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PubMedDate not supplied

Bacterial colonization in neonates with sibling visitation.

The effect of postpartum sibling visitation on the incidence of bacterial colonization in neonates was investigated in a 25-bed ob/gyn unit at a military hospital. The visitation policy allowed siblings to visit with the infant at the mother's bedside, and siblings were allowed unrestricted contact with the infant after handwashing with an iodine scrub preparation. Data comparison revealed bacterial colonization on discharge in 70% of 214 control infants (admitted prior to sibling visitation program) and 67% of 182 study infants. It was concluded that postpartum sibling visitation did not increase the incidence of bacterial colonization in neonates.

Child↗
PubMedDate not supplied

Mother-infant interaction and breastfeeding outcome 6 weeks after birth.

OBJECTIVE: This study explored the relationship of early postpartum maternal-infant interactions to breastfeeding outcome at 6 weeks postpartum. DESIGN: Prospective, comparative descriptive study. SETTING: Women, Infants, and Children Supplemental Nutrition Program and Comprehensive Perinatal Services Programs in northern California. PARTICIPANTS: Forty-two Latina participants were recruited in the 3rd trimester of pregnancy. Eligibility criteria included age 18 years or older, primiparous at recruitment, antepartum desire to breastfeed 8 weeks or longer postpartum, planned hospital birth, full-term vaginal birth of a healthy newborn, and an uncomplicated, immediate postpartum course for mother and newborn, including being discharged together. MAIN OUTCOME MEASURES: The study examined breastfeeding dyads' early postpartum scores on Barnard's Nursing Child Assessment Feeding Scale (NCAFS) in relation to breastfeeding outcome 6 weeks postpartum. NCAFS tests were performed 28-90 hours postpartum in the participants' homes, and breastfeeding status was assessed by phone contact 6 weeks postpartum. RESULTS: Dyads continuing to breastfeed at 6 weeks postpartum had significantly higher early postpartum NCAFS scores than did dyads who had weaned from the breast by 6 weeks postpartum. CONCLUSIONS: Optimal maternal-infant interactions, as evidenced by higher scores on Barnard's NCAFS, were related to longer breastfeeding duration. Lower scores on the NCAFS, suggesting difficulties in maternal-infant interaction, were related to weaning earlier than planned.

Adult↗
PubMedDate not supplied

Postpartum safety and satisfaction following early discharge.

Two Ontario sites were involved in the evaluation of an obstetrical discharge program. Before program implementation a group of eligible women were enrolled as the preprogram control group (n = 542). During the program, eligible women who agreed to early discharge (ED) became the ED group (n = 319), and those opting not to go home early but consenting to participate in the evaluation became the concurrent group (n = 456). All groups were mailed a self-administered postpartum questionnaire. On demographic characteristics, safety and satisfaction, the ED group was comparable to the concurrent group. Hospital readmission rates did not differ across groups after stratification by site or hospital. Multiple classification analyses revealed a similar pattern for overall satisfaction levels. This unique ED program, which allowed pre- or postnatal enrollment and did not require an initial home assessment, appears to be a safe, effective and flexible approach to obstetrical care.

Adult↗
PubMed2000

The evaluation of determinants of early postpartum low mood: the importance of parity and inter-pregnancy interval.

OBJECTIVES: The aim of this study is to determine the extent of early postpartum low mood and possible relevant variables in our population. STUDY DESIGN: Depressive symptoms were examined in a sample of 85 women in the first week of postpartum period using Beck Depression Inventory (BDI). The relevant sociodemographic variables were tested by multiple logistic regression analysis. RESULTS: The rate of postpartum low mood (BDI score >10) was found 35.2%. High parity, long marriage period and low education level were all significantly associated with low mood in the postpartum first week. When logistic regression analysis was used to eliminate confounding effect of the parameters; grandmultiparity, short inter-pregnancy interval and low educational level were found to have important effect on postpartum low mood. CONCLUSION: Pregnant women with risk factors for postpartum low mood such as grandmultiparity, short inter-pregnancy interval and low educational level should be identified early during antenatal period. Educational and social support should be given to those in such a risk. We believe that effective family planning programs and improvement of women's educational level are important preventive factors for postpartum low mood and subsequently developing depression.

Adult↗
PubMed1990

Impact of single session post-partum counselling of HIV infected women on their subsequent reproductive behaviour.

During an ongoing study investigating the impact of maternal HIV infection on pregnancy outcome at a large maternity hospital in Nairobi, Kenya, asymptomatic HIV positive women who had recently delivered were informed of their HIV sero-status and counselled by a trained nurse regarding contraception and reproductive behaviour in a single session. Both HIV infected women and a comparison group of uninfected women matched for pregnancy outcome were followed up after an interval of one year. Contraceptive use, condom use and pregnancy rates were similar in both groups. Only 37% of HIV infected women had informed their partners of their sero-status. The single session of counselling for the HIV positive women did not seem to influence decisions on subsequent condom use or reproductive behaviour. More intensive approaches to counselling need to be developed and evaluated, but may be difficult to implement in the busy maternity and antenatal clinics commonly found in developing countries.

Abortion, Induced↗
PubMed1995

Impact and sustainability of a "baby friendly" health education intervention at a district hospital in Bihar, India.

OBJECTIVES: To evaluate the impact and sustainability of a baby friendly training intervention for staff at an Indian district hospital on initiation of breast feeding and use of prelacteal feeds by mothers. DESIGN: Intervention study with assessment by interviewing mothers. SUBJECTS: 172 mothers recruited before the intervention, 195 recruited immediately after the intervention, and 101 recruited six months later. SETTING: District hospital in a small town in Bihar, India. MAIN OUTCOME MEASURES: Age of infant when breast feeding started, use of prelacteal feeds, and colostrum feeding. INTERVENTION: 10 day training programme for doctors, nurses, and midwives, explaining the benefits and feasibility of early breast feeding and dangers of prelacteal feeds together with instruction on explaining this information to mothers. RESULTS: Breast feeding was started within 24 hours of birth by 53 (29%) of control mothers, 164 (84%) in the early follow up group, and 60 (59%) in the late follow up group. Prelacteal feeds were used by 165 (96%), 84 (43%), and 78 (77%) respectively. Only 36 mothers in the late follow up group reported receiving education on feeding. Mothers in this group who had received the education were significantly more likely than mothers who received no education to breast feed early (28 (78%) v 11 (17%), P < 0.001) and not use prelacteal feeds (21 (58%) v 2 (3%), P < 0.001). CONCLUSIONS: Training doctors and midwives greatly improves the feeding practices of mothers. However, the impact of the training fell off quickly and refresher training is needed to sustain the improvement.

Adult↗
PubMed1988

Postnatal care.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Nutrition of Honduran mothers/caretakers.

In 1996, the Honduran Ministry of Health conducted a national micronutrient survey of children 12-71 months old, which also included an assessment of the nutrition status of their mothers/caretakers. The 1,126 mothers/caretakers who participated in the survey tended to be short and plump. About 15% of them were at obstetric risk by virtue of their short stature and/or low body weight. About 9% had chronic energy deficiency (CED), but 27% were at least 20% overweight. CED was associated with socioeconomic indicators of poverty. Risk factors for being at least 20% overweight included being over 30 years old, not breast-feeding, having attended no higher than grade 4, 5, or 6 of primary school, coming from a wealthier household, and living in San Pedro Sula or medium-sized cities. Among the women surveyed, 26% of nonpregnant and 32% of pregnant mothers/caretakers were anemic. The likely principal cause of anemia was the low intake of bioavailable iron from food and, in some cases, excessive iron loss associated with intestinal parasites, especially hookworm. Only 50% of the mothers/caretakers participating in this study had received iron during their last pregnancy, and just 13% had received postpartum vitamin A. The results highlight the need to develop and implement an effective program to control iron deficiency anemia in women of reproductive age, including by fortifying such widely consumed foods as processed wheat and maize flour and by routinely administering iron supplements to high-risk groups. Postpartum vitamin A supplementation should be encouraged to protect both the mother and newborn infant against vitamin A deficiency.

Adult↗
PubMed2006

Short communication: A potential antiapoptotic phenotype in neutrophils of cows milked once daily in early lactation.

The objectives of this experiment were to compare the circulating concentrations of cortisol and determine whether these correlated with the expression profiles of a set of candidate apoptosis genes in neutrophils of Holstein-Friesian cows milked once vs. 3 times daily for 28 d postpartum. Cows on the once-daily milking regimen had significantly higher plasma cortisol concentrations on d 3, 14, and 28 postpartum than did those milked 3 times daily. On d 3 postpartum, when differences in cortisol and neutrophil counts were highest between the groups, mean mRNA abundance of nuclear factor kappaB p65 subunit, IkappaBalpha, X-linked inhibitor of apoptosis; and heat shock protein 70 were higher in neutrophils of the cows milked once daily than in cows milked 3 times daily. However, no correlations were detected among plasma cortisol concentration, neutrophil count, or neutrophil gene expression in this study. Results suggest that the modest neutrophilia associated with once daily milking of cows immediately postpartum may be related to modifications in the cells' apoptotic program by factors other than cortisol.

Animals↗
PubMed2001

Promoting smoking abstinence in pregnant and postpartum patients: a comparison of 2 approaches.

OBJECTIVE: To compare the implementation, delivery, and implications for dissemination of 2 different maternal smoking-cessation/relapse-prevention interventions in managed care environments. STUDY DESIGN: Healthy Options for Pregnancy and Parenting (HOPP) was a randomized, controlled efficacy trial of an intervention that bypassed the clinical setting. Stop Tobacco for OuR Kids (STORK) was a quasi-experimental effectiveness study of a point-of-service intervention. Both incorporated prenatal and postnatal components. PATIENTS AND METHODS: Subjects in both studies were pregnant women who either smoked currently or had quit recently. The major intervention in HOPP was telephone counseling delivered by trained counselors, whereas the STORK intervention was delivered by providers and staff during prepartum, inpatient postpartum, and well-baby visits. RESULTS: In HOPP, 97% of telephone intervention participants reported receiving 1 or more counselor calls. The intervention delayed but did not prevent postpartum relapse to smoking. Problems with intervention delivery related primarily to identification of the target population and acceptance of repeated calls. STORK delivered 1 or more cessation contacts to 91% of prenatal smokers in year 1, but the rate of intervention delivery declined in years 2 and 3. Modest differences were obtained in sustained abstinence between 6 and 12 months postpartum, but not in point prevalence abstinence at 12 months. CONCLUSIONS: The projects were compared using 4 of the 5 dimensions of the RE-AIM model including reach, adoption, implementation, and maintenance. It was difficult to apply the fifth dimension, efficacy, because of the differences in study design and purpose of the interventions. The strengths and limitations of each project were identified, and it was concluded that a combined intervention that incorporates elements of both HOPP and STORK would be optimal if it could be implemented at reasonable cost.

Adult↗
PubMed2005

Broader skills for working with perinatal depression.

Health visitors' involvement in work with maternal depression has developed considerably over the last 10 years, with a focus upon problems in the postnatal period. In a paper last month we reported on research highlighting dilemmas that can arise for health visitors connected with a lack of an agreed conceptual framework. Conflicting roles they find themselves using when working with distressed mothers, and within a pressured organisational work setting, make it hard to give sufficient priority to such work. By focussing too narrowly on postnatal depression, other important perinatal psychological difficulties may be left unattended. We argue the need to create workplace time to address these issues by describing the provision of a training and supervision package to facilitate this. We give some informal indications of its success and some indicators of the broadening development of its membership and its content

Adult↗
PubMed1988

Interviews or postal questionnaires? Comparisons of data about women's experiences with maternity services.

Surveys by personal interview are often assumed to be superior to those conducted by mail questionnaire. An experimental study of experiences and attitudes of 800 newly delivered mothers revealed surprising advantages to postal surveys: they are cheaper, more easily repeatable, and minimize interviewer effects. While response rates differed, the quality of responses was similar, except between middle- and working-class mothers. Postal surveys can be used with considerable assurance in national studies of fairly intimate experiences of pregnancy and delivery.

Asia↗
PubMedDate not supplied

Infant care knowledge of primiparous urban mothers.

Because hospitals are discharging postpartum women within 48 hours of delivery, little time is available for maternal baby care instruction. Therefore it is important that any teaching, whether in the hospital or in an outpatient setting, concentrate on topics that provide the greatest benefit to the mother and child. This study provides an initial view of maternal knowledge of well baby care in an attempt to discern topics of common misinformation and misunderstanding. Fifty primiparous, English-speaking mothers were interviewed. The interview consisted of questions dealing with social support for the mother; employment or schooling; source of prior child care knowledge; and knowledge of feeding, diapering, sleeping, calming, bathing, and sickness of newborn infants. The data gathered indicate that although most women report one or more sources of knowledge, several gaps exist in their preparedness. The traditional information presented may overemphasize known areas at the expense of some that have significant consequences for health and safety. Many hospitals offer postpartum classes in bathing. These data indicate that if these programs could be expanded to include more practical information, they would provide a beneficial learning experience at a critical time in a new mother's life.

Adolescent↗
PubMed2004

Translating efficacy research to effectiveness studies in practice: lessons from research to promote smoking cessation in community health centers.

Researchers and their community partners have been challenged by funders and political entities to translate what is learned in research into practice. Such translation is more challenging than it appears, and it is important to systematically make use of opportunities available to learn about facilitators and barriers to the implementation of effectiveness research in real-world settings. This article presents a case study of the process evaluation undertaken as part of Quit Together, a randomized trial of the effectiveness of an intervention to improve smoking cessation and relapse prevention among low-income pregnant and postpartum women who receive care at community health centers (CHCs). The analysis considers areas of program implementation failure that may need critical rethinking. The article demonstrates the importance of process-monitoring methods to examine context factors of collaborative research, outlines lessons learned and the challenges of research carried out in CHCs, and summarizes implications for researchers and for practitioners.

Community Health Centers↗
PubMed1977

[Programmed labor: methods, results, guidelines (author's transl)].

The programming of labor (setting the best possbile time under optimal conditions) was carried out in the University Women's Hospital, Freiburg i. Br. between 1970 and 1975 in 1121 cases. No perinatal mortality was reported. The secondary frequency of cesarean section for this primarily uncomplicated labor was 3.21% (general hospital statistics for this time period: 6.29%). The most important factors for the strict standardized method of induction is the observation of the pelvic score (desired: greater than 6) and a moderate dose of oxytocin or prostaglandin based on the essential amniotomy. In a statistical comparison of three groups of patients (n = 786): programmed labor (n = 427), induction via the same type of method where transference was suspected (n = 158), and uncomplicated spontaneous labor (n=183), the results with induced labor were better than those with spontaneous labor. In addition for the fact that the course of labor could be preplanned and the period of labor shortened intrauterine and partal complications occurred less frequently with programmed labor than with spontaneous labor. Placental complications and the tendency toward postpartum atony must be discussed. Minor complications decreased as the weight, length and gestation period of the newborn increased. Individual palpation until the physiological maturity for birth is reached would, therefore, seem to be required. Observe the conditions and increase antepartal controls. Only by setting the exact time for labor with modern methods of supervision is it theoretically possible to eliminate the danger of active management. The organizational problem involved with a general programming of labor poses the major problem at present.

Cesarean Section↗
PubMed2000

[Rubella vaccination in the post-partum: which is the best approach?].

BACKGROUND: Two different post partum Rubella vaccination's programs for seronegative women in puerperium are compared. METHODS: In the Borgosesia hospital (Piedmont Region) the vaccination has been proposed by gynecologists already during pregnancy to all the pregnants proved to be negative at the Rubella's test in the initial pregnancy. The little number of enlisted patients is the consequence of the availability of only one doctor to take part in the vaccination's program. In this hospital the cost of vaccination was paid by the patient that had to buy the vaccine before hospitalization. In the Vigevano's hospital (Lombardia Region) the rubella's vaccination has been instead proposed by the nursery pediatrist to all the women who has just given birth in the period between 1995-1997, seronegative for rubella's test in pregnancy or in puerperium. RESULTS: The results (88% of the seronegative women vaccinated in Borgosesia versus 72.6% in Vigevano) show that the best way is to make the pregnant women aware by the gynecologist during pregnancy, even though the vaccine wasn't free for the patients. CONCLUSIONS: The action of pediatrists combined with the availability from hospital administration to offer a free vaccine will make possible to reach an almost total success of the Rubella vaccination's program.

Female↗
PubMedDate not supplied

A competency based approach to comprehensive pregnancy care.

This paper assesses the quality and cost of a pregnancy care program based on explicit and achieved patient competencies. By using the USPHS Content of Prenatal Care (1989), key psychosocial/education elements of perinatal care were identified. The goal was a process of patient education that is competency based, integrated, and outcome oriented. Psychosocial assessment, patient education tools, criterion-based length of postpartum stay, and home nursing follow-up were implemented as part of a Comprehensive Pregnancy Program (CPP). Case-control and cohort survey methodology were used to evaluate outcome. There was a significant decrease in hospital length of stay for mothers and newborns after implementation of the CPP. Post-discharge maternal emergency room visits and/or readmits did not increase. Differences in newborn emergency room visits and/or readmits were non-significant. There was a marked reduction in hospital costs for mothers and newborns. Patient satisfaction remained high. Core competencies forming the basis of educational and assessment programs allow the focus of care to be optimal outcome, and provide a useful template against which to measure prenatal, intrapartum, and postpartum care.

Adaptation, Psychological↗