Married Mothers'' Perceptions of Their Premature or Term Infants and the Quality of Their Relationships with Their Husbands

Twenty-eight mothers of premature infants and 37 mothers of term infants were examined for their perceptions of their infants and of their relationships with their husbands at two to four postpartum days and at six to eight postpartum weeks. The mothers tended to perceive their infants positively, whether or not the infants were born prematurely. Preterm mothers who compared their infants to an average premature infant were more positive than term mothers who compared their infants to an average term infant. An association was not found in either group between mothers' perceptions of their infants and of the quality of their relationships with their husbands. However, mothers with negative perceptions of their infants also tended to have difficult marriages.     

Adjustment to a Newborn

Two groups of 20 mothers and their firstborn children (matched for age and sex) were investigated to determine whether sibling preparation for the birth of a newborn made a difference in the behavior of the children and in the mothers' perceptions of their own ability to cope with the children. One group of mothers and their children attended a sibling preparation class; the other group did not. Each group was pretested and posttested with the Parent-Child Assessment Tool. A significant difference was found between the two groups.     

Influence of maternal attitudes on urban, black teens' decisions about abortion v delivery

Two hundred thirty-one inner city black teenagers, aged 14-17, were followed for two years to assess whether (1) their decision to deliver or abort a pregnancy differed from their perceptions of their mothers' attitudes about having a child or aborting a pregnancy, (2) satisfaction with the decision differed between the abortion and delivery groups, and (3) satisfaction with the decision was affected by who made the decision. Eight-one percent chose the pregnancy outcome that their mothers supported. Those who did decide without their mothers' support (19%) were divided equally between abortion and continuing the pregnancy. The majority in both groups were satisfied with the outcome decision, but initially more deliverers than aborters were satisfied. Satisfaction initially was related to who made the decision, but by the one-year follow-up the difference was no longer significant. Young teens do not seem likely to make a decision about pregnancy outcome that differs from their mothers' views; initial differences in satisfaction with the decision disappear over a one- to two-year period.     

Whom can I rely on? Mothers' approaches to support for feeding: an interview study in suburban Dar es Salaam, Tanzania

OBJECTIVE: to explore and describe mothers' perceptions of baby feeding and approaches to support for baby feeding. DESIGN: individual qualitative semi-structured interviews conducted with mothers. Method used for analysis was qualitative content analysis. SETTING: suburban Dar es Salaam, Tanzania. PARTICIPANTS: 8 mothers with babies under 6 months of age. FINDINGS: the study revealed four categories of mothers' perceptions of baby feeding: (1) baby feeding, housework and paid work have to adjust to each other; (2) breast feeding has many benefits; (3) water or breast milk can be given to quench baby's thirst; and (4) crying provides guidance for baby feeding. Four different themes describing approaches to support emerged from the data: (1) adhering to diverse sources; (2) relying wholeheartedly on a mother figure; (3) working as a parental team; and (4) making arrangements for absence from the child. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: knowledge of the different approaches to support for baby feeding described in this study can help define counselling and promotional strategies in order to reach mothers with more effective messages and support for optimal baby-feeding practices.     

A study of Welsh mothers' experiences of postnatal depression

OBJECTIVE: to examine the experiences of Welsh mothers diagnosed with postnatal depression and to question whether postnatal depression is socially determined. DESIGN: qualitative interviews using a semi-structured questionnaire to clarify mothers' thoughts and feelings within the postnatal period. SETTING: a semi-rural part of south-west Wales, previously dominated by the mining industry. PARTICIPANTS: ten mothers with one or more children participated in the study. Most of the mothers were from lower socio-economic groups. They were selected from 30 women diagnosed with postnatal depression. FINDINGS: mothers had little knowledge of the effects of postnatal depression before becoming pregnant, and were initially reluctant to confide or share their feelings. Economic pressures determined a second income and necessitated mothers returning to work. This left them with little quality time for their babies and family. The prime support networks, which in previous generations were grandmothers, were absent, and mothers relied on social services and voluntary support groups. IMPLICATIONS FOR PRACTICE: a greater understanding of the emotional and social effects of childbirth may help mothers to avoid feelings of isolation and the inability to cope. Discussing the issues of socio-emotional strain during pregnancy may help the mother to recognise the symptoms that identify postnatal depression, legitimise the condition and begin the recovery process.     

Maternal Perceptions of Infant Exercise in the Neonatal Intensive Care Unit

Objective: To identify important factors that influence mothers' perceptions of engaging in exercise with their preterm infants.
Design: Qualitative, semistructured individual interviews.
Setting: Neonatal Intensive Care Unit.
Participants: Thirteen mothers of preterm infants who were in the Neonatal Intensive Care Unit.
Methods: Two researchers conducted interviews with mothers in English or Spanish. Interviews were recorded, transcribed, and analyzed.
Results: Mothers tended to view infant exercise as beneficial but feared for the safety of their infants. They perceived nurses as experts who could safely exercise their infants but feared that they themselves might harm their infants. Factors that influenced their beliefs included previous experiences with infant exercise and views regarding the fragility or the strength of their own infants. Mothers identified nurses, doctors, family members, and research studies as trusted sources of information on exercise efficacy and safety.
Conclusion: Understanding and addressing mothers' perceptions is a crucial component of a nursing intervention that teaches parents to do assisted exercises at home with their preterm infants.     

Validity and reliability of the Perceived Readiness for Discharge After Birth Scale

Objective:  To assess the psychometric properties of a scale measuring mothers' perceptions of readiness for discharge after birth.
Design:  Psychometric analyses including construct validity using factor analysis and known groups comparisons, predictive validity, and reliability. Data were collected at discharge and 6 weeks postdischarge.
Setting: Tertiary-level perinatal center in the Midwestern United States.
Participants:  1,462 postpartum mothers.
Intervention:  None.
Main outcome measures:  Perceived Readiness for Discharge After Birth Scale scores; subscale scores for personal status and knowledge factors.
Results:  Exploratory and confirmatory factor analyses indicated that the scale contained two factors. Perceived Readiness for Discharge After Birth Scale scores were lower for mothers who were breastfeeding, married, primiparous, and had a short hospital stay (less than 30 hours) than for their comparison groups. The Perceived Readiness for Discharge After Birth Scale personal status factor was predictive of self-reported physical and psychosocial problems and unscheduled utilization of health services in the first 6 weeks postpartum. The knowledge factor was predictive of postdischarge telephone calls to the pediatric provider. Reliability estimates ranged from 0.83 to 0.89 for the total scale and subscales.
Conclusions:  The Perceived Readiness for Discharge After Birth Scale performed well in psychometric testing. Assessing mothers' perceptions of readiness for discharge is important for measuring outcomes of hospitalization and for identifying mothers at risk for postdischarge problems. JOGNN , 35, 34-45; 2006.DOI: 10.1111/J.1552-6909.2006.00020.x     

Application of the baby friendly hospital initiative to neonatal care: suggestions by Swedish mothers of very preterm infants

The aim of this study was to obtain suggestions from mothers of very preterm infants regarding modification of the Baby Friendly Hospital Initiative (BFHI) 10 Steps to Successful Breastfeeding. Thirteen mothers were interviewed 2 to 6 months after their infants' discharge from the hospital. The interviews generated 13 steps, which partly agree with the BFHI steps. The new steps address respect for mothers' individual decisions about breastfeeding, education of staff in specific knowledge and skills, antenatal information about lactation in the event of preterm birth, skin-to-skin (kangaroo mother) care, breast milk expression, early introduction of breastfeeding, facilitation of mothers' 24-hour presence in the hospital, preference for mother's own milk, semi-demand feeding before transition to demand breastfeeding, special benefits of pacifier sucking, alternative strategies for reduction of supplementation, use of bottle-feeding when indicated, a family-centered and supportive physical environment, support of the father's presence, and early transfer of infants' care to parents.     

Adolescent Parenting: Outcomes and Maternal Perceptions

Objective: To describe selected outcomes and maternal perceptions of adolescent parenting.
Design: Qualitative and quantitative methods, interview, and two standardized instruments were combined in this follow-up study of adolescents who received perinatal services between 1985 and 1988.
Setting: Data were collected in the mothers' homes.
Participants: Mothers who were randomly selected for an earlier chart outcome audit ( N = 98) and could be located ( n = 19).
Main outcome measures: Subsequent pregnancies; school completion; children's development, indicated by the Developmental Profile II (DPII); parental attitudes, indicated by the Adult-Adolescent Parenting Inventory (AAPI); and maternal perceptions.
Results: Responses revealed irregular use of contraceptives as one reason for the initial pregnancy and for subsequent unplanned pregnancies. Sixteen mothers completed high school, and 18 intend to complete postsecondary programs. The DPII indicated age-appropriate development of the children. AAPI scores for 84% of the mothers indicated nonnurturing attitudes. Mothers described family support, motherhood, and their children.
Conclusions: Research is needed with larger samples and to test interventions to promote regular use of contraception. Findings support the need for research-based programs to educate and promote the development of adolescent mothers and their children.     

Differences within couples' experience of their hospital care and well-being three months after experiencing a stillbirth

BACKGROUND: The present study aimed to investigate possible differences, within the couple, in their encounter with their stillborn child and the assistance of caregivers during the event and to evaluate the parents' psychological well-being three months after the stillbirth. METHODS: Twenty-two couples, who experienced a stillbirth, participated in the study. A study-specific questionnaire and a previously evaluated well-being questionnaire were used to assess the parents' psychological condition. Chi-square analysis, Wilcoxon's signed rank test, Student's paired t-test, and Spearman's rank correlation coefficient were used to detect differences within the couples. RESULTS: The parents had feelings of fear when they conceptualized the stillborn child, but with support from staff all but one couple held their child. The fathers had the same strong feelings of warmth, pride, tenderness, and grief as the mothers when they held the child. Most parents reported that the staff had treated them with understanding during the delivery. Three months after the event the mothers scored significantly higher on Negative Well-being, lower on Positive Well-being, and lower on General Well-being than the fathers. A majority of the mothers, but no fathers, were on sick leave three months after the event. CONCLUSIONS: Our study suggests that mothers and fathers need to be emotionally supported in the encounter with their stillborn child. The mothers' scoring of lower well-being may be due to a stronger antenatal attachment to the child. This should, however, be a subject of further studies.     

Mothers' performing creamatocrit measures in the NICU: accuracy, reactions, and cost

OBJECTIVE: To determine whether mothers of infants in the neonatal intensive-care unit could be taught to perform creamatocrits (CRCTs) accurately on own mothers' milk (OMM). These mothers' reactions to performing CRCTs also were measured. SAMPLE: Twenty-six mothers and four advanced-practice nurses (RNs) participated in this study. DESIGN: For Phase One of this blinded trial, mothers were taught to perform the CRCT by one of the two instructional RNs. For Phase Two, mothers and one of the two validation RNs performed CRCTs simultaneously and independently on the same OMM sample, and the mother completed a Maternal Reactions questionnaire. RESULTS: Mothers' CRCT measures were highly accurate. The mean absolute difference between RNs' and mothers' CRCTs was 0.69%, with 50% and 84.6% of these differences, respectively, < or = 0.5% and < or = 1.0% CRCT. A strong linear correlation was noted between RNs' and mothers' CRCTs. Ninety-six percent of the mothers reported that the CRCT was easy to learn, they felt comfortable performing the procedure, and it made them feel more involved in infant care. A mean of 23.6 minutes was spent teaching the mother to perform CRCT, a figure that reflects the cost-effectiveness of the approach. CONCLUSION: Mothers can be taught to perform CRCTs accurately and easily on their OMM. This practice exemplifies high quality, cost-effective care that maximizes maternal involvement and satisfaction.     

Women's experiences breastfeeding in public places.

This two-part field study compared researchers' recorded observations to mothers' perceptions of attention they received while publicly breastfeeding. In part 1, four breastfeeding and four bottle-feeding mothers each made eight restaurant visits. On average, there were more neutral looks from customers (P = .01) during breastfeeding visits, but no differences in the amount of overtly negative or positive attention given during breastfeeding versus bottle feeding. In part 2, four breastfeeding mothers made a total of 24 visits to shopping malls. There were more neutral looks given while mothers were breastfeeding and more smiles and comments while they were not feeding, but no difference in total amount of attention received. Breastfeeding mothers acknowledged they had anticipated some undesirable attention but instead received little attention. Nevertheless, they felt "vulnerable" nursing in public. Certain proactive behaviors and personal attributes as well as support from other women enabled them to breastfeed successfully in public.     

Effects of providing hospital-based doulas in health maintenance organization hospitals

OBJECTIVE: To evaluate whether providing doulas during hospital-based labor affects mode of delivery, epidural use, breast-feeding, and postpartum perceptions of the birth, self-esteem, and depression. METHODS: This was a randomized study of nullipara enrollees in a group-model health maintenance organization who delivered in one of three health maintenance organization-managed hospitals; 149 had doulas, and 165 had usual care. Study data were obtained from the mothers' medical charts, study intake forms, and phone interviews conducted 4-6 weeks postpartum. RESULTS: Women who had doulas had significantly less epidural use (54.4% versus 66.1%, P < .05) than women in the usual-care group. They also were significantly (P < .05) more likely to rate the birth experience as good (82.5% versus 67.4%), to feel they coped very well with labor (46.8% versus 28.3%), and to feel labor had a very positive effect on their feelings as women (58.0% versus 43.7%) and perception of their bodies' strength and performance (58.0% versus 41.0%). The two groups did not differ significantly in rates of cesarean, vaginal, forceps, or vacuum delivery, oxytocin administration; or breast-feeding, nor did they differ on the postpartum depression or self-esteem measures. CONCLUSION: For this population and setting, labor support from doulas had a desirable effect on epidural use and women's perceptions of birth, but did not alter need for operative deliveries.     

Mothers' behavior with home infant apnea monitors

This study presents findings from 35 interviews with mothers of infants who were monitored for apnea following discharge from the same neonatal intensive care unit. The interviews took place at a mean of 28 weeks following discontinuation of the infant home apnea monitor and focused upon the mothers' behavior with the monitor. One family had independently ceased to use the monitor within 1 week of their infant's hospital discharge. All other mothers reported always having used the monitor at night, and 92% always used it during their infants' daytime naps. Approximately one half of the mothers would not have been able to consistently hear an alarm, however, when their infant was asleep. Consistency of availability to a monitored infant was not related to the mothers' background, attitudes, or experiences with their infant. These data indicate the need to emphasize for all caregivers the importance of being available to their monitored infant at all times.     

Postpartum Teaching Priorities: The Viewpoints of Nurses and Mothers

Objective: To compare mothers' and nurses' perceptions of postpartum learning needs and effective teaching modalities.
Design: Cross-sectional research design. Mothers were given a questionnaire during their postpartum stay to rate how important it was for them to learn about 44 maternal-infant topics before discharge. Nurses rated similar items on the basis of their perception of what is most important for mothers to learn during their postpartum stay.
Setting: Postpartum units in six hospitals that are part of a large midwestern health care system.
Participants: English-speaking women who delivered either vaginally or by cesarean section without complications and the nurses on their postpartum units.
Main outcome Measures: Identification of preferred topics and methods for postpartum teaching.
Results: Mothers and nurses agreed that topics related to immediate physical health needs were most important. Unmarried mothers considered topics related to personal care and mobility as particularly important. First-time mothers rated more topics as important than did experienced mothers. Individual teaching was rated most effective by both groups. Classroom teaching and the use of audiovisual media were considered less effective.
Conclusions: This study supports postpartum education that focuses on the physical needs of mothers and infants, as well as individual teaching models. The special learning needs of new mothers, including those who are not married, must be considered.