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Place JMS, Renbarger K, Van De Griend K, Guinn M, Wheatley C, Holmes O. Barriers to help-seeking for postpartum depression mapped onto the socio-ecological model and recommendations to address barriers. Front Glob Womens Health 2024; 5:1335437. [PMID: 38855482 PMCID: PMC11157017 DOI: 10.3389/fgwh.2024.1335437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 05/13/2024] [Indexed: 06/11/2024] Open
Abstract
Postpartum depression affects nearly a quarter of women up to a year after childbirth. Although it is treatable, significant barriers to help-seeking prevent women from being treated. This paper assesses key literature on the barriers for help-seeking among women with postpartum depression. The barriers identified have been mapped onto the socio-ecological model in addition to potential recommendations that professionals can use to address barriers on individual, interpersonal, organizational, community and societal levels. The recommendations provided are meant to serve as leverage points for professionals in efforts to create appropriate support and interventions. As such, this paper serves as a mapping tool for healthcare and public health professionals to assess obstacles to women's help-seeking and to guide multi-pronged interventions on various levels of the socio-ecological model that may increase help-seeking among women with postpartum depression. Holistically and comprehensively providing support to women will require significant effort throughout all sectors of society as opposed to isolated, siloed interventions.
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Affiliation(s)
- Jean Marie S. Place
- Department of Nutrition and Health Science, Ball State University, Muncie, IN, United States
| | - Kalyn Renbarger
- School of Nursing, Ball State University, Muncie, IN, United States
| | - Kristin Van De Griend
- Department of Community and Public Health, Idaho State University, Pocatello, ID, United States
| | - Maya Guinn
- Department of Biology, Ball State University, Muncie, IN, United States
| | - Chelsie Wheatley
- Medical Imaging, Idaho State University, Pocatello, ID, United States
| | - Olivia Holmes
- Department of Community and Public Health, Idaho State University, Pocatello, ID, United States
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Olabisi OI, Ogunmodede E, Ojo S, Ilori O, Esan DT. Body image perception and social support as predictors of psychological distress among third trimester pregnant women in Nigeria. BMC Pregnancy Childbirth 2024; 24:298. [PMID: 38649873 PMCID: PMC11034077 DOI: 10.1186/s12884-024-06463-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 03/29/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Body image perception and social support during pregnancy can impact the psychological distress levels experienced by pregnant women. As a result, the purpose of this study was to examine the relationship between various components of social support and body image perception on psychological distress levels among pregnant women in their third trimester in Nigeria. METHOD A cross-sectional study was conducted among 246 pregnant women who were in the third trimester and attending selected health care facilities in Ogbomoso, a semiurban city in Oyo State, Nigeria. Body image perception, social support, and psychological distress scales were used to collect the data. Data were analyzed and summarized using descriptive and inferential statistics (ANOVA and multiple regression), with significance set at p < 0.05. RESULTS Regression analysis showed that 44% of the variation in psychological distress among pregnant women was explained by the background variables, marital status, body image perception, appraisal support, tangible support, belonging support, interaction between body image perception and appraisal support, belong support and tangible support. CONCLUSION Intervention programs focusing on bolstering tangible support, belonging support and appraisal support are recommended at reducing the psychological distress due to body image perception among pregnant women at third trimester.
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Affiliation(s)
- Oluwaseyi Isaiah Olabisi
- Department of Mental Health and Psychiatric Nursing, Faculty of Nursing Science, Bowen University, Iwo, Nigeria.
| | - Eunice Ogunmodede
- Department of Maternal and Child Health Nursing, Faculty of Nursing Science, Bowen University, Iwo, Nigeria
| | - Simeon Ojo
- Department of Medico-Surgical Nursing, Faculty of Nursing Science, Bowen University, Iwo, Nigeria
| | - Oluwafemi Ilori
- Department of Medico-Surgical Nursing, Faculty of Nursing Science, Bowen University, Iwo, Nigeria
| | - Deborah T Esan
- Department of Community Health/Public Health Nursing, Faculty of Nursing Science, Bowen University, Iwo, Nigeria
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Biringer A, Morson N, Walji S, Tregaskiss N, Merritt S, Makuwaza T, Forte M. Recreating the village: the patient experience with a hybrid model of Group Perinatal Care (GPPC) in an academic family health team. BMC Pregnancy Childbirth 2024; 24:227. [PMID: 38566095 PMCID: PMC10986064 DOI: 10.1186/s12884-024-06405-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 03/11/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Group prenatal care (GPC) has been shown to have a positive impact on social support, patient knowledge and preparedness for birth. We developed an interprofessional hybrid model of care whereby the group perinatal care (GPPC) component was co-facilitated by midwives (MW) and family medicine residents (FMR) and alternating individual visits were provided by family physicians (FP's) within our academic family health team (FHT) In this qualitative study, we sought to explore the impact of this program and how it supports patients through pregnancy and the early newborn period. METHODS Qualitative study that was conducted using semi-structured telephone interviews with 18 participants who had completed GPPC in the Mount Sinai Academic Family Health Team in Toronto, Canada and delivered between November 2016 and October 2018. Interviews were audio-recorded and transcribed verbatim. Thematic analysis was conducted by team members using grounded theory. RESULTS Four over-arching themes emerged from the data: (i) Participants highly valued information they received from multiple trusted sources, (ii) Participants felt well cared for by the collaborative and coordinated interprofessional team, (iii) The design of GPPC enabled a shared experience, allowing for increased support of the pregnant person, and (iv) GPPC facilitated a supportive transition into the community which positively impacted participants' emotional well- being. CONCLUSIONS The four constructs of social support (emotional, informational, instrumental and appraisal) were central to the value that participants found in GPPC. This support from the team of healthcare providers, peers and partners had a positive impact on participants' mental health and helped them face the challenges of their transition to parenthood.
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Affiliation(s)
- Anne Biringer
- Ray D. Wolfe Department of Family Medicine, Sinai Health, 60 Murray Street, Box 25, Toronto, ON, M5T 3L9, Canada.
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
| | - Natalie Morson
- Ray D. Wolfe Department of Family Medicine, Sinai Health, 60 Murray Street, Box 25, Toronto, ON, M5T 3L9, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Sakina Walji
- Ray D. Wolfe Department of Family Medicine, Sinai Health, 60 Murray Street, Box 25, Toronto, ON, M5T 3L9, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Natalie Tregaskiss
- Ray D. Wolfe Department of Family Medicine, Sinai Health, 60 Murray Street, Box 25, Toronto, ON, M5T 3L9, Canada
| | - Susannah Merritt
- Ray D. Wolfe Department of Family Medicine, Sinai Health, 60 Murray Street, Box 25, Toronto, ON, M5T 3L9, Canada
| | - Tutsirai Makuwaza
- Ray D. Wolfe Department of Family Medicine, Sinai Health, 60 Murray Street, Box 25, Toronto, ON, M5T 3L9, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Milena Forte
- Ray D. Wolfe Department of Family Medicine, Sinai Health, 60 Murray Street, Box 25, Toronto, ON, M5T 3L9, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
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Malchi F, Abedi P, Iravani M, Maraghi E, Mohammadi E, Saadati N. The Effect of Group Prenatal Care on the Empowerment of Pregnant Adolescents: Randomised controlled trial. Sultan Qaboos Univ Med J 2023; 23:502-509. [PMID: 38090240 PMCID: PMC10712397 DOI: 10.18295/squmj.6.2023.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 03/19/2023] [Accepted: 04/19/2023] [Indexed: 12/18/2023] Open
Abstract
Objectives This study aimed to evaluate the effect of group prenatal care (GPNC) on the empowerment of pregnant adolescents. Methods In this trial, 294 pregnant adolescents (aged 15-19 years) were randomly assigned into the GPNC (n = 147) and individual prenatal care (IPNC; n = 147) groups, where they received 5 sessions of GPNC (90-120 min) and IPNC, respectively, between the 16th and 40th weeks of pregnancy. The empowerment of participants in the two groups was measured using the Empowerment Scale for Pregnant Women. Data were analysed using various tests. Results The mean total score of pregnant women's empowerment in both groups after the intervention was 86.46 ± 4.95 and 81.89 ± 4.75, respectively (β = 6.11, 95% confidence interval: 4.89, 7.33; P <0.0001). Conclusion GPNC can improve pregnant adolescent empowerment. The current study's results can provide a foundation for implementing the GPNC model in Iran.
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Affiliation(s)
- Fatemeh Malchi
- Midwifery Department, Nursing and Midwifery School, Reproductive Health Promotion Research Center, Tarbiat Modares University, Tehran, Iran
| | - Parvin Abedi
- Midwifery Department, Nursing and Midwifery School, Reproductive Health Promotion Research Center, Tarbiat Modares University, Tehran, Iran
| | - Mina Iravani
- Midwifery Department, Nursing and Midwifery School, Reproductive Health Promotion Research Center, Tarbiat Modares University, Tehran, Iran
| | - Elham Maraghi
- Department of Biostatics and Epidemiology, Faculty of Public Health, Tarbiat Modares University, Tehran, Iran
| | - Eesa Mohammadi
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Najmieh Saadati
- Department of Obstetrics and Gynecology, School of Medicine, Fertility Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Smith JC, Heberlein EC, Domingue A, LaBoy A, Britt J, Crockett AH. Randomized Controlled Trial on the Effect of Group Versus Individual Prenatal Care on Psychosocial Outcomes. J Obstet Gynecol Neonatal Nurs 2023; 52:467-480. [PMID: 37604352 PMCID: PMC10840617 DOI: 10.1016/j.jogn.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 07/23/2023] [Accepted: 07/31/2023] [Indexed: 08/23/2023] Open
Abstract
OBJECTIVE To assess the effect of group prenatal care (GPNC) compared with individual prenatal care (IPNC) on psychosocial outcomes in late pregnancy, including potential differences in outcomes by subgroups. DESIGN Randomized controlled trial. SETTING An academic medical center in the southeastern United States. PARTICIPANTS A total of 2,348 women with low-risk pregnancies who entered prenatal care before 20 6/7 weeks gestation were randomized to GPNC (n = 1,175) or IPNC (n = 1,173) and stratified by self-reported race and ethnicity. METHODS We surveyed participants during enrollment (M = 12.21 weeks gestation) and in late pregnancy (M = 32.51 weeks gestation). We used standard measures related to stress, anxiety, coping strategies, empowerment, depression symptoms, and stress management practices in an intent-to-treat regression analysis. To account for nonadherence to GPNC treatment, we used an instrumental variable approach. RESULTS The response rates were high, with 78.69% of participants in the GPNC group and 83.89% of participants in the IPNC group completing the surveys. We found similar patterns for both groups, including decrease in distress and increase in anxiety between surveys and comparable levels of pregnancy empowerment and stress management at the second survey. We identified greater use of coping strategies for participants in the GPNC group, particularly those who identified as Black or had low levels of partner support. CONCLUSION Group prenatal care did not affect stress and anxiety in late pregnancy; however, the increased use of coping strategies may suggest a benefit of GPNC for some participants.
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Childbirth experience during the COVID-19 pandemic: A qualitative thematic analysis. Midwifery 2023; 121:103669. [PMID: 37001431 PMCID: PMC10038889 DOI: 10.1016/j.midw.2023.103669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 02/16/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023]
Abstract
Introduction Pregnancy is a period of special vulnerability for the mental health of women. The arrival of the COVID-19 pandemic altered the routines of pregnant women, its effects on this population are thus far unknown. Therefore, the objective of this study is to understand the impact of the pandemic on the birth experience of women during the state of emergency in Andalusia, Spain. Methods A qualitative study was conducted with 14 women, using semistructured interviews via telematics. These were recorded and later transcribed using the F4transkript software. In order to analyse the data retrieved from the interviews and identify the main patterns of meaning/responses, the thematic analysis method was applied. Results The main emerging themes were 'prenatal medical care', 'hospital safety', and 'postpartum with COVID-19 restrictions'. The results indicated that the reorganization of perinatal medical care, the lack of information, and the fear of contagion were the factors that most negatively influenced the participants. Instead, the security during the birth process and the tranquillity in postpartum were the positive aspects of the birth experiences during COVID-19. Conclusion This is the first qualitative study in Andalusia that identifies the specific aspects of the COVID-19 pandemic that have affected the mental health of pregnant women. The results contribute to a broader perception of the experience of women and the creation of health protocols for emergencies akin to the COVID-19 pandemic.
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Baney L, Greene A, Sherwood-Laughlin C, Beckmeyer J, Crawford BL, Jackson F, Greathouse L, Sangmo D, Ward M, Kavaya S. "It Was Just Really Hard to Be Pregnant in a Smaller Town …": Pregnant and Parenting Teenagers' Perspectives of Social Support in Their Rural Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16906. [PMID: 36554786 PMCID: PMC9778672 DOI: 10.3390/ijerph192416906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/13/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
Teenage pregnancy has a history of being a "social problem" in the United States, with there being higher rates in rural communities. Social support, a contributor to improving mental health outcomes, can significantly impact a teenager's pregnancy and parenting experience. Using House's (1981) social support framework, this study explores the teenagers' perceptions of how their rural community reacted and responded to them as pregnant and parenting teenagers. The results were formulated through the thematic analysis of semi-structured interviews (n = 26) with current and former pregnant and/or parenting teenagers. The participants reported experiencing both positive and negative social support. There were more reports of emotional support and instrumental support among the forms of positive support than there were in the other categories. Informational support was lacking. The appraisal support from community members was negative. There is a need for rural communities to develop effective social support strategies to provide positive support for pregnant and parenting teenagers.
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Affiliation(s)
- Lauren Baney
- School of Public Health, Indiana University-Bloomington, Bloomington, IN 47405, USA
| | - Alison Greene
- School of Public Health, Indiana University-Bloomington, Bloomington, IN 47405, USA
| | | | - Jonathon Beckmeyer
- College of Applied Human Sciences, West Virginia University, Morgantown, WV 26506, USA
| | - Brandon L. Crawford
- School of Public Health, Indiana University-Bloomington, Bloomington, IN 47405, USA
| | - Frederica Jackson
- School of Public Health, Indiana University-Bloomington, Bloomington, IN 47405, USA
| | - Lisa Greathouse
- Community Health, Indiana University Health, Bloomington, IN 47401, USA
| | - Dechen Sangmo
- School of Public Health, Indiana University-Bloomington, Bloomington, IN 47405, USA
| | - Michaella Ward
- School of Public Health, Indiana University-Bloomington, Bloomington, IN 47405, USA
| | - Susan Kavaya
- School of Public Health, Indiana University-Bloomington, Bloomington, IN 47405, USA
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Ahrne M, Byrskog U, Essén B, Andersson E, Small R, Schytt E. Group antenatal care (gANC) for Somali-speaking women in Sweden - a process evaluation. BMC Pregnancy Childbirth 2022; 22:721. [PMID: 36131237 PMCID: PMC9494829 DOI: 10.1186/s12884-022-05044-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/09/2022] [Indexed: 11/18/2022] Open
Abstract
Background Language supported group antenatal care (gANC) for Somali-born women was implemented in a Swedish public ANC clinic. The women were offered seven 60-min sessions, facilitated by midwives and starting with a presentation of a selected topic, with an additional 15-min individual appointment before or after. The aim of this study was to assess the feasibility for participants and midwives of implementing The Hooyo (“mother” in Somali) gANC intervention, including implementation, mechanisms of impact and contextual factors. Methods A process evaluation was performed, using The Medical Research Council (MRC) guidelines for evaluating complex interventions as a framework. A range of qualitative and quantitative data sources were used including observations (n = 9), complementary, in-depth and key-informant interviews (women n = 6, midwives n = 4, interpreters and research assistants n = 3) and questionnaire data (women n = 44; midwives n = 8). Results Language-supported gANC offered more comprehensive ANC that seemed to correspond to existing needs of the participants and could address knowledge gaps related to pregnancy, birth and the Swedish health care system. The majority of women thought listening to other pregnant women was valuable (91%), felt comfortable in the group (98%) and supported by the other women (79%), and they said that gANC suited them (79%). The intervention seemed to enhance knowledge and cultural understanding among midwives, thus contributing to more women-centred care. The intervention was not successful at involving partners in ANC. Conclusions The Hooyo gANC intervention was acceptable to the Somali women and to midwives, but did not lead to greater participation by fathers-to-be. The main mechanisms of impact were more comprehensive ANC and enhanced mutual cultural understanding. The position of women was strengthened in the groups, and the way in which the midwives expanded their understanding of the participants and their narratives was promising. To be feasible at a large scale, gANC might require further adaptations and the “othering” of women in risk groups should be avoided. Trial registration The study was registered in ClinicalTrials.gov (Identifier: NCT03879200).
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Affiliation(s)
- Malin Ahrne
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
| | - Ulrika Byrskog
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Birgitta Essén
- Women's and Children's Health, IMCH, Uppsala University, Uppsala, Sweden
| | - Ewa Andersson
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Rhonda Small
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Judith Lumley Centre, La Trobe University, Melbourne, Australia
| | - Erica Schytt
- Centre for Clinical Research Dalarna, Uppsala University, Falun, Sweden.,Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
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Descriptions of Maternal Mortality From Nurses Who Practice in Perinatal Settings. Nurs Womens Health 2022; 26:288-298. [PMID: 35690097 DOI: 10.1016/j.nwh.2022.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/30/2022] [Accepted: 05/17/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To explore nurses' descriptions of maternal mortality when caring for women in the perinatal period in Indiana. DESIGN A qualitative descriptive approach was used to produce nurses' descriptions of maternal mortality. SETTING/PARTICIPANTS Convenience sample of 16 nurses recruited from the Indiana Section of the Association of Women's Health, Obstetric and Neonatal Nurses. MEASUREMENTS Semistructured phone interviews were conducted, and participants were asked to explain their experiences related to maternal mortality. This information, which was summarized using content analysis, provided data related to nurses' descriptions of maternal mortality when caring for women in the perinatal period. RESULTS Analysis revealed three main themes that explain nurses' descriptions of maternal mortality: When It Comes to Maternal Mortality: Out of Sight Is Out of Mind, Nurses Express Detachment From Their Role in Preventing Maternal Mortality, and Experience With Maternal Mortality or a Near-Miss Event Is a Turning Point for Nurses. CONCLUSION Nurses who have limited experience with maternal mortality and who approach the issue in a detached manner may miss opportunities to provide health education to women in the perinatal period. Nurses need education on substance use disorders in the perinatal period, guidance on how to support women in the postpartum period, and support for coping with death and dying in the perinatal period.
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