Factors associated with utilization of physical therapy services during pregnancy and after childbirth

Objective

To explore demographic and clinical factors associated with utilization of antepartum/postpartum physical therapy.

Methods

This is a secondary analysis of a cross-sectional survey of 298 women who were receiving or had received obstetric care at a medical center in southern Taiwan. Data were collected between May 2021 and May 2022 using an online questionnaire, which included demographic, medical, and obstetric details, the symptom severity questionnaires, management strategies, and experience and perception about physical therapy. Descriptive statistics, independent t-test, chi-square analysis and multivariate logistic regression model were used to analyze data.

Results

Among 298 respondents, 190 (63.8%) were pregnant and 108 (36.2%) were postpartum. Thirteen percent of pregnant participants and 27% of postpartum participants had received physical therapy during and/or after childbirth. Multivariate analyses showed that being postpartum, having an associate degree and below, and experiencing depressive symptoms were significantly associated with an increased utilization of physical therapy (postpartum: OR = 3.039, 95% CI = 1.530, 6.035; associate degree and below: OR = 2.521, 95% CI = 1.007, 6.316; depressive symptoms: OR = 3.606, 95% CI = 1.067, 12.185). The odds of utilizing physical therapy decreased with age (OR = 0.935, 95% CI = 0.874, 1.000).

Conclusions

Individual factors, such as age, education level, pregnancy status, and experience of depressive symptoms, have a significant association with utilization of antepartum/postpartum physical therapy and should be considered when developing obstetric care pathways to optimize clinical and healthcare utilization outcomes.

Postnatal quality of life, depressive symptoms, and social support among women in southern India

Evaluation of postnatal quality of life (QOL) has remained a poorly researched area in India. The present cross-sectional study assessed postnatal QOL, using the Mother Generated Index (MGI) and its associated risk factors, and was conducted during January-March 2013 among 274 mothers, 6-8 weeks postnatally. A semi-structured questionnaire was used to evaluate sociodemographic and obstetric characteristics and social support. Depressive symptoms were assessed by the Patient Health Questionnaire (PHQ-9) and QOL using the MGI. The vast majority (90.1 percent) of respondents in our study had a primary MGI score <5, those with significantly higher prevalence of physical problems and psychological distress. A total of 39.8 percent of respondents were screened as having other (not major) depressive symptoms and 4.7 percent as having major depressive symptoms. Multiple regression analysis revealed that age (β = 0.033, p = .018) and socioeconomic status (β = 0.156, p < .001) were significantly positively associated with QOL, while increased depressive symptom scores (β = -0.075, p < .001) were significantly negatively associated with QOL. A wide spectrum of QOL aspects were reported, including physical, emotional, social, and economic concerns by the mothers. Prevention, evaluation, and treatment of postnatal depressive symptoms and impaired QOL are warranted, taking into account the role of various biopsychosocial risk factors and specific concerns raised by the mothers.

Factors associated with seeking treatment for postpartum morbidities in rural India

OBJECTIVES

To understand the prevalence of postpartum morbidities and factors associated with treatment-seeking behaviour among currently married women aged 15-49 residing in rural India.

METHODS

We used data from the nationally representative District Level Household Survey from 2007-2008. Cross-tabulation was used to understand the differentials for the prevalence of postpartum morbidities and treatment-seeking behaviours across selected background characteristics. Two-level binary logistic regression was applied to understand the factors associated with treatment-seeking behaviour.

RESULTS

Approximately 39.8% of rural women suffered from at least one of the six postpartum morbidities including high fever, lower abdominal pain, foul-smelling vaginal discharge, excessive bleeding, convulsions, and severe headache. Morbidities were more prevalent among poor, illiterate, Muslim, and high-parity women. About 55.1% of these rural women sought treatment/consultation for their problems. The odds of seeking treatment/consultation increased as economic status and years of schooling among both the woman and her husband increased. Poor, uneducated, unemployed, Hindu, and tribal women were less likely to seek treatment/consultation for postpartum morbidities than their counterparts were. The odds of seeking treatment/consultation decreased as the distance to the nearest private health facility increased. Most women visited a private hospital (46.3%) or a friend/family member's home (20.8%) for treatment/consultation. Only a small percentage visited publicly funded health institutions such as a primary health centre (8.8%), community health centre (6.5%), health sub-centre (2.8%), or district hospital (13.1%). Rural women from the northeast region of India were 50% less likely to seek treatment/consultation than women from the central region were.

CONCLUSIONS

Providing antenatal and delivery care, and ensuring nearby government healthcare facilities are available to serve rural women might increase the likelihood of care-seeking for postpartum morbidities. Targeted interventions for vulnerable groups should be considered in future policies to increase the likelihood women will seek treatment or advice postpartum.