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 access to physical, emotional, and spiritual support from empathetic family, friends and community.

References:

  1. Brown, M. A. (1986). Social support, stress, and health: A comparison of expectant mothers and fathers. Nursing Research, 35, 72-76. (abstract)
  2. Rogers, M. M., Peoples-Sheps, M. D., & Suchindran, C. (1996). Impact of social support program on teenage prenatal care use and pregnancy outcomes. Journal of Adolescent Health, 19, 132-140. (abstract)
  3. Gottlieb, L., & Mendelson, M. (1998). Mothers’ moods and social support when a second child is born. Journal of Maternal-Child Nursing, 23(1), 3-13. (abstract)
  4. Reece, S. (1993). Social support and the early maternal experience of primiparas over 35. Journal of Maternal-Child Nursing, 21(3), 91-97. (abstract)
  5. Lodgson, C., Burkener ,J., & Usui, W. (2000). The link of social support and postpartum depressive symptoms in African-American women with low incomes. Journal of Maternal-Child Nursing, 25(5), 262-266. (abstract)

Abstract 1:

Brown, M. A. (1986). Social support, stress, and health: A comparison of expectant mothers and fathers. Nursing Research, 35, 72-76.

Premise: An effect of social support and stress exists on expectant mothers and fathers.

Research Question: What is the effect of social support and stress on the health of expectant mothers and fathers?

Subjects: A total of 313 expectant couples in the second trimester of pregnancy.

Study Design: Participants were evaluated using questionnaires to assess their partner support and satisfaction with that support, and to measure stress and chronic illnesses delineating between men and women. Questionnaires were given during care in prenatal clinic and also during childbirthing class. These questionnaires were completed and returned via mail. The Support Behavior Inventory, using the Satisfaction with Partner Support and Satisfaction with Other People Support subscales, was used and revealed internal consistency reliabilities of .97 and .98 as assessed by Cronbach’s alpha. The Health Responses Scale was used to determine perceived levels of illness and wellness in the participants with a Cronbach’s alpha of .89. Stress levels were calculated using the Stress Amount Checklist with an internal consistency of .72 using Cronbach’s alpha.

Findings: When good partner support was present, expectant fathers faired better with regard to their health. The mothers, however, had a better health status when they had a strong social support system of social networks.

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

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Abstract 2:

Rogers, M. M., Peoples-Sheps, M. D., & Suchindran, C. (1996). Impact of social support program on teenage prenatal care use and pregnancy outcomes. Journal of Adolescent Health, 19, 132-140.

Premise: A resource mothers program (RMP) has an effect on the acquisition and continuation of prenatal care, low birth weight (LBW), and preterm birth (PTB).

Research Question: What effect does the use of mentors have on the initiation and continued use of prenatal care, low birth weight rates, and preterm birth rates?

Background: A lack of social support in an at-risk group (low-income, nonwhite, adolescents) is believed to contribute to maternal health issues and risks for their newborns.

Subjects: A total of 1,901 primiparous adolescents were placed in the mentoring group and compared with a control group of 4,613 adolescents in other counties where the program was not available. Referrals were from the food program for Women, Infants, and Children (WIC), prenatal clinics, human services agencies, schools, churches, etc.

Study Design: Participants in the study were compared to the same population (16 years or younger and 17-18 years) in other counties in which the mentoring program was not available. Other factors were marital status, race, age, and previous pregnancies. The mentored-group data and other-counties data were collected and entered into the Maternity Data System. Birth certificates on all babies born to these women were obtained from county vital statistics offices. Approximately 95% of the women in this study were followed by the department of health. Mentors were paraprofessional women who received three weeks of training.

Findings: The adolescent participants in the mentored group were found to be more likely to begin prenatal care early in their pregnancy and to continue, when compared with those in the other-counties group. No significant difference was noted in the low birth weight rate among babies born to either group members. However, those in the RMP group were less likely to experience preterm birth than their cohorts in the other-counties group.

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

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Abstract 3:

Gottlieb, L., & Mendelson, M. (1998). Mothers’ moods and social support when a second child is born. Journal of Maternal-Child Nursing, 23(1), 3-13.

Premise: The transitions to second-time mothering includes facing multiple demands and balancing personal and family needs.

Research Hypothesis: Different types of support serve different functions before and after birth. Support must fit the mother's perceived needs.

Subjects: This study included married mothers expecting a second child when their first-born child was already 28-54 months old. The sample consisted of 90% Caucasian women. The age range of the mothers was 26-40 years old. Average educational preparation included 13 years of formal education.

Study Design: Descriptive. Mothers were visited on two occasions. Questionnaires were used to collect demographic characteristics and note change over time in the variables of interest. Stress was measured using a stress checklist. Maternal mood, along with the type and amount of support provided, were analyzed for patterns.

Findings: Depressed, angry, and/or tired mothers reported a perception of inappropriate amounts of support and dissatisfaction with the nature of the support that they did receive.

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

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Abstract 4:

Reece, S. (1993). Social support and the early maternal experience of primiparas over 35. Journal of Maternal-Child Nursing, 21(3), 91-97.

Premise: Maternal experience is affected by age.

Research Hypothesis: Older first-time mothers experience the transition to parenthood differently than their younger counterparts.

Subjects: A total of 91 first-time mothers over the age of 35 years.

Study Design: Longitudinal descriptive design was used to assess the relationships between social support and early maternal experience in primiparas. Data was collected during the last trimester and after one month postpartum.

Findings: Consistent with the literature on social support and transition to parenthood, social support had positive influences on the mother's self-evaluation and stress levels. Also, social support positively affected maternal perception of parenting ability and diminished perceived stress levels in the early postpartum period.

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

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Abstract 5:

Lodgson, C., Burkener ,J., & Usui, W. (2000). The link of social support and postpartum depressive symptoms in African-American women with low incomes. Journal of Maternal-Child Nursing, 25(5), 262-266.

Premise: A link exists between postpartum support and depression in African-American women.

Subjects: A total of 57 African-American women, 4-6 weeks postpartum.

Study Design: Descriptive.

Findings: In this sample, a high incidence of depression and depressive symptoms was noted and found to be associated with inadequate social support coupled with the maternal perception of the importance of the missing support to their wellbeing.

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

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