Rubella immunisation and pregnancy.
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Adolescent↗
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Results for “Postpartum Programs”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
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Education for contraceptive use by women after childbirth.
OBJECTIVES: Postpartum education on contraceptive use is a routine component of discharge planning in many different countries with a wide variety of health care systems. This education is based on assumptions concerning women's receptivity to contraceptive education during the postpartum period and their presumed lack of access to such education after that time. The objective of this review is to assess the effects of education about contraceptive use to postpartum mothers. SEARCH STRATEGY: We searched the Cochrane Controlled Trials Register, MEDLINE, EMBASE, CINAHL, Psychlit, Popline, citations indexes and reference lists of relevant articles. We contacted subject experts to locate additional research, in addition to the Group's Specialised Register of Controlled Trials. Date of the most recent search: April 1999. SELECTION CRITERIA: Trials using random or quasi-random methods of allocation which evaluated the effectiveness of postpartum education about contraceptive use. DATA COLLECTION AND ANALYSIS: Two independent reviewers abstracted data on trial characteristics and results. MAIN RESULTS: Three trials were identified with 5438 women. These trials were conducted in Lebanon, Peru and Nepal. None of the trials examined all major prespecified endpoints. Postpartum education about contraceptive use influenced short-term use assessed between 40 days and three months post-partum. Women in the intervention groups were less likely to be non-users than women in the comparison groups (Odds Ratio (OR) = 0.47, 95% Confidence Interval (CI) 0.39 to 0.58). This benefit was not apparent following analysis of data from better quality studies (OR = 0.67, 95% CI 0.41 to 1.13). An apparent benefit on contraceptive use at six months post-partum (OR = 0.52, 95% CI 0.37 to 0.74) was not apparent following sensitivity analyses (OR = 0.59, 95% CI 0.33 to 1.06). Data are inadequate to assess the impact on cessation of breast feeding and non-attendance at family planning clinics. Unplanned pregnancies, knowledge about contraception and satisfaction with care were not assessed in any trial. REVIEWER'S CONCLUSIONS: The effectiveness of postpartum education about contraceptive use has not yet been established in randomised controlled trials. Such education may be effective in increasing the short-term use of contraception. However, there are only limited data examining a more-important longer-term effect on the prevention of unplanned pregnancies. Research needs to be undertaken to assess the effectiveness of the minimalist education provided in more developed countries and the variety of programs provided in less developed regions. Such research should examine the content, timing, range and organisation of postpartum education on contraceptive use, as well as its impact on breast feeding rates.
Contraception↗
[Morbidity among mothers and infants after ambulatory deliveries].
Postpartum early discharge programs are reviewed. Few programs were mandatory and both primi- and multiparae were included. Discharge varied from two to 72 hours after delivery. Nearly all programs had prenatal preparation and all patients had postpartum follow-up at home. Approximately one per cent of the infants were readmitted mostly on account of hyperbilirubinemia and infections, and half as many mothers were readmitted mostly for hemorrhage and endometritis. Infants discharged very early were readmitted more frequently than others. There were no statistical significant difference in mortality or morbidity between mothers or infants in early discharge groups and control groups.
Ambulatory Care↗
Improving the delivery of prenatal care and outcomes of pregnancy: a randomized trial of nurse home visitation.
We evaluated a comprehensive program of prenatal and postpartum nurse home visitation. The program was designed to prevent a wide range of health and developmental problems in children born to primiparous women who were either teenagers, unmarried, or of low socioeconomic status. During pregnancy, women who were visited by nurses, compared with women randomly assigned to comparison groups, became aware of more community services; attended childbirth classes more frequently; made more extensive use of the nutritional supplementation program for women, infants, and children; made greater dietary improvements; reported that their babies' fathers became more interested in their pregnancies; were accompanied to the hospital by a support person during labor more frequently; reported talking more frequently to family members, friends, and service providers about their pregnancies and personal problems; and had fewer kidney infections. Positive effects of the program on birth weight and length of gestation were present for the offspring of young adolescents (less than 17 years of age) and smokers. In contrast to their comparison-group counterparts, young adolescents who were visited by nurses gave birth to newborns who were an average of 395 g heavier, and women who smoked and were visited by nurses exhibited a 75% reduction in the incidence of preterm delivery. (P less than or equal to .05 for all findings.)
Birth Weight↗
Nurse practitioner intervention to improve postpartum appointment keeping in an outpatient family planning clinic.
A nurse practitioner (NP) program to improve postpartum appointment keeping in an outpatient family planning clinic is described and evaluated. The subjects (N = 59) were non-high-risk obstetric patients prescheduled to be seen at 6 weeks postpartum by the NP. Two groups were identified by convenience sampling: Group A (n = 25), the nonintervention group, and Group B (n = 34), the intervention group. Two types of intervention were used: a postpartum telephone call after discharge (n = 11), or a predischarge postpartum visit (n = 23). Results suggest that those in the intervention group were more likely to keep their appointments (p less than .02); only the postpartum visit increased the probability of appointment keeping (p less than .05).
Adolescent↗
Effects of an intervention program for pregnant adolescents: educational outcomes at two years postpartum.
Examined postpartum effects of a school-based intervention program for pregnant adolescents. Interviews were conducted with 102 innercity black, low-income, school-aged mothers who had attended the program, and their academic and medical records were reviewed. For teenagers who had been poor students prior to becoming pregnant, a strong linear effect was found for duration of program attendance: with sufficient time in the program, poorer students became indistinguishable from better students in educational success. Most of the better students were educationally successful at 2 years postpartum, independent of their length of time in the program. For all students, longer durations of postnatal intervention were predictive of lower likelihood of subsequent childbearing. Numerous academic, medical, social, and demographic variables were ruled out as possible confounding factors that might have produced the positive educational outcomes for poorer students. The results suggest that adolescents who appear to have minimal academic promise prior to their pregnancy are nevertheless very responsive to school-based intervention.
Adolescent↗
The effect of postpartum lactation counseling on the duration of breast-feeding in low-income women.
We investigated the effectiveness of a program of intensive postpartum support for low-income, breast-feeding women and identified potential predictors of prolonged breast-feeding in this population. Ninety-seven low-income women were randomized to receive intensive postpartum education and support for breast-feeding or to receive only the routine assistance provided by the obstetrical nurses. Both groups were telephoned 6 weeks post partum to determine the method of infant feeding then, and those still breast-feeding were contacted monthly until complete weaning had occurred. No significant difference in breast-feeding duration between the two groups was noted. There was no association between duration of nursing and race, marital status, or the need to return to work or school. Earlier age at introduction of supplement, younger maternal age, and participation in prenatal classes predicted breast-feeding duration by logistic regression.
Breast Feeding↗
Postpartum IUDs in Mexico.
Dr. Ramon Aznar, head of the medical subdivision of the Mexican health insurance program (IMSS), reports that postpartum insertion of IUDs has met great success in Mexico. In 1983, the number of postpartum IUD acceptors in the family planning program of the IMSS reached 83,763, making it the most popular method of postpartum contraception there. The program emphasizes the need for adequate training of delivery room staff and for alerting women to possible contraceptives postpartum. FHI has conducted studies of postpartum IUD use worldwide, including Mexico before the programmatic use of the method. Mexico now has the largest experience of any country in postpartum insertion. The Mexican experience serves to validate the contention that postpartum IUD insertion, accomplished during 1 of the few times in many women's lives that they have contact with the health care system, can make a significant contribution to family planning in the developing world.
Americas↗
Use of prostaglandin F2 alpha as a postpartum reproductive management tool for lactating dairy cows.
This study compared three programs for reproductive management of the postpartum period for reproductive performance and net economic benefit within three dairy herds (n = 1624 cows). Cows on one program received PGF alpha injection at 25 to 32 d postpartum for reproductive therapy, and cows on a second program received additional PGF2 alpha at 39 to 46 d postpartum for synchronization of estrus. These programs were compared with a postpartum program of rectal palpation based on veterinary intervention. Survival analysis indicated that cows receiving PGF2 alpha for reproductive therapy and synchronization of estrus had an 11% higher rate of first AI and 10% higher rate of pregnancy than did cows receiving the rectal palpation. No differences existed between the cows receiving rectal palpation and those receiving the PGF2 alpha. Because overall conception rates and conception rates at first AI did not differ among programs, the improved reproductive performance of cows receiving PGF2 alpha for both therapy and synchronization may be attributed to greater synchronization of estrus, which resulted in improved estrus detection. A partial budget indicated that the PGF2 alpha programs were less expensive than the rectal palpation program. When PGF2 alpha was used for postpartum reproductive therapy and synchronization of estrus, reproductive performance and net economic benefit were increased compared with those of the other programs.
Animals↗
Postpartum smoking relapse.
While it has been established that many women quit smoking during pregnancy, little is known about postpartum maintenance of smoking cessation and relapse. A sample of 567 women were surveyed at about 6 months postpartum in order to (a) describe the patterns of smoking relapse; (b) assess the perceived importance of smoking cessation in pregnancy and postpartum; and (c) identify potentially high risk situations for smoking relapse. Results indicate that about half (56%) of the women who quit smoking during pregnancy relapse to smoking by 30 days postpartum. Most of these relapses occur in the company of other smokers. Socializing and/or living with a smoker had a powerful negative impact on ability to maintain abstinence in postpartum. Smoking cessation programs for pregnant women should emphasize the importance of continued abstinence in postpartum.
Adolescent↗
Frigidity in women, with special reference to postpartum frigidity; some clinical observations and study programs.
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Female↗
[Do's and don'ts in post-partum contraception].
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Attitude↗
Group treatment for postpartum depression: a pilot study.
OBJECTIVE: There are few reports on the efficacy of treatment programs for women with postpartum depression, despite the long-term nature of this disorder. This study describes a pilot evaluation of a treatment program with educational, social support and cognitive-behavioural components. METHOD: Ten women with persistent depression originating in the postpartum period were offered a 10-week group treatment program and compared to a wait-list control group. RESULTS: Following treatment, a significant improvement in depression was demonstrated on the Edinburgh Post-Natal Depression Scale, Beck Depression Inventory, and Profile of Mood States. Several common factors in women suffering from postpartum depression were also identified, as were drop-out characteristics. CONCLUSION: These results are encouraging and suggest that a cognitive-behavioural group program might be effective as a treatment for depression in the postpartum period. However, further detailed studies are required to conform this pilot study.
Adult↗
Management of teenage pregnancies in three different health care settings.
A retrospective study was undertaken to determine if differences existed in obstetric outcome, contraceptive usage, and repeat pregnancy rates of teenage patients cared for in three different health care settings. The sites included the Rochester Adolescent Maternity Project (RAMP), a traditional obstetric clinic, and a neighborhood health center. Comparison of the three groups revealed that RAMP patients experienced a lower incidence of anemia and preeclampsia than patients in the other programs. At one year postpartum, 25% of the hospital clinic patients were using contraception compared to 45% for the health center and 49% for RAMP patients, compared to 15.8% for the health center and 6.5% for the RAMP group.
Adolescent↗
[Postpartum contraception and sex life during the puerperium].
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Contraception↗
Survey on the programs of Sanhujori centers in Korea as the traditional postpartum care facilities.
Sanhujori is the term used for the traditional Korean concept of non-professional postpartum care after delivery or abortion. Recently, postpartum care has been transferred to facilities appropriately named Sanhujori centers. This study investigates the programs offered at Sanhujori centers in order to understand the effects of this new type of health care delivery system on postpartum care. A qualitative descriptive study was conducted that included twenty-seven centers. Data were collected via face-to-face interviews followed by telephone interviews conducted from May first until the eighteenth of 2001. The findings permitted description of the general characteristics of Sanhujori centers. Programs for physical recovery, psychosocial recovery, postpartum education, parents-infant bonding, and baby care were analyzed and discussed.
Adult↗
Comparison of two timed artificial insemination (TAI) protocols for management of first insemination postpartum.
Two estrus-synchronization programs were compared and factors influencing their success over a year were evaluated. All cows received a setup injection of PGF2alpha at 39 +/- 3 d postpartum. Fourteen days later they received GnRH, followed in 7 d by a second injection of PGF2alpha. Cows (n = 523) assigned to treatment 1 (modified targeted breeding) were inseminated based on visual signs of estrus at 24, 48, or 72 h after the second PGF2alpha injection. Any cow not observed in estrus was inseminated at 72 h. Cows (n = 440) assigned to treatment 2 received a second GnRH injection 48 h after the second PGF2alpha, and all were inseminated 24 h later. Treatment, season of calving, multiple birth, estrual status at insemination, number of occurrences of estrus before second PGF2alpha, prophylactic use of PGF2alpha, retained fetal membranes, and occurrence of estrus following the setup PGF2alpha influenced success. Conception rate was 31.2% (treatment 1) and 29.1% (treatment 2). A significant interaction occurred between protocol and estrual status at insemination. Cows in estrus at insemination had a 45.8% (treatment 1) or 35.4% (treatment 2) conception rate. The conception rate for cows not expressing estrus at insemination was 19.2% (treatment 1) and 27.7% (treatment 2). Provided good estrous detection exists, modified targeted breeding can be as successful as other timed artificial insemination programs. Nutritional, environmental, and management strategies to reduce postpartum disorders and to minimize the duration of postpartum anestrus are critical if synchronization schemes are used to program first insemination after the voluntary waiting period.
Animal Husbandry↗
Coordinated care early discharge of postpartum patients at Irwin Army Community Hospital.
A trial program of early discharge of postpartum patients was instituted at the Fort Riley MEDDAC as part of a coordinated-care initiative. The goals of this program were to increase quality and access to care while containing health costs. A total of 788 bed days valued at $705,260 were made available for use by other patients. Maternal readmission rate was 0.3%; length of stay was decreased from 3.22 days to 1.22 days. Early discharge was made possible through a combination of medical record screening and comprehensive patient education. This study indicates that early discharge provides quality of care and cost effectiveness without adverse outcomes.
Adolescent↗