Abstract
China has the largest population of floating rural-to-urban women worldwide, most of whom are of childbearing age. However, few studies have been conducted to monitor the changing trends in parenting outcomes, mental health and social support for these women in the early postpartum period. In this quantitative longitudinal study, 680 primiparous women among the floating population were recruited in Shenzhen, China. Face-to-face collection of socio-demographic questionnaires was completed by researchers in maternity wards on the third postnatal day. Follow-up electronic questionnaires were dispatched to women via email or WeChat at 6 weeks and 12 weeks following childbirth, including the Self-efficacy in Infant Care Scale (SICS), Edinburgh Postnatal Depression Scale (EPDS) and Postnatal Social Support Scale (PSSS), to measure maternal self-efficacy (MSE), postpartum depression (PPD) and social support, respectively. The mean scores of MSE for these floating women were 67.16 (14.35) at 6 weeks postpartum and slightly increased to 68.71 (15.00) at 12 weeks postpartum. The mean scores of EPDS remained almost stable, from 11.19 (4.89) to 11.18 (5.34) at the two time points. The prevalence of mild and severe PPD among floating women at 6 and 12 weeks after childbirth decreased from 54.4% to 40.1% and from 50.6% to 35.4%, respectively. The mean score of social support was 37.04 (10.15) at 6 weeks postpartum and slightly improved to 38.68 (10.46) at 12 weeks postpartum. Primiparous women among the rural-to-urban migrant population had an obviously negative status of parenting outcomes and mental health; and there was a lack of social support after childbirth. In future, tailored evidence-based interventions are highly needed to promote floating women’s parenting outcomes, mental wellbeing and social support in the early stages of motherhood. As a higher-risk group of PPD, primiparous women among the floating population require effective and accessible mental health care after childbirth, such as early PPD screening and timely therapeutic methods.
Highlights
Due to rapid urbanization processes, China has witnessed a great number of people migrating from rural to urban areas during the past 30 years, called a “floating population” or “internal migrants” [1,2]
The items of “give mouth care to my baby every day”, “use a suction bulb correctly when my baby has phlegm”, “relieve my baby’s gas pain”, and “give proper care when my baby gets mild diarrhoea”, all scored lower than 50.00 at the two time points. These findings indicated that this population of floating women had lower confidence in parenting tasks surrounding baby health care, i.e., common baby disease management and emergency care
The proportions of city-resident women with Edinburgh Postnatal Depression Scale (EPDS) scores of 10 or above and 13 or above were 47.4% and 21.4% at 6 weeks postpartum, respectively; these were 38.3% and 18.2% at 12 weeks postpartum, respectively [14]. These results clearly indicate that a higher proportion of rural-to-urban floating women are likely to have postpartum depression (PPD) symptoms than city-resident women
Summary
Due to rapid urbanization processes, China has witnessed a great number of people migrating from rural to urban areas during the past 30 years, called a “floating population” or “internal migrants” [1,2]. Research has found that imbalance in the allocation of health resources has led to health inequalities between the city residents and floating women [6,7]. Compared with city residents, floating women of childbearing age are likely to suffer from more reproductive problems and use fewer perinatal health services, such as antenatal care and postnatal home visiting [5,8]. The wellbeing of rural-tourban floating women of reproductive age ought to attract significant attention from the government, health professionals and researchers [1,8,9]
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