Perinatal Support Research Articles

Postnatal social support group needs and explanatory models of Iraqi Arabic speaking women in the year following the birth of their baby in Perth, Western Australia

The aim of the current research was to explore the nature and type of support required in a postnatal support group intervention for Iraqi women. A further aim was to understand Iraqi Arabic speaking mothers’ explanatory models surrounding motherhood, relevant to the appropriate design of a culturally sensitive support group. The qualitative research involved semi structured interviewing from which data was extracted and categorised into relevant themes using an interpretative phenomenological approach (Smith, 1995). In depth interviews were conducted with 7 Iraqi Arabic speaking mothers. A number of major themes emerged, suggesting key aspects to include in a perinatal social support group for Iraqi women based on their explanatory model of their mental health. Themes included: significance of motherhood; physical and emotional difficulties confronted; postnatal health care experiences and negotiating motherhood in a new country; and receptivity to the provision of a support group intervention. Findings will be used to design and evaluate a perinatal social support group for Iraqi women and, potentially, provide a generic family model of intervention for mothers from culturally and linguistically diverse (CALD) backgrounds in the year following the birth of their baby.

Mechanisms behind psychosocial stress-induced spontaneous colitis in male mice

To examine the association between prenatal stress and infant physical health in the first year of life within an understudied, racially and ethnically diverse, highly stressed community sample. We expected that greater stress exposure would predict higher rates of infant illness.Low-income, racially/ethnically diverse, overweight women with low medical risk pregnancies were recruited (2011-2014) during pregnancy. Pregnancy Stressful Life Events were assessed retrospectively (mean, 11.88 months postpartum). Perceived stress was assessed twice during pregnancy (at a mean of 17.4 weeks and again at a mean of 25.6 weeks) and at 6 months postpartum. Women with live births (n = 202) were invited; 162 consented to the offspring study. Medical records from pediatric clinics and emergency departments for 148 infants were abstracted for counts of total infectious illnesses, total noninfectious illness, and diversity of illnesses over the first year of life.The final analytic sample included 109 women (mean age, 28.08 years) and their infants. In covariate-adjusted negative binomial models, maternal perceptions of stress across pregnancy were positively associated with infant illness. Each 1-point increase in average stress was associated with a 38% increase in incidence of infant infections (Incidence rate ratio, 1.38; 95% CI, 1.01-1.88; P < .05), a 73% increase in noninfectious illness (IRR, 1.73; 95% CI, 1.34-2.23; P < .05), and a 53% increase in illness diversity (IRR, 1.53; 95% CI, 1.25, 1.88; P < .01); effect sizes were larger for perceived stress later in pregnancy. Stressful life events count and postnatal stress were not uniquely associated with illness.In line with recommendations from the American Academy of Pediatrics to screen for maternal perinatal depression, screening and support for stress reduction during pregnancy may benefit both maternal and child health.

Postnatal Social Support Group Needs and Explanatory Models of Iraqi Arabic Speaking Women in the Year Following the Birth of their Baby in [capital city

The aim of the current research was to explore the nature and type of support required in a posttnatal support group intervention for Iraqi women. A further aim was to understand Iraqi Arabic speaking mothers' explanatory models surrounding motherhood which are relevant to the appropriate design of a culturally sensitive support group. The qualitative research involved semi structured interviewing and qualitative data analysis. In depth interviews were conducted with 7 Iraqi Arabic speaking mothers. A number of major theme categories emerged which suggested key aspects to include in a perinatal social support group for Iraqi women based on their explanatory model of their mental health. Aspects included: significance of motherhood; physical and emotional difficulties confronted; postnatal health care experiences and negotiating motherhood in a new country; and receptivity to the provision of a support group intervention. It is anticipated that the findings will be used to design and evaluate a perinatal social support group for Iraqi women.

Psychosocial impact of mothers with perinatal loss and its contributing factors: an insight

To evaluate the psychosocial impact among mothers with perinatal loss and its contributing factors. A cross sectional study was conducted in University Kebangsaan Malaysia Medical Centre (UKMMC) from April 2008 to May 2009 using Edinburgh Postnatal Depression Scale (EPDS) and self administered questionnaire. Sixty-two respondents were included and most of them were working mothers (77.4%). The mean age of the respondents was (31.0+/-5.6) years and a majority of the subjects aged between 20-34 years (77.4%). According to the EPDS score, 53.2% of the respondents had a psychosocial impact with a total score of >9, out of 30. There was a significant relationship between psychosocial impact after perinatal loss and support from friends (P=0.019). However, there were no significant differences between psychosocial impact and history of previous perinatal loss, ethnicity, occupation, educational level, age or total income. Mothers with perinatal loss should be screened for psychosocial impact and offered support when needed. Family and friends should continue to provide emotional support. People who have experienced similar problem before will be able to provide better support than those who have not.

Perceived Satisfaction With Social Support and Depressive Symptoms in Perinatal Latinas

This study examined the relationship between satisfaction with social support and postpartum depressive symptoms in Latinas. A secondary data analysis of 62 women at "high risk" or "low risk" for postpartum depression (PPD) was conducted during pregnancy and at 1 month postpartum. High-risk Latinas were less satisfied with perceived perinatal support from the baby's father and postnatal support from family and "others." Dissatisfaction with postpartum support from the baby's father was associated with higher depressive symptoms. Dissatisfaction with certain sources of support is related to high risk for PPD. Practice: Health care providers should assess levels and sources of social support as part of their PPD screening.

Explaining “Unexplained” Perinatal Loss

To explore women's experiences of 1 or more perinatal losses associated with antiphospholipid syndrome (APS) and describe their perceptions about losses related to this disorder and its effects on both their outlook and subsequent childbearing. The participants included thirty-eight 18- to 50-year-old women from 5 countries, who were members of general and APS online perinatal support groups and had 1 or more perinatal losses associated with APS. The respondents were recruited from various online perinatal loss support groups, using convenience and snowball sampling. Semistructured e-mail interviews were conducted, using the qualitative technique of phenomenology. Two major themes that emerged from the data are existence in bewilderment and persistence in the quest for knowledge and information. The first theme has 2 subthemes: delayed diagnosis and living in uncertainty. Women with APS and related perinatal losses perceive the need to persist in seeking scientific knowledge because the information they receive from healthcare providers is limited and unclear. Evidence-based medical and nursing education about antiphospholipid antibody syndrome is necessary to improve clinical practice and thereby the perinatal outcome and the ill effects of this condition for women during and after the childbearing period.

RETRACTED: Attitudes of midwives towards perinatal bereavement in Hong Kong

to explore attitudes towards perinatal bereavement care among midwives working in Hong Kong through examination of relationships between attitudes towards bereavement support, need for bereavement education and appropriate hospital policy. a descriptive correlational survey. the obstetric and gynaecology units at two hospitals. a structured self-report questionnaire on attitudes towards perinatal bereavement support; required support and education needs for midwives on bereavement care. 154 out of 202 midwives (76.2% response rate) working at the two units. two-step cluster analysis yielded two clusters. Cluster 1 consisted of 91 (59.1%) midwives and cluster 2 consisted of 63 (40.9%) midwives. Cluster 2 midwives were younger, had less obstetric and gynaecology experience, junior ranking and less post-qualification education than cluster 1 midwives. Cluster 1 midwives had additional personal grieving experiences and experience of caring for grieving parents. Attitudes towards bereavement care were positively correlated with educational needs (r(s)=0.55, p< 0.001) and hospital policy support (r(s)=0.50, p< 0.001). Hong Kong midwives require increased bereavement care knowledge and experience, improved communication skills, and greater hospital and team member support. Findings may be used to improve support of midwives, to ensure sensitive bereavement care in perinatal settings and to reflect training needs in the midwifery education curricula. Study findings highlight the universality of grief for a lost baby, irrespective of cultural differences in approaching emotional topics. This study may help midwives internationally to gain a broader perspective in this area.

Improved Outcomes of Extremely Premature Outborn Infants: Effects of Strategic Changes in Perinatal and Retrieval Services

The goal was to evaluate the impact of statewide coordinated changes in perinatal support and retrieval services on the outcomes of extremely premature births occurring outside perinatal centers in the state of New South Wales, Australia. The intervention included additional, network-coordinated, perinatal telephone advice to optimize in utero transfers and centralization of the neonatal retrieval system, with preferential admission of retrieved infants (outborn infants) to perinatal centers instead of freestanding pediatric hospitals, from the middle of 1995. Population birth and NICU admission cohorts of infants of 23 to 28 weeks of gestation were studied. Outcomes of epoch 1 (1992 to the middle of 1995; 1778 births and 1100 NICU admissions) were compared with those of epoch 2 (1997-2002; 3099 births and 2100 NICU admissions), after an 18-month washout period. There were 25% fewer nontertiary hospital live births (19.7% vs 14.9%) and more prenatal steroid use. Despite an 11.4% average annual increase in NICU admissions between the 2 epochs, fewer infants were outborn (12.0% vs 9.3%) and outborn mortality rates decreased significantly (39.4% vs 25.1%), particularly for those between 27 and 28 weeks of gestation. The overall improvement was equivalent to 1 extra survivor per 16 New South Wales births. There were also significantly fewer serious outcome morbidities in outborn infants during epoch 2, over the improvements in inborn infants. Statewide coordinated strategies in reducing nontertiary hospital births and optimizing transport of outborn infants to perinatal centers have improved considerably the outcomes of extremely premature infants. These findings have vital implications for health outcomes and resource planning.

Perinatal bereavement support: a quantitative study

This article aims to explore Hong Kong-based midwives' attitudes towards perinatal bereavement care and identify their required support and bereavement care training needs. It is based on a study of 93 certified midwives working in an obstetrics and gynaecology unit in one of Hong Kong Island's largest public hospitals. Data were collected through a structured self-administrated questionnaire. The study measured: midwives' attitudes towards perinatal bereavement support; required support and bereavement care training needs. The main findings were that the majority of this study's sample held a positive attitude towards bereavement care and there was a significant difference in attitudes towards perinatal bereavement support in terms of demographics, practical experiences and training factors.

Attitudes of Nurses Toward Perinatal Bereavement

Nurses' attitudes toward perinatal bereavement care are explored by identifying profiles of nurses working in 2 obstetrics and gynecology units in Hong Kong. Relationships between nurses' attitudes toward bereavement supports, need for bereavement education, and hospital policy are explored. A descriptive, correlational survey design was used, and 169 nurses recruited from an obstetric and gynecology (ob-gyn) unit at 2 local public hospitals in Hong Kong completed a structured questionnaire. Attitudes toward perinatal bereavement support; required support and education needs for nurses on bereavement care. Two-step cluster analysis yielded 2 clusters. Cluster 1 consisted of 55.6% (n = 94) and cluster 2 consisted of 44.3% (n = 75) of nurses. Cluster 2 nurses were younger and had less ob-gyn experience, more junior ranking, and less education than cluster 1 nurses. Cluster 1 nurses had additional midwifery and bereavement care education, personal grieving experiences, and experience handling grieving clients. The majority held positive bereavement care attitudes, but only 29.6% (n = 50) had bereavement-related education. Attitudes toward bereavement care were positively correlated with educational needs (r(s) = 0.52) and hospital policy support (r(s) = 0.56). Hong Kong nurses emphasized the need for increased bereavement care knowledge and experience, improved communication skills, and greater hospital and team members' support. Findings may be used to improve support of nurses, to ensure sensitive bereavement care in perinatal settings, and to enhance nursing curricula. The desire of Hong Kong nurses for bereavement education highlights the universality of grief for a lost infant, regardless of cultural differences in approaching emotional topics. This study may help nurses in the United States and elsewhere gain a broader perspective in this area.

Right Sided Hernia of Bochdalek: A Case Report

Congenital diaphragmatic hernias (CDH) of the foramen of Bochdalek are commonly reported in newborn Caucasian children; in contrast, they are rarely seen in African children. We report a case of right-sided Bochdalek's hernia that presented after the neonatal period and was successfully managed at the Lagos University Teaching Hospital. The seeming rarity of this lesion in African children may really represent a low incidence or it may be due to underdiagnosis as a result of the paucity of prenatal diagnostic and perinatal support services. Nigerian Journal of Paediatrics Vol.31(2) 2004: 59-60

Grief Enriched Us: A Model of Perinatal Loss Support

This article provides an example of the clinical application of one of the Lamaze International's Institute for Normal Birth evidence-based care practices. The practice of keeping mother and baby together, even in unusual circumstances, enhances family relationships and provides for positive lifetime memories.

A pilot study on nurses' attitudes toward perinatal bereavement support: a cluster analysis

Aim: Nurses' attitudes towards perinatal bereavement care are explored by identifying profiles of nurses working in a Hong Kong Obstetrics and Gynaecology (OAG) unit. Relationships between nurses' attitudes towards bereavement support, need for bereavement training and hospital policy are explored. Research method: 110 nurses recruited from the OAG unit of a large Hong Kong public hospital completed a structured questionnaire. Outcome measures: Attitudes towards perinatal bereavement support; required support and training needs for nurses on bereavement care. Results: Two-step cluster analysis yielded two clusters. Cluster A consisted of 55.5% ( n=61) and cluster B consisted of 44.5% ( n=49) of nurses. Cluster A nurses were younger, had less OAG experience, more junior ranking and less education than cluster B nurses. Cluster B nurses had additional midwifery and bereavement care training, personal grieving experiences and experience handling grieving clients. The majority held positive bereavement care attitudes. Significant differences towards perinatal bereavement support were found. Only 25.5% ( n=28) had bereavement related training. Attitudes towards bereavement care were positively correlated with training needs ( r s=0.59) and hospital policy support ( r s=0.60). Conclusion: Hong Kong nurses emphasized need for increased bereavement care knowledge and experience, improved communication skills, and greater hospital and team members' support. Findings may be used to improve support of nurses, to ensure sensitive bereavement care in perinatal settings, and to enhance nursing curricula.

La Familia: methodological issues in the assessment of perinatal social support for Mexicanas living in the United States

Do Mexicanas receive social support from a close network of family and friends during the perinatal period? To answer this question, a longitudinal ethnographic study followed 28 urban Mexican-origin women living in the US from their last trimester of pregnancy through their first month post-partum. A total of 93 interviews with Mexicanas focused on health and social support. All of the women lived in a large western city in the US but varied in their acculturation and income levels. Analyses identified four social support themes from women's experience (the emic analysis) and four social support typologies from the researcher (etic) analyses. The kinds of support women described as emanating from their support networks were inductively identified as Helping with Daily Hassles, Showing Love and Understanding, Being There for Me, and My Family Failing Me. Approximately half of the women reported densely supportive networks. The other women were disconnected from their support networks, or dealt with antagonism or instability in their networks. Women's perceptions of social support differed from the judgements made by the researcher about received support. Specifically, women perceived more network members in the supportive category than did the researcher by a factor of 1.4, and fewer network members in the disconnected category by a factor of 0.7. From an emic perspective, women listed only half as many antagonistic network members compared to the etic analysis (a factor of 0.50). These emic/etic discrepancies complicate clinical assessment of social support, but suggest that data on social support should be collected as part of the clinical processes of perinatal risking. To enhance assessment of social support, a clinically relevant guide is proposed for use by practitioners caring for Mexicanas in the perinatal period.

Guidelines for health care professionals supporting families experiencing a perinatal loss

Despite the lack of evidence from randomized trials that pro­ viding specific psychological support or counselling after peri­ natal death has any effect on the prevention of pathological grieving or long term psychosocial morbidity [2], an empathet­ ic, caring environment that facilitates a mother’s and family’s acceptance of the reality of death are now part of standard perinatal care and support [3]. This statement provides in­ sights into the phases, and processes of grieving and mourn­ ing, especially the unique aspects of pregnancy loss and neonatal death. Based on descriptive studies and common sense practice, general guidelines for caregivers are provided, with more specific suggestions for special conditions.

Sources of Infant Feeding Information Used by Pregnant Women

Selecting an infant feeding method is one of the most important decisions a mother-to-be makes. Little information is available to characterize women who plan to use both formula and breast milk. In this study, 89 pregnant women indicated their anticipated feeding method and the sources and initiator of infant feeding information. No differences were found in the type of resources used by women who planned to breastfeed, formula feed, or combination feed. Women in the study were four times more likely to initiate a conversation about infant feeding methods with a family member or friend than with a health care provider. Involving these key individuals in perinatal education classes and support programs is a simple, but powerful, strategy that childbirth educators can use to promote breastfeeding.

Evaluating a support group for perinatal loss.

This study attempted to determine if a support group intervention makes a difference in grief reactions of parents who have experienced a perinatal loss, and describes what parents perceived as being helpful and not helpful in handling the loss. A cross-sectional, retrospective, two-group research design was used. The independent variable was having attended or not having attended a perinatal loss support group. A convenience sample of 121 participants (n = 67 in support groups; n = 51 not in support groups) was obtained from a mail survey to families who were on a perinatal loss support newsletter mailing list. The participants completed the Hogan Grief Reactions Checklist and a demographic questionnaire. There were no statistically significant differences in parents' grief reaction scores between the two groups, but there were some differences in grief scores by gender and ethnicity. In both groups, the parents perceived their spouse, their extended families, and their friends as "most helpful." Physicians were perceived as "least helpful." Grief is very individual, and not all individuals may benefit from a support group. When suggesting a support group or any intervention, timing and a caring approach are essential.

Evolution of the perinatal care system.

The perinatal support system for mothers and babies, which has evolved over the past 6 years at the Morioka Red Cross Hospital, is described. Between July 1995 and August 1999, 1864 puerperal mothers at the Morioka Red Cross Hospital responded to the Maternity Blues Scale (MB) and the Edinburgh Postnatal Depression Scale (EPDS) at 1 month, each with an open comment form. There was a significant difference in each MB item between individuals who scored above 9 points and those who scored lower in the EPDS. Those who later scored high in the EPDS had responses to a preceding MB where we had checked items of 'confusion', 'experience of crying', 'anxiety', 'exhaustion', 'feeling depressed', 'nervousness', 'agitation' and 'forgetfulness'. Administration of the MB and provision of a free comment form significantly decreased EPDS scores. Ensuring that the views of mothers are acknowledged within the context of an adequate care system is central to effective perinatal care.

Mothers' Perceptions of Benefits of Perinatal Loss Support Offered at a Major University Hospital

This qualitative research investigated the perception of mothers regarding hospital support after perinatal loss. Twelve in-depth interviews demonstrated that the mothers recalled the circumstances of the loss. Most identified the hospital's support services and made comments on aspects of hospital support as influential in grief recovery. Most interviewees considered themselves somewhat recovered from the loss.

Early discharge: its impact on low-income mothers and newborns in the state of Hawaii.

The objectives of this survey were to investigate whether, in the state of Hawaii, early discharge had a negative effect on the health of new mothers and their infants, especially those at high sociodemographic risk, and whether early discharge was implemented in compliance with the early-discharge guidelines of the American Academy of Pediatrics (AAP), and the American College of Obstetricians and Gynecologists (ACOG). This statewide survey was conducted from June 17 through July 12, 1996. The data was collected and recorded by perinatal providers at 14 PSS (Perinatal Support Services) sites through interviews of mothers using questionnaires. This report is based on the 108 questionnaires that were returned from the PSS sites. A descriptive analysis was performed, using the statistical/epidemiologic program EPI INFO 6. The survey reveals that the practice of early discharge had been implemented extensively but not in compliance with AAP/ACOG early discharge guidelines. The neonatal readmission rate for this survey group was 6.5% among low-income mothers and infants. This was found to be among the highest rates reported in the United States and Canada; in the United States, reported neonatal readmission rates vary from 1 to 4%. Early discharge greatly contributes to negative outcomes among low-income mothers and infants. This paper reports on the results of this survey in Hawaii and recommends a comprehensive approach for promoting the health and well-being of low-income mothers and infants.