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Effects of hospital experience on postpartum feelings and attitudes of women Bradley, Christine Felecia

Abstract

The purpose of this investigation was twofold. First, to investigate the attitudes and feelings of a group of normal women expecting their first child. Second, to evaluate the effectiveness of a family centred maternity programme in promoting a positive feeling towards the infant and in terms of preparing the mothers for their new role. The subjects were 94 married women who attended prenatal classes with their husbands. They were white, Caucasian, with a mean age of 27 years and a mean level of education of 14 and one half years. The women were raised in North America or the British Commonwealth. All women delivered a single full term infant and experienced no major medical complications of either themselves or their infant during pregnancy, delivery or the postpartum period. Each woman completed a series of questionnaires relating to attitude towards pregnancy, labour and delivery, childbirth, the new baby and the hospital experience. These measures were completed at four points in time; in the ninth month of pregnancy, while in hospital and after one and five weeks at home. In addition, she completed the Depression Adjective Checklists, the Beck Depression Index and the Pleasant Events Schedule in the ninth month of pregnancy and in the sixth week after delivery of her child. The Depression Adjective Checklist was also completed each day that the woman was in hospital. Major comparisons were (a) type of maternity hospital programme experienced — a family centred maternity programme versus a more traditional maternity programme and (b) type of delivery — whether vaginal or caesarian. Multivariate analyses conducted on the set of variables at each time period revealed a significant difference between the two groups of women depending upon which hospital programme they experienced, both while in hospital and after they had been home for one week. Univariate analyses revealed significant difference between the two groups on their responses to the following variables: The women in the family centred maternity programme had a more positive attitude towards their babies while in hospital; considered that they received more experience in how to care for their babies in hospital and perceived that they obtained more help from the hospital in preparing them for their mothering role. There was no difference in attitude towards the baby once the women had been home for one week caring for and interacting with their babies. A repeated measures analysis of variance indicated that there were no differences in the level of depressive affect between the women in the two types of programme over the time periods involved. Multivariate, analyses of the sets of variables at each time period indicated a significant difference between those who had a vaginal delivery and those who had a caesarian section. Those women who had a caesarian section had a less positive attitude towards their labour and delivery. There was no difference between these two groups of women in either their attitude towards their infant or their feelings of self-confidence. A repeated measures analysis of variance revealed that those women who had caesarians were more depressed after the birth of their baby than those women who delivered their baby vaginally. Although the women in the present study were not clinically depressed there were significant correlations between levels of depressive affect and other variables. For example, in the ninth month of pregnancy depressive affect was related to a less positive attitude towards pregnancy; in hospital depressive affect was related to a less positive attitude towards labour and delivery and towards the baby; at six weeks postpartum depressive affect was related to a less positive attitude towards the baby. The discussion centred around the implication of the findings for hospital programmes and prenatal class curricula, current behavioural theories of depression and the myth of maternal instinct.

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