Attempts to strengthen maternal functioning in the postpartum period: A literature review

Objective: This study aims to examine that the effects of home visiting, prenatal education, parent classes, and tele counselling on maternal functioning.Methods: The search process was conducted in PubMed, Scopus, Cochrane and Google Scholar using key words of “motherhood’’, ‘‘maternity functioning’’, ‘‘postpartum’’, ‘‘postpartum care’’, ‘‘home visiting’’, ‘‘prenatal education’’, ‘‘parent classes’’, ‘‘tele counseling’’ and a combination of them English-Turkish language papers were searched between 2000 and 2015 years.  All studies relating to subject was included.Results: Discharge occurs shortly after birth in some countries such as the United States and Turkey, women do not receive adequate care, training and counseling and the demands of childrearing often exceed the mother’s expectations.Conclusion: Women should be supported with training programs, home visits, and phone counseling aimed at optimal maternal child health and development

The Development and Testing of the Barkin Index of Maternal Functioning

Maternal functioning in the year following childbirth has exacted inadequate attention in the research literature. The negative effects of postpartum depression on mother and child have been more extensively studied. This deficit in the area of maternal functioning research is of public health significance as functional status may be a more direct measure of deleterious effects on infant development than depression status. Functioning and factors associated with functioning during this critical time period for infant development has been primarily studied by a handful of researchers. Prior to the development of the Barkin Index of Maternal Functioning (BIMF), the Inventory of Functional Status After Childbirth (IFSAC) was the only instrument designed for the express purpose of measuring functional status. However, the IFSAC is less than ideal for measuring this important concept; its rigid definition of functional status makes it difficult for women to achieve full functional status. This precipitated the development of the BIMF. The BIMF was developed through qualitative methods. New mother focus group discussions provided much of the content (and the framework for a new definition of functional status) that is reflected in the BIMF. This method of survey development has many advantages and helps to ensure content validity and a patient-centered product. The BIMF was also critiqued by a panel of experts in relevant fields. This work resulted in a new 20-item self-report measure of maternal functioning. In an initial psychometric analysis, the BIMF exhibited good reliability (and validity), with a Cronbach's Alpha of 0.87.An analysis of factors related to maternal functioning (as measured by the BIMF) in a population of women who screened positive for depressive symptoms revealed an association of functioning with depression and atypical depression. Race and atypical depression were independently associated with the BIMF in a stepwise regression analysis. The BIMF and the Gratification Checklist were also significantly and positively correlated

Evidence‐Based Survey Design: The Use of Negatively Worded Items in Surveys

A close examination of the literature on including positively and negatively worded items in structured survey questionnaires revealed that contrary to the traditional wisdom, it is better not to use a mix of positively and negatively worded items as doing so can create threats to validity and reliability of the survey instrument. If mixing, it is recommended to use strategies derived from research to improve the quality of data and the instrument validity and reliability

Motherhood and Me (Mom-Me): The Development of an Acceptance-Based Group for Women with Postpartum Mood and Anxiety Symptoms

Untreated postpartum mood and anxiety disorders (PMADs) place women and their families at risk for negative biopsychosocial sequelae. Innovative and tailored treatments are needed to address potential disruptions in maternal functioning. Third-wave cognitive-behavioral approaches, including acceptance and commitment therapy (ACT) and dialectical behavioral therapy (DBT), hold promise for optimizing functioning given the focus on values-based living, rather than symptom reduction. Purpose: The purpose of this paper is to describe the development of an innovative psychotherapy group for women with symptoms of PMADs. Methods: This seven-session group, Motherhood and Me (Mom-Me), includes selected skills training from ACT, DBT, and Emotion-Centered Problem-Solving Therapy. Results: Mom-Me group sessions are described, and an outline of key information (session goals, content, and homework assignments) is provided to facilitate practical implementation. Conclusion: In line with third-wave approaches, this group was developed to enhance maternal functioning, which, in turn, may help women cope with psychological distress during the transition to motherhood

Effects of extreme weather events on child mood and behavior

Extreme weather events (EWEs) are increasing in frequency and severity as the planet continues to become warmer. Resulting disasters have the potential to wreak havoc on the economy, infrastructure, family unit, and human health. Global estimates project that children will be disproportionately impacted by the changing climate – shouldering 88% of the related burdens. Exposure to EWEs in childhood is traumatic, with ramifications for mental health specifically. Symptoms of posttraumatic stress, depression, and anxiety have all been associated with childhood EWE exposure and have the potential to persist under certain circumstances. Conversely, many childhood survivors of EWE also demonstrate resilience and experience only transient symptoms. While the majority of studies are focused on the effects resulting from one specific type of disaster (hurricanes), we have synthesized the literature across the various types of EWEs. We describe psychological symptoms and behavior, the potential for long-term effects, and potential protective factors and risk factors

Characteristics of effective peer mentorship for primiparous mothers: Qualitative findings from a peer support program

The early days of motherhood can be challenging, especially for first-time mothers. These challenges can predispose women to maternal distress, and social support—such as that offered by peers—can be important in assisting mothers to manage such distress. While existing research has identified that first time mothers often seek for and value peer support programs (e.g., practical advice, not feeling alone), few researchers have investigated factors that contribute to successful peer support and mentorship for primiparous women. Insight into these factors can be key to enhancing the success of future peer support interventions. Thematic analysis was applied to thirty-six semi structured interviews conducted with fourteen primiparous mothers and seventeen peer mentors in a peer support program. Four key factors were identified and included: expectations about the peer mentor relationship, independence of peer mentor (i.e., not part of the mother’s immediate circle of friend or family), nature of contact between primiparous mothers and peer mentors (e.g., frequency, content of conversation), and similarities between primiparous mothers and peer mentors (e.g., pregnancy and parenting experience, personality, beliefs). This study adds to existing research on factors that contribute to building successful peer mentor relationships for primiparous women. The identification of additional factors that influence peer mentor relationships, and the interplay between those factors appear important in the formulation of support networks for first time mothers. To encourage successful peer support relationships, future intervention developers need to understand the dynamics between these factors and their influence on successful relationships in a peer support context

Strengthening Peer Mentoring Relationships for New Mothers: A Qualitative Analysis

(1) Background: The transition to motherhood can be challenging, especially for first-time mothers, and can accompany maternal distress. Social support—such as that offered by peers— can be important in assisting mothers to manage such distress. Although primiparous mothers often seek out and value peer support programs, few researchers have investigated factors that may influence the strength of relationships in non-professional maternal peer support programs. Insight into these factors can be key to enhancing the success of future peer support interventions. (2) Methods: Reflexive thematic analysis was applied to data gathered from 36 semi-structured interviews conducted with 14 primiparous mothers and 17 peer mentors in a peer support program. (3) Results: Four themes related to successful mentorship were identified: expectations of peer relationship, independence of peer mentor, contact, and similarities. (4) Conclusions: For primiparous mothers who are developing their support network, these factors appear important for promoting close and effective peer support relationships. Interventions that harness the dynamics between these factors may contribute to more successful peer support relationships and mental health outcomes for participants

Caregiver socioemotional health as a determinant of child wellâ being in schoolâ aged and adolescent Ugandan children with and without perinatal HIV exposure

ObjectiveCaregiver socioâ emotional attributes are major determinants of child wellâ being. This investigation in vulnerable schoolâ aged Ugandan children estimates relationships between children’s wellâ being and their caregiver’s anxiety, depression and social support.MethodsPerinatally HIVâ infected, HIVâ exposed uninfected and HIVâ unexposed Ugandan children and their caregivers were enrolled. Perinatal HIV status was determined by 18 months of age using DNAâ polymerase chainâ reaction test; status was confirmed via HIV rapid diagnostic test when children were 6â 18 years old. Five indicators of child wellâ being (distress, hopelessness, positive future orientation, esteem and quality of life (QOL)) and caregiversâ socioemotional status (depressive symptoms, anxiety and social support) were measured using validated, culturally adapted and translated instruments. Categories based on tertiles of each caregiver psychosocial indicator were defined. Linear regression analyses estimated percent differences (β) and corresponding 95% confidence intervals (CI) for child wellâ being in relation to caregiver’s psychosocial status.ResultsAs per tertile increment, caregiver anxiety was associated with 2.7% higher distress (95%CI:0.2%, 5.3%) and lower selfâ esteem/QOL (β = â 1.3%/â 2.6%; 95%CI: â 5.0%,â 0.2%) in their children. Child distress/hopelessness increased (β = 3.3%/7.6%; 95%CI:0.4%, 14.7%) and selfâ esteem/QOL decreased 2.3% (β = â 2.3%/â 4.4%; 95%CI: â 7.2%, â 1.3%) as per tertile increment in caregiver depression. Higher caregiver social support was associated with lower distress and higher positive outlook (β = 3%; 95%CI:1.4%, 4.5%) in their children. HIVâ infected/exposed children had most caregiver depressionâ related QOL deficit (β = â 5.2%/â 6.8%; 95%CI: â 12.4%, â 0.2%) and HIVâ unexposed children had most caregiver social supportâ related enhancements in positive outlook (β=4.5%; 95%CI:1.9%, 7.1%).ConclusionsCaregiver anxiety, depressive symptoms and low social support were associated with worse wellâ being in schoolâ aged and adolescent children. Improvement of caregiver mental health and strengthening caregiver social support systems may be a viable strategy for improving wellâ being of vulnerable children and adolescents in this setting.ObjectifLes attributs socioâ affectifs des responsables d’enfants sont des déterminants majeurs du bienâ être des enfants. Cette investigation menée auprès d’enfants ougandais vulnérables dâ âge scolaire a estimé les relations entre le bienâ être des enfants et l’anxiété, la dépression et le soutien social de leur responsable.MéthodesDes enfants ougandais infectés par le VIH de manière périnatale, exposés au VIH mais non infectés, et non exposés au VIH ainsi que leurs responsables ont été inscrits. Le statut VIH périnatal a été déterminé à lâ âge de 18 mois à l’aide du test de PCR de lâ ADN; le statut a été confirmé par un test de diagnostic rapide du VIH chez les enfants âgés de 6 à 18 ans. Cinq indicateurs du bienâ être de l’enfant (détresse, désespoir, orientation future positive, estime et qualité de vie (QV)), et le statut psychosocial des responsables (symptômes dépressifs, anxiété et soutien social) ont été mesurés à l’aide de méthodes validées, adaptées à la culture et respectées et d’outils traduits. Des catégories basées sur les tertiles de chaque indicateur psychosocial du responsable ont été définies. Des analyses de régression linéaire ont estimé les différences en pourcentage (β) et les intervalles de confiance (IC) à 95% correspondants pour le bienâ être de l’enfant par rapport au statut psychosocial de leurs responsables.RésultatsPar incrément de tertile, l’anxiété des responsables était associé à 2,7% de détresse plus élevé (IC95%: 0,2%, 5,3%) et de faible estime de soi/QV (β = â 1,3%/â 2,6%; IC95%: â 5,0%, â 0,2%) chez leurs enfants. La détresse et le désespoir des enfants augmentaient (β = 3,3%/7,6%; IC95%: 0,4%, 14,7%) et l’estime de soi/QV diminuait de 2,3% (β = â 2,3%/â 4,4%; IC95%: â 7,2%, â 1,3%) par incrément de tertile de la dépression chez le responsable. Un soutien social plus élevé des responsables était associé à une détresse moindre et à une perspective positive plus élevée (β = 3%; IC95%: 1,4%, 4,5%) chez leurs enfants. Les enfants infectés/exposés au VIH présentaient pour la plupart un déficit de QV lié à la dépression de leurs responsables (β = â 5,2%/â 6,8%; IC95%: â 12,4%, â 0,2%), et ceux non exposés au VIH présentaient pour la plupart des améliorations en perspective positive liées au soutien social de leurs responsables (β = 4,5%; IC95%: 1,9%, 7,1%).ConclusionsL’anxiété, les symptômes dépressifs et un faible soutien social du responsable étaient associés à un bienâ être précaire chez les enfants dâ âge scolaire et les adolescents. L’amélioration de la santé mentale des responsables et le renforcement des systèmes de soutien social pour les responsables peuvent constituer une stratégie viable pour améliorer le bienâ être des enfants et des adolescents vulnérables dans cette région.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149358/1/tmi13221.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149358/2/tmi13221_am.pd

Climate Change is an Emerging Threat to Perinatal Mental Health

Objective: In this discussion, we build the case for why climate change is an emerging threat to perinatal mental health. Method: A search of current literature on perinatal and maternal mental health and extreme weather events was conducted in PubMed/MEDLINE and Web of Science databases. Only articles focusing on maternal mental health were included in this narrative review. Results: The perinatal period represents a potentially challenging timeframe for women for several reasons. Necessary role adjustments (reprioritization), changes in one’s ability to access pre-birth levels (and types) of social support, fluctuating hormones, changes in body shape, and possible complications during pregnancy, childbirth, or postpartum are just a few of the factors that can impact perinatal mental health. Trauma is also a risk factor for negative mood symptoms and can be experienced as the result of many different types of events, including exposure to extreme weather/natural disasters. Conclusion: While the concepts of “eco-anxiety,” “climate despair,” and “climate anxiety” have garnered attention in the mainstream media, there is little to no discussion of how the climate crisis impacts maternal mental health. This is an important omission as the mother’s mental health impacts the family unit as a whole

Factors Associated with Postpartum Maternal Functioning in Black Women: A Secondary Analysis

In the United States, 29–44% of Black women experience postpartum depressive symptoms (PDS), yet few are properly identified and/or connected to mental care services. The purpose of this secondary analysis was to examine the relationship between maternal functioning and clinical variables (PDS, maternal–infant attachment), racial variable (Black racial identity types—low race salience, assimilated and miseducated, self-hating, anti-White, multiculturalist, and conflicted), and sociodemographic characteristics (relationship status, education, insurance, childbirth type). A total of 116 women living in the southern United States were included in the analysis. Multivariate analyses revealed that Black racial identity (p = 0.02), PDS (p < 0.0001), maternal–infant attachment (p < 0.0001), and educational level (p = 0.03) were independently associated with maternal functioning. This work provides new evidence regarding the role of various clinical and racial factors on Black postpartum women’s adjustment to motherhood. This analysis also adds to the growing body of evidence of reliability for the BIMF in Black postpartum women