The Broken Thread of Health Promotion and Disease Prevention for Women During the Postpartum Period

Abstract

Postpartum maternal health affects maternal functional status, future pregnancy outcomes, maternal chronic disease development, and infant health. After pregnancy, however, many mothers may find that they face gaps in care related to their health and caregiving roles. Research shows that they were unprepared, uninformed, and unsupported during the postpartum period as they struggle with physical and emotional symptoms, infant caregiving, breastfeeding concerns, and lifestyle adjustments. Limited follow-up after a diagnosis of gestational hypertension or gestational diabetes and screening for postpartum depression are additional gaps in preventive and supportive care. Integrative reviews revealed modest efficacy and limitations of recent postpartum health promotion and disease prevention interventions. System, clinical, and community strategies are identified to address these gaps in women's postpartum health services.

Understanding maternal postpartum needs: A descriptive survey of current maternal health services

“…Further needs regarding newborn care were identified such as breastfeeding, safety and sleeping (Gazmararian et al., ; Kanotra et al. ; Sword et al., ; Walker et al., ).…”

“…These needs and concerns could relate to physical and emotional symptoms, infant care giving, breastfeeding concerns and lifestyle adjustments (Gazmararian et al, 2014;Martin, Horowitz, Balbierz, & Howell, 2014). Main postpartum learning needs and concerns were highlighted in many international studies; these include physical and emotional health (Sword & Watt, 2005;Walker et al, 2015), psychological adaptations and help with postpartum depression (Kanotra et al, 2007), maternal role attainment and life style adjustment (Walker et al, 2015), and social support (Kanotra et al, 2007). Further needs regarding newborn care were identified such as breastfeeding, safety and sleeping (Gazmararian et al, 2014;Kanotra et al 2007;Sword et al, 2012;Walker et al, 2015).…”

“…In addition, they concluded that teaching in Jordanian hospitals after giving birth was not effective. For many women, unaddressed concerns and having insufficient knowledge during the postpartum period could increase the risk of maternal postpartum complications such as postpartum depression (Walker et al, 2015), fatigue and sleep disturbances (Fahey & Shenassa, 2013;Troy, 2003), and self-care deficit (Jeon & Hwang, 2013). These health problems interfere with a woman's ability to perform her own basic needs and interfere with providing care to the new baby.…”

Postpartum Psychosocial and Behavioral Health: A Systematic Review of Self-Administered Scales Validated for Postpartum Women in the United States

“…First, there is evidence that scale attributes, such as sensitivity in accurately measuring postpartum depression, may vary by country (Gibson, McKenzie-McHarg, Shakespeare, Price, & Gray, 2009). Second, there are unique features of the U.S. health care system, such as gaps in postpartum services (Walker, Murphey, & Nichols, 2015), including in some cases a lack of health care providers with whom women feel comfortable discussing postpartum issues such as depression (Walker, Im, & Tyler, 2013a). As a result, postpartum women in the United States often find themselves facing a life transition in which they have limited contact with the health care system for their own health.…”

Postpartum emergency department use among women with intellectual and developmental disabilities: a retrospective cohort study

“…These limitations, coupled with the dearth of population-based research examining postpartum experiences of US women with IDD, motivated the objective of this study: to compare the risk of postpartum ED visits in women with and without IDD across the three critical phases of the postnatal period: within 1–42 days, 1–90 days (the fourth trimester) and 1–365 days of delivery. The health of women during the ‘fourth trimester’ (90 days post childbirth)17 and the extended postpartum period (1 year post childbirth) has significant effects on the health of both mother and child 18. Further, we examine the primary reason for an ED visit during these three time periods and the probability that the visit is classified as non-urgent or primary-care sensitive, using the New York University (NYU) ED Algorithm, a retrospective ED classification system 19…”