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PubMed1990

Postpartum smoking relapse.

While it has been established that many women quit smoking during pregnancy, little is known about postpartum maintenance of smoking cessation and relapse. A sample of 567 women were surveyed at about 6 months postpartum in order to (a) describe the patterns of smoking relapse; (b) assess the perceived importance of smoking cessation in pregnancy and postpartum; and (c) identify potentially high risk situations for smoking relapse. Results indicate that about half (56%) of the women who quit smoking during pregnancy relapse to smoking by 30 days postpartum. Most of these relapses occur in the company of other smokers. Socializing and/or living with a smoker had a powerful negative impact on ability to maintain abstinence in postpartum. Smoking cessation programs for pregnant women should emphasize the importance of continued abstinence in postpartum.

Adolescent↗
PubMed1996

Group treatment for postpartum depression: a pilot study.

OBJECTIVE: There are few reports on the efficacy of treatment programs for women with postpartum depression, despite the long-term nature of this disorder. This study describes a pilot evaluation of a treatment program with educational, social support and cognitive-behavioural components. METHOD: Ten women with persistent depression originating in the postpartum period were offered a 10-week group treatment program and compared to a wait-list control group. RESULTS: Following treatment, a significant improvement in depression was demonstrated on the Edinburgh Post-Natal Depression Scale, Beck Depression Inventory, and Profile of Mood States. Several common factors in women suffering from postpartum depression were also identified, as were drop-out characteristics. CONCLUSION: These results are encouraging and suggest that a cognitive-behavioural group program might be effective as a treatment for depression in the postpartum period. However, further detailed studies are required to conform this pilot study.

Adult↗
PubMed1978

Management of teenage pregnancies in three different health care settings.

A retrospective study was undertaken to determine if differences existed in obstetric outcome, contraceptive usage, and repeat pregnancy rates of teenage patients cared for in three different health care settings. The sites included the Rochester Adolescent Maternity Project (RAMP), a traditional obstetric clinic, and a neighborhood health center. Comparison of the three groups revealed that RAMP patients experienced a lower incidence of anemia and preeclampsia than patients in the other programs. At one year postpartum, 25% of the hospital clinic patients were using contraception compared to 45% for the health center and 49% for RAMP patients, compared to 15.8% for the health center and 6.5% for the RAMP group.

Adolescent↗
PubMed2003

Survey on the programs of Sanhujori centers in Korea as the traditional postpartum care facilities.

Sanhujori is the term used for the traditional Korean concept of non-professional postpartum care after delivery or abortion. Recently, postpartum care has been transferred to facilities appropriately named Sanhujori centers. This study investigates the programs offered at Sanhujori centers in order to understand the effects of this new type of health care delivery system on postpartum care. A qualitative descriptive study was conducted that included twenty-seven centers. Data were collected via face-to-face interviews followed by telephone interviews conducted from May first until the eighteenth of 2001. The findings permitted description of the general characteristics of Sanhujori centers. Programs for physical recovery, psychosocial recovery, postpartum education, parents-infant bonding, and baby care were analyzed and discussed.

Adult↗
PubMed2002

Comparison of two timed artificial insemination (TAI) protocols for management of first insemination postpartum.

Two estrus-synchronization programs were compared and factors influencing their success over a year were evaluated. All cows received a setup injection of PGF2alpha at 39 +/- 3 d postpartum. Fourteen days later they received GnRH, followed in 7 d by a second injection of PGF2alpha. Cows (n = 523) assigned to treatment 1 (modified targeted breeding) were inseminated based on visual signs of estrus at 24, 48, or 72 h after the second PGF2alpha injection. Any cow not observed in estrus was inseminated at 72 h. Cows (n = 440) assigned to treatment 2 received a second GnRH injection 48 h after the second PGF2alpha, and all were inseminated 24 h later. Treatment, season of calving, multiple birth, estrual status at insemination, number of occurrences of estrus before second PGF2alpha, prophylactic use of PGF2alpha, retained fetal membranes, and occurrence of estrus following the setup PGF2alpha influenced success. Conception rate was 31.2% (treatment 1) and 29.1% (treatment 2). A significant interaction occurred between protocol and estrual status at insemination. Cows in estrus at insemination had a 45.8% (treatment 1) or 35.4% (treatment 2) conception rate. The conception rate for cows not expressing estrus at insemination was 19.2% (treatment 1) and 27.7% (treatment 2). Provided good estrous detection exists, modified targeted breeding can be as successful as other timed artificial insemination programs. Nutritional, environmental, and management strategies to reduce postpartum disorders and to minimize the duration of postpartum anestrus are critical if synchronization schemes are used to program first insemination after the voluntary waiting period.

Animal Husbandry↗
PubMed1993

Coordinated care early discharge of postpartum patients at Irwin Army Community Hospital.

A trial program of early discharge of postpartum patients was instituted at the Fort Riley MEDDAC as part of a coordinated-care initiative. The goals of this program were to increase quality and access to care while containing health costs. A total of 788 bed days valued at $705,260 were made available for use by other patients. Maternal readmission rate was 0.3%; length of stay was decreased from 3.22 days to 1.22 days. Early discharge was made possible through a combination of medical record screening and comprehensive patient education. This study indicates that early discharge provides quality of care and cost effectiveness without adverse outcomes.

Adolescent↗
PubMed1997

The frequency of coitus during breastfeeding.

BACKGROUND: New mothers and clinicians would benefit from an understanding of typical sexual behavior during breastfeeding. Unfortunately, little information is available about both the typical length of time to resumption of coitus and the frequency of sexual relations during breastfeeding. This paper describes the commencement and frequency of coitus among breastfeeding women in a variety of settings. METHODS: The analysis draws on data from two separate research studies. The first was undertaken in three sites (Birmingham, United Kingdom; Montreal, Canada; Sydney, Australia), the purpose of which was to correlate natural observations of fertility with the underlying hormonal profile among breastfeeding women using the symptom-thermal method of natural family planning. The second was a clinical trial of the lactational amenorrhea method of family planning conducted in Manila, the Philippines. RESULTS: Coital frequency reported by these populations of breastfeeding women appears to be lower than that reported in other studies for married women in general. As other research demonstrated, we found coital frequency and postpartum resumption of coitus to be associated with age, but not with the number of children in the household. CONCLUSIONS: A better understanding of the level of sexual activity among breastfeeding women could inform and improve programs that offer postpartum support and counseling about family planning.

Adult↗
PubMedDate not supplied

Participation in prepared childbirth. Baccalaureate nursing education.

Nurses need to meet consumer demands for quality maternal-infant health care. To meet this need, the College of Nursing faculty at the University of Florida included prepared childbirth classes as a clinical experience in a BSN program. Each student works with a client couple in an ambulatory care setting to provide complete and individualized nursing care through the final weeks of pregnancy, the labor and delivery experience, and for a brief period postpartum. How this program facilitates students' development of a holistic approach to maternal-infant nursing and increases the quality of health care for expectant parents is described.

Consumer Behavior↗
PubMed1996

Post-partum contraception.

The choice of a post-partum contraceptive method depends on many factors, including the need for a temporary versus a permanent method, the infant feeding choice and the extent to which informed consent is made prior to delivery. For maximum protection, the non-breast-feeding woman should be protected from the fourth week post-partum, even if that means using a temporary method, such as condoms or spermicides, until her method of choice is procured. Combined oestrogen/progestin methods should be avoided by all women for 2-3 weeks to avoid elevating the risk of thromboembolism. Preparations containing oestrogen should be avoided altogether during lactation because they have been associated with a reduction in milk production. POPs, implants and injectables are appropriate regardless of infant feeding choice. They can be administered immediately post-partum in bottle-feeding women, but should ideally be postponed for 6 weeks in breast-feeding women. It is best to insert IUDs within 10 minutes of delivery of the placenta, in order to minimize the risk of IUD expulsion. Insertion immediately after expulsion of the placenta requires special training, and expulsion rates are reduced with the insertion experience of the practitioner. Breast-feeding is not associated with an increase in IUD expulsion or uterine perforation, and it is associated with fewer removals for bleeding or pain. Tubal sterilization is safe, convenient and cost-effective when performed immediately after delivery, but it requires extensive counselling and fully informed consent prior to the onset of labour to avoid potential regret over post-partum tubal ligation. If the procedure is performed immediately, any effect on the establishment of lactation may be minimized. LAM is a method that can only be used by breast-feeding women. It may prove to be a useful way to time the commencement of a second, less temporary contraceptive method. Natural family planning methods require a period of abstinence for the establishment and identification of the new symptoms of fertility. When LAM is used during this interval, the need for abstinence may be reduced significantly for breast-feeding women. Breast-feeding provides health benefits for the woman and her infant, as well as the best possible nutrition for the baby. The International Planned Parenthood Federation (1990) (among others) recommends that, 'As far as is practicable, all women should be advised and encouraged to breastfeed fully'. The infant feeding decision affects the choice of a contraceptive method, and this is an important reason for the woman's physician to be interested in her infant feeding choice.

Breast Feeding↗
PubMed2006

Postpartum practices of puerperal women and their influencing factors in three regions of Hubei, China.

BACKGROUND: 'Sitting month' is a Chinese tradition for women's postpartum custom. The present study aims to explore the postpartum dietary and health practices of puerperal women and identify their influential factors in three selected regions of Hubei, China. METHODS: A cross-sectional retrospective study was conducted in the selected urban, suburban and rural areas in the province of Hubei from 1 March to 30 May 2003. A total of 2100 women who had given birth to full-term singleton infants in the past two years were selected as the participants. Data regarding postpartum practices and potentially related factors were collected through questionnaire by trained investigators. RESULTS: During the puerperium, 18% of the participants never ate vegetables, 78.8% never ate fruit and 75.7% never drank milk. Behaviour taboos such as no bathing, no hair washing or teeth brushing were still popular among the participants. About half of the women didn't get out of the bed two days after giving birth. The average time they stayed in bed during this period was 18.0 h. One third of them didn't have any outdoor activities in that time periods. The educational background of both women and their spouses, location of their residence, family income, postnatal visit, nutrition and health care educational courses were found to be the influencing factors of women's postpartum practices. CONCLUSION: Traditional postpartum dietary and health behaviours were still popular among women in Hubei. Identifying the factors associated with traditional postpartum practices is critical to develop better targeting health education programs. Updated Information regarding postpartum dietary and health practices should be disseminated to women.

Adult↗
PubMed1999

The development of a physiotherapy continence promotion program using a customer focus.

Health promotion programs provide information, education for health and opportunity for the development of the skills that people need to make healthy choices. The current climate of health care practice also directs its focus to the needs and wants of the health care consumers. This entails active input from the target group. The present study used focus groups in an attempt to ensure input from women in early postpartum into the development of a postpartum continence promotion program. The focus groups revealed anomalies in women's perceived susceptibility to, and knowledge about, urinary incontinence and pelvic floor exercises, while highlighting other areas of need. Focus groups proved an invaluable tool in the development of a more effective physiotherapy continence promotion program.

Journal Article↗
PubMed1995

Postpartum early discharge: impact on maternal fatigue and functional ability.

The purpose of this study was to determine the impact of a postpartum early discharge program, with home follow-up by hospital nursing staff, on the maternal fatigue and functional ability of low-risk mothers with healthy neonates. A quasi-experimental design was used. Subjects were randomly assigned to one of two groups receiving the early-discharge program (hospital stay less than 60 hours plus home follow-up by hospital-based nurses; n = 35) or traditional hospital care (hospital stay more than 60 hours and no home follow-up by hospital staff; n = 17). A third group emerged from those originally assigned to traditional care but later transferred to early discharge due to bed shortages (n = 29). The Rhoten Fatigue Scale and the Inventory of Functional Status After Childbirth were used to collect the data at discharge and 1 and 6 weeks postpartum period. No significant differences between groups were found, suggesting that early discharge with adequate home follow-up does not affect the low-risk mother's fatigue and functional ability to any significantly greater extent than traditional care. It was also noted that, regardless of type of care, the proportion of subjects reporting severe fatigue was relatively large (25%, 31%, and 19% at discharge, 1 and 6 weeks postpartum period), highlighting the need for further study of maternal fatigue in the postpartum period.

Activities of Daily Living↗
PubMed2002

Predictive factors of developing diabetes mellitus in women with gestational diabetes.

BACKGROUND: To investigate which factors during gestational diabetes pregnancies correlate with the risk of developing impaired glucose tolerance or diabetes 1 year postpartum and to compare this risk in women with gestational diabetes and women with a normal oral glucose tolerance test during pregnancy. METHODS: Of 315 women with gestational diabetes, defined as a 2-hr blood glucose value of at least 9.0 mmol/l at a 75-g oral glucose tolerance test, who delivered in Lund 1991-99, 229 (73%) performed a new test 1 year postpartum. We compared maternal and fetal factors during pregnancy with the test value at follow up. A control group of 153 women with a 2-hr test value below 7.8 mmol/l during pregnancy were invited to a new test 1 year postpartum and 60 (39%) accepted. RESULTS: At 1 year follow up, 31% of the women with gestational diabetes but only one of the 60 controls showed pathologic glucose tolerance and one had developed diabetes. The following factors in women with gestational diabetes were identified as predicting impaired glucose tolerance or diabetes at 1 year follow up: maternal age over 40 and--in a multiple regression analysis, independent of each other--a high 2-hr value at oral glucose tolerance test during pregnancy and insulin treatment during pregnancy. CONCLUSION: The risk of developing manifest diabetes after gestational diabetes may be high enough to justify a general screening or diagnostic procedure in all pregnant women to identify women with gestational diabetes and a postpartum follow up program for them. This study did not identify any particular factor during pregnancy with enough precision to predict a later progression to diabetes.

Adult↗
PubMed1999

Postpartum home visits: infant outcomes.

Early postpartum discharge of mothers and infants has increased as health care providers and payers attempt to control health care cost. Questions regarding patient safety have been raised. Literature supports the safety of early discharge when providers adhere to strict discharge guidelines and when clients comply with home follow-up. Previous studies calculated hospital readmission rates, but few examined other outcomes or characteristics. The purposes of this descriptive study were to examine outcome data for infant participants in a postpartum home visit program and to explore factors that may influence hospital readmissions for infants. Using an audit tool with established reliability and validity, a convenience sample of 199 infant medical records was reviewed for demographic information, characteristics, and outcomes. The hospital readmission rate for all infants within 3 weeks of discharge was comparable to other studies; however, the rate for only early discharge infants was higher than the rate reported in other studies. The study of postdelivery outcomes for infants provides additional insight into the issue of early discharge and may reflect the significance of postpartum follow-up care and education.

Adolescent↗