Examining the pathways of pre- and postnatal health information

Quality improvement in postnatal care: Findings from two cohorts of women in Sweden

INTRODUCTION

Postnatal care is an important area of midwifery practice. Changes in the length of postnatal stay, models of postnatal care, and the content of care have influenced women's satisfaction. The aim of this study was to describe women's assessment of postnatal care in a Swedish hospital in 2017, and to compare this with women who gave birth in 2006 in the same hospital.

METHODS

A comparative study was conducted of two cohorts of women who gave birth in 2006 and 2017 in a hospital in the middle-north part of Sweden with 1700 annual births. Data were collected by questionnaires, where data from 2017 were compared with data from 2006.

RESULTS

In all, 366 women who gave birth in 2006 and 342 in 2017 responded. There was a reduction in time of discharge in 2017 and more women went home directly from the labour ward and fewer women had their postnatal stay in the hotel ward, compared to postnatal women in 2006. A higher percentage of women were 'Very satisfied' with the overall aspects of postnatal care in 2017 compared to women in 2006. The content of postnatal care showed statistically significant improvements over time for the majority of variables studied, but some women reported not receiving information/help with specific postnatal aspects. Multiparous women, women older than 35 years, and women who had had a caesarean section received less information and practical help.

CONCLUSIONS

The study showed an increase in overall satisfaction with postnatal care over time and most areas were improved. Continuous work is therefore needed in order to improve postnatal care and put the women and their families at the centre of care. More research is needed to try new models of care that will increase satisfaction with postnatal care.

Mind the Gap: Assessing the Disconnect Between Postpartum Health Information Desired and Health Information Received

INTRODUCTION

Seeking and receiving health information are critical aspects of prenatal and postpartum care; however, many informational sources lack postpartum content. This study explores the gaps between information desired and information received postpartum and identifies the sources women use for health information seeking, with an emphasis on emergent online and mobile phone-based resources.

METHODS

Participants were recruited from our community partners' client base for a cross-sectional study. Mothers (n = 77) of a child 48 months or younger completed a survey on health information seeking, health information needs, and technology use. Postpartum health information gaps were defined as topics about which a participant indicated that she wanted information, but did not receive information. Bivariate analyses assessed the association between demographic characteristics, sources of health information used during pregnancy, and postpartum information gaps.

RESULTS

Health care providers, Internet-based resources, and mobile applications were common sources of health information during pregnancy. Mental and sexual health were the most common types of postpartum health information gaps. In bivariate analyses, higher income and education were associated with postpartum information gaps in mental health and sexual health, respectively (p < .05).

CONCLUSIONS

Postpartum health information gaps were common in this sample, particularly for topics in mental and sexual health. Unexpected associations between higher levels of education and income and postpartum health information gaps were observed in bivariate analyses. Health educators have the opportunity to capitalize on high rates of Internet information seeking by providing health information online. Health care providers must incorporate mental and sexual health into routine postpartum care.

Prenatal Education: Program Content and Preferred Delivery Method From the Perspective of the Expectant Parents

The purpose of this research is to better understand expectant parents' perception of importance regarding a wide range of prenatal education topics and their information delivery method preferences. One hundred and eighty-one expectant parents completed the investigator-developed survey tools. Most of the participants rated each item on the Perceived Importance of Topics survey as "important" or "very important." Overall, the topics of Newborn Safety, Birth, and Breastfeeding had the highest percentage of participants who indicated the topic was "very important." Most of the respondents (47.5%, n = 86) indicated that their preference was to attend face-to-face-prenatal education sessions. Additional delivery method preferences are discussed. Findings from this study provide valuable information to inform future prenatal education program content and delivery.

Internet Use by First-Time Mothers for Infant Feeding Support

BACKGROUND

Optimal nutrition during infancy has benefits to individuals and to society. Australian women actively seek health and nutrition information from a wide variety of sources and have extensive access to the Internet, but its efficacy in supporting recommendation-consistent infant feeding is unknown.

OBJECTIVES

The objectives of this study were to evaluate sources of infant feeding information used by first-time mothers and to describe breast and formula feeding patterns 6 months post birth associated with successful use of the Internet for breastfeeding support.

METHODS

Healthy women between 18 and 40 years of age in their first pregnancy were recruited to the Feeding Queensland Babies Study by convenience sampling in Brisbane, Australia, between June 2010 and March 2011. Participants completed a questionnaire online when their infants were 6 months of age and a demographic questionnaire.

RESULTS

Health care providers, books, general Internet searches, family, and friends were common sources of breastfeeding information for women during infants' first 6 months. Information sources for infant formula were less often accessed. Of mothers who sought breastfeeding assistance on the Internet, those who found it unhelpful had lower odds of giving breast milk at 6 months (odds ratio [OR] = 0.3; 95% confidence interval [CI], 0.1-0.5) and higher odds of giving formula (OR = 3.3; 95% CI, 1.7-6.5) compared with those who found the help they needed, adjusted for age and socioeconomic status.

CONCLUSION

Professional, print, and interpersonal information resources for infant feeding are widely accessed by mothers. Online breastfeeding information and support may help women to meet their breastfeeding intentions and to minimize formula use.

Effects of a Brief, Prevention-Focused Parenting Education Program for New Mothers

We evaluated the effects of a parenting program, Baby and You, on parenting knowledge, parenting morale, and social support using a single-group, pre-test, and post-test design with 159 Canadian mothers of infants aged 2 to 9 months old. Baby and You is a prevention-focused parenting program (PFPP) to improve maternal and infant health through education and social support. The 4-week curriculum focuses on infant development and safety, parent–child relationships, maternal self-care, and community resources. We computed repeated-measures ANOVAs separately for scores on Parenting Knowledge Scale, Parenting Moral Index, and Family Support Scale. We found a significant increase between pre-test and post-test on parenting knowledge, but not parenting morale or social support. Parenting morale may be a stable construct that shows little change over time. It may take more than 4 weeks of programming for mothers to identify and integrate new sources of social support.

An Exploratory Survey of Low-Risk Pregnant Women’s Perceptions of Antenatal Care and Services in Southern Ireland

Ireland currently has the highest birthrate of the 27 European Union countries which has led to an increase in demand for maternity services. In the Irish Republic, most maternity units have traditionally followed the medical-led model of care, which, as a result, has limited women’s choice for maternity care. Although various different midwifery-led schemes are available, concerns exist regarding the knowledge and accessibility of these schemes.

The aim of this descriptive, exploratory survey was to explore and determine the views of “low-risk” pregnant women (n= 394) regarding their antenatal care and services. A purposive homogeneous sample comprised the first phase of a mixed methods study and data were analyzed using Predictive Analytics Software. The findings identified a lack of awareness and understanding of the concept of a low-risk pregnancy. Consequently, women identified an overall lack of information and an inability to access available options for their care.

Influence of health information levels on postpartum depression

While extensive research has been conducted on postpartum depression (PPD), the majority has been focused on psychological risk factors and treatments. There is limited research on the explicit relationship between the degree to which individuals are informed about relevant prenatal and postnatal health topics and whether this level of knowledge influences psychological outcome. This study assesses health information levels of new mothers and their influence on PPD as measured by Edinburgh Postnatal Depression Scale (EPDS) scores. Data from the 2006 Maternity Experiences Survey developed by the Canadian Perinatal Surveillance System (N = 6,421) were used. The study population included mothers ≥15 years of age at the time of the birth, who had a singleton live birth in Canada during a 3-month period preceding the 2006 Census and who lived with their infants at the time of the survey. Pre- and postnatal health information components were measured using latent variables constructed by structural equation modeling. EPDS score was added to the model, adjusting for known covariates to assess the effects of information levels on EPDS score. Pre- and postnatal health information levels are associated with decreased EPDS scores. More specifically, information on topics such as postnatal concerns and negative feelings was associated with the largest decrease in score for primiparous and multiparous women, respectively (p < 0.0001 for both). The pre-established predictors of PPD were confirmed for both samples, with life stress associated with the largest change in EPDS score for both samples (p < 0.0001 for both). This study demonstrates a distinct role for pre- and postnatal health information in influencing EPDS scores, supplementing previous literature. Primiparous and multiparous women benefited from different information content, with information on postnatal concerns had the largest effect on the primiparous group while information on negative feelings had the largest effect on the multiparous group. Therefore, information provision should be tailored to these two groups.