Browsing by Subject "prenatal care"

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    Maternal confidence for physiologic childbirth: Instrument development and testing
    (2018-08) Neerland, Carrie
    Maternal confidence is associated enhanced birth experiences through a greater sense of control, feeling more informed, and less pain during labor. However, there is no current definition of maternal confidence for physiologic birth. Further, a valid and reliable measure of prenatal confidence for physiologic birth for clinical use to identify areas where confidence might be enhanced has not yet been developed. The objective of this research was to examine the construct of confidence for physiologic birth and to develop and test a valid and reliable instrument to measure maternal confidence for physiologic birth in the prenatal period. A five-phased instrument development study is presented. In the first section of this dissertation, the results of an in-depth concept analysis using Rodgers’ evolutionary concept analysis method are discussed and an evolving definition of confidence for physiologic birth is provided. This analysis advances the concept of maternal confidence for physiologic birth and contributes new knowledge regarding how confidence for physiologic birth might be enhanced prenatally. The second section describes the development and testing of an instrument to measure prenatal maternal confidence for physiologic birth. Qualitative analysis from a previous study with 14 women who birthed physiologically, along with concept analysis on maternal confidence, informed the development of a 25-item Likert scale. Content validity and face validity were established by a panel of 10 experts. Psychometric testing of the instrument was performed with a sample of 206 women from five Midwestern prenatal clinics. In the third section, prenatal characteristics and birth outcomes are examined in relationship to maternal confidence for physiologic birth. The development of a valid and reliable instrument to measure confidence for physiologic birth during the prenatal period will help to guide interventions to enhance women’s confidence and preparation for childbirth. This may lead to better birthing experiences and improved outcomes for women and infants.
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    Prenatal Care for You and Your Growing Baby!
    (2010-07-29) Witt, Leah
    In prenatal care (which simply means, “before birth”), your doctor will track your overall health and baby’s health by talking to you, and with lab tests and a physical exam. These doctor’s visits are very important. One way the doctor will measure your baby’s growth is through a measurement of your growing belly, called “symphysis-fundal height (SFH) measurement”. This is an inexpensive and easy screening tool for fetal growth (an important measure of fetal health). Your doctor will also feel your belly for your baby’s position and fluid around your baby. If your doctor has any concerns about your baby’s growth, she will refer you to have an ultrasound and help you through the process of looking at those results. These measures of your baby’s growth aren’t 100% accurate and your doctor will use all parts of your story and exam to decide how best to help you and your baby.
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    Prenatal depressive symptoms and social support: An examination of their role in prenatal care adequacy, birth outcomes, and risk for postpartum depressive symptoms among low-income urban women
    (2016-05) Sidebottom, Abbey
    Background. Decreasing the prevalence of inadequate prenatal care, poor birth outcomes, and postpartum depression are public health priorities. Objectives. To examine, in a low-income, racially diverse, urban clinic-based sample the associations of: 1) Social support and depressive symptoms with prenatal care adequacy. 2) Social support and depressive symptoms with poor birth outcomes. 3) Prenatal and postpartum depressive symptoms, as well as their magnitude, and correlates of occurrence. Methods. The study sample was women who received prenatal care at five community health centers from 2005-2009. Maternal data from prenatal and postpartum risk screening tools were linked to data from their infants’ birth certificates. We examined the associations of social support and prenatal depressive symptoms with late and less than adequate prenatal care (Paper 1, n = 2,341) and preterm birth, low birthweight, and small size for gestational age (Paper 2, n = 2,868). We also characterized depressive symptoms in the prenatal and postpartum periods (Paper 3, n = 594). For all papers, multivariable analyses included personal, social, behavioral, and environmental risk factors associated with maternal and infant health. Results. Lack of social support was associated with inadequate prenatal care. Women with poor partner support and depressive symptoms were at the highest risk for starting care late. Neither prenatal depressive symptoms nor social support were independently associated with birth outcomes. There was an association between prenatal and postpartum depressive symptoms. Over half of women with postpartum symptoms had elevated symptoms prenatally. Variability in risk markers suggest unique risk factors are associated with experiencing depressive symptoms in either or both time periods. Conclusions. This study assessed understudied psychosocial risks with public health priority outcomes in a sample of women served by the public health system. Findings support efforts to increase screening for prenatal depression to better identify those at risk of postpartum depression.