Checked in but not always checked out’ and ‘The struggle of postnatal fatigue’. The original insights from this research clearly illuminate the vulnerability women face in the days following birth. A further in-depth interpretation and synthesis of the findings was undertaken. This philosophical-based discussion drew from the work of Heidegger (1962) and Arendt (1998). Engaging with these theoretical perspectives contributed to a new understanding about why some women within a similar context, have positive experiences of postnatal care while others do not. As such, the very nature that midwives and other postnatal carers are human beings has an influence on a woman’s experience of her care. These carers, in their exposition of ‘being’ have the ability to demonstrate ‘inauthentic’ or ‘authentic’ caring practices. It is those who choose to be ‘the sparkling gems’ that are the postnatal carers who make a difference and stand out from the others. For the women in this study, their postnatal care experiences mattered. While some new mothers reported positive and meaningful experiences others revealed experiences which impacted unnecessarily. The relevance of these findings, recommendations and suggestions for future research are offered.

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2

Ellberg, Lotta. "Postnatal care - outcomes of various care options in Sweden." Doctoral thesis, Umeå universitet, Obstetrik och gynekologi, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-1818.

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Background: In high-income countries, hospital length of stay after a normal birth has gradually decreased correspondingly to length of stay in care of other patients. A short stay provides a greater opportunity for autonomy and an increased sense of participation, but it may involve great challenges satisfying parental guidance as well as on the possibility of preventing, discovering, and treating neonatal medical conditions. Aim: This study evaluates postnatal care based on cost calculations, risk assessments, and parents’ satisfaction with care. Methods: Questionnaires were sent to 1 122 new mothers and her partner during 1998-1999. For the summary of utilization of health care services during the first 28 days postdelivery, the participants were linked with registry data from the hospital administration system for mothers and newborns (n= 773). The answers were also used to describe new parents’ experiences with postnatal care (n = 1 479). The costs for five postnatal care models were estimated, including three care options: Maternity Ward, Family Suite, and Early Discharge. Data about neonatal readmissions and death within 28 days was retrieved from the Swedish Medical Birth Register, the Swedish Hospital Discharge Registry, and the Swedish Cause-of-Death Register between 1999 and 2002 (n = 197 898). This data was related to data about postnatal follow-up practices from all 48 Swedish delivery wards. Results: The readmission rate for the mothers was similar among the various care options, and there was no difference in utilization of health care or breastfeeding outcome due to type of maternity care. As a proxy for morbidity, the readmission rate for the newborns was influenced by postdelivery follow-up routines as routine neonatal examination timing. Depending on the proportion of mothers receiving care at the Maternity Ward, the costs differed significantly between the various care models, while parents’ preferences complied with the cost-minimizing option Family Suite. Most mothers and fathers (70%) were satisfied with the overall impression of the postnatal care, but 72% were dissatisfied with at least one particular topic. A main finding was that the parents experienced a close emotional attachment, an affinity that was not always supported by the staff. The father was not treated as a principal character even though the parents wanted the father’s to be involved and recognized. Conclusions: Since the postnatal care options are not always the most cost minimizing and postnatal routines influence neonatal morbidity and parental satisfaction, the postnatal services need to be improved. Without increasing risks or costs, every postnatal care option ought to meet the families’ need for support, security, autonomy, and attachment with each other.

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3

Edwards, Nancy C. "Predictors of infant-care behaviours among postnatal immigrants." Thesis, McGill University, 1995. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=28730.

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To identify predictors of infant-care behaviours among immigrants, women were recruited on hospital postpartum units. Among the 3,484 women screened, 11.8 percent were eligible for enrollment and 77.3 percent agreed to participate. The follow-up rate was 94 per cent. Data on predictor variables were collected during face-to-face interviews in the early postpartum period. Follow-up telephone interviews occurred at three months postpartum to assess infant-care behaviours. Using a chunkwise, hierarchial approach to multiple linear regression modelling, maternal and infant predictors accounted for 24.2 percent of the variance in the 'Infant-care Behaviours' Score. In the second stage of model building, ethnocultural variables explained an additional 5.8 percent of the variance. Separate analyses for women who had lived in Canada less than three years versus three or more years yielded some differences in predictors for women in the two strata. Among recent immigrants; worries about the infant's health, mother's education, and current immigration status by parity were significant predictors, explaining 23 percent of the variance. Among less recent immigrants; worries about the baby's health, prenatal class attendance, marital status, and official language comprehension ability explained 37.7 percent of the variance. To establish effectiveness of the hospital liaison referral process, data from the predictors' study were linked with records of public health postpartum follow-up. Sensitivity of the hospital liaison referral process was less than 55 percent. Study findings provide direction for strengthening the postpartum referral process for ethnically diverse immigrants. The significant predictor variables are readily identified by the hospital staff of postpartum units. Results illustrate the importance of assessing theory-based ethnocultural characteristics among immigrants to determine their 'at-risk' status.

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4

Glazener, Cathryn. "Investigation of postnatal experience and care in Grampian." Thesis, University of Aberdeen, 1999. http://digitool.abdn.ac.uk/R?func=search-advanced-go&find_code1=WSN&request1=AAIU118245.

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Patients and staff who participate in PNC were surveyed by postal questionnaires and interviews to obtain a complete picture of the structures, processes and experiences which comprise it. 1249 newly delivered mothers and 648 health professional staff involved in PNC responded to the surveys (response rates 90.2% and 83.4% respectively). Maternal morbidity was reported by 85% of women in hospital, 87% at home in the first two months and 76% subsequently. Excess anxiety affected up to 27% of women, and depression occurred in around 16%. These factors influenced parental attitudes to their babies, as did aspects of babies' behaviour. 3% of women were readmitted to hospital for puerperal complications within the first two months, and 5% subsequently. At least one health problem occurred in 76% of babies in hospital, 82% in the first two months at home and 88% in the year thereafter, and the proportion treated increased with time. Readmission was necessary for 4% of babies in the first two months and 15% subsequently. Problems in PNC identified by respondents included lack of staff time, lack of continuity of care (resulting in conflicting advice), unrecognised maternal morbidity and need for support, high (and increasing) use of NHS services by babies, care focused on physical health problems rather than psychological and emotional ones, and deficiency in the quality of care after the first two months. Reorganisation of PNC so that the care of the patients (mother and baby) was its focus might enable the delivery of more effective and efficient care. A redefinition of the role of the midwife, greater autonomy and better professional recognition would increase job satisfaction and improve care. Forms of care which have been shown to be ineffective or harmful should be discontinued, and those which improve postnatal outcomes should be promoted.

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5

Doan, Daniel. "Pamper Partum, LLC| A Postnatal Facility." Thesis, California State University, Long Beach, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10749979.

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The rigors of labor and childbirth are incredibly demanding on the mother's body physically, emotionally, and psychology. Most new mothers deliver in a hospital setting where they are discharged after approximately two days. However, the mother's health and well-being does not improve that drastically within those two days of post-delivery recovery. Common struggles that new mothers face include postpartum depression, intimate partner violence, mood and body changes, as well as nutrition and sleep deprivation. Therefore, it is not only important to be attentive to the newborn but to the mother's recuperation as she adjusts to postnatal life. While there are many options for new mothers to deliver their baby through hospitals or birth centers, there is a lack of postnatal care facilities in comparison. Pamper Partum, LLC is a private company with an organizational mission to offer quality service and care that eases the transition to motherhood, to empower a new mother through education and community support, and to reduce any preventable risks associated with the postnatal period. Pamper Partum, LLC is an all-inclusive healthcare facility that provides services such as breastfeeding assistance, peer-support groups, private counseling, nutrition, general health care, and 24/7 infant monitoring in a state-of-the-art nursery. Pamper Partum, LLC will seek to be the first postnatal care facility that serves Orange County.

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6

McGuire, Margaret Maher. "Community postnatal care provision in Scotland : the development and evaluation of a template for the provision of woman centred community postnatal care." Thesis, University of Glasgow, 2001. http://theses.gla.ac.uk/1184/.

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The specific objectives of the study were to: 1. Investigate women's perceptions and experiences of postnatal care; 2. Examine the current pattern of postnatal care provision in terms of clinical outcomes (maternal and neonatal) and maternal satisfaction; 3. Evaluate the new model in terms of clinical outcomes (maternal and neonatal) and maternal satisfaction; 4. Compare the outcomes of both models; and 5. Evaluate midwives' perceptions of both models of care. There were no difference between the two Phases in terms of clinical outcomes (maternal and neonatal) midwifery and maternal satisfaction. In both stages of the study, the average day of postnatal discharge was day three, the mean number of postnatal visits was 4.2, and the average number of midwives to visit a woman was two. Women were very satisfied with the community postnatal care provided by midwives, although concerns were expressed about hospital postnatal care. All women agreed that community postnatal care was an important service and would choose to have the midwife visit her in their own home rather than attend health or drop in centres. Midwives applied aspects of the new template of postnatal visiting and were more likely to visit low risk women three times following introduction of the ne template. There was not change in community of carer. Findings of focus group discussions highlighted that women were not prepared for motherhood and the postnatal period. Women stated that the educational support antenatally and in the postnatal ward did not meet their expectations and needs.

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7

Almalik, Mona M. A. "A comparative evaluation of postnatal care for migrant and UK-born women." Thesis, University of Aberdeen, 2011. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=165719.

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The aim of this research was to explore perinatal clinical indicators and experiences of postnatal care among European and Middle Eastern migrant women, and to compare them with those of British women, at one tertiary hospital in the North East of Scotland. The numbers of non-British maternity service users increased over the period 2004 to 2008. This increase was not only in numbers but also in diversity of the countries of origins, religions, languages and specific cultural needs, which form new demands on the health services. European women were more likely to be younger, and primigravida and Middle Eastern women were more likely to be married, than British women. Both these migrant groups were more likely to breastfeed at birth and at discharge than British women. However, there was no significant difference in maternal postnatal length of stay in hospital between the study groups. The data do not suggest poorer processes of care or birth outcomes for the new migrant groups. Both migrant and British women reported positive experiences of postnatal care when their needs, those considered basic and essential for each woman after giving birth, were met. Negative postnatal experiences were explored among women from both groups when there were shortcomings in meeting those essential needs. The acceptance of and the expectations about the postnatal care provided differed between migrant and British women, due to their previous experiences in different countries. Although both migrant groups were first generation in Aberdeen and shared some needs and preferences, each migrant group had its own specific needs and beliefs that reflected the women’s culture, religion and country of origin.

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8

Taylor, Janice D., University of Western Sydney, College of Social and Health Sciences, and of Nursing Family and Community Health School. "Exploring postnatal fatigue : influential factors and management strategies for women." THESIS_CSHS_NFC_Taylor_J.xml, 2003. http://handle.uws.edu.au:8081/1959.7/740.

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Caring for a new child is a significant, demanding, and time consuming role, often associated with increased stress. Postnatal depression is one possible outcome of increased stress and research has highlighted the importance of detecting depression in new mothers. However fatigue a correlate of depression, has only recently become a focus of research among health professionals. Understanding the nature of fatigue and its management within the postnatal period, the focus of this study, may reduce its impact on women’s lives. This longitudinal study explores changes in intensity, physical, mental and emotional dimensions of fatigue, factors associated with higher levels of fatigue, the impact of fatigue on women’s usual activities, and strategies for managing fatigue. Self-administered structured questionnaires gathered data form 504 women at 1, 6, 12 and 24 weeks after birth. Reliable and valid instruments were used to measure the relationship between the defined factors and the outcome of fatigue at the various time points. State anxiety was a consistently strong predictor of fatigue intensity across time and group. Women sought to manage their fatigue by using self-care practices and asking for help from family and friends. This research highlights two issues for health professionals – care of new mothers must include recognition that higher levels of state anxiety are associated with higher levels of postnatal fatigue: ongoing assessment of fatigue and the strategies used to manage it is essential beyond the early postnatal period Doctor of Philosophy (PhD)

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9

Gilinsky, Alyssa. "Promoting physical activity among postnatal women : the More Active Mums in Stirling (MAMMiS) study." Thesis, University of Stirling, 2014. http://hdl.handle.net/1893/21226.

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Background: Adults benefit from participating in physical activity (PA) for chronic disease prevention and treatment. Postnatal women are encouraged to commence a gradual return to PA 4-6 weeks after giving birth, with participation in line with PA guidelines. The potential benefits of postnatal PA include weight management, improvements in cardiovascular fitness and psychological wellbeing. There has been limited high-quality information about the efficacy, feasibility and acceptability of PA interventions in postnatal women and few studies in the UK. Behavioural counselling interventions informed by behaviour change theory have been shown to successfully increase PA in low-active adults. Physical activity consultations (PACs) use structured and individualised behavioural counselling to enhance individuals’ motivation for change, and improve self-management skills. This approach may support adoption of PA in low-active postnatal women with research demonstrating that modifiable socio-cognitive factors influence PA behaviour. This thesis reports on the efficacy of a postnatal PA intervention, the More Active MuMs in Stirling (MAMMiS) study on change in PA behaviour. Efficacy of the intervention was tested in a randomised controlled trial. The effect on secondary health and wellbeing outcomes and PA cognitions targeted by the intervention and feasibility results are also reported. Methods: The intervention comprised a face-to-face PAC of around 35-45 minutes and 10-week group pramwalking programme. Non-attenders to the pramwalking group received a support telephone call. A follow-up PAC (15-20 minutes) was delivered after three month assessments. The first PAC involved raising awareness about benefits of PA, developing self-efficacy for change, setting goals and action planning PA, developing strategies for overcoming barriers, encouraging self-monitoring, prompting social support and selecting/changing the environment to support PA. The second PAC involved feedback about changes and preventing a return to sedentary habits. The pramwalking group met weekly for 6 walks of 30-55 minutes at a brisk pace, providing opportunities to demonstrate moderate-intensity walking and to encourage and support PA behaviour change. The control group received an NHS leaflet, which encouraged PA after childbirth. Postnatal women (six weeks to 12 months after childbirth) were identified through a variety of NHS-based and community-based strategies plus local advertisements and word-of-mouth. The primary outcome measure was evaluation of PA behaviour change using the Actigraph GT3X/GT3X+ accelerometer, an objective measure of PA behaviour; self-reported moderate-vigorous physical activity (MVPA) was measured using a recall questionnaire (Seven-Day Physical Activity Recall) and cardiovascular fitness using a submaximal step-test (Chester step-test). Secondary health and wellbeing measures were; anthropometric (i.e. weight and body mass index (BMI)) and body composition (measured using a bioelectrical impedance), psychological wellbeing (measured using the Adapted General Wellbeing Index) and fatigue (measured on a 100-point visual analogue scale). PA cognitions were measured via a questionnaire with constructs adapted from previous studies. All were taken at baseline (prior to randomisation), three and six months follow-up from baseline. Process measures were used to investigate intervention fidelity and feasibility. Acceptability was investigated in a post-trial interviews, conducted by a researcher not involved in the trial. RESULTS: Sixty-five postnatal women (average 33 years old with an infant 24 weeks old) were recruited (77% of those eligible). There was a 91% rate of retention at six months; participants who missed a follow-up assessment were younger (30 versus 34 years old) and had younger infants (21 versus 34 weeks old). Participants were less deprived and older compared with postnatal women in Scotland. Objectively measured PA behaviour did not change in response to the intervention. There was no between-groups difference in change in mean counts/minute from baseline to three months (p=0.35, 95% CI -73.50, 26.17, d=0.22) or three to six months (p=0.57, 95% CI -39.46, 71.18, d=0.13). There was no change in MVPA 7 minutes/day in either group from baseline to three (intervention =-0.70, IQR -9.86, 8.36; control =1.65, IQR -4.79, 8.21) or three to six months (intervention =0, IQR -1.13, 1.10; control =0, IQR -9.86, 8.23), with no between-groups difference baseline to three (p=0.43; r=0.10) or three to six months (p=0.75, r=0.09). Results for relative MVPA were similar. Median steps/day from baseline to three months did not change in the intervention group (0, IQR –1619.44, 1047.94) and increased by 195.95 (IQR -1519.55, 1691.03) among controls. The between-groups difference was non-significant (p=0.37, r=0.18). From three to six month follow-up steps/day increased in the intervention group and not in controls (0, IQR -1147.50, 1303.52), this between-groups difference was also non-significant (p=0.35, r=0.16). From baseline to three months self-reported MVPA declined in the intervention group (15 minutes/week; IQR -111, 15) and increased in the control group (30 minutes/week; IQR –68, 75): a non-significant between-groups difference, with a small effect size (p=0.71, r=0.22). From three to six months a decline in self-reported MVPA was found in controls (53 minutes/week; IQR -41,-101) and no change among the intervention group (0, IQ range -26, 71); a significant between-groups difference with a small effect size (p=0.04, r=0.26). There were no differences between the groups for the change in aerobic capacity from baseline to three months or three to six months with no evidence for change over time in aerobic capacity or fitness category in either group. Change in secondary outcomes did not differ between the groups from baseline to three or three to six months (although fatigue did improve in the intervention group relative to controls from baseline to three months). Considering PA cognitions, outcome expectancies declined in both groups from baseline to three months and continued to decline only in the intervention group from three to six months, a between-groups difference with a small effect size (p=0.03, r=0.26). Self-efficacy increased in the intervention group from baseline to three months and declined in the control group with a small effect size for the between-groups difference (p=0.03, r=-0.27). An increase in action 8 planning was seen among the intervention group but not controls from baseline to three months (p<0.01, r=-0.34). Both groups showed an increase in coping planning and action control; the change was larger among the intervention group relative to controls (i.e. p<0.01, r=0.44, r=0.43, respectively). Increased self-efficacy and action control were maintained from three to six months in the intervention group. Coping planning increased relative to controls (p<0.01, r=0.41) and action planning increased among controls from three to six months (p<0.01, r=0.39). Intervention fidelity and feasibility was good. All intervention participants received the initial PAC and adoption of self-management strategies was high for ‘thinking about the benefits of PA’, ‘action planning’ and ‘self-monitoring’, between baseline and three months. Most participants attended at least one walk (61% attended five or more), 89% of planned walks were conducted with no evidence of poor attendance due to season. Walks were conducted at a brisk pace and met moderate-intensity thresholds. DISCUSSION: MAMMiS aimed to recruit low-active healthy postnatal women to test the efficacy of a PAC and group pramwalking intervention. There was no evidence for an intervention effect on PA or on secondary health and wellbeing outcomes.

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10

黃香君 and Heung-kwan Wong. "Enhancing coping in mothers of preterm infants." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2008. http://hub.hku.hk/bib/B40721607.

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Wong, Heung-kwan. "Enhancing coping in mothers of preterm infants." Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B40721607.

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12

Van, der Klei Jannine Daphne. "Health promotion for primiparous women in the puerperium : the role of the midwife." Thesis, The University of Sydney, 1995. https://hdl.handle.net/2123/26796.

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The purpose of this descriptive study was to explore the role of the midwife in health promotion for primiparous women in the puerperium, as perceived by midwives and primiparous women. Perceptions of midwives and primiparous women in the puerperium were sought in relation to the midwife’s role in health promotion for primiparous women in the puerperium. The sample consisted of twenty-three midwives and forty-nine primiparous women from three public hospitals in the central, southern and western areas of Sydney. Two questionnaires, one for the midwives and one for the primiparous women, consisting of quantitative and qualitative components, were developed and used for data collection in the study. The relationship between the perceptions of the two groups was examined by comparison of the results. Health promotion methods used by midwives for primiparous women in the puerperium were perceived as occurring to a much greater extent by the midwives than reported as experienced by the women. All of the midwives thought that they educated the women for health in the puerperium and that they gave adequate health information to the women. However, a number of the women felt that the health information given to them was inadequate and that midwives could have helped to promote health better for them during the puerperium. Nevertheless, the majority of the women indicated their comfort in asking midwives questions that concerned them during their postpartum hospital stay. There were many areas of difference between the midwives’ perceptions of how commonly various health concerns or problems occurred for prirniparous women in the puerperium and the incidence of their occurrence reported by the women. A number of women felt either only minimally prepared or not prepared at all for the health concerns or problems experienced by them during the puerperium and thought that midwives could have provided them with further health information in the early days after birth. Only forty-one percent of the primiparous women were debriefed by midwives concerning their labour and birth and all of these women found it helpful. The majority of women who were not debriefed after birth would have liked this opportunity. Conflicting information given by midwives in the early puerperium was reported by almost half of the prirniparous women as occurring often or always, particularly with regard to breastfeeding. Most of the women commenced breastfeeding in hospital but by six weeks after birth, thirty-one percent had ceased breastfeeding, with many experiencing breastfeeding difficulties. The majority of the midwives identified constraints in their health promoting role for prirniparous women in the early puerperium and provided a variety of suggestions of how they could promote health better for puerperal women.

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13

Sharp, Deborah J. "Childbirth related emotional disorders : a longitudinal prospective study in primary care." Thesis, King's College London (University of London), 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.243897.

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14

Taylor, Janice D. "Exploring postnatal fatigue : influential factors and management strategies for women." Thesis, View thesis, 2003. http://handle.uws.edu.au:8081/1959.7/740.

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Caring for a new child is a significant, demanding, and time consuming role, often associated with increased stress. Postnatal depression is one possible outcome of increased stress and research has highlighted the importance of detecting depression in new mothers. However fatigue a correlate of depression, has only recently become a focus of research among health professionals. Understanding the nature of fatigue and its management within the postnatal period, the focus of this study, may reduce its impact on women’s lives. This longitudinal study explores changes in intensity, physical, mental and emotional dimensions of fatigue, factors associated with higher levels of fatigue, the impact of fatigue on women’s usual activities, and strategies for managing fatigue. Self-administered structured questionnaires gathered data form 504 women at 1, 6, 12 and 24 weeks after birth. Reliable and valid instruments were used to measure the relationship between the defined factors and the outcome of fatigue at the various time points. State anxiety was a consistently strong predictor of fatigue intensity across time and group. Women sought to manage their fatigue by using self-care practices and asking for help from family and friends. This research highlights two issues for health professionals – care of new mothers must include recognition that higher levels of state anxiety are associated with higher levels of postnatal fatigue: ongoing assessment of fatigue and the strategies used to manage it is essential beyond the early postnatal period

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15

Selkirk, Rosemary. "The effect of postnatal debriefing on the psychological health of mothers." Thesis, Federation University Australia, 2012. http://researchonline.federation.edu.au/vital/access/HandleResolver/${Handle}.

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One hundred and forty-nine women were recruited in Ballarat during the third trimester of their pregnancy, and systematically assigned to treatment and control conditions, to assess the effect of midwife-led postnatal debriefing on psychological variables. Doctor of Psychology (Clinical)

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16

Nankwanga, Annet. "Factors influencing utilisation of postnatal services in Mulago and Mengo Hospitals Kampala, Uganda." Thesis, University of the Western Cape, 2004. http://etd.uwc.ac.za/index.php?module=etd&amp.

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Maternal and child-health and health education are three major concerns of public health organisations and researchers throughout the world. Health education for mothers is a strategy many countries have adopted to improve maternal and child-health. The present study was carried out in Uganda with the objective of exploring the factors influencing the utilisation of postnatal services at Mulago and Mengo hospitals, a government and private hospital. Both hospitals are located in Kampala district in Uganda. The survey, was completed by 330 women who responded to a structured questionnaire that was given to them six to eight weeks after delivery. Questions that were asked generated demographic information about the mothers mothers&rsquo knowledge about postnatal services mothers&rsquo socio-economic status and barriers to utilisation of the postnatal services. The participants included all women who delivered in Mulago and Mengo hospitals in November 2003 except for those who had had a neonatal death. The data was analysed using descriptive and inferential statistics. Some of the key findings of the study were that most women lacked awareness about postnatal services and those who knew about these services only knew about immunisation and family planning services. The majority of the mothers did not know about other services, such as physiotherapy, counselling, growth monitoring, and physical examination. Lack of money for transport or service costs, distance from the health care facility, not being aware of the services, lack of somebody to take care of the child at home were some of the main barriers to utilisation of postnatal services. Others included, lack of education, lack of employment, lack of decision-making powers, and lack of time to go back for the service. The ministry of health should educate women and communities about the importance of postnatal care, its availability, and the importance of women having decision-making power over their own health. The health service organization should improve on the quality of care by ensuring that services are provided at convenient hours with privacy, confidentiality and respect and it should evaluate the services periodically from the users perspective to maintain the quality of service.

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17

Abuidhail, Jamila. "Rural Jordanian mothers' cultural health beliefs, knowledge and practices of postnatal care." Thesis, Glasgow Caledonian University, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.494576.

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Cultural beliefs, knowledge and practices have been found to be interlinked factors that have led to increased maternal and infant mortality and morbidity during postpartum period (Thompson 2003). In Jordan, despite being one of the most modem countries in the Middle East, postpartum (postnatal) care services are still under-utilised by Jordanian rural mothers (MOH 2004). Postpartum (postnatal) care is the aspect of reproductive health care that has received limited attention in research to date. This is particularly true in the Jordanian rural areas. The aim of this study is to explore, analyse and critique the postnatal cultural health beliefs, knowledge and practices of rural Jordanian mothers. These issues are approached from a critical ethnographic perspective. Based on this theoretical framework, the cultural health beliefs, knowledge and practices of 13 rural Jordanian postpartum mothers from four rural areas of the Mafraq Govenorate were studied.

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18

Yeh, Yeuh-Chen. "Tso Yeuh Tzu in a Taiwanese Maternity Care Centre: New Interpretations of an Old Postnatal Ritual." Thesis, Griffith University, 2012. http://hdl.handle.net/10072/366571.

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The purpose of this ethnographic study was to explore how the traditional Chinese postnatal practices of Tso Yueh Tzu are being reshaped by first-time mothers in the modern health care setting of a maternity care centre in Taiwan. The traditional Chinese ritual practice of Tso Yueh Tzu is a long-lasting custom. The postnatal woman engages in a series of ritual practices with assistance from her family, especially her mother-in-law. The thirty day ritual involves a range of physical and social prescriptions and taboos that aim to bring the postnatal woman back to her pre-pregnancy state and achieve the psychological adaptation of the whole family to the new situation. Although traditionally carried out in the home, many modern Taiwanese women now follow Tso Yueh Tzu ritual practices in maternity care centres, which are becoming very popular. This interpretive ethnography explored the ritual of Tso Yueh Tzu, particularly how the ritual has been reshaped and renegotiated in the modern health care setting of the maternity care centre. Data collection techniques included participant observation, informal discussions, formal interviews, documentation, field notes, maps and photographs for eight months in a maternity care centre in Taipei. Data were analyzed using the method developed by Creswell (2003). Thesis (PhD Doctorate) Doctor of Philosophy (PhD) School of Nursing and Midwifery Griffith Health Full Text

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Taylor, Janice D. "Exploring postnatal fatigue : influential factors and management strategies for women /." View thesis, 2003. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20051125.152732/index.html.

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Frei, Irena Anna. "First-time mothers' experiences and the perception of nurses' provision of postnatal care." Thesis, University of Edinburgh, 2005. http://hdl.handle.net/1842/24591.

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In this study I explore and describe first-time mothers’ initial experiences of motherhood and postnatal care. The women selected were in-patients in a postnatal care setting in Switzerland. The women’s expectations of motherhood and postnatal care were investigated through conversations prior to birth. Further data about their experiences and postnatal care provision were obtained from conversations with participating women and nurses, observations of day-to-day practice and related documentary materials during the six-month period of fieldwork. Follow-up conversations were conducted after discharge. For its theoretical underpinnings the study draws especially on the theory of ‘becoming a mother’ by Barclay and colleagues (1997) and on Swanson’s theory of caring (1991; 1993). The data analysis was organised around two main themes: experience of ‘being on postnatal journeys’ and ‘caring relationships’. The women’s initial journeys into motherhood were intertwined with their journeys through the postnatal unit. The study explores the tensions and discontinuities between these two journeys notably in relation to the availability of competent care and support; the mothers’ requirements in terms of recovery and recuperation; and the tensions between individualised and routinised care. It identifies the extent to which women were able to regain physical strength, attain competence and develop confidence as caring mothers during their days in the unit. The study also explores how women anticipated their return to life at home with their baby and experienced the process of discharge. The second main theme concerns caring relationships. The study investigates these form the perspectives of the nurses and the unit’s mission as well as those of the first-time mothers. It identifies how the participating nurses and first-time mothers related to each other as well as examining continuity and constituency in care provision. The study further explores the tensions of structural influences on care provision and first-time mothers’ and nurses’ satisfaction with received and provided care respectively. This study specifically raises the issues of fragmented care provision, a lack of family-centeredness and the anxiety that arises at discharge. The findings of this study will be useful in effecting change in the provision of postnatal care to women and their families, and implications for nursing practice, research and policy are therefore highlighted.

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Lindberg, Inger. "Postpartum care in transition : parents' and midwives' expectations and experience of postpartum care including the use of videoconferencing /." Luleå : Division of nursing, Luleå University of Technology, 2007. http://epubl.ltu.se/1402-1544/2007/20/.

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Carpenter, Rhiannon. "Influence of regular antenatal physical exercise on cardiovascular, haemodynamic and autonomic nervous system function during and after pregnancy." Thesis, Swansea University, 2015. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.678358.

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Titaley, Christiana Rialine. "Neonatal mortality in Indonesia : the protective role of antenatal, delivery and postnatal care services." Thesis, School of Public Health, 2011. http://hdl.handle.net/2123/9394.

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24

Gamble, Jennifer Anne. "Improving emotional care for childbearing women an intervention study /." [South Bank, Queensland : Griffith University], 2003. http://www4.gu.edu.au:8080/adt-root/uploads/approved/adt-QGU20030904.154204/public/02Whole.pdf.

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25

Gillenstrand, Sara, and Fia Hedblom. "Barnmorskors erfarenheter och upplevelser kring postpartumsamtal." Thesis, Högskolan Dalarna, Vårdvetenskap, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:du-24414.

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Bakgrund: Forskningen visar att kvinnor tycker det finns en vinst i att ha ett postpartumsamtal, de värdesätter att få stämma av sin förlossningsupplevelse. Ändå erbjuds inte alla kvinnor detta. Tidigare forskning har visat att barnmorskor likaså värdesätter postpartumsamtal för kvinnans skull men att barnmorskorna saknar utbildning i att genomföra postpartumsamtal på ett tillfredsställande sätt. Syfte: Syftet var att beskriva barnmorskors erfarenheter och upplevelser kring postpartumsamtal. Metod: Tre fokusgruppsintervjuer genomfördes med barnmorskor som arbetar på förlossningsavdelning. Semistrukturerad intervju genomfördes utifrån en frågeguide. Som analysmetod användes kvalitativ innehållsanalys. Resultat: Ett tema, fyra kategorier och 15 underkategorier identifierades. Temat var: Postpartumsamtal idag: Att möta behovet och framtidens utmaningar. Kategorierna var: Postpartumsamtalets betydelse för kvinnan, Postpartumsamtal inte för alla, Genomförande av postpartumsamtal och Förutsättningar för postpartumsamtal. Slutsats: Barnmorskornas upplevelse var att postpartumsamtalet är viktigt för kvinnor, deras partners samt för barnmorskorna själva. Anpassning av organisationen behövs för att erbjuda postpartumsamtal utifrån föräldraparets behov. Kunskap från postpartumsamtal kan tillvaratas för utveckling både för personlig yrkesutveckling för barnmorskan och vårdutveckling för organisationen. Detta kan vara ett steg mot en mer kvinnocentrerad vård. Klinisk tillämpbarhet: Studiens resultat skulle kunna leda till utveckling av rutiner kring postpartumsamtal. Ytterligare forskning behövs för att utveckla en samtalsmodell som kan tydliggöra postpartumsamtalets utförande och innehåll. Background: Previous research shows postpartum counselling beneficial, women value to talk about their childbirth experiences. Still, not all women are offered the option of postpartum counselling. Midwives find it beneficial for women to have a postpartum counselling. Midwives find they have a lack of knowledge to perform fulfilling postpartum counselling. Aim: The aim was to describe midwives’ experiences of postpartum counselling. Method: Three focus group interviews were conducted with midwives employed at the maternity ward. The interviews were semi-structured, based on a questionnaire. Qualitative content analysis was used as the analyze method. Results: One theme, four categories and 15 subcategories were identified. The theme was: Postpartum counselling today: To meet the need and challenges for the future. The categories were: The meaning of postpartum counselling for the woman, Postpartum counselling, not for everyone, To perform postpartum counselling, Conditions to perform postpartum counselling. Conclusion: The midwives’ experiences were that postpartum counselling was of importance to women, their partners but also for the midwive. The organization is in need for adjustment to be able to offer postpartum counselling based on the parents’ needs. Knowledge could be drawn from postpartum counselling for both professional development and care development. This could be one step closer to women centered care. Clinical application: The results of the study could lead to development of routines surrounding postpartum counselling. Yet there is a need for more research in the development of a postpartum counselling model. The model could clarify the content and how to perform postpartum counselling.

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Johansson, Margareta. "Becoming a father : Sources of information, birth preference, and experiences of childbirth and postnatal care." Doctoral thesis, Mittuniversitetet, Institutionen för hälsovetenskap, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-15161.

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The period of pregnancy and childbirth is an important and sensitive time for men’s upcoming parenthood. Research into fathers’ experiences of childbearing has received less attention compared to maternal experiences. The purpose of this thesis was to study the sources fathers use to obtain information about pregnancy and childbirth, fathers’ preference for the mode of birth of their baby, and fathers’ childbirth experience and their perception of postnatal care quality.In 2007, 1105 expectant fathers were enrolled in the study when their partner had reached the middle of pregnancy. The fathers were followed until one year after the birth of their baby. The fathers were living in the county of Västernorrland in Sweden and their babies were born in one of the three hospitals in the county. Data was analysed using descriptive and inferential statistics, and content analysis. An index was created from a combination of fathers’ experiences of postnatal care quality.iiiCommon sources of information about pregnancy and childbirth used by prospective fathers were the Internet, their partners and the midwife. Fathers who were expecting their first baby (OR 1.4; 1.2-1.7), had a high level of education (OR 1.3; 1.2-1.5) and fathers with previous experience of caesarean section (OR 1.3; 1.1-1.6) were the greatest users of the Internet. Of the prospective fathers 71 (6.4%) desired caesarean section for the birth of their baby. Previous negative birth experience (PR 8.6; 2.6-28.3) and the experience of caesarean section (PR 5.7; 2.8-11.9) were factors associated with the wish that the baby would be born by caesarean section. A desire to plan the day of the baby’s birth (PR 6.0; 1.5-24.1) was associated with a preference for caesarean section for the men who were expecting their first baby. Two months after the birth of the baby 604 (74%) of the fathers in this group had had a positive birth experience. A correlation with a less-positive birth experience was with emergency caesarean section (OR 7.5; 4.1-13.6), instrumental vaginal birth (OR 4.2; 2.3-8.0) and if the man was unhappy with the medical care which the partner received (OR; 4.6; 2.7-7.8). Positive experience of healthcare professionals’ knowledge and attitudes was related to a satisfactory birth experience. The deficiencies in the postnatal care were mainly related to deficiencies in the information on the baby’s care and needs, and fathers’ experiences of their partners’ inadequate check-ups and medical care. A year after the birth 488 (79%) of the fathers were satisfied with the overall postnatal care, although they had pointed to deficiencies in the provision. Deficiencies in the attitude of the staff (OR 5.01; 2.80-8.98) and the medical care and check-ups their partner received were associated with fathers’ dissatisfaction with the overall postnatal care (OR 2.13; 1.25-3.62).ivMost fathers in this study had a positive birth experience and were happy with the postnatal care. The thesis highlights, however, opportunities for improvements in intrapartum and postnatal care. Healthcare professionals should be informed regarding the information provided via the web and to discuss the information that expectant fathers receive about pregnancy and childbirth. Prospective fathers should be given the opportunity to discuss their preferences and attitudes to the mode of birth. In addition, professionals should provide supportive information and be present in the delivery room. The information about the newborn baby’s care and needs can be strengthened, both before and after birth.

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Krauss, Rosa. "A study of a group intervention for postnatal depression at a community health care centre." Master's thesis, University of Cape Town, 2010. http://hdl.handle.net/11427/3824.

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Untreated postnatal depression may have serious and long-lasting consequences for mother and infant. These range from feelings of inadequacy and worthlessness in the mother to social, emotional, cognitive and behavioural disturbances in her child. Postnatal depression is also associated with maternal and infant death. In South Africa, postnatal depression is not screened for as a matter of routine and many women go undiagnosed and untreated. The research was conducted at a community health centre using a mixed methodology of quantitative and qualitative techniques. A sample of six women with postnatal depression participated in a group intervention programme for eight sessions. A single system design was used to quantitatively determine whether a change had occurred, and to what extent, in the mothers' depressive symptoms and attitude towards mothering at the conclusion of the group intervention. Baseline measures on the Edinburgh Postnatal Depression Scale and the Maternal Attitudes Questionnaire were compared with these scores measured at the conclusion of the intervention. A focus group was held at the conclusion of the intervention to gather qualitative data on the mothers' experience of the group processes and personal outcomes. The results of this study demonstrate that mothers' moods and maternal attitudes improved as a result of this therapeutic group intervention, although they still remained above the diagnostic cut-off threshold for postnatal depression. The intervention was also noted by mothers to be a desirable method of treatment for postnatal depression. Further research is indicated to test whether the positive outcomes hold over a period of time.

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Binti, Mohd Arifin Siti Roshaidai. "Perspectives of postnatal depression in Malaysia : exploring experiences of women and healthcare practitioners." Thesis, University of Stirling, 2016. http://hdl.handle.net/1893/24176.

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Background: Postnatal depression (PND) is one of the most common maternal mental health problems for women worldwide. Yet the wide range of reported rates of PND in different countries raises questions about how PND is experienced by women in different cultures and whether interventions developed in western cultures are appropriate in very different settings. It is important to establish how PND is defined, experienced and managed in different cultures in order to create culturally relevant interventions. No previous studies of experience of PND and its management have been conducted in Malaysia. The aim of this study was to explore women’s experiences and healthcare practitioners’ (HCPs) perspectives of PND in a multicultural country, Malaysia. Methods: This was a qualitative study informed by a critical realist approach. Semi-structured interviews were carried out with 33 women (from three different cultural backgrounds) attending for child or postnatal care and 18 HCPs in six purposively selected maternal and child health (MCH) clinics and a female psychiatric ward in Kuala Lumpur, Malaysia. Data were analysed using framework analysis. Findings: There were some differences in the women’s perceptions of PND experience across three different cultural backgrounds in Malaysia. Malay women were more likely to describe the symptoms of PND based on a combination of emotional and behavioural changes, whereas Chinese and Indian women talked more about emotional changes. Traditional postnatal practices were described as contributing to PND by some Malay women but were accepted as promoting maternal and infant well-being by the majority of Indian women. Religious activities were reported as an effective strategy for the Malay women but were not seen as helpful by the majority of Chinese women. Considering HCPs, it appeared that the absence of a clear and specific policy and guideline in the management of PND within the Malaysian healthcare system has resulted in a lack of professional ownership in the management of PND, especially among HCPs in MCH clinics. Conclusion: The women and the HCPs had distinct ways of conceptualising PND experiences, although they agreed on several symptoms and causal explanations. This study calls for a system-based enhanced PND care with an initiation of culturally appropriate care for PND within the healthcare system.

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Gamble, Jennifer Anne. "Improving Emotional Care For Childbearing Women: An Intervention Study." Thesis, Griffith University, 2003. http://hdl.handle.net/10072/365390.

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Childbirth can be associated with short and long-term psychological morbidity including depression, anxiety and trauma symptoms. Some previous studies have used psychological interventions to reduce postpartum distress but have primarily focussed on attempting to relieve symptoms of depression with little recognition of trauma symptoms. Furthermore, the intervention used in these studies has generally been poorly documented. The first aim of the present study was to develop a counselling framework, suitable for use by midwives, to address psychological trauma following childbirth. Multiple methods were used to develop the intervention including focus groups with women and midwives. Both the women and midwives gave unequivocal support for postpartum debriefing. Themes that emerged from the focus groups with women included the need for opportunities to talk about their birth experience, an explanation of events, an exploration of alternative courses of action that may have resulted in a different birth experience, talking about their feelings such as loss, fear, anger and self-blame, discussing social support, and discussing possible future childbearing. There was a high level of agreement between the women's and midwives' views. These themes were synthesized with contemporary literature describing counselling interventions to assist in reconciling a distressing birth experience and a model for understanding women's distressing birth experiences to develop a counselling framework. The counselling intervention was then tested using a randomised controlled study involving 400 women recruited from antenatal clinics of three public hospitals. When interviewed within seventy-two hours of birth, 103 women reported a distressing birth experience and were then randomised into either the treatment or control group. Women in the intervention group had the opportunity to debrief at the initial postpartum interview (< 72 hours postpartum) and at four to six weeks postpartum. The prevalence of posttraumatic stress disorder was quite high; 9.6% of participants meeting the diagnostic criteria for acute PTSD at four to six weeks postpartum. Fewer participants (3.5%) met the diagnostic criteria for chronic PTSD at three months postpartum. As with previous research relating to childbearing women, few demographic factors or antenatal psychological factors were associated with the development of a PTSD symptom profile following childbirth. The development of PTSD symptom profile was strongly associated with obstetric intervention and a perception of poor care in labour. This finding is also consistent with previous research. Emotional distress was reduced for women in the intervention group in relation to the number of PTSD symptoms [t (101) = 2.144, p = .035], depression [c2 (1) = 9.188, p = .002], stress [c2 (1) = 4.478, p = .029] and feelings of self-blame [t (101) = -12.424, p <.001]. Confidence about a future pregnancy was higher for these women [t (101) = -9.096, p <.001]. Although there was not a statistically significant difference in the number of women with a PTSD symptom profile at three months postpartum, fewer women in the intervention group (n=3) than in the control group (n=9) met PTSD criteria. Likewise, there were fewer women in the intervention group (n=1) with anxiety levels above mild than in the control group (n=6). Importantly, this study found that offering women who have had a traumatic birth the opportunity for counselling using the framework documented in this dissertation was not harmful. This finding is in contrast to previous findings of other studies. The intervention was well received by participants. All the women in the intervention group found the counselling sessions helped them come to terms with their birth experience. Maternity service providers need to be cognizant of the prevalence of this debilitating condition and be able to identify women at risk for early intervention and referral to a mental health practitioner if appropriate. This research offers further support for the compelling need to implement changes to the provision of maternity services that reduce rates of obstetric intervention and humanise service delivery as a means of primary prevention of birth-related PTSD. Thesis (PhD Doctorate) Doctor of Philosophy (PhD) School of Nursing Full Text

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Wilson, Suzanne Elizabeth. "Mothers with a learning disability : their experiences of service provision during the postnatal period." Thesis, University of Edinburgh, 2012. http://hdl.handle.net/1842/6387.

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Introduction: There is growing evidence that many parents with learning disabilities, when given adequate support, can parent successfully. Childbirth is a significant life event that marks a woman's transition to motherhood and is a time when parents first learn to nurture their children. Postnatal care aims to facilitate this learning experience as well as promote the emotional and physical well-being of both infant and mother. To date, no research has explored the support mothers with learning disabilities receive during the postnatal period. To fill this gap in the research and help inform service provision, this study aims to explore how mothers with learning disabilities experience postnatal care. Method: Semi-structured interviews were carried out with six mothers with learning disabilities. The data were collected and analysed using Interpretative Phenomenological Analysis. Results: Mothers experiences of postnatal care were conceptualised within four superordinate themes: challenges of providing support, how support was delivered , learning to cope and challenges to building trust. All of these had accompanying subthemes. Discussion: The results are discussed in the context of relevant literature. Consistent with previous research which has been carried out with parents with learning disabilities, participants were found to be highly dependent on informal support. The participants acknowledged the value of professional input and their perceptions of how this support was delivered had important implications. Learning how to cope with the demands of their new role raised issues not dissimilar to those of parents without learning disabilities. Challenges, however, were faced in establishing trusting relationships with professionals. The findings were found to have implications for clinical practice which are described and suggestions for future research made. Conclusion: The findings suggest that participant informal supports play a key role during the initial stages of parenthood particularly with providing practical support in areas which present challenges. Professional input was valued when delivered according to the typical pathway of care post-birth. It is recommended that consideration is given to how the support is delivered to participants. This should essentially seek to empower parents rather than undermine them as how support was perceived by parents impacted on their subsequent engagement with professionals.

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Mikaelsdotter, Carolina. "Barriers affecting women’s decision to seek care during pregnancy, childbirth and postnatal period in rural Kenya." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-387655.

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Background: Antenatal care (ANC), facility delivery and postnatal care (PNC), are proven to reduce maternal and child mortality and morbidity in high burden settings. However, few rural pregnant women use these services sufficiently and it is essential to identify the barriers. Aim: The aim of this study was to examine barriers, with a focus on water, sanitation and hygiene (WASH), affecting women’s decision to seek care during pregnancy, childbirth and postnatal period in rural Kenya, and to examine if the Afya intervention helped overcome barriers. Methods: A qualitative study was conducted in the Siaya County, Kenya. 25 mothers were selected by using purposive sampling for in-depth interviews and focus group discussions. Assessment of WASH facilities was conducted at 5 healthcare facilities. Data were analysed by content analysis method. The “three delay model” informed the analytic process and discussion. Results: Women delayed seeking or did not attend ANC and PNC or gave birth at home, due to lack of knowledge of benefits of maternal health services and on complications; traditional and religious beliefs; embarrassed over pregnancy; busy with other life activities or of fear of HIV status and hospitals. Gender norms, distance and transport costs were the contributing factor for delaying in reaching the hospital. Unprofessional and inadequate number of staff, lack of equipment and supplies, and the water, sanitation and hygiene quality were factors delaying receiving quality care. The assessment showed on inadequate WASH facilities. Conclusion: Use of antenatal care, delivery and postnatal care in rural western Kenya is influenced by several barriers. The findings suggest a need to increase the knowledge about ANC and PNC, and to lower barriers preventing women from reaching the healthcare facility. There is also a need to improve the WASH facilities and the healthcare personnel’s treatment.

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Virkar, Pratima. "Auditory and visual determinants of maternal preference in bobwhite quail neonates." Thesis, Virginia Tech, 1988. http://hdl.handle.net/10919/43298.

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Imprinting studies have traditionally stressed the importance of visual features in the formation of early postnatal attachments. However, recent studies by Johnston & Gottlieb (1981, 1985) have demonstrated that visually imprinted preferences can be altered by the maternal call. Thus, in the present study the interaction between natural visual and auditory stimulation in the control of filial behavior was examined in bobwhite quail chicks during the first 4 days of postnatal life. Previous research has revealed that bobwhite quail hatchlings are differentially responsive to their species-specific maternal call in the period right before and immediately following hatching (Heaton, Miller & Goodwin, 1978). Results from this study indicate that quail chicks begin to lose this naive preference for their maternal call over a non-conspecific call (a domestic chicken maternal call) by 72 hrs following hatch, and do not respond to either the bobwhite call or chicken call by 96 hrs following hatch. However, differential responsiveness to the bobwhite call can be reinstated in bobwhite chicks at 72 hrs and 96 firs following hatching if the birds are provided with integrated audiovisual stimulation (i.e., a quail hen model emitting the maternal call). These results suggest that in the initial stages of postnatal development, species identification in bobwhite quail is based primarily on the auditory component of maternal stimulation. Later in development, combined auditory and visual stimulation appears necessary to control species-specific filial behavior despite the fact that auditory cues remain dominant over visual cues. These findings conform well to what is known about the neuroembryological development of sensory systems, in that the auditory system of birds (and mammals) develops in advance of the visual system. This prenatal sequence of sensory system development appears to influence the sequence of early postnatal perceptual preferences in precocial avian neonates. Master of Science

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Mandima, Patrica Fadzayi. "Determining the level of non-booking for antenatal care and associated barriers as well as risk for mother to child transmission of HIV among pregnant women in Chitungwiza city, Zimbabwe." University of Western Cape, 2020. http://hdl.handle.net/11394/7671.

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Master of Public Health - MPH PMTCT is an effective strategy in preventing paediatric HIV infection. In Zimbabwe the success of PMTCT is entirely dependent on pregnant women accessing antenatal care services and through that, getting linked to PMTCT. Failure of pregnant women to book for antenatal care through the course of pregnancy presents a missed opportunity for PMTCT and a high risk for maternal HIV transmission. It is therefore important to determine the burden of unbooked women and the factors associated with it, if elimination of maternal HIV transmission is to be achieved in the country.

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Parsons, Janine, and janine parsons@svhm org au. "The Experiences of Men whose Partners have been Admitted to an Intensive Care Unit (ICU) Immediately after Childbirth." RMIT University. Health Sciences, 2008. http://adt.lib.rmit.edu.au/adt/public/adt-VIT20080805.141158.

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ABSTRACT Naturalistic Inquiry was used to explore, describe and discover the experiences and perceptions of men whose partners have been admitted to an Intensive Care Unit (ICU) immediately after childbirth. The sixteen men's experiences were explored using semi-structured open-ended questions. Data were analysed using thematic content analysis. The research questions driving this study were: What are men's experiences and perceptions of the incidence and impact of their partners being admitted to ICU following the complications of childbirth? What is the nature of the relationships and interactions that men have with healthcare professionals before, during and after their partner's ICU admission following the complications of childbirth? What impact did the experience of their partners being admitted to ICU, following the complications of childbirth, have on the men's relationships with their partners, newborn child, and other children? What impact did the experiences of their partners being admitted to ICU following the complications of childbirth have on their future life plans? During the time of their partners' obstetric crisis the men, in this study, were left isolated, alone and struggling. The current healthcare policy and practice for men with their partners in life-threatening situations intrapartum and immediately postpartum failed 16 families.

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Hodges, Nichole Laureen. "Infant Safe Sleep in Ohio: Where Do Prenatal and Postnatal Healthcare Providers Fit In?" The Ohio State University, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=osu1467982677.

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Andrén, Andersson Anna, and Helena Flodén. "Kvinnors upplevelser i samband med BB vård på sjukhus : En litteraturöversikt." Thesis, University of Skövde, School of Life Sciences, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-3557.

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Bakgrund: BB vården i de västerländska länderna har genomgått stora förändringar desenaste decennierna. Trots detta visar studier på att ett stort antal kvinnors inte är nöjda medden vård de fått efter barnets födelse. Syfte: Syftet med denna litteraturöversikt är att beskrivanyförlösta kvinnors upplevelser i samband med BB vård på sjukhus. Metod: Enlitteraturöversikt baserad på tio vetenskapliga artiklar med både kvalitativ och kvantitativmetod. Resultat: Fyra huvudteman framkom vid analysen av artiklarna; information,vårdorganisation och vårdmiljö, bemötande och attityder samt stöd. Det visade sig finnasväldigt många olika faktorer som påverkade kvinnors upplevelser av BB vården. Dessa kundevara mer eller mindre betydelsefulla för olika kvinnor. Kunskapen om detta kan bidra till attvårdpersonalen får en ökad förståelse för att varje nyförlöst kvinna är en unik individ medegna specifika önskemål och behov och att BB vården inte får generaliseras. Diskussion: Densjukhusförlagda BB vården måste bedrivas så att den uppfyller kravet på god vård. Detta föratt förhindra att nyförlösta kvinnor upplever onödigt vårdlidande. Background: Postnatal care in western countries has undergone major changes in recentdecades. Despite this, studies show that many women are not satisfied with the care theyreceived after the birth. Objective: The purpose of this literature review is to describewomen's experiences of postnatal hospital care. Method: A literature review based on tenscientific articles in both qualitative and quantitative approach. Result: Four major themesemerged from the analysis of the articles; information, health care organization and healthcare environment, encounter and attitudes and support. It proved to be very many differentfactors that influenced women's experiences of postnatal care. These could be more or lessimportant for different women. Knowledge of this can contribute to health care professionalswith a better understanding of that each woman that recently given birth is a unique individualwith their own specific wants and needs and that postnatal care can not be generalized.Discussion: The postnatal hospital care must be conducted so that it meets the requirement ofgood care. This is to prevent unnecessary care suffering among women that recently givenbirth.

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Colebrook, Binda. "Mothering the mother : can a postpartum doula enhance maternal self-confidence and maternal empathy in a primiparous mother? : a project based upon an independent investigation /." View online, 2008. http://hdl.handle.net/10090/5875.

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Smit, Joalida. "Postpartum mood disorders : a feminist critique with specific reference to postnatal depression." Thesis, Stellenbosch : Stellenbosch University, 2002. http://hdl.handle.net/10019.1/53010.

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Thesis (MA)--University of Stellenbosch, 2002 ENGLISH ABSTRACT: This review examines the medical model's conceptualisation of postnatal depression (pND) from a feminist perspective. The arguments are fourfold: Firstly, it argues that the fundamental problem underlying the concept of PND is its conception as existing on a continuum with psychosis at the most severe end and maternity blues at the least severe end. The link with psychosis implies that it is potentially pathological requiring medical and psychiatric intervention. On the other hand its link with maternity blues gives scientific credence to continued research on emotional sequelae of reproduction that are below the psychiatric threshold of urgency. Secondly, the medical model's construction of PND implies that women are predisposed to mental illness because of their ability to bear children and thus pathologises normal experiences of childbirth. Thirdly, the medical model's preoccupation with classification and categorisation has become little more than an exercise in labeling that has removed women from their own experiences. Focusing on birth as an activity that is separate from the rest of pregnancy objectify women and ignores the socio-political context within which they give birth and care for their infants. Fourthly, it is argued that a different way of researching postpartum mood disorders is necessary to overcome a reductionistic and pathological model of childbirth. This is important if healthcare delivery hopes to provide adequate treatment for all women in the postnatal period. Especially in South Africa, where the dominant culture has for many years defined the experiences of the 'other', it is important to generate research that should include the 'voices' of the 'other' to prevent hegemonic practice from assuming an expert understanding of PND. This review does not deny the contributions from the medical establishment, but argues that a critique of its underlying assumptions is important to prevent women from being further marginalised by ignoring the socio-political context in which their lives are embedded. The implications for research within South Africa are also addressed. AFRIKAANSE OPSOMMING: Hierdie oorsig ondersoek die mediese model se konseptualisering van postnatale depressie vanuit 'n feministiese perspektief. Die argument is vierledig: Eerstens blyk die konseptualisering van postnatale depressie, naamlik dat dit op 'n kontinuum bestaan, met psigose aan die mees disfunksionele kant en 'maternity blues' aan die minder ernstige kant, 'n fundamentele, onderliggende probleem te wees. Die verband met psigose impliseer dat postnatale depressie potensieel patologies is en mediese en psigiatriese insette benodig. Die verband met 'maternity blues' aan die ander kant, bied wetenskaplike begronding vir volgehoue navorsing op die gebied van emosionele aspekte van kindergeboorte wat nie van psigiatriese belang is nie. Tweedens impliseer die mediese model se konstruksie van postnatale depressie dat vroue 'n predisposisie tot geestessiektes het bloot deur die feit dat hulle die vermoë het om kinders voort te bring. Sodoende word patologiese kenmerke gekoppel aan normale ervarings van kindergeboorte. Derdens het die mediese model se beheptheid met klassifikasie en kategorisering verval in etikettering wat vroue van hul eie ervarings vervreem. Deur te fokus op geboorte as 'n aktiwiteit wat verwyder is van die res van swangerskap maak van vroue objekte wat verwyderd is van die sosio-politieke konteks waarbinne hulle geboorte skenk en sorg vir hul babas. Vierdens word dit beredeneer dat 'n nuwe benadering tot navorsing oor postpartum gemoedsteurings daar gestel behoort te word om 'n reduksionistiese en patologiese model van kindergeboorte te voorkom. Dit is belangrik as gesondheidsorgdienste hoop om toereikende behandeling te bied vir alle vroue in die postnatale periode. Veral in Suid-Afrika, waar 'n dominante kultuurgroep vir so lank die ervarings van ander omskryf het, is dit belangrik om navorsing voort te bring wat die 'stemme' van die 'ander' insluit om sodoende te verhoed dat die heersende praktykvoeringe van die dag 'n eensydige deskundige-verstaan van postnatale depressie voorveronderstel. Hierdie oorsig ontken nie die bydraes van die mediese model nie, maar beredeneer die feit dat 'n kritiese beskouing van die onderliggende aannames belangrik is om sodoende te verhoed dat vroue verder gemarginaliseer word deurdat die sosio-politieke konteks waarin hul lewens gegrond is, buite rekening gelaat word. Die implikasies vir navorsing binne 'n Suid-Afrikaanse konteks word dus ook ondersoek.

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39

Gamble, Jennifer Anne, and n/a. "Improving Emotional Care For Childbearing Women: An Intervention Study." Griffith University. School of Nursing, 2003. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20030904.154204.

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Childbirth can be associated with short and long-term psychological morbidity including depression, anxiety and trauma symptoms. Some previous studies have used psychological interventions to reduce postpartum distress but have primarily focussed on attempting to relieve symptoms of depression with little recognition of trauma symptoms. Furthermore, the intervention used in these studies has generally been poorly documented. The first aim of the present study was to develop a counselling framework, suitable for use by midwives, to address psychological trauma following childbirth. Multiple methods were used to develop the intervention including focus groups with women and midwives. Both the women and midwives gave unequivocal support for postpartum debriefing. Themes that emerged from the focus groups with women included the need for opportunities to talk about their birth experience, an explanation of events, an exploration of alternative courses of action that may have resulted in a different birth experience, talking about their feelings such as loss, fear, anger and self-blame, discussing social support, and discussing possible future childbearing. There was a high level of agreement between the women's and midwives' views. These themes were synthesized with contemporary literature describing counselling interventions to assist in reconciling a distressing birth experience and a model for understanding women's distressing birth experiences to develop a counselling framework. The counselling intervention was then tested using a randomised controlled study involving 400 women recruited from antenatal clinics of three public hospitals. When interviewed within seventy-two hours of birth, 103 women reported a distressing birth experience and were then randomised into either the treatment or control group. Women in the intervention group had the opportunity to debrief at the initial postpartum interview (< 72 hours postpartum) and at four to six weeks postpartum. The prevalence of posttraumatic stress disorder was quite high; 9.6% of participants meeting the diagnostic criteria for acute PTSD at four to six weeks postpartum. Fewer participants (3.5%) met the diagnostic criteria for chronic PTSD at three months postpartum. As with previous research relating to childbearing women, few demographic factors or antenatal psychological factors were associated with the development of a PTSD symptom profile following childbirth. The development of PTSD symptom profile was strongly associated with obstetric intervention and a perception of poor care in labour. This finding is also consistent with previous research. Emotional distress was reduced for women in the intervention group in relation to the number of PTSD symptoms [t (101) = 2.144, p = .035], depression [c2 (1) = 9.188, p = .002], stress [c2 (1) = 4.478, p = .029] and feelings of self-blame [t (101) = -12.424, p <.001]. Confidence about a future pregnancy was higher for these women [t (101) = -9.096, p <.001]. Although there was not a statistically significant difference in the number of women with a PTSD symptom profile at three months postpartum, fewer women in the intervention group (n=3) than in the control group (n=9) met PTSD criteria. Likewise, there were fewer women in the intervention group (n=1) with anxiety levels above mild than in the control group (n=6). Importantly, this study found that offering women who have had a traumatic birth the opportunity for counselling using the framework documented in this dissertation was not harmful. This finding is in contrast to previous findings of other studies. The intervention was well received by participants. All the women in the intervention group found the counselling sessions helped them come to terms with their birth experience. Maternity service providers need to be cognizant of the prevalence of this debilitating condition and be able to identify women at risk for early intervention and referral to a mental health practitioner if appropriate. This research offers further support for the compelling need to implement changes to the provision of maternity services that reduce rates of obstetric intervention and humanise service delivery as a means of primary prevention of birth-related PTSD.

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40

Wallén, Annelie, and Catrine Bonnedahl. "Identifiering och uppföljning av kvinnor med postpartumdepression : Distriktssköterskors och barnmorskors uppfattning." Thesis, Uppsala University, Department of Public Health and Caring Sciences, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-105272.

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ABSTRACTBackgroundPostpartum depression (PPD) occurs in 10% of women who have recently given birth. Postpartum depression is treatable but unidentified and untreated it could lead to serious consequences. There are multiple instruments for screening available. The Edinburgh Postnatal Depression Scale is the most frequently used and is regarded as the best instrument. AimThe aim of this study was to analyze to what extent and how midwifes and primary care nurses identify mothers with symptoms of depression respectively PPD. A further aim was to enquire if there are routines for follow up and if there is any collaboration among the professions?MethodA descriptive and comparative design with collection of quantitative and qualitative data was chosen. Midwifes (n=20) and primary care nurses (n=26) at 9 primary care centres answered a questionnaire concerning PPD.ResultsAlmost all of the primary care nurses reported that they used EPDS as a screening instrument. They also described signs of depression/PPD. Midwifes and primary care nurses had some education in PPD, but there was a need for more education. Even if there was some collaboration among the professions there still was a wish for an increase of co-working.ConclusionEPDS-screening and referrals to psychologist, physicians and psychiatrists are routines used to identify PPD and also for follow-ups. The midwifes have not received education and does not use EPDS-screening in the same extension as the primary care nurses.

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41

Boardley, Graeme N. "Early discharge planning : Primiparous women's perceptions of their readiness for going home." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1998. https://ro.ecu.edu.au/theses/1003.

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Early discharge for women after childbirth was introduced in Australia approximately ten years ago. Early discharge involves going home from hospital within three days of giving birth. Since its introduction, early discharge has been the subject of much debate. Previous research has argued the cost effectiveness and safety of early discharge, but little has been done to examine this phenomenon from the human aspect. An exploratory study of first time mothers, in an early discharge programme was undertaken to address how these women felt in relation to their readiness for going home. A purposive sample of twenty Caucasian, English speaking women were interviewed in their homes, three weeks after the birth of their baby. Data from personal interviews, telephone follow-up interviews and the researchers observational field notes were analysed using content analysis. Significant statements were extracted from data transcriptions and were clustered into appropriate themes and sub-themes. Validity and reliability was confirmed during data analysis. The study findings revealed that the 20 participants felt ready to go home from hospital on or before day three. Four key themes emerged from the data: Getting Information and Help for Going Home; Getting Information and Help after Going Home; Caring for Baby; and Own Environment. The conceptual framework developed from the current literature on early discharge was modified to incorporate the themes drawn from the data. More exploratory-descriptive research on early discharge needs to be undertaken to examine the perceptions of other groups within the community. The experiences of non-English speaking women, single mothers, and adolescents in early discharge programmes need to be explored.

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42

Rudman, Ann Ingmarsdotter. "Women's evaluations of intrapartum and postpartum care /." Stockholm : Karolinska insitutet, 2007. http://diss.kib.ki.se/2007/978-91-7357-273-6/.

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43

Ridgers, Margareta Irene. "'Passing through but needing to be heard' an ethnographic study of women's perspectives of their care on the postnatal ward." Thesis, Bournemouth University, 2007. http://eprints.bournemouth.ac.uk/17785/.

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Background. There is a wealth of literature demonstrating that women are critical of their care on the postnatal ward, but little information as to why. This ethnographic study therefore explored the context of care on the postnatal ward and women's views of that care. Method. The study was undertaken in one Acute NHS maternity unit in the South of England. Non-participant observation was undertaken to explore activities and interactions between the care-givers and women within the ward environment. This was followed by in-depth interviews with twelve women between two and five weeks postnatally about that experience. Findings. Analysis revealed the impact of the hierarchical structure within the organisation which pervaded through and rendered the care of women marginalised. Midwives maintained efficiency in their interaction with the women and their main focus was on 'processing' the women through the ward. Care was articulated through the procedural language of 'checks' and 'work' illustrating an ethos of 'task-based' contacts between midwives and women. The midwives felt ambivalent and physically withdrew from the women upon completion of set 'tasks'. comprising primarily physical care. Women, as passive recipients, were not able to make themselves heard and therefore individual care needs were not always met. This 'functional relationship', valued and supported by the organisation, offered an 'unconnected presence' to the women. Women sought a 'connected presence' from the midwife in recognition of their needs. In the absence of emotional or physical support, some women sought support from the other women or 'opted out' by transferring home earlier that originally intended to receive support from their immediate family and their community midwife. Conclusions. A formal definition of 'care' which encompasses physical and emotional aspects appears lacking. Midwives must reconsider how individualised care, desired by the women, can best be provided.

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44

Hoosen, Nikhat. "Interventions for Improving Adherence and Retention in HIV-Infected Women on ART During Antenatal and Postnatal Care: A Systematic Review." Master's thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/33814.

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Introduction Universal access to antiretroviral therapy (ART) during pregnancy and breastfeeding has implications for retention in HIV care and adherence to ART. Retention and adherence may be especially challenging during antenatal and postnatal periods, where women living with HIV have competing responsibilities between infant care, self-care and personal responsibilities. Lifelong ART also highlights the role interconception care (ICC) and preconception care (PCC) interventions can play in improving maternal outcomes. While the latter exist for other health topics, ICC and PCC interventions targeting women living with HIV has the potential to maintain retention in care and adherence to ART during, after, and in between pregnancies. This systematic review evaluates interventions that aim to improve retention and adherence in pregnant and postpartum women. Methods The Cochrane Library; MEDLINE via PubMed; Web of Science; and EBSCOHOST (Africa Wide, Academic Search Premier, CINAHL, PsychArticles, Health Source Nursing Academic, PsychInfo) and conference databases were searched for articles in English published between 1990 to 2020. All study designs, intervention types and geographic locations were included. Data were extracted using a standardized tool, and effect sizes recalculated for all studies. Risk of bias was conducted using tools suited to specific study designs, and the PRECIS-2 tool assessed intervention applicability in real-world settings. The protocol was registered with PROSPERO (ID: CRD42020185196). Results Thirty-one studies were identified, of which 31 and 16 provided retention and adherence data, respectively. No interconception or preconception care interventions were found. Interventions were predominantly from Sub-Saharan Africa, except one from the USA. Intervention types varied and included integration of services, peer support, mhealth and multicomponent interventions. The definitions of retention and adherence used for outcome assessment varied widely across studies, but almost all were scored as pragmatic in real-world settings. Due to high heterogeneity, a narrative approach was used based on study reported data and the effect sizes. Conclusion Overall, heterogeneity of identified studies make definitive recommendations for interventions scale up difficult. Future interventions will benefit from consistent study designs, outcome definitions, outcome measurements, validated tools, and longer retention time points will strengthen the evidence base. Ongoing studies being conducted show promise in addressing some of these points.

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45

Alrumaih, Ali M. S. "Early environments and neurobehavioural programming: Therapeutic actions of antidepressants. Neurobehavioural programming during development." Thesis, University of Bradford, 2013. http://hdl.handle.net/10454/6317.

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Following decades of research on stress and its impact on behaviour, it is now widely accepted that selective psycho-pathologies, in particular clinical depression are more prevalent in humans with prior history of life-stress events. Interest in stress has led to questions about how it might affect the physiology and behaviour of animals exposed indirectly during gestational development. Not unexpectedly gestational stress has been shown to affect the offspring in several ways: endocrine responses to stress are elevated, fear, arousal and affective disturbances are all subject to vary if the pregnant animal is subjected to periods of aversive stimulation. Beginning in 1997, Michael Meaney of McGill University produced a series of publications suggesting that peri-natal events influence offspring and infant development, not via physical discomfort or physiological disturbance, but does so through modifications of maternal behaviour. Highly nurturant mothers (those who engage in active arched-back nursing (ABN), and spend more time licking and grooming (L/G) their pups), programme their offspring with improved cognitive abilities, decreased anxiety and fear, and reduced HPA axis hormone secretion. Low-nurturant mothers, who engage in less ABN and less L/G, tend to programme the opposite responses in their offspring. Our initial foray into this field was to investigate if gestational stress might also produce responses in the offspring via changes in maternal behaviour, and indeed ABN and L/G were reduced in dams which were subjected to gestational stress. We queried why stressed Dams would be less maternal towards their infants, and tested gestationally-stressed Dams in the Porsolt test for depressive-like behaviour. Our results suggested that these stressed Dams were actually depressed and this resulted in less maternal behaviour. Human mothers with depression are also less maternal and have been shown to divest themselves of infant care much like our prenatally-stressed Dams. On this basis we have proposed that gestational stress induced decrements in maternal behaviour represent a novel rat model for postnatal depression with face and construct validities. In the present work we have attempted to replicate the findings of Smythe¿s group (Smith et al., 2004), and have investigated the potential for antidepressants to alter the influence of gestational stress on maternal behaviours and depressive-like response, and whether or not the offspring¿ are modified by maternal treatment with ant-depressants. Approximately 140 time-mated, lister hooded rats were generated in house, and subjected to gestational stress on days 10-20 (1hr restraint/day) or remained undisturbed in their home cages. Following birth, cohorts of control and stressed Dams were administered vehicle or an antidepressant (imipramine 15mg/kg; or sertraline 10mg/kg) once daily until postnatal day 10. We assessed maternal Porsolt activity, nurturance (ABN, L/G, nest building) and anxiety-like behaviour in the elevated plus maze (EPM). Representative offspring of each Dam¿s treatment conditions were maintained post weaning and assessed in the Porsolt and EPM to determine if any changes in maternal behaviour elicited by the antidepressants altered their behavioural programming. Our findings confirm that Dams show depressive-like symptoms following gestational stress, and that administration of antidepressants to the Dams reduces depressive-like behaviour and increased maternal care. We propose that rat gestational stress is a putative model for human postnatal depression. Prenatal stress effects on maternal behaviour in the rat Dam represent a novel, and innovative model for human postnatal depression. Ministry of Defence, Prince Sultan Military College of Health Sciences and the Saudi Culture Bureau

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46

Malkin, Jesse D. "The postpartum mandate estimated costs and benefits /." Santa Monica, CA : Rand, 1998. http://books.google.com/books?id=Uw_bAAAAMAAJ.

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47

Özdemir, Raziye Kişioğlu Ahmet Nesimi. "Isparta İl Merkezinde gebe lohusa izlem fişlerinin değerlendirilmesi /." Isparta : SDÜ Sağlık Bilimleri Enstitüsü, 2005. http://tez.sdu.edu.tr/Tezler/TT00206.pdf.

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48

Jern, Frida, and Uldine Sigfridsson. "BVC-sköterskors upplevelser att möta mödrar med symtom på postpartumdepression : En kvalitativ intervjustudie." Thesis, Högskolan i Skövde, Institutionen för hälsa och lärande, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-12165.

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Bakgrund: Under graviditeten och efter förlossningen genomgår kvinnan en period som innebär en stor förändring i hennes liv och det är vanligt att uppleva ett brett spektrum av olika känslor. Den första tiden efter förlossningen kan symtom på allvarliga psykiska hälsoproblem utlösas, såsom en depression. Depression hos nyblivna mödrar, en så kallad postpartumdepression, har sedan 1990-talet ökat i intresse inom hälso- och sjukvården, inom omvårdnadsforskningen samt bland föräldrar. Syfte: Syftet med denna studie var att belysa BVC-sköterskors upplevelser av att möta mödrar med symtom på postpartumdepression. Metod: En induktiv ansats användes där datamaterialet analyserades med kvalitativ innehållsanalys. Datamaterialet utgjordes av intervjuer och åtta BVC-sköterskor intervjuades. Resultat: Ur analysen av datamaterialet framkom fyra kategorier: etablera ett gott samarbete, ge råd och vägledning, att använda instrument som underlättar och kommunikativa hinder i arbetat samt tillhörande underkategorier. Konklusion: För att kunna möta mödrar med symtom på postpartumdepression bör BVC-sköterskorna etablera ett bra samarbeta. Det första hembesöket var också betydelsefullt för att kunna etablera ett bra samarbete mellan BVC-sköterskorna och mödrarna. Att använda instrument såsom EPDS-formuläret, underlättade samtalet och var ett viktigt verktyg för BVC-sköterskorna. Background: During pregnancy and after childbirth the woman go through a period that represents a major change in her life and it´s common to experience a wide range of different emotions. The first time after birth, symptoms of serious mental health problems can be triggered, such as depression. Depression in new mothers, known as postpartum depression, has increased in interest since the 1990s in health care, nursing research and among parents. Aim: The aim of the study was to illustrate Child health care nurses’ experiences of encounting mothers’ with symptoms of postpartum depression. Method: Qualitative content analysis with inductive approach was used and data were collected through interviews. Eight Child health care nurses’, CHCN, were interviewed. Results: Four categories emerged from the analysis: establish a good collaboration, provide advice and guidance, to use instruments that facilitate and communicative barriers at work and associated subcategorys. Conclusion: In order to meet mothers with symptoms of postpartum depression CHCN need to establish a good collaboration. The first home visit was also important to establish a good collaboration between CHCN and mothers. The use of instruments such as EPDS, facilitate the conversation and was an important tool for the CHCN.

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49

Araya, Winta Negusse. "Knowledge and Practice of Reproductive Health among Mothers and their Impact on Fetal Birth Outcomes: A Case of Eritrea." Scholar Commons, 2013. http://scholarcommons.usf.edu/etd/4627.

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Maternal mortality is a huge concern globally leading to more than a quarter of a million deaths every year. Similarly, an estimated 4 million neonates die every year worldwide, contributing to the majority of deaths of under-5 children. The majority of these deaths take place in under-developed countries, and specifically, in the sub-Saharan Africa region. It is evidenced that maternal ill-health and death contribute to the majority of child deaths. Reducing the death of children under 5 years by two thirds and also improving maternal health/reducing maternal death by three quarters between the years 1990 and 2015 are two of the eight aims of the Millennium Development Goals (MDGs), MDG-4 and MDG-5 respectively. The report on maternal health services in Eritrea, a nation in the sub-Saharan Africa, shows a low utilization of antenatal care, family planning services, and postnatal care. Furthermore, there is insufficient use of skilled assistance at delivery. The purpose of this study was to explore the reproductive health knowledge and practice of women aged 18-49 and the impact of these on infant birth outcomes. Participants were all living in the Central Zone of Eritrea. This study proposed that knowledge of reproductive health is one of the key factors contributing to the health of women in the reproductive age group, and thereby reduction of maternal and child deaths and morbidities. An exploratory cross-sectional study design was implemented in this study using an investigator-designed questionnaire. Data were collected from participants intending to assess awareness on the domains of reproductive health including knowledge of family planning, sexually transmitted diseases (STDs), antenatal and postnatal care, importance of vaccinations, and identification of pregnancy/labor danger signs. Data on the most recent birth outcome that took place in the past five years were collected to investigate any existing associations. Findings showed that a majority of participants recognized danger signs and where to seek help in case of complications related to pregnancy and childbirth. Participants also stated the importance of child vaccination, identified STDs and family planning methods as well. Further, the majority also acknowledged the importance of antenatal care (ANC) and postnatal care by skilled personnel. However, a large percentage did not start ANC visits until after the first trimester. Also, a large number of participants did not know when fetal anomalies were most likely to occur or when conception can happen in relation to the menstrual cycle. Looking at birth outcomes, marital status and educational status showed a significant relationship with birth weight, while educational status was further a significant predictor of maturity of fetus at birth. Overall, these findings indicate the need for increased efforts in providing adequate reproductive health education, especially in certain target areas, so that women are better equipped with the necessary basic reproductive health information. This will hopefully contribute to the betterment of maternal health, further leading to a desired birth outcome.

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50

Alrumaih, Ali Mohammed S. "Early environments and neurobehavioural programming : therapeutic actions of antidepressants : neurobehavioural programming during development." Thesis, University of Bradford, 2013. http://hdl.handle.net/10454/6317.

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Following decades of research on stress and its impact on behaviour, it is now widely accepted that selective psycho-pathologies, in particular clinical depression are more prevalent in humans with prior history of life-stress events. Interest in stress has led to questions about how it might affect the physiology and behaviour of animals exposed indirectly during gestational development. Not unexpectedly gestational stress has been shown to affect the offspring in several ways: endocrine responses to stress are elevated, fear, arousal and affective disturbances are all subject to vary if the pregnant animal is subjected to periods of aversive stimulation. Beginning in 1997, Michael Meaney of McGill University produced a series of publications suggesting that peri-natal events influence offspring and infant development, not via physical discomfort or physiological disturbance, but does so through modifications of maternal behaviour. Highly nurturant mothers (those who engage in active arched-back nursing (ABN), and spend more time licking and grooming (L/G) their pups), programme their offspring with improved cognitive abilities, decreased anxiety and fear, and reduced HPA axis hormone secretion. Low-nurturant mothers, who engage in less ABN and less L/G, tend to programme the opposite responses in their offspring. Our initial foray into this field was to investigate if gestational stress might also produce responses in the offspring via changes in maternal behaviour, and indeed ABN and L/G were reduced in dams which were subjected to gestational stress. We queried why stressed Dams would be less maternal towards their infants, and tested gestationally-stressed Dams in the Porsolt test for depressive-like behaviour. Our results suggested that these stressed Dams were actually depressed and this resulted in less maternal behaviour. Human mothers with depression are also less maternal and have been shown to divest themselves of infant care much like our prenatally-stressed Dams. On this basis we have proposed that gestational stress induced decrements in maternal behaviour represent a novel rat model for postnatal depression with face and construct validities. In the present work we have attempted to replicate the findings of Smythe's group (Smith et al., 2004), and have investigated the potential for antidepressants to alter the influence of gestational stress on maternal behaviours and depressive-like response, and whether or not the offspring are modified by maternal treatment with ant-depressants. Approximately 140 time-mated, lister hooded rats were generated in house, and subjected to gestational stress on days 10-20 (1hr restraint/day) or remained undisturbed in their home cages. Following birth, cohorts of control and stressed Dams were administered vehicle or an antidepressant (imipramine 15mg/kg; or sertraline 10mg/kg) once daily until postnatal day 10. We assessed maternal Porsolt activity, nurturance (ABN, L/G, nest building) and anxiety-like behaviour in the elevated plus maze (EPM). Representative offspring of each Dam's treatment conditions were maintained post weaning and assessed in the Porsolt and EPM to determine if any changes in maternal behaviour elicited by the antidepressants altered their behavioural programming. Our findings confirm that Dams show depressive-like symptoms following gestational stress, and that administration of antidepressants to the Dams reduces depressive-like behaviour and increased maternal care. We propose that rat gestational stress is a putative model for human postnatal depression. Prenatal stress effects on maternal behaviour in the rat Dam represent a novel, and innovative model for human postnatal depression.

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