References for:

B. Fostering an Optimal Womb Environment

1A. Honor pregnancy as a natural event (not a medical condition) and recognize the importance of the mother's emotional, mental, and physical wellbeing; a safe environment; and a strong support system.

  1. Fundamentals include active involvement of the father as a vital partner during pregnancy and childbirth preparation.

References:

  1. Bloom, K. C. (1998). Perceived relationship with the father of the baby and maternal attachment in adolescents. Journal of Obstetric, Gynecologic & Neonatal Nursing, 27(4), 420-430. (abstract)
  2. Curry, M. A., Perrin, N., & Wall, E. (1998). Effects of abuse on maternal complications and birth weight in adult and adolescent women. Obstetrics and Gynecology, 92(4), 530-534. (abstract)

Abstract 1:

Bloom, K. C. (1998). Perceived relationship with the father of the baby and maternal attachment in adolescents. Journal of Obstetric, Gynecologic & Neonatal Nursing, 27(4), 420-430.

Premise: The higher the adolescent mother’s perception of her relationship with the father of the baby, the greater the maternal-fetal and maternal-infant bond

Research Hypothesis: Adolescent mother’s perception of her relationship with the father of the child impacts the development of attachment behaviors during the pregnancy and early postpartum period.

Subjects: Seventy-nine pregnant adolescents, ages 12 to 19 years, attending one of four antepartum clinics for low-income women.

Study Design: Each adolescent was interviewed at four stages during the pregnancy and early postpartum period: less than 20 weeks gestation (n=79), 20-29 weeks gestation (n=64), 30-40 weeks gestation (n=54), and within one week of delivery (n=47). The perceived relationship with the father of the baby was rated on a five-point Likert-type scale. Maternal-fetal attachment was assessed using a 24-item, 5-point Likert-type scale. Each of the above was assessed at stages 1-3. Maternal-infant attachment was rated by using Avant’s Maternal Attachment Assessment Scale during observation at one week postpartum. Also, the perceived relationship with the father of the baby was reassessed at this time.

Findings: The adolescents reported a feeling of closeness with the baby throughout the pregnancy, with a significant increase after birth. When scores on maternal-fetal attachment were combined with a positive perception of the relationship with the father, a significant correlation was found to maternal-infant attachment.

Research reviewed by Dara Steele, RN, while a student at Virginia Commonwealth University, School of Nursing, in Richmond, VA.

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Abstract 2:

Curry, M. A., Perrin, N., & Wall, E. (1998). Effects of abuse on maternal complications and birth weight in adult and adolescent women. Obstetrics and Gynecology, 92(4), 530-534.

Premise: Physical and/or sexual abuse of women during pregnancy and the period around pregnancy has been identified as a serious health risk to both mothers and their infants.

Research Question: Does physical and/or sexual abuse cause maternal complications? Does physical and/or sexual abuse lead to decreases in birth weights of infants born to adult and adolescent women?

Background: The study was conducted in Portland, Oregon. A total of 1,897 women were interviewed while attending 1 of 6 prenatal clinics. Women were asked the same three questions as part of the assessment: 1.) Within the last year, have you been hit, slapped, kicked, or otherwise physically hurt by someone? 2.) Since you have been pregnant, have you been hit, slapped, kicked, or otherwise physically hurt by someone? 3.) Within the last year, has anyone forced you to have sexual activities?

Subjects: Subjects consisted of 1,897 women attending 6 prenatal clinics in Portland, Oregon. Fifty-eight percent of the participants were white, 26.6% African American, 4.9% Hispanic, 3% Native American, 2.6% Asian, and 4.9% other. Thirty percent were adolescent. Among the adolescents, 8.6% were married and 28% lived with a partner. Among the adults, 37.8% were married and 26% were living with a partner.

Study Design: Study design was prospective, descriptive. A graduate-nursing student privately interviewed each woman in an exam room as part of a routine prenatal visit.

Findings: In the past year or during the pregnancy, 27% of the women who were interviewed reported physical abuse, and 4.5 % reported sexual abuse. Adolescents were more likely to report physical and/or sexual abuse. African-American, Native American, and women belonging to ethnic groups described as "Other" in this study were significantly more likely to report abuse. In general, women reporting abuse were less educated, younger, had more previous pregnancies, and were poorer. If reported, abuse was related to poor obstetrical history, drug and alcohol abuse, and low birth weights.

Research reviewed by Debra Lynn Magee, RN, while a student at Virginia Commonwealth University School of Nursing, in Richmond, VA.

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