Abstract
BackgroundPostpartum Care is a strategy to improve survival of women and newborns, especially in low- and middle-income countries. Early post-partum care can promote healthy behaviors and the identification of risk factors associated with poorer pregnancy-related outcomes. The objective of this study was to assess the association of perceived social support with attendance to post-partum care in women from three Latin-American and Caribbean countries: Costa Rica, Dominican Republic and Honduras.MethodsWomen aged 18+ who completed a pregnancy in the past 5 years were interviewed in local healthcare and community settings in each country. Perceived social support (PSS) was the primary explanatory variable and the primary outcome was self-reported attendance to post-partum care. Odds Ratios (OR) with 95% confidence intervals derived from logistic regression documented the association between variables. Adjusted Odds Ratios (AOR) were calculated, controlling for social and pregnancy-related confounders. Hosmer– Lemeshow’s Goodness-of-Fit statistic was computed to assess model fit.ResultsOur cohort of 1199 women across the three Latin-American and Caribbean countries showed relatively high attendance to post-partum care (82.6%, n = 990). However, 51.7% (n = 581) of women reported lower levels of total PSS. Women were more likely to attend postpartum care if they had mean and higher levels of PSS Family subscale (OR: 1.9, 95%CI: 1.4, 2.7), Friends subscale (OR 1.3, 95%CI: 0.9,1.8), Significant Other subscale (OR 1.8, 95%CI: 1.3, 2.4) and the Total PSS (OR 1.8, 95%CI: 1.3, 2.5). All associations were statistically significant at p < 0.05, with exception of the Friends subscale. Women with higher levels of total PSS were more likely to attend to post-partum care (AOR:1.40, 0.97, 1.92) even after controlling for confounders (education, country, and food insecurity).ConclusionsWomen with higher perceived social support levels were more likely to attend to post-partum care. From all countries, women from Dominican Republic had lower perceived social support levels and this may influence attendance at post-partum care for this subgroup. Societal and geographic factors can act as determinants when evaluating perceived social support during pregnancy.
Highlights
Postpartum Care is a strategy to improve survival of women and newborns, especially in low- and middle-income countries
Results can serve as a baseline for the scientific community and practitioners where interventions can be implemented and maternal health can be improved for Latin American and Caribbean (LAC). Setting and sample This cross-sectional study was nested within a larger NIH-funded maternal health research and training initiative (MundoComm; www.mundocomm.org) and evaluated differences in postpartum care attendance, its relationship with perceived social support, and affiliated social, demographic, and pregnancy-related characteristics
Sample characteristics Our cohort consisted of 1199 women across countries (Costa Rica: 401; Dominican Republic: 404; Honduras: 394)
Summary
Postpartum Care is a strategy to improve survival of women and newborns, especially in low- and middle-income countries. The objective of this study was to assess the association of perceived social support with attendance to post-partum care in women from three Latin-American and Caribbean countries: Costa Rica, Dominican Republic and Honduras. In low- and middle-income countries, PPC has been a interventional tool to decrease maternal and neonatal morbidity and mortality [1, 2]. Between 20 and 35% of women use any PPC services [2]. The poorest 20% of the population in most Latin American and Caribbean (LAC) countries is still lagging behind toward reducing inequalities in reproductive and maternal-child health [5]. Attendance to care and risks during the postpartum period may affect populations disproportionally and renewed actions are needed to improve maternal health equity
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