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At least 109 records · Page 6Linked to original sources
PubMed1984

Meeting the needs of the teen-age pregnant student: an in-school program that works.

The drop-out rate for pregnant students in the York (Pennsylvania) City School District is dramatically lower than the national average because the district recognized the need for meeting the unique problems of the pregnant student. In York, as in the rest of the nation, teen-age pregnancy was on the increase. Administrators of the district realized that a separately housed alternative education program would be too costly. In January 1979, the authors designed and implemented an in-school program called "Changing Roles." Five years later, that program has become an important factor in keeping the majority of pregnant students in school, at the same time, providing the girls the special information they need. In the 1982-83 school year, only 9.5% of the pregnant students dropped out of York City schools. This rate is far below the national drop-out rate of 80% to 90%.

Adolescent↗
PubMedDate not supplied

[Bases for formulating a program to promote breast-feeding: methodological aspects].

Based on the relevance of breastfeeding for maternal-infant health, it is necessary that the prospective and longitudinal studies carried out in Mexico be analyzed as a whole in order to create an analytic model and to develop an institutional intervention program concerning the mother's risk of not starting or of abandoning lactation. To create this program all the factors which can be modified must be taken into account in order to make sure the mother has the elements to make a decision. The National Institute of Perinatology has developed a research program about lactation that consists of 3 studies that have been carried out since 1983. The general aim of these studies is to understand the breastfeeding phenomenon in an integral way considering the role of the institution as an educational instrument and a means of providing health support. These studies were based on different perspectives, approaches and times but had similar objectives. For this reason it is desirable to analyze them as a whole in order to obtain new considerations and temporal projections. In order to integrate the 3 studies a database will be created and then an analytical model (from a multivariate analysis) will be generated from the 1st study (by temporal order) which will be tested in the 2nd study making the pertinent modifications and finally it will be applied in the 3rd study. At the same time it will be necessary to group the variables into 2 classification systems: The first according to the temporal proximity with regard to lactation and the second according to the organization level to which they belong.

Americas↗
PubMed1988

Minimizing adverse effects of low birthweight: four-year results of an early intervention program.

The outcome of an early intervention program for low-birthweight (LBW) infants was examined in this study. The intervention consisted of 11 sessions, beginning during the final week of hospitalization and extending into the home over a 3-month period. The program aimed to facilitate maternal adjustment to the care of a LBW infant, and, indirectly, to enhance the child's development. Neonates weighing less than 2,200 grams and under 37 weeks gestational age were randomly assigned to experimental or control conditions. A full-term, normal birthweight (NBW) group served as a second control. 6-month analyses of dyads who completed all assessments over a 4-year period (N's = 25 LBW experimental, 29 LBW control, and 28 NBW infant-mother dyads) showed that the experimental group mothers reported significantly greater self-confidence and satisfaction with mothering, as well as more favorable perception of infant temperament than LBW control group mothers. A progressive divergence between the LBW experimental and LBW control children on cognitive scores culminated in significant group differences on the McCarthy GCI at ages 36 and 48 months, when the LBW experimental group caught up to the NBW group. Possible explanations for the observed delay in the emergence of intervention effects on cognitive development and the mediating role of favorable mother-infant transactional patterns are discussed in light of recent evidence from the literature.

Child, Preschool↗
PubMed1998

Implementation of early discharges after uncomplicated vaginal deliveries: maternal and infant complications.

BACKGROUND: Short-stay obstetric stays have been the recent focus of many social and medical debates. We did a retrospective study of a large community teaching hospital's experience in making a safe transition to short-stay obstetrics. METHODS: Over a 10-month period, a multidisciplinary committee developed an intrapartum and postpartum education program to allow short hospital stays after uncomplicated vaginal deliveries. Computerized data were then retrieved on all uncomplicated spontaneous vaginal deliveries (DRG 373) from January 1994 to March 1995. RESULTS: During the study period, 554 women were discharged on the first postpartum day, resulting in three maternal readmissions and nine pediatric readmissions (combined readmission rate of 2.2%). This low readmission rate compared favorably with our experience with 2,563 uncomplicated vaginal deliveries from January 1991 to December 1993, immediately before the institution of the short-stay obstetrics program (combined readmission rate of 3.9%). The average hospital cost for a 1-day stay was $1,714 compared with $2,477 for a 2- to 3-day stay, representing a saving of only 31%. CONCLUSIONS: Early obstetric discharges after an uncomplicated spontaneous vaginal delivery can be safe and effective with appropriate patient selection and support.

Cost Savings↗
PubMed2001

Training patterns of athletes during pregnancy and postpartum.

The purpose of the present investigation was to examine exercise patterns and psychological variables mediating a return to training and competition after pregnancy. Competitive female athletes who had given birth within the last 10 years completed surveys concerning (a) training patterns before, during, and after childbirth, (b) childbirth complications and training advice, (c) perceptions of success in their postpartum comebacks to training, and (d) self-efficacy, social support, and perceived barriers to training during pregnancy and after childbirth. Results indicated that women decreased both cardiovascular and resistance training during pregnancy. Additionally, training efforts during pregnancy were independent of those during the pre- and postpartum periods. This finding suggests that athletes may be able to alter their training patterns during pregnancy without a significant impact on their postpartum training program.

Adult↗
PubMed2004

Length-of-stay policies and ascertainment of postdischarge problems in newborns.

OBJECTIVE: The purpose of this study was to evaluate the effects of an early postpartum discharge program and a subsequent legislative mandate for 48 hours of hospital coverage on incidence of newborn jaundice and feeding problems. We tested the hypothesis that heightened postdischarge ascertainment (rather than short stays) is responsible for apparent increases in these outcomes. METHODS: Interrupted time series analysis was conducted on retrospective data from the automated medical records of a large Massachusetts health maintenance organization (HMO). A population of 20,366 mother-infant pairs with normal vaginal deliveries between October 1990 and March 1998 was identified. The interventions included a new HMO protocol in 1994 of 1 hospital overnight after delivery, plus a nurse home visit, then the Massachusetts' 1996 minimum coverage law. Postpartum length of stay, clinical evaluation on day 3 or 4 of life, health center visits up to day 21, health center diagnoses of jaundice or feeding problems, bilirubin testing and test severity, rehospitalizations, and emergency department visits were measured. RESULTS: Postpartum stays <2 nights rose from 28% of newborns before implementation of the program to 70% immediately after implementation. Later, this rate fell from 66% before the mandate to 21% just after the law went into effect. Day 3 or 4 evaluation rose from 24.5% to 64% after the program, then dropped somewhat to 53% after the mandate. Controlling for longer-term trends in health center visits, implementation of the early discharge program was associated with approximately 1 extra visit for every 4 newborns within the first 21 days of life. The state mandate did not affect health center visit rates. Jaundice diagnoses were flat at 8% of newborns during the baseline, then rose to a constant 11% throughout the program and postmandate periods. Bilirubin testing of newborns also rose by 3.4 percentage points at the time of program implementation, and the proportion of tested newborns with results calling for at least consideration of phototherapy rose by 6 percentage points. Phototherapy use rose from a flat 1.8% to 2.4% of newborns after program implementation. Feeding problem diagnoses more than doubled at the time of program implementation and remained elevated after the mandate. Rehospitalizations overall and specifically for jaundice were constant over time, whereas more rare emergency department visits for jaundice dropped from 0.3% of newborns to 0 on program implementation. CONCLUSIONS: Sudden increases in jaundice-related measures and identification of infant feeding problems were not associated with changes in length of stay in this setting. Instead, these increases seem to be the result of more frequent evaluation of newborns during the critical day 3 to 4 period and may also have been elevated by a new climate of concern about neonatal vulnerability. "Ascertainment bias" may have confounded findings in previous reports that raised concerns about the safety of early discharge.

Breast Feeding↗
PubMed1984

Post-cesarean section insertion of intrauterine devices.

Among 52 women who delivered by cesarean section in a medical center in Beijing, China and had either a Delta Loop or Delta T intrauterine device (IUD) inserted manually through the incision wound, the expulsion rates were significantly lower than among a comparable group of 147 women who both delivered and had the IUD inserted vaginally (4.1 versus 20.5 per 100 women at six months post-insertion). Since the cesarean delivery rate is increasing worldwide, we deem this preliminary finding important for postpartum contraception programs and urge further studies.

Adult↗