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Rudman, Ann Ingmarsdotter. "Women's evaluations of intrapartum and postpartum care /." Stockholm : Karolinska insitutet, 2007. http://diss.kib.ki.se/2007/978-91-7357-273-6/.
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Quosdorf, Ashley. "Connecting with Adolescent Mothers: Perspectives of Hospital-Based Perinatal Nurses." Thesis, Université d'Ottawa / University of Ottawa, 2019. http://hdl.handle.net/10393/38838.
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Background: Adolescents are more likely to be dissatisfied with perinatal care than adults. Adolescents’ perspectives of their perinatal care experiences have been explored; however, there are few studies exploring adolescent-friendly inpatient care from nurses’ perspectives.
Purpose: To explore adolescent-friendly care from the perspective of hospital-based adolescent-friendly perinatal nurses.
Research Questions: (1) How and why do perinatal nurses in inpatient settings adapt their practice when caring for adolescents? (2) What are the individual nursing behaviours and organizational characteristics of adolescent-friendly care in inpatient perinatal settings, from the perspective of perinatal nurses?
Methods: I report the qualitative component of a mixed methods study. Open-ended interviews were conducted with twenty-seven purposively-sampled expert nurses. Data were analyzed using Interpretive Description.
Findings: Nurses described being mother-friendly to adolescents by being nonjudgmental, forming connections, individualizing care, and employing behavioural strategies that facilitate relationship-building.
Implications: These findings will inform the development of interventions to facilitate connections between nurses and adolescent mothers.
3
Polaha, Jodi. "Postpartum Depression in Pediatric Primary Care." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/6677.
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Lindberg, Inger. "Postpartum care in transition : parents' and midwives' expectations and experience of postpartum care including the use of videoconferencing /." Luleå : Division of nursing, Luleå University of Technology, 2007. http://epubl.ltu.se/1402-1544/2007/20/.
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Du, Preez Antoinette. "Quality improvement intervention programme (QIIP) for intrapartum care / Antoinette du Preez." Thesis, North-West University, 2010. http://hdl.handle.net/10394/4816.
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Maternal and perinatal mortality is one of the biggest challenges to public health, especially
in developing countries. South Africa?s health care system is struggling to meet the “health
for all” criteria against a backdrop of staff shortages (especially midwives) in an HIV/AIDS
epidemic. These factors, together with the economic constraints of a developing country,
places great demands on delivering cost–effective, safe, quality intrapartum care that
exceeds expectations. The challenge for the manager is to organise the available resources
to render the best quality of care cost effectively within the shortest period of time. Various
reasons exist for the alarming shortage of nurses and midwives globally and also in South
Africa. Unhealthy practice environments are the main cause of the problem as such
environments have an impact on the job satisfaction of the midwives as well on patient
satisfaction. In the turmoil of the health care system, patients are demanding greater quality
of care and are insisting not only on excellent clinical skills, but also on empathetic and
personalised care.
This research was conducted to make a meaningful contribution to the body of knowledge,
specifically knowledge related to quality intrapartum care through the development of a
Quality Improvement Intervention Programme (QIIP?). The research was conducted in two
phases including five objectives. The first objective gave a theoretical foundation of quality
intrapartum care. The second objective included a situational analysis of the resources
(personnel and equipment) and determine the quality improvement initiatives that could be
implemented for intrapartum care. The third objective determined the practice environment
in maternity units at Level 2 hospitals in the North West province that may influence quality
intrapartum care. The fourth and last objective of Phase 1 determined the perceptions of
management and midwives regarding the facilitating and impeding factors that influence the
quality of intrapartum care. From the data that emerged from the first four objectives,
specific themes kept repeating themselves, namely structure (what must be in place, e.g.
infrastructure and human resources), process (what we do, e.g. life–long learning and
implementation of policies) and outcome (the results, e.g. patient satisfaction and a positive practice environment). These collectively contribute to the quality of intrapartum care
rendered.
Phase 2 consisted of the development of a “Quality Improvement Intervention Programme
(QIIP?)” for intrapartum care. In this phase the data from the first four objectives were used
to develop the QIIP?. The QIIP? will be marketed as an accreditation tool for maternity
units to measure themselves against the best in the world. Qualifying for QIIP? accreditation
means improving the quality of intrapartum care resulting in satisfied patients, the
establishment of a positive practice environment and a decrease in the Maternal Mortality
Rate (MMR).Thesis (Ph.D. (Nursing))--North-West University, Potchefstroom Campus, 2011.
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Schroeder, Elizabeth-Ann. "The cost-effectiveness and efficiency of intrapartum maternity care in England." Thesis, University of Oxford, 2013. http://ora.ox.ac.uk/objects/uuid:f9cf3e25-34ae-49a3-ab50-5721e81a7458.
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Background: High quality evidence on the cost-effectiveness of planned birth in alternative settings (at home, in a midwifery unit or an obstetric unit) has been lacking, and is a priority area for maternity policy. Aim: To provide evidence about the efficiency of the configuration of maternity care in England and to estimate the cost-effectiveness of alternative settings for intrapartum care for ‘low risk’ women, thereby providing guidance for commissioners, clinicians and for pregnant women and their families. Methods: A literature review of existing evidence was followed by four stand-alone empirical studies using different methods to determine the efficiency and cost-effectiveness of alternative settings for intrapartum care. Data from the Birthplace in England Programme of Research were analysed to explore whether there are differences in the efficiency of maternity units when they are stratified according to the type and scale of unit. Incremental cost-effectiveness ratios were used to estimate the short-term cost-effectiveness of different planned settings for birth for ‘low risk’ women and to develop a template for the design of decision-analytic models to estimate life-long cost-effectiveness for the mother and baby dyad. Findings: The larger obstetric units (OUs) tended to be more efficient than the smaller OUs. Less than half of free-standing midwifery units (FMUs) were operating at full efficiency. The cost of intrapartum and after birth care, and associated related complications, was less for births planned at home, in a free standing midwifery unit (FMU), or in an alongside midwifery unit (AMU) compared with planned births in an obstetric unit (OU). Planned birth in a FMU or in an AMU compared with an OU will generate incremental cost savings but with uncertainty surrounding the outcomes for the baby. Planned birth in all non-OU settings generated incremental cost savings and improved outcomes for mothers. For ‘low risk’ women having a second or subsequent birth, planned birth at home was found to be the most cost-effective option.
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Pothisiri, Wiraporn. "Postpartum care in Thailand : experience, practice and policy." Thesis, London School of Economics and Political Science (University of London), 2010. http://etheses.lse.ac.uk/2205/.
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In developing countries, hundreds of thousands of women still die shortly after giving birth and thousands who make it to survive suffer with short-term or longterm health problems related to pregnancy and childbirth that impact their quality of life. However, empirical evidence shows that the majority of these women did not receive any care after delivery. Unlike antenatal and obstetric care, relatively little is known about the factors that explain levels of postpartum care use. This thesis examines the utilisation of postpartum care services in the context of Thailand, which is best known among the developing countries for its success on maternal and child healthcare improvement. Thailand's maternal mortality rate is low (12 deaths per 100,000 live births) and 92 per cent of women have at least four antenatal visits and 97 per cent of women deliver in hospitals. However, rates of postpartum service use remain low at 61.2 per cent. The thesis considers the explanations for low levels of postpartum service use observed in Thailand from a range of perspectives: women, health providers, policy actors and interrelationships among them. Using sequential mixed methods, the study first examines quantitatively the contemporary context of postpartum services and the individual-level factors influencing the use of postpartum services. This is followed by a qualitative analysis which explores the attitudes and perceptions of women, health providers and policy actors towards postpartum care services. Analyses reveal interacting influences that facilitate and impede women's use of postpartum care service. Whilst the quantitative study reveals several demographic, socio-economic and motivating factors, the qualitative study shows that women's perception of the content of postpartum care services and healthcare systems, as well as their experience of encounters with health providers, have significant impact on decisions whether to use postpartum services. The health service delivery system has some significant negative impacts on women's use of postpartum services. Although Thailand has had postpartum care policies in place since the 1960s, the significance of postpartum care for the mother's health has been neglected. The study finds that there is a complex array of individual, health system-related and political factors that influence the utilisation of postpartum care services. Unless adequate attention is given to these factors and their interrelation, it is unlikely that women's use of postpartum care services will be improved.
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Smith, Sarah C. "Evaluating a Stepped Care Protocol for Postpartum Depression in a Pediatric Primary Care Clinic." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etd/3277.
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Postpartum depression (PPD) is a prevalent, complex illness impacting 10% to 20% of mothers and their families. Treatments for PPD, such as medication and psychotherapy, are effective at reducing the severity of symptoms and generally improving quality of life for new mothers and their families. Unfortunately, many mothers with PPD go unrecognized due to a lack of standardized screening methods. Further, mothers regularly encounter barriers to accessible, evidence-based follow-up care to treatment even when symptoms of PPD are detected. The use of a stepped care protocol, set in a pediatric primary care clinic, is one proposed strategy to address the insufficient rates of screening, detection, and maternal contact with treatment. This study examines the feasibility of implementing a stepped care protocol to screen and provide brief therapeutic treatment to mothers reporting symptoms of PPD in one pediatric primary care clinic. The RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework was used to evaluate implementation outcomes. Results suggest this stepped care protocol was feasibly implemented in one pediatric primary care clinic. The protocol was largely successful in screening mothers at a majority of well child checks (83.76%) for PPD and connecting them with resources based on the severity of symptoms reported. Future studies should further evaluate the impact brief onsite mental health treatments have on reports of PPD symptoms, longitudinal maternal and child outcomes as a result of the protocol, as well as the protocol’s replicability to pediatric practices elsewhere.
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Bedwell, Carol. "An analysis of the meaning of confidence in midwives undertaking intrapartum care." Thesis, University of Manchester, 2012. https://www.research.manchester.ac.uk/portal/en/theses/an-analysis-of-the-meaning-of-confidence-in-midwives-undertaking-intrapartum-care(613415b1-a583-49eb-84ac-e1dee6ab7433).html.
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Midwives are often the lead providers of maternity care for women. To provide the variety of care required by women, they need to be confident in their role and practice. To date, only limited evidence exists in relation to confidence as experienced by midwives. This thesis aims to explore the phenomena of confidence through the lived experience of midwives. In particular, this will encompass confidence in the context of the intrapartum care setting. The theoretical basis for the study was hermeneutic phenomenology, guided by the work of Heidegger and Gadamer. Midwives were recruited from three clinical settings to obtain a diversity of views and experiences. Rich data from diaries and in-depth interviews, from twelve participants, provided insight into the phenomena of confidence and the factors midwives encountered that affected their confidence. The phenomena of confidence consisted of a dynamic balance, between the cognitive and affective elements of knowledge, experience and emotion. This balance was fragile and easily lost, leading to a loss of confidence. Confidence was viewed as vital to midwifery practice by the participants of the study; however, maintaining their confidence was often likened to a battle. A number of cultural and contextual factors were identified as affecting confidence within the working environment, including trust, collegial relationships and organisational influences. Midwives also described various coping strategies they utilised to maintain their confidence in the workplace environment. This study provides unique insight into the phenomena of confidence for midwives working in intrapartum care, resulting in a number of recommendations. These highlight the importance of leadership, education and support for midwives in the clinical environment in enabling them to develop and maintain confidence in practice.
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Mead, Marianne Marie Paule. "Decision making by midwives involved in the intrapartum care of women suitable for full midwifery care : processes and influences." Thesis, University of Hertfordshire, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.366028.
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Kapinos, Linda A. "POSTPARTUM DEPRESSION: AN EDUCATIONAL MODULE FOR HEALTH CARE PROVIDERS." Thesis, The University of Arizona, 2003. http://hdl.handle.net/10150/609886.
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Postpartum depression (PPD) is a well- recognized public health problem with a
predictable onset beginning after childbirth and lasting from 3 to 14 months. Studies
consistently report that cases of PPD are not identified and treated which results in
serious personal, family, and social consequences (Webster et al., 2000). Therefore, it is
of great importance that this disorder be diagnosed and treated early to prevent these
deleterious consequences. The reported prevalence for PPD ranges from 3.5% to 33%
depending upon assessment criteria used (Whifen as cited in Evins et al., 2000).
The purpose of this clinical project was to review the literature in order to identify
those factors that prevent postpartum depression from being identified and treated. A
critique of the literature led to assessing one commonly used screening tool and to
proposing strategies to increase early diagnosis and treatment. Not a single article
reported PPD as being identified and treated, and this resulted in the development of an
education module for health care providers.
A suggestion for future educational modules includes targeting women in their
reproductive years, as well as the community. The goal of these educational modules
would be to is increase awareness of PPD risk factors, screening, and treatment strategies
to avoid women and their families from suffering from PPD sequelae.
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Ho, Kit-ching Jane. "Screening for antenatal depression in a primary health care setting." Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B43251183.
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Ngula, Asser Kondjashili. "Women's perception on the under utilization of intrapartum care services in Okakarara district, Namibia." Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&.
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Maternal health care services are one of the health interventions to reduce maternal and infant morbidity and mortality. The health of mothers of childbearing age and of the unborn babies is influenced by many factors some of which include the availability and accessibility of health services for pregnant women. Low quality of health services being provided, and limited access to health facilities is correlated with increases maternal morbidity and mortality. This situation is caused by long distances between facilities as well as the people's own beliefs in traditional practices. This study was about the assessment of the women's knowledge on benefits of delivery in a hospital, the barriers to delivery services, and the perception of the delivery services rendered in the maternity ward of Okakarara hospital.
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Williams, Danielle. "Relationship Between Maternal Expectations of Perinatal Care and Postpartum Depression." Thesis, The University of Arizona, 2012. http://hdl.handle.net/10150/221420.
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A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.The incidence of postpartum depression (PPD) is estimated at 13-19%, with effects reaching far beyond the affected mother. However, its precise cause is still unknown. In this double-blinded study, a 30-question Maternal Expectations Survey (MES) was developed to explore the notion that unmet maternal expectations for labor, delivery, and the immediate postpartum period impose risk factors for PPD. The MES was administered to postpartum women at Banner Good Samaritan Medical Center; and scores were compared to those on the Edinburgh Postnatal Depression Scale (EPDS), administered 6 weeks postpartum to the same women in the outpatient setting of the clinic of their attending physician. Results of this interim analysis, using Poisson regression models, indicated that there is no significant correlation between total MES score and EPDS score. Two MES queries (relating to spontaneous onset of labor and coping mechanisms during labor) are independently predictive of an increased EPDS score. With attainment of adequate power, other components of the MES may emerge as genuine risk factors for PPD and help identify women who would benefit from earlier-than-usual, pre-emptive postpartum counseling. This study also served to buttress the validity of 5 considering the presence of neonatal health complications as a risk factor for PPD; and, conversely, it identified obstetric complications, neonatal health complications and a recent stressful life event as significant predictors of an increased MES score. Additionally, the presence of a written birth plan is also a significant predictor of increased
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Smith, S. C., Jodi Polaha, Deborah A. Thibeault, Debra Q. Mills, and Gayatri Jaishankar. "Team-Based Care for Postpartum Depression in a Pediatric Clinic." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/6572.
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The aim of this presentation is to describe the development, implementation, and one-year outcomes of a team-delivered, evidence-based protocol to identify and address postpartum depression in a pediatric primary care clinic. The presentation will include: 1) a description of the development process based on implementation science, 2) engaging activities for the audience such as a video illustration of the protocol itself, and providing an opportunity to learn and practice administering the Ecomap, an evidence-based assessment for social determinants of health, and 3) data from a records review showing outcomes. Additionally, this presentation will illuminate barriers and facilitators at varying levels to team-based healthcare in general and within this specific clinic. At the conclusion of this presentation, participants will be able to: Explain the inception and development of a stepped-care protocol set within a pediatric primary care clinic as conceptualized by the Consolidated Framework for Implementation Research. Describe the function and utility of an Ecomap to understand a family's social determinants of health. Apply the RE-AIM model to evaluate a clinical intervention implemented within an interdisciplinary pediatric primary care clinic.
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Smith, Lindsay Frederick Paul. "The effect of education and training on the provision of intrapartum care by general practitioners." Thesis, University of Bristol, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.319197.
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Ellberg, Lotta. "Postnatal care - outcomes of various care options in Sweden." Doctoral thesis, Umeå universitet, Obstetrik och gynekologi, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-1818.
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Background: In high-income countries, hospital length of stay after a normal birth has gradually decreased correspondingly to length of stay in care of other patients. A short stay provides a greater opportunity for autonomy and an increased sense of participation, but it may involve great challenges satisfying parental guidance as well as on the possibility of preventing, discovering, and treating neonatal medical conditions. Aim: This study evaluates postnatal care based on cost calculations, risk assessments, and parents’ satisfaction with care. Methods: Questionnaires were sent to 1 122 new mothers and her partner during 1998-1999. For the summary of utilization of health care services during the first 28 days postdelivery, the participants were linked with registry data from the hospital administration system for mothers and newborns (n= 773). The answers were also used to describe new parents’ experiences with postnatal care (n = 1 479). The costs for five postnatal care models were estimated, including three care options: Maternity Ward, Family Suite, and Early Discharge. Data about neonatal readmissions and death within 28 days was retrieved from the Swedish Medical Birth Register, the Swedish Hospital Discharge Registry, and the Swedish Cause-of-Death Register between 1999 and 2002 (n = 197 898). This data was related to data about postnatal follow-up practices from all 48 Swedish delivery wards. Results: The readmission rate for the mothers was similar among the various care options, and there was no difference in utilization of health care or breastfeeding outcome due to type of maternity care. As a proxy for morbidity, the readmission rate for the newborns was influenced by postdelivery follow-up routines as routine neonatal examination timing. Depending on the proportion of mothers receiving care at the Maternity Ward, the costs differed significantly between the various care models, while parents’ preferences complied with the cost-minimizing option Family Suite. Most mothers and fathers (70%) were satisfied with the overall impression of the postnatal care, but 72% were dissatisfied with at least one particular topic. A main finding was that the parents experienced a close emotional attachment, an affinity that was not always supported by the staff. The father was not treated as a principal character even though the parents wanted the father’s to be involved and recognized. Conclusions: Since the postnatal care options are not always the most cost minimizing and postnatal routines influence neonatal morbidity and parental satisfaction, the postnatal services need to be improved. Without increasing risks or costs, every postnatal care option ought to meet the families’ need for support, security, autonomy, and attachment with each other.
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Tennyson, Sarah Elizabeth. "An Analysis of Postpartum Depression and Care Seeking Behaviors in Georgia." Digital Archive @ GSU, 2009. http://digitalarchive.gsu.edu/iph_theses/120.
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Postpartum depression is recognized as an important maternal and child health issue. Postpartum depression is the most common perinatal psychiatric disorder and one of the most common complications of childbirth. Studies show prevalence rates in women ranging from 10% to 25%. Postpartum depression affects the emotional wellbeing of mothers, infant behavior, mother-infant bonding, and marital relationships. However, the majority of women who experience postpartum depression do not seek care. The purpose of this analysis is to examine the demographic differences between women in Georgia who report symptoms of postpartum depression but do not seek care, versus women who report postpartum depression symptoms and seek care. Approximately 15% of respondents in this study reported postpartum depression. Of these women, approximately 80% did not seek care for their symptoms. This analysis found that women with the following characteristics were more likely to not seek care for depression: non-White and Hispanic women; women that were uninsured before their pregnancy; women that had their prenatal care paid for by Medicaid or the Military; and women who did not seek care for depression during their pregnancy. The results of this study may help to guide the implementation of public health interventions among postpartum women in Georgia.
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Lundh, Emma. "Plant Use in Ante- and Postpartum Health Care in Lao PDR." Thesis, Uppsala universitet, Systematisk biologi, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-141826.
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Ramirez, Nancy Jeannette. "U.S. Mexican immigrant women| Postpartum depression and barriers to accessing care." Thesis, California State University, Long Beach, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=1522594.
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An analysis was conducted to examine the prevalence and risk factors for depressive symptoms and the factors associated with accessing healthcare among 2 groups of immigrant postnatal Mexican women living in California less than 10 years. Using Andersen's Behavioral Model for Health Care Utilization, this study's findings are consistent with prior research. The demographic variables of the women who lived in the United States less than 5 years and women who lived in the United States less than 10 years did not differ. Recent immigrants were more likely to see the doctor more frequently or wait less time between visits. Over 90% of participants experienced limited English proficiency. The percentage of women experiencing depression symptoms was 12.6%. The fmdings underscore the need for social workers to assess the risk factors associated with postpartum depression and evaluate the predisposing, enabling and need factors of Mexican immigrant women associated with accessing care.
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Peterson, Wendy E. DiCenso Alba. "Adolescent mothers' satisfaction with postpartum nursing care : quantitative and qualitative approaches /." [Hamilton, Ont.] : McMaster University, 2004.
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Tillett, Marsha Jane 1952. "The effect of postpartum home teaching on knowledge of infant care." Thesis, The University of Arizona, 1992. http://hdl.handle.net/10150/278075.
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This study investigated the effect of postpartum home teaching on primiparous women's knowledge of infant care. Twenty-one low-risk primigravidae women were randomly placed in a control or experimental group. Subjects in the experimental group viewed a videotaped program on infant care a second time, at home on the third day postpartum. Tests were administered prior to hospital discharge, on the third day postpartum, and at 28-32 days postpartum. A short interview was conducted to obtain opinions regarding videotaped educational materials. The subjects (n = 21) retained most of the information presented after the first viewing and expressed satisfaction with the educational format. The results were not statistically significant, though mean test scores increased over the three test intervals.
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Solomon, Julia 1950. "Prenatal and postpartum health care beliefs and practices of Arab women." Thesis, The University of Arizona, 1990. http://hdl.handle.net/10150/278338.
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The purpose of this study was to describe the prenatal and postpartum health care beliefs and practices of Arab student wives in a small Southwestern university town. The study also explored whether temporary migration to the United States altered or complicated any of the traditional beliefs and practices. The sample consisted of five Moslem Arab women (all from different regions of the Middle East) who had experienced at least one pregnancy prior to the interview. An ethnographic method was used in guiding questions which dealt with beliefs and practices during the prenatal and postpartum periods. Analysis of data showed the importance of upholding traditional beliefs regarding pregnancy, and beliefs in religion and God, which determine the health of the pregnancy and the postpartum period, the importance of following advice of mothers, and the support system of female family members during the postpartum period.
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Ho, Kit-ching Jane, and 何潔貞. "Screening for antenatal depression in a primary health care setting." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B43251183.
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Parlier-Ahmad, Anna B. "Predictors of Peripartum Care Attendance Among a Sample of African American Women at Increased Risk for Poor Prenatal Care Compliance." VCU Scholars Compass, 2019. https://scholarscompass.vcu.edu/etd/6104.
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Prenatal and postpartum care are important for reducing maternal and infant morbidity. Racial and ethnic disparities are prevalent in maternal peripartum health and infant birth outcomes as well as peripartum care access and utilization. They highlight the need to identify and better understand correlates of poor prenatal and postpartum care compliance. While risk factors for low adherence to peripartum care have been identified, no studies have looked specifically at predictors of prenatal and postpartum care attendance in an at-risk sample of African American pregnant women. Using existing data from an RCT targeting maternal and infant health disparities and comparing a patient navigation/behavioral incentive intervention to treatment as usual, the present study sought to identify predictors of prenatal and postpartum care attendance. Participants were African American women at risk for poor prenatal care compliance, who participated in the RCT and had a documented live birth (n=123). Using hierarchical linear and logistic regression, the study identified predictors of prenatal and postpartum care attendance, respectively. The study found high-risk pregnancy (p < .001) and fewer barriers to care (p = .013) significantly predicted better prenatal care attendance. Less than adequate prenatal care attendance significantly predicted postpartum visit nonattendance (p < .001).
In addition, given that study participants were limited to women who provided informed consent to RCT participation, the present study also examined representativeness of the clinical trial sample. Specifically, women who consented to the RCT (consenters; n=149) were compared to those who did not (non-consenters; n=122) on a variety of demographic and psychosocial variables using chi-square for categorical variables and t-tests for continuous variables. Consenters and non-consenters differed only on education level, with consenters more likely to have at least a high school education than non-consenters. The present study provides benchmark data on sample representativeness and predictors of peripartum care in a clinical trial of strategies to improve prenatal care compliance. These findings could have important implications for healthcare system changes and treatment interventions among this population.
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Kamara, Aminata Sankoh. "Assessing Postpartum Depression in the Refugee Population in a Primary Care Setting." Diss., North Dakota State University, 2019. https://hdl.handle.net/10365/29400.
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Mental health is an area lacking emphasis in the United States healthcare systems. Many patients have suffered due to the decrease in focus and resources required to help individuals struggling with mental disorders (Lieberman, Goldman, Olfson, Pincus, & Sederer, 2017). While the struggle for adequate screening for mental illness continues, minority populations, such as refugee women, are affected more due to multifactorial risk factors and lack of treatment emphasis (Ganann, Sword, Thabane, Newbold & Black, 2016; Lieberman et al., 2017). Due to the increase in the number of refugees that migrate to the United States, particularly in the Midwest, healthcare providers must continue to enhance their knowledge on risk factors of mental illness in vulnerable populations, such as refugee women, and implement evidence-based practices that will promote the best possible patient outcomes. The practice improvement project aimed to increase healthcare provider awareness of the increased risk of postpartum depression (PPD) in refugee women compared to other patient populations and improve incidence rates of PPD during the first year of the postpartum period in refugee women. The project took place at a primary care clinic where the Edinburgh Postpartum Depression Scale (EPDS), an evidence-based screening tool for identifying risk for PPD, was implemented over a two-month period assessing for PPD. The results of EPDS were compared to the standard previously used Patient Health Questionnaire (PHQ-2) results over two months. A 30-minute educational session was given to the providers regarding how to assess for PPD, risk factors, providing culturally sensitive care, utilizing appropriate evidence-based screening tools for PPD, treatment options, and the results comparing the EPDS to the PHQ-2 implementation. Pre and post-survey evaluations were completed by the providers to evaluate the educational session and provider knowledge. Results indicated an increase in provider confidence and knowledge in assessing for PPD and caring for refugee women during the first year postpartum. The EPDS screening tool indicated PPD in more refugee women, suggesting the EPDS to be a more sensitive screening tool for PPD in refugee women when compared to the PHQ-2. The providers preferred to continue using the EPDS instead of the PHQ-2.
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Tolliver, Sarah, Sara Reed, Robert Matthew Tolliver, Jodi Polaha Jones, and Karen E. Schetzina. "Assessing For and Treating Postpartum Depression in a Pediatric Primary Care Setting Using a Stepped-Care Model: Is It Feasible?" Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/5073.
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Postpartum Depression (PPD) occurs in 10-20% of new mothers. PPD can lead to serious health risks to both the mother and infant, increase the risk of complications during birth, and cause lasting effects on the development and wellbeing of the child. Many mothers suffering from PPD do not receive treatment due to fear of being stigmatized, lack of education, or not being able to access mental health services. High prevalence of PPD, along with the negative and lasting effects it can cause point to the importance of developing an effective and feasible method of assessing and treating this disorder. A pediatric primary care office may be an opportune setting to screen for PPD since mothers often accompany their children to regularly scheduled well child visits. While some studies have examined PPD screening within the pediatric primary care setting, few have explored the addition of an on-site Behavioral Health Consultant to provide brief interventions for depressed mothers as part of a stepped care model. The primary aim of the current study is assess the feasibility of implementing a stepped care protocol that assesses PPD and provides brief interventions and referrals for depressed mothers within a pediatric primary care clinic. The protocol consists of several phases including: 1) distribution of the Edinburgh Postpartum Depression Screener to every mother arriving for a well child visit during the first six months of their child’s life; 2) appropriate documentation in the clinic’s electronic health record (EHR) of the Edinburgh score and resulting plan of action; 3) a brief same day intervention by the on-site Behavioral Health Consultant and referral to outside provider, if applicable; and 4) phone call follow up with the mother and referred provider, if applicable. Research assistants will monitor the EHR to determine the clinic’s fidelity to the protocol (e.g., if the Edinburgh is being administered properly). Data will also be collected from the EHR to determine if a correlation exists between Edinburgh scores and number of Emergency Room visits made by the child, immunizations administered to the child, and number of well child checks the child attended. Data collected throughout the month of March showing the Edinburgh uptake, consistency with protocol, and any correlation between Edinburgh scores and other variables will be presented.
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Tolliver, Sarah, and Jodi Polaha. "Assessing for and Treating Postpartum Depression in a Pediatric Primary Care Setting Using a Stepped Care Model: Is It Feasible?" Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/6630.
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Postpartum Depression (PPD) occurs in 10-20% of new mothers. PPD can lead to serious health risks to both the mother and infant, increase the risk of complications during birth, and cause lasting effects on the development and wellbeing of the child. Many mothers suffering from PPD do not receive treatment due to fear of being stigmatized, lack of education, or not being able to access mental health services. High prevalence of PPD, along with the negative and lasting effects it can cause point to the importance of developing an effective and feasible method of assessing and treating this disorder. A pediatric primary care office may be an opportune setting to screen for PPD since mothers often accompany their children to regularly scheduled well child visits. While some studies have examined PPD screening within the pediatric primary care setting, few have explored the addition of an on-site Behavioral Health Consultant to provide brief interventions for depressed mothers as part of a stepped care model. The primary aim of the current study is assess the feasibility of implementing a stepped care protocol that assesses PPD and provides brief interventions and referrals for depressed mothers within a pediatric primary care clinic. The protocol consists of several phases including: 1) distribution of the Edinburgh Postpartum Depression Screener to every mother arriving for a well child visit during the first six months of their child’s life; 2) appropriate documentation in the clinic’s electronic health record (EHR) of the Edinburgh score and resulting plan of action; 3) a brief same day intervention by the on-site Behavioral Health Consultant and referral to outside provider, if applicable; and 4) phone call follow up with the mother and referred provider, if applicable. Research assistants will monitor the EHR to determine the clinic’s fidelity to the protocol (e.g., if the Edinburgh is being administered properly). Data will also be collected from the EHR to determine if a correlation exists between Edinburgh scores and number of Emergency Room visits made by the child, immunizations administered to the child, and number of well child checks the child attended. Data collected throughout the month of March showing the Edinburgh uptake, consistency with protocol, and any correlation between Edinburgh scores and other variables will be presented.
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Tall, Märta, and Matilda Sellergren. "Fysioterapeuters upplevelser och erfarenheter av fysioterapi postpartum." Thesis, Uppsala universitet, Fysioterapi, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-351920.
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Bakgrund Kvinnosjukvården i Sverige idag har stor förbättringspotential då det bland annat saknas riktlinjer kring behandling och uppföljning av bristningar i bäckenbottenmuskulaturen. Förlossningsskador kan påverka livskvaliteten hos den drabbade. Fysioterapeuter kan vara behjälpliga med rehabiliteringen av dessa. Syfte och frågeställning Syftet var att ta reda på fysioterapeuters upplevelser och erfarenheter av att arbeta med fysioterapi postpartum. Design och metod En kvalitativ explorativ och deskriptiv design användes och studien baserades på semistrukturerade intervjuer av fem fysioterapeuter. Intervjumaterialet bearbetades med kvalitativ innehållsanalys enligt Graneheim et al. Resultat Under databearbetningen framkom fem kategorier med totalt 14 subkategorier. Kategorierna var kultur och synsätt, vårdmötet, patienten, positiva aspekter av yrket samt utveckling. Det som beskrevs var bland annat en önskan om att fysioterapeuter ska bli en större del av mödravården, bortprioritering av kvinnosjukvård, bristen på riktlinjer, att patienterna ofta har stora besvär trots tidigare uppföljning i mödravården samt glädjen i yrket. Konklusion Fysioterapeuter upplever sig ha en viktig roll i rehabiliteringen efter förlossningsskador, och önskar att få en större roll i mödravården. Kvinnosjukvård upplevs inte ha hög prioritet inom fysioterapeutisk grundutbildning, och informanterna efterfrågar svenska riktlinjer kring rehabilitering efter gynekologisk kirurgi och kejsarsnitt. Fysioterapeuter upplever dock att arbetet är roligt och att de har tacksamma patienter de kan göra stor skillnad för. Vidare forskning kring fysioterapi efter förlossning anses vara nödvändigt. Nyckelord Physiotherapy, experiences, women’s health, post partum care.Background Women's healthcare in Sweden today has great potential of improvement, as there is, among other things, no guidelines for treatment and follow-up of injuries to the pelvic floor muscles. These injuries can affect the quality of life. Physiotherapists can assist with the rehabilitation of these conditions. Purpose The purpose was to investigate physiotherapists experiences of physiotherapy after childbirth. Design and method A qualitative, explorative and descriptive design was used and was based on semi structured interviews. Five physiotherapists were interviewed and the material was processed using qualitative content analysis according to Graneheim et al. Results Five categories emerged during the data analysis, with a total of 14 subcategories. The categories were culture and approach, the patient meeting, the patient, positive aspects of the profession and progress. What was described was, among other things, the desire for physiotherapists to become a bigger part of maternity care, the prioritization of women’s health care, the lack of guidelines, the patient often having problems despite previous follow- up in the maternity care and the joy of the profession. Conclusion Physiotherapists experience that they have an important role in rehabilitation after maternal injuries and wish to have a greater role in rehabilitation in maternity care. Women’s health care is not percieved as a high priority in physioterapeutic primary education. The informants perceive a need for Swedish guidelines for rehabilitation after gynecological surgery and cesarean sections. Physiotherapists, however, find that the work is fun and that they have grateful patients they can make a big difference to. Further research on physical therapy after child birth is considered necessary. Key words Physiotherapy, experiences, women’s health, post partum care.
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Coast, Mary Jo Ciancio. "Understanding respect through the lived experience of postpartum women /." Connect to full text via ProQuest. Limited to UCD Anschutz Medical Campus, 2008.
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Thesis (Ph.D. in Nursing) -- University of Colorado Denver, 2008.Typescript. Includes bibliographical references (leaves 151-159). Free to UCD Anschutz Medical Campus. Online version available via ProQuest Digital Dissertations;
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Gamble, Jennifer Anne. "Improving emotional care for childbearing women an intervention study /." [South Bank, Queensland : Griffith University], 2003. http://www4.gu.edu.au:8080/adt-root/uploads/approved/adt-QGU20030904.154204/public/02Whole.pdf.
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Melo, Forchu Midou. "The design of a hands-free speech recognition application during the intrapartum stage." Thesis, Cape Peninsula University of Technology, 2015. http://hdl.handle.net/20.500.11838/2416.
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Thesis (MTech (Information Technology))--Cape Peninsula University of Technology, 2016.Unlike the developed nations, the health sector within the developing countries is faced with the triple challenges of human, financial and technological scarcity of resources. This insufficiency of resources results into amongst other intrapartum mishaps. To ameliorate some of these conditions, the World Health Organization (1994) promoted the use of the pathogram as an informative and data capturing tool that could help reduce intrapartum mishaps. The usage of the partogram within the intrapartum environment also introduced a dilemma as birth attendants spent quite a good amount of time using their eyes and hands (in pen and paper) capturing medical data onto the partogram instead of investing these resources onto the expectant mother and or fetus. This study adopted Design Science Research as a suitable research approach, strengthened by a pragmatic philosophical standpoint. This study involved the following methods; • A review of literature in the intrapartum environment, along with topics from relevant reference disciplines including speech recognition • A series of semi-structured contextual interviews with birth attendants, student nurses and senior midwives • A design science research study using the knowledge from the reference disciplines to design a hands-free voice driven epartogram • A simulation of the capturing of intrapartum data to evaluate and refine the prototype (epartogram) by applying anonymized intrapartum data driven by natural speech • An evaluation of the artifact (epartogram) based on a number of published guidelines recommended by scholars to demonstrate its potential utility as well as to establish if the solution is generic to the contextual environment. Although the introduction of ICT into the problem domain abetted the process of data capturing (specifically the referral process), the fundamental aspect of using the prototype to free the hands and eyes of the birth attendants proved challenging due to issues with the recognition of natural speech by speech recognition systems and background noise. Monitoring of MOU and the referral process from a lower MOU to a higher one could benefit a great deal from this study as the prototype thrived well in that regard. Natural speech recognition by machines in an uncontrolled environment is still at its infancy (some of the most powerful engines can not differentiate between background noise and direct instruction). Not withsatnding the challenges posed by the infancy of speech recognition, the artifact showed potential as a manual epartogram providing spatial access to multiple participating MOU via the cloud.
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Kabakian-Khasholian, Tamar. "Improving women's health postpartum : the impact of provision of written information." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.269771.
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Malkin, Jesse D. "The postpartum mandate estimated costs and benefits /." Santa Monica, CA : Rand, 1998. http://books.google.com/books?id=Uw_bAAAAMAAJ.
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Andersson, Camilla, and Pernilla Behrenfeldt. "Mammors behov av stöd under barnets första år." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-166260.
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Syfte: Att undersöka mammors behov av kunskapsmässigt, emotionellt och socialt stöd under barnets första år samt identifiera vilka stödgivande aktörer kvinnorna upplever är viktigast. Metod: Deskriptiv tvärsnittstudie. Sjuttio mammor som besökte någon av sex kommunala öppna förskolor i Uppsala läns landsting svarade på en enkät om deras behov av stöd. Resultat: Hälso- och sjukvården var den viktigaste aktören för många av mammorna som sökte informationsstöd. Studien visade att alla mammorna inte fått det kunskapsstöd de önskade. Socialt stöd och emotionellt stöd var viktigt för nästan alla mammor och många efterfrågade emotionellt stöd från hälso- och sjukvården. Mammornas behov var relaterat till deras ålder, och även i viss utsträckning utbildning och sysselsättning. Slutsats: Om BVC-sjuksköterskor och annan vårdpersonal som möter mammor med barn under ett år, ser till helheten i deras situation genom att erbjuda såväl kunskapsstöd som emotionellt stöd kan de bidra till att skapa långsiktigt nöjda och trygga mödrar.Aim: To explore mother's needs in terms of knowledge, emotional and social support during the baby’s first year and to identify what support giving conductors the women feel important. Method: Descriptive cross-sectional study. Seventy mothers who visited one of six municipal open pre-schools in Uppsala County Council responded to a questionnaire about their support needs. Results: Health care was the main conductor for many of the mothers who sought information support. The study showed that not all mothers have got the knowledge support they wished. Social support and emotional support was important most mothers, and many sought emotional support from health care. Mothers' needs were related to their age, and also to some extent, education and employment. Conclusion: If child health nurses and other health care professionals, who encounter mothers with children under the age of one year, see the whole picture of their situation by offering both knowledge and emotional support, they can help create satisfied and secure mothers in the long term.
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Horii, Naoko. "Postpartum breastfeeding in rural Niger : demographic analysis of a communication program for child health care." Thesis, Sorbonne Paris Cité, 2015. http://www.theses.fr/2015USPCB168.
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Introduction : Cette recherche a pour but d'évaluer les effets du programme de communication sur le changement comportemental de quels acteurs pour promouvoir l'allaitement dans la première heure qui suit l'accouchement chez les mères les plus vulnérables au Niger. Les objectifs consistent à identifier les déterminants de l'allaitement précoce et à élaborer une typologie de stratégies de communication intégrées. Les facteurs de résultat comportemental relatifs à la santé de l'enfant constituent un objet de recherche important en démographie. Toutefois, peu d'études ont abordé l'allaitement postpartum en Afrique Sub-Saharienne. Les interventions de soins de santé néonatale n'ont pas suffisamment été explorées dans la région selon des perspectives démographiques tout en mettant en évidence l'inégalité socio-économique dans la région. Cette thèse est une étude démographique qui a quantifié les pratiques de l'allaitement, qui se caractérise par les information qualitatives et non scientifique dans la plupart des études comportementales, et ce parmi le groupe des mères les plus démunies. Méthodes : L'analyse secondaire des études quantitatives transversales au Niger a été réalisée sur la base de la revue de la littérature sur des études menées en Afrique sub-saharienne. Les enquêtes transversales dont fait l'objet cette recherche sont les suivantes: l'Enquête démographique et de santé (EDS) 2006 Niger, l'EDS 2012 Niger et l'enquête d'évaluation dans les 4 régions de Niger en 2011, le dernier a pour but d'examiner l'impact du programme de communication sur la promotion de soins de santé de l'enfant au niveau familial et communautaire. Pour constituer une population d'étude pour chaque base de donnée, le même critère d'exclusion a été appliqué afin d'inclure les femmes de 15-49 ans, ayant au moins un enfant de moins de 24 mois et qui ont accouché par voie basse. Un échantillon aléatoire stratifié a été tiré pour sélectionner 2091 femmes divisées en deux strates, le groupe d'intervention et le groupe de contrôle. Les outils d'analyse de données ont été le test du chi2 et la régression logistique multivariée. Les variables indépendantes incluent les actions de communication, les statuts démographiques et économiques des mères, les recours aux soins de santé de l'enfant ainsi que les pratiques et infrastructures d'hygiène. Résultats : Le retard de l'allaitement postpartum s'est caractérisé par le niveau de vie des plus démunis au Niger. Quelque soit la vulnérabilité socio-économique, des pratiques d'hygiène ont augmenté la chance de l'initiation de l'allaitement précoce. L'enquête d'évaluation dans les 4 régions de Niger a montré que le lavage des mains et l'utilisation des latrines traditionnelles étaient fortement corrélées avec l'allaitement précoce qui a augmenté respectivement de l'OR à 2.4 (IC 95%: [76; 220]) et à 2.3 (IC 95%: [51; 248]). Les agents de santé des établissements sanitaires, les sages-femmes, ont joué un rôle clef déterminant sur l'allaitement postpartum. Le statut valorisant de sages-femmes impliquées dans le programme de communication était à l'origine d'une hausse significative de l'allaitement précoce. Toutefois, les consultation prénatale (CPN) par les sages femmes a augmenté l'allaitement initial de 52% (IC 95%: [14; 103]) par rapport à celles qui n'ont jamais effectué de CPN. L'enquête d'évaluation ne procure aucune information à savoir si le programme de communication a intégré les accoucheuses traditionnelles afin d'appliquer une approche à base communautaire. Une approche inter-sectorielle qui s'adresse aux multiples dimensions de soins de santé maternelle et infantile a augmenté à 6.9 l'OR de l'allaitement initial (95%CI: [374; 900]). Les visites à domicile par les relais communautaires se sont avérées statistiquement non significatives (IC 95%: [-10; 54]). La promotion par les pairs a réduit le risque de retard de l'initiation de l'allaitement de 100% (IC 95%: [39; 189])Introduction. This research aims to evaluate the effects of a behavior change communication program promoting early initiation of breastfeeding within the first hour of birth among the most vulnerable mothers in rural Niger. The main objectives are to identify the social determinants of initial breastfeeding and to examine the typology of integrated communication strategies for the socio-economically vulnerable group of populations. Behavioral child health outcomes have become an important research subject in Demography. However, few studies have examined breastfeeding during the postpartum period in Sub-Saharan Africa (SSA). Very few demographic approaches were applied to evaluate neonatal care by looking into socio-economic inequity in SSA. This thesis quantifies predominantly qualitative information characterizing behavioral studies in breastfeeding among the most deprived population. Methods. This is a secondary analysis of cross-sectional quantitative studies conducted in Niger at different points of time based on a literature review of previous studies conducted in Sub-Saharan Africa. The cross-sectional surveys include: the 2006 Niger Demographic Health Survey (DHS), the 2012 Niger DHS and the post-intervention survey (PIS) conducted in 2011 to evaluate a communication program promoting family and community based child health care in 4 regions of Niger. To constitute a study population for each dataset, the same exclusion criteria were applied to include women aged 15-49 years, having at least one child less than 24 months born with vaginal delivery. The PIS study population, drawn from the original survey with stratified random sampling, was divided into two strata, the intervention and control groups according to exposure to the communication program. Statistical analysis tools were the chi-square test and multivariate logistic regression. Independent variables include behavior change activities, socio-demographic and economic status of mothers, health seeking behavior and hygiene practices. Results. Postpartum breastfeeding is impaired by income poverty in Niger. Regardless of socio-economic vulnerability, hygiene practice increases the chance of early initiation of breastfeeding. Multivariate analysis with the 2011 PIS shows that hand washing and use of a traditional latrine increases by 2.4 (95%CI: 76; 220) and by 2.3 (95%CI: 51; 248) respectively the odds of early initiation of breastfeeding. Government health workers, midwives, play a key role determining mothers' postpartum breastfeeding. Antenatal care (ANC) provided by midwives increases the chance of early breastfeeding that increases by 52% (95%CI: 14, 103) compared to ANC provided by other health professionals among the most deprived group of populations. The PIS does not provide any information to evaluate the role of traditional birth attendants in neonatal care. An inter-sectorial approach addressing multiple dimensions of maternal and child health significantly increases by 6.9 odds (95%CI: 374, 900) early initiation of breastfeeding compared to those who are not reached by the whole integrated KFP promotion. Home visits by community volunteers are not significant (IC 95%: -10; 54). Involvement of mothers as a peer promoting exclusive breastfeeding significantly reduces the risk of delayed initiation of breastfeeding by 2.0 odds (IC 95%: 39; 189). However, the number of exposures to different types of communication strategies does not influence positively early breastfeeding. Conclusions. The impact of community volunteers and health workers is limited with regard to early breastfeeding among the most deprived group of mothers. The model of behavior change communication with participatory peer promotion and a multi-sectorial approach combining optimal hygiene promotion suggests a response to socio-economic disparity
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Mustafa, Alrasheed. "Information practices in midwifery: a case study of an antenatal and intrapartum care environment in the Western Cape, South Africa." Thesis, Cape Peninsula University of Technology, 2015. http://hdl.handle.net/20.500.11838/1394.
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Thesis submitted in fulfilment of the requirements for the degree Master of Technology in Information Technology in the Faculty of Informatics & Design at the Cape Peninsula University of TechnologyResearch on health informatics has seen a steady increase during this decade as the role of information technology in the health sector becomes pertinent. Findings of previous research in this domain have uncovered vast information needs of health workers, particularly in developing countries. However, there is a need to continue with multidisciplinary research in priority areas such as midwifery practice and in the environment of marginalised settings. This study explores the significance of the information needs and information-seeking behaviour or practice of midwives during the antenatal and intrapartum care within the environment of a midwifery unit. Additionally, the researcher obtained permission from Faculty of Informatics and Design – CPUT and Health department authority – Western Cape Government in South Africa, to conduct research in the Elsies River Midwifery Obstetric Unit (ERMOU). The research was carried out as case study in a Midwifery Obstetric Unit in the Western Cape, South Africa. The investigator conducted semi-structured interviews and observations to collect qualitative data of the antenatal and intrapartum care environment. The data was transcribed and analysed using thematic analysis and essomenic modelling. The findings comprehensively point to the importance of this research context. The study found that midwives acquired patients’ information from a handwritten Maternity Case Record (MCR) book and midwives’ colleagues, and often during handovers. In addition, midwives also communicate with each other during care activities in the ERMOU. It was apparent that the use of such communication practices is inadequate, and midwives did not always have sufficient information to make appropriate decisions in the ERMOU. All patient information, referral notes, and reporting is paper-based. In addition, essomenic models were used to depict the midwives’ work activities in the antenatal and intrapartum care environment in the Unit. Furthermore, essomenic models defined all the systematic processes that occur in the ERMOU which is described by midwives’ activities and work environment. To improve communication, future research is recommended to consider the importance of the continuity of the education of midwives. Further research will be on the implementation of nursing informatics and the electronic health record system in the Elsies River Midwifery Obstetric Unit.
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Gamble, Jennifer Anne, and n/a. "Improving Emotional Care For Childbearing Women: An Intervention Study." Griffith University. School of Nursing, 2003. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20030904.154204.
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Childbirth can be associated with short and long-term psychological morbidity including depression, anxiety and trauma symptoms. Some previous studies have used psychological interventions to reduce postpartum distress but have primarily focussed on attempting to relieve symptoms of depression with little recognition of trauma symptoms. Furthermore, the intervention used in these studies has generally been poorly documented. The first aim of the present study was to develop a counselling framework, suitable for use by midwives, to address psychological trauma following childbirth. Multiple methods were used to develop the intervention including focus groups with women and midwives. Both the women and midwives gave unequivocal support for postpartum debriefing. Themes that emerged from the focus groups with women included the need for opportunities to talk about their birth experience, an explanation of events, an exploration of alternative courses of action that may have resulted in a different birth experience, talking about their feelings such as loss, fear, anger and self-blame, discussing social support, and discussing possible future childbearing. There was a high level of agreement between the women's and midwives' views. These themes were synthesized with contemporary literature describing counselling interventions to assist in reconciling a distressing birth experience and a model for understanding women's distressing birth experiences to develop a counselling framework. The counselling intervention was then tested using a randomised controlled study involving 400 women recruited from antenatal clinics of three public hospitals. When interviewed within seventy-two hours of birth, 103 women reported a distressing birth experience and were then randomised into either the treatment or control group. Women in the intervention group had the opportunity to debrief at the initial postpartum interview (< 72 hours postpartum) and at four to six weeks postpartum. The prevalence of posttraumatic stress disorder was quite high; 9.6% of participants meeting the diagnostic criteria for acute PTSD at four to six weeks postpartum. Fewer participants (3.5%) met the diagnostic criteria for chronic PTSD at three months postpartum. As with previous research relating to childbearing women, few demographic factors or antenatal psychological factors were associated with the development of a PTSD symptom profile following childbirth. The development of PTSD symptom profile was strongly associated with obstetric intervention and a perception of poor care in labour. This finding is also consistent with previous research. Emotional distress was reduced for women in the intervention group in relation to the number of PTSD symptoms [t (101) = 2.144, p = .035], depression [c2 (1) = 9.188, p = .002], stress [c2 (1) = 4.478, p = .029] and feelings of self-blame [t (101) = -12.424, p <.001]. Confidence about a future pregnancy was higher for these women [t (101) = -9.096, p <.001]. Although there was not a statistically significant difference in the number of women with a PTSD symptom profile at three months postpartum, fewer women in the intervention group (n=3) than in the control group (n=9) met PTSD criteria. Likewise, there were fewer women in the intervention group (n=1) with anxiety levels above mild than in the control group (n=6). Importantly, this study found that offering women who have had a traumatic birth the opportunity for counselling using the framework documented in this dissertation was not harmful. This finding is in contrast to previous findings of other studies. The intervention was well received by participants. All the women in the intervention group found the counselling sessions helped them come to terms with their birth experience. Maternity service providers need to be cognizant of the prevalence of this debilitating condition and be able to identify women at risk for early intervention and referral to a mental health practitioner if appropriate. This research offers further support for the compelling need to implement changes to the provision of maternity services that reduce rates of obstetric intervention and humanise service delivery as a means of primary prevention of birth-related PTSD.
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Morrell, Allison, Halie Dyer, Courtney Smith, Kammy Kuang, Deb Mills, Gayatri Jaishankar, Karen Schetzina, and Jodi Polaha. "Evaluating the Feasibility of a Stepped-Care Protocol for Postpartum Depression via Adoption and Maintenance (Cost)." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/6621.
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Introduction: Research has shown that Postpartum Depression (PPD) occurs in 10-20% of new mothers. Symptoms of PPD include excessive sadness, increased anxiety, guilt, and possible suicidal ideation. PPD can increase a mother’s risk for health and psychological dysfunction including future psychiatric illnesses, substance abuse, and decrease her adaptive functioning. PDD can also have negative implications on child safety practices and a child’s psychosocial and developmental wellbeing. Treatments for PPD, such as medication and psychotherapy, have been shown to be effective at reducing the number and severity of a mother’s symptoms, and generally improving their lives and the lives of their families. Unfortunately, many mothers do not receive treatment due to fears of stigma, inadequate screening practices and an inability to access care. Thus, early detection and improved access to care is critical and literature suggests formal screening practices increases the rate of detection. Pediatrician’s offices serve as ideal locations to screen mothers and connect them to appropriate services because of frequent contact with the mother. Methods: Recognizing this public health concern, the American Academy of Pediatrics developed PPD screening guidelines. ETSU Pediatrics, a local pediatric primary care clinic, adhered to these guidelines, assembled an interdisciplinary health care team, and developed a stepped care protocol to not only screen all new mothers but connect them with immediate, onsite behavioral health services. The protocol consisted of four distinct phases: 1) distribution of the Edinburgh Postnatal Depression Scale (EPDS), an evidence- based tool screening for depression in new mothers, to every mother of infants 0 to 6 months at their well- child visit; 2) appropriate documentation of the EPDS score and plan of action noted within the electronic medical record (EHR); 3) brief behavioral health intervention conducted by the on-site behavioral health consultant, and/or referral to outside provider; 4) phone call follow up with mother and referred provider. The aim of the study is to evaluate components of intervention feasibility based upon the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance), which stems from the Dissemination and Implementation Science field. This particular project extends past previous pilot studies to include EHR chart review from an entire year and evaluates the protocol’s feasibility by examining Adoption and Maintenance domains. Results: Results were collected from EHR and billing records of all patients, 0 to 6 months of age, seen at the clinic from February 26, 2014 to February 25, 2015 (n = 755) for their well-child visit (n = 2,459). Adoption will examine feasibility by noting the percentage of mothers who were administered the EPDS as well as the general trend in administration across the year. Maintenance will examine feasibility from a financial perspective and reveal the amount of reimbursement accrued by billing for the EPDS. Conclusions: The anticipated results will have implications on the
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Smith, Caleb, Jodi Polaha, K. Schetzina, and M. Tolliver. "A Screening and Stepped Care Intervention for Postpartum Depression in a Pediatric Setting: Implementation and Feasibility." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/6628.
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Cha, Susan. "The Association between Prenatal Care Content and Quality with Preterm Birth and Maternal Postpartum Health Behaviors." VCU Scholars Compass, 2010. http://scholarscompass.vcu.edu/etd/2079.
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Background: Health policies that seek to improve pregnancy outcomes focus on increasing the availability and access to prenatal care (PNC) services based on studies that support an association between insufficient PNC and adverse birth outcomes. These studies employ PNC utilization indices that measure the adequacy of PNC use, but these indices fail to account for the content or specific components of PNC. Objectives: The purpose of this study was to utilize PRAMS and birth certificate data to evaluate the content and quality of PNC in Virginia, and its impact on preterm birth and maternal postpartum health behaviors. Methods: Data was from the 2007 Virginia Pregnancy Risk Assessment Monitoring System (PRAMS). This population-based data is representative of all Virginia women who have had a live birth recently and included 1,236 female participants. Results: Inadequate PNC was associated with nearly a three-fold increase in risk of low birth weight (OR = 2.8, 95% CI = 1.5, 5.2), but not preterm birth. Women with adequate plus PNC were more likely to deliver infants who were preterm (OR = 10.2, 95% CI = 4.3, 24.4) and low birth weight (OR = 6.3, 95% CI = 4.2, 9.4). After adjusting for method of payment, income, and reported problems during pregnancy, women with lower income and no private insurance were more likely to have inadequate PNC (OR = 1.4, 95% CI = 0.5, 4.1) and (OR = 8.8, 95% CI = 1.3, 59.8), respectively. Provider discussions were not different based on adequacy of PNC. In addition, among women who received adequate PNC, those whose providers discussed postpartum birth control use were 4.5 times more likely to use birth control after delivery compared to women who did not receive education (95% CI=1.7, 11.8). Conclusion: The lack of strong associations between adequacy of PNC and birth outcomes indicate that there are other factors (intergenerational, stress, cultural) that may play a more prominent role in predicting maternal and infant health.
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Lindgren, Julia, and Elin Herlitz. "Kvinnors erfarenheter av vården vid förlossningsdepression : en litteraturöversikt." Thesis, Sophiahemmet Högskola, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-3920.
Full textAbstract:
Bakgrund Förlossningsdepression är en sjukdom som drabbar 8 till 15 procent av alla kvinnor efter förlossningen. Detta kan leda till långvariga konsekvenser för både kvinnan och barnet. För många kvinnor kan hjälpsökandeprocessen vara svår, vilket leder till att flertalet inte får den vård de behöver. Förlossningsdepression är en komplex sjukdom med flera allvarliga symtom. Därför är det viktigt för sjuksköterskor och annan vårdpersonal att ha kunskap om sjukdomen för att kunna ge adekvat vård. Syfte Syftet var att belysa kvinnors erfarenheter av vården vid förlossningsdepression. Metod Designen för detta arbete var en litteraturöversikt. Författarna för arbetet har genomfört sökningar i databaserna PubMed samt CINAHL för att hitta relevanta forskningsstudier som besvarade syftet. Totalt 16 vetenskapliga artiklar inkluderades och analyserades samt granskades av författarna. De vetenskapliga artiklarna var främst baserade på kvalitativ forskning med inslag av kvantitativa delar. Data analyserades med hjälp av en integrerad analys. Resultat Resultatet av litteraturöversikten visade att många kvinnor med förlossningsdepression är missnöjda med den vård som erbjuds och hur de blir bemötta av vården. Vidare visade resultatet att information om var kvinnor kan söka hjälp var bristfällig. Flertalet kvinnor uppgav att de inte blivit tagna på allvar samt att de upplevt att stigmatiseringen i samhället som så stor att de inte vågat söka hjälp trots symtom. Ett annat resultat är att kvinnor upplevde att sjukvården inte tagit hänsyn till deras åsikter om önskad behandling. Slutsats Utifrån resultatet kan slutsatsen dras att stigmatiseringen i samhället påverkar kvinnor i deras hjälpsökande, något som bör förändras. Sjukvården behöver utveckla vården vid förlossningsdepression på flera sätt, bland annat genom att göra den mer lättillgänglig. Sjukvårdspersonalen bör även lyssna mer på kvinnorna och anpassa behandlingen utifrån deras behov och önskemål.Background Postpartum depression is a disease that affects 8-15 percent of all women after childbirth. This can lead to long-term consequences for both the woman and the child. For most women, the help-seeking process can be difficult, leading to the majority not receiving the care they need. Postpartum depression is a complex disease with various serious symptoms. Therefore, it is important for nurses and other healthcare professionals to have knowledge of the disease in order to provide adequate care. The Edinburgh Postnatal Depression Scale (EPDS) screening tool is used to diagnose postpartum depression. Aim The purpose was to shed light on women's experiences of the healthcare in the event of postpartum depression. Method The design for this study was a literature review. The authors have conducted searches in the databases PubMed and CINAHL to find relevant research studies that answered the aim. A total of 16 scientific articles were included and analysed and reviewed by the authors. The scientific articles were mainly based on qualitative research with elements of quantitative parts. The data were analysed using an integrated analysis. Results The results of the literature review showed that the majority of women with postpartum depression are dissatisfied with the care provided and the treatment. Furthermore, the results showed that information on where women can seek help was deficient. The majority of women stated that the healthcare professionals had not taken the women seriously and that the stigma felt so big in society that they did not dare to seek help. The results of the literature review also showed that women felt that the health service did not take into account their views on the desired treatment. Conclusions Based on the results, it can be concluded that the stigma in society affects women in their search for help, something that should change. The healthcare system needs to develop care for postpartum depression in several ways, including by making it more accessible. Healthcare professionals should also listen more to women and adapt treatment based on their needs and wishes. Keywords
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Uwaliraye, Parfait. "Factors influencing job performance of nurses and midwives in postpartum care : case of Kibagabaga and Muhima District hospitals in Rwanda." University of the Western Cape, 2011. http://hdl.handle.net/11394/4545.
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Magister Public Health - MPHEnsuring a good performance of health workers is one of the key components for provision of quality health care services in order to progress toward one of the priorities of MDGs namely improving maternal health care. In 2005, Rwanda adopted the “Performance Based Financing (PBF)” program to remunerate and motivate health professional based on their job performance. This lead to increase in the number of health workers by 62% between 2005 and 2008 and public subsidies for health worker remuneration tripled. Despite promotion of this motivation mechanism to enhance job performance in maternal health care, recent data in Rwanda show that MMR is still high with 383 per 100,000 live births and high rates of postpartum complications. All these problems have been attributed to poor performance of staff. To date, little research has been conducted on the factors that affect job performance among health care providers in low income countries and particularly in Rwanda. The present study assesses factors that influence job performance of health care providers working in postpartum care in two public hospitals of Rwanda. Ninety six nurses and midwives were observed providing early and late postpartum care and interviewed about the presence or absence of the performance factors within their work environment. Data were analyzed to determine if there is an association between observed providers performance and variables of interest. Observation revealed that staff performed poorly in the use of guidelines for the management in the postpartum care. The bivariate analysis showed that (a) receiving feedback about job performance (b) receiving training in postpartum care management, (c) training in the use of the tools for the daily work, (d) being satisfied with the way the work is organized, and (e) finding the organization interested in the staff creativity in general, are factors associated with good performance. In conclusion, the study identified important factors that need to be taken into consideration when planning strategies to improve the quality of care and reducing morbidity and mortality in the postpartum wards of the two hospitals.
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Muzeya, Fungai. "Knowledge, attitudes and practices of nurse-midwives related to obstetric care at Thaba-Tseka district in Lesotho." Diss., 2015. http://hdl.handle.net/10500/19663.
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The purpose of the study was to describe the knowledge, attitudes and practices of nurse-midwives related to obstetric care at Thaba-Tseka, Lesotho. A quantitative, descriptive, cross-sectional research design was used. Data were collected using structured questionnaire from 45 nurse-midwives. The findings revealed that nurse-midwives had mean knowledge score of 10.5(80.7%) out of a possible 13(Standard Deviation (SD) 1.31) on obstetric care issues. However, the majority of nurse-midwives (n=28, 62.2%) did not have knowledge on the steps of the active management of third stage of labour according to the WHO. The mean scores on practice were 34.5(86.2%) against a possible 40(SD 5.43) for antenatal care, 39.2(89%) against a possible of 44(SD 4.66) and 22.4(93.3%) against a possible of 24(SD 2.18) for postnatal care. The study revealed that nurse-midwives had positive attitudes towards obstetric care practices with mean score for attitudes was 23.4(86.7%) against a possible score of 27(SD 3.02)Health Studies
M.A. (Public Health)
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Frost, Jordana. "Equitable access to maternity care practices that promote high-value family-centered intrapartum care." Thesis, 2018. https://hdl.handle.net/2144/32699.
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BACKGROUND: Despite large investments in maternity care services, perinatal health outcomes in the U.S. are among the worst compared to other industrialized countries, with documented perinatal health disparities disproportionately impacting racial and ethnic minorities. Midwifery-led freestanding birth centers (FSBC) have emerged as an underutilized model for the safe and cost-effective care of women with low-risk pregnancies. Despite approximately 85% of all US pregnancies being considered low-risk, only 0.5% of all US births occurred in a FSBC in 2016. The goal of the study is to elucidate strategies used to develop and sustain freestanding birth centers (FSBCs) that are seeking to serve high proportions of publicly-insured women and women of color.
METHODS: I conducted an embedded unit case study, including semi-structured in-depth interviews and focus groups with 49 stakeholders from three exemplary FSBCs. Supplemental interviews were led with five key informants from three additional FSBCs and a relevant national membership organization. Additional data sources used to complete this case study include, where relevant and permitted, observations of maternity care settings, patient-provider encounters, management meetings, community events, and review of pertinent documents. Qualitative analysis methods were used to identify common themes and variations.
FINDINGS: Midwifery-led birth center care can improve the experience and outcomes of maternity care among publicly insured women of color. The study revealed persistent multi-level challenges, as well as the use of common approaches to overcome these organizational, financial, and cultural barriers, resulting in greater, yet still fragile, access to family-centered intrapartum care within the communities in which these FSBCs operate.
CONCLUSIONS: The careful integration of FSBCs into health systems such as a Federally Qualified Health Center (FQHC) may contribute to the broad scale-up of this underutilized model of care. While integrating FSBCs into FQHCs may be helpful in expanding equitable access to birth center care, it is not necessary, and also not sufficient. Expansion efforts should include additional deliberate processes and strategies to ensure equitable uptake and sustainability of birth center care.2020-10-23T00:00:00Z
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Sun, Ai Hsin, and 孫愛欣. "After Pregnant: Postpartum Care in Taiwan." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/sk4vj8.
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碩士國立東華大學
歷史學系
103
This thesis based on my first documentary After Pregnant content analysis, supplement and rethink. I try to rethink Historiophoty and Historical documentary through the literature reviews, field research and the process of making this documentary. And I also pointed out that the subject of history film a documentary would have dilemma and limitations, but I also figure out solutions. After Pregnant is difference with current television campaniles film marco history programs. It’s a history documentary of plebeian life. According to the historical data and the morden postpartum care cases, I try to rebuild postpartum care is not only a medical behavior also a pass down a legacy of experiences between women. This thesis explains the dilemma of make this documentary, it also reflects postpartum is not only a personal health care period, also is the interaction between family and woman.
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Lin, Yu Ju, and 林鈺儒. "Postpartum Women’s Experiences in Postnatal Care." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/37550052296272229248.
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碩士長庚大學
護理學系
103
This study investigated the methods of postnatal care provided to postpartum women, how postpartum women coped with physical and psychological changes, as well as their needs for postnatal information and care. This study involved a qualitative research design, and purposive sampling was employed to recruit 24 four–six-week postpartum women from a medical center in Northern Taiwan between June 1, 2014, and June 1, 2015. The Edinburgh Postnatal Depression Scale (EPDS) was used to determine the depression state of the participants, and data were collected using a semi-structured interview guideline and which were subsequently analyzed using content analysis. In this study, the results obtained from postpartum women who showed no depression tendencies comprised 4 major categories. Category 1 involved the methods and customary norms of postnatal care: the methods used in postnatal care, and the cognition of postpartum women toward postnatal culture. Category 2 involved the physical and psychological postnatal changes and resilience: physical and psychological changes after delivery, the benefits of postnatal norms (positive energy), and the strength to overcome adversity. Category 3 involved the sources of and need for information: channels through which to acquire information on postnatal care and childcare, and the dilemmas and need for obtaining information. Category 4 involved postnatal care needs and relevant suggestions: the predicaments and needs involved in postnatal care, and suggestions for future postnatal care. The results obtained from postpartum women who showed depression tendencies comprised the same categories, items and units as those of their counterpart, except for Category 2. Category 2 for postpartum women who showed depression tendencies involved postpartum stress, conflicts, and self-isolation: physical and psychological postnatal stress, constraints (negative thinking) resulting from postnatal norms, and being at their wit’s end with deep-ingrained stress. The difference in the contents of Category 2 indicates that postpartum women who presented depression tendencies experienced difficulty in coping with changes after delivery because the coping method used and family support system were inadequate. Therefore, clinical health professionals should be trained in assessing postnatal depression. Furthermore, the means of alleviating stress and individualized healthcare guidance should be provided to postpartum women. Nursing education should incorporate courses relevant to postnatal depression and care, thereby assisting postpartum women in coping with their physical and psychological changes to prevent postnatal depression.
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Louis, Michelle Reid. "Maternal morbidity and postpartum care in Black women: analyzing postpartum rehospitalizations and access to care in Georgia." Thesis, 2021. https://hdl.handle.net/2144/42583.
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BACKGROUND: Severe maternal morbidity (SMM) is defined as having unexpected outcomes at labor and delivery that result in significant consequences to a woman’s health. The rate of SMM has risen 99% domestically between 1998 and 2015, and has been found to increase postpartum rehospitalizations, but more research needs to be done to understand the impact by race/ethnicity.
The postpartum period is a critical time for monitoring the health of women. It is possible that the impact of SMM on postpartum rehospitalizations could be mediated through more effective and frequent follow-up. However, there is a gap in the literature around the experiences of Black women and postpartum care.
METHODS: A mixed methods study was conducted to determine 90-day postpartum rehospitalization rates among a population of Black women in the state of Georgia (retrospective cohort study). Additionally, an assessment of the barriers, facilitators, and preferences for postpartum care among low-income Black women in the Atlanta Healthy Start Initiative was conducted (in-depth interviews). The quantitative analysis was based on 317,735 births between 2015-2017, while the qualitative analysis involved 26 in-depth interviews conducted May 2020-August 2020.
RESULTS: Black women had a 78% greater likelihood of experiencing SMM (207/10,000 to 116/10,000 deliveries) than White women. The relative risk of SMM was 60% higher for Blacks, compared to Whites, even after adjusting for confounders (1.6: 95% CI 1.4-1.7). The relative risk of 90-day postpartum rehospitalization for women with SMM was 100% higher (RR 2.0, 95% CI: 1.6-2.5) than without SMM, though there was no difference between the likelihood of rehospitalization for Black or White women with SMM.
Qualitatively, interviewees reported an array of difficulties in accessing Medicaid, challenges with scheduling appointments, and a lack of coordination of care. Facilitators to care included appointment reminders, consistent childcare, and positive coordination of care. Our study also documents the stigma that some Black women face in healthcare, such as unfair treatment or feeling ignored during their maternal healthcare experience.
CONCLUSION: Strategies implemented at hospital discharge and early postpartum should be explored to prevent rehospitalizations in the SMM population. In addition, reducing policy-related and organizational-related barriers are key to improving access to postpartum care for low-income Black women in Atlanta.2022-05-14T00:00:00Z
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Mathebula, Pauline Magugudi. "Exploring experiences of quality intrapartum care in a public hospital in Gauteng / Pauline Magugudi Mathebula." Thesis, 2013. http://hdl.handle.net/10394/10762.
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All mothers and newborns deserve competent care and continuous support during the intrapartum period (Tinker et al., 2006:269). According to the Saving Mothers: Fifth Report on Confidential Enquiries into Maternal Deaths in South Africa, 2008-2010 (SA, 2011:4), the maternal mortality rate (MMR) is 176.22/100 000 live births (SA, 2011:4). The majority of maternal deaths are preventable and have many common preventable factors which are mostly related to the knowledge and skills of the healthcare providers and the challenges within the health care system (SA, 2011:5).
The research was conducted in an attempt to make a meaningful contribution to the body of knowledge, specifically knowledge related to the experiences of women regarding the quality intrapartum care in a public hospital in Gauteng Province, and to make recommendations to enhance the quality of intrapartum care.
A qualitative study design was used and data collected with the use of individual in-depth interviews. Purposive sampling was used to select participants who represent the target population. The sample used for the study included all women who had given birth within 24 hours before the interviews by normal vaginal delivery. A pilot study was conducted and the interview schedule was finalised. Sixteen individual in-depth interviews were done until data saturation had been achieved. Trustworthiness was ensured according to the principles of credibility, transferability, dependability and confirmability. A digital voice recorder was used to capture data and the data were transcribed verbatim. Field notes were written down for each interview.
Data analysis was done by means of content analysis by the researcher and an independent co-coder. Themes and sub-themes were identified. The findings indicated that most of the women‟s experiences were positive regarding the quality of intrapartum care while a lesser percentage had had negative experiences. Identified areas of concern are staff attitudes, communication and staff shortages. Conclusions drawn are that women‟s experiences of quality of intrapartum care were that it is not of the highest standard. There is a need for provision of continuous emotional support during labour, improvement of staff attitudes and promotion of rooming-in, and a need not to be separated from their babies for long periods of time
The research concluded with the researcher‟s recommendations for policy, nursing practice, nursing research and nursing education, for the enhancement and adherence of midwives to recommendations in improving the quality of intrapartum care in public hospitals.MCur, North-West University, Potchefstroom Campus, 2014
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Chen, Chueh-Ru, and 陳珏如. "Relationship of Postpartum Depression and Sleep Quality in Postpartum Care Facilities Women." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/4cg8ey.
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碩士臺北醫學大學
護理學研究所
102
Background: Postpartum depression is a common problem of postpartum women in Taiwan with high prevalence and impact.Postpartum women than pregnant or women of other phases, more likely to have sleep disorders, but this issue has not research in Taiwan. Objective: This study aimed to investigate relationship of postpartum depression and sleep quality. Methods: The study was cross-sectional study design, convenience sampling, in July 2014, in New Taipei city and Taipei, a total of 11 women Postpartum Care Facilities, a total of 187 subjects, use the Chinese version of the Edinburgh Postnatal Depression Scale, and Postpartum Sleep Quality Scale study. Results: Age(r=-.16；p=.03) and parity(rho=-.32；p＜.001) are negatively correlated postpartum depression and physical symptoms positive correlation postpartum depression(rho=.19；p=.01), good postpartum experience, breastfeeding, and postpartum women confinement feel good, significantly lower postpartum depression . Physical symptoms positive correlation postpartum sleep quality scale(rho=.34；p＜.001), postpartum experience is good, do not take care of the baby at night, and feel good confinement in the postpartum sleep quality significantly better. Postpartum depression and sleep quality scale was positive correlated(r = .41；p＜.001). Conclusion: Postpartum depression is higher, the worse the quality of sleep, postpartum depression and postpartum women sleep quality factors, including physical symptoms, postpartum experience, as well as feelings of confinement, should enhance the experience postpartum women and confinement satisfaction and reduce postpartum physical symptoms in order to reduce the incidence of postpartum depression postpartum women, and thus enhance the quality of sleep.