Effects of Resilience and Optimism in Maternal Role Attainment after Six to Twelve Months Postpartum in Women Hospitalized for Pregnancy Complications

Abstract

Background: Each year in the US, approximately 1,200,000 pregnant women are hospitalized on bed rest with the intent to improve pregnancy outcomes. However, postpartum bed rest is not benign and may contribute to physical debilitation, postpartum depression (PPD), impaired maternal role attainment (MRA), and altered maternal-infant attachment. There are gaps in the literature about the effects of resilience, optimism, and PPD on MRA and the effects of resilience and optimism on PPD at six to 12 months postpartum. Although the effects of resilience and optimism have been studied in general adult populations, few studies have considered resilience and optimism as protectors that support MRA and reduce the risk of PPD. Methods: The theoretical framework was Maternal Role Attainment (Rubin). The purpose of this cross-sectional comparative survey design study was to examine differences in resilience, optimism, PPD, and MRA, the effects of resilience, optimism, and PPD on MRA at six to 12 months postpartum and the effects of resilience and optimism on PPD for mothers with (high-risk) and without hospitalization (low-risk) due to pregnancy complications. The hypotheses were: 1) Low-risk women will have higher resilience scores than high-risk women; 2) Low-risk women will have higher optimism scores than high-risk women; 3) Low-risk women will have lower PPD scores than high-risk women; 4) Low-risk women will have higher MRA scores than high-risk women; 5) Higher levels of resilience will predict lower scores on the MRA scale, controlling for risk status; 6) Higher levels of optimism will predict lower scores on the MRA scale, controlling for risk status; 7) Higher levels of depression will predict higher scores on the MRA scale, controlling for risk status; 8) Higher levels of resilience will predict lower scores on the PPD scale, controlling for risk status; 9) Higher levels of optimism will predict lower scores on the PPD scale, controlling for risk status. A convenience sample of 10 high-risk mothers hospitalized for at least five days during pregnancy and 24 low-risk mothers at six to 12 months postpartum participated in the study. Data collection was accomplished through self-report questionnaires: Being a Mother Scale (MRA); Life Orientation Test-Revised (optimism); Conner-Davidson Resilience Scale (resilience); Edinburgh Postnatal Depression Scale (PPD); and a Demographic Questionnaire (participant demographics). The investigator and the participants met in person or by phone to complete the questionnaires. Data analysis was comprised of descriptive statistics and inferential statistics including Student's t tests and multiple linear regression models to test the hypotheses. Bivariate correlations were run on all continuous variables and crosstabs on categorical variables to check for significant relationships and differences between the groups. Written perceptions of difficult feelings about being a mother were reported by description and themes. Results: This study found no statistical differences between the…