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Background: Becoming a parent can be challenging. Becoming a parent for the first time during the COVID-19 pandemic might pose additional challenges, as the pandemic has imposed restrictions on society, thus affecting parental support. There were changes in parental support from child health services and preschools available for all children and their parents, so called open preschools, have been closed. This study explored first-time parents’ experiences of the parental support they received during the COVID-19 pandemic. Methods: A qualitative study involving individual semi-structured interviews with nine first-time mothers who had been on parental leave during the pandemic was conducted. Data were analyzed with inductive content analysis and the results are presented in a main category with three generic categories. Results: The main category is entitled, A gap between the needs of parental support and the support provided, and it encompasses three generic categories: The first category, Formal support, refers to support from child health nurses and open preschools. The second category, Lack of formal support, encompasses the lack of person-centred support and lack of parental groups. The third category, Informal support, encompasses support from family, friends, and social media. Conclusions: The findings indicate that under the restrictions imposed by the pandemic, first-time mothers expressed the need for person-centred support to both parents which will ensure that all parents get the support they expect and need. The participants also expressed a desire for adapted parental groups that are feasible despite the restrictions to allow them to connect with other parents and build networks. [ABSTRACT FROM AUTHOR]

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Abstract Background Becoming a parent can be challenging. Becoming a parent for the first time during the COVID-19 pandemic might pose additional challenges, as the pandemic has imposed restrictions on society, thus affecting parental support. There were changes in parental support from child health services and preschools available for all children and their parents, so called open preschools, have been closed. This study explored first-time parents’ experiences of the parental support they received during the COVID-19 pandemic. Methods A qualitative study involving individual semi-structured interviews with nine first-time mothers who had been on parental leave during the pandemic was conducted. Data were analyzed with inductive content analysis and the results are presented in a main category with three generic categories. Results The main category is entitled, A gap between the needs of parental support and the support provided, and it encompasses three generic categories: The first category, Formal support, refers to support from child health nurses and open preschools. The second category, Lack of formal support, encompasses the lack of person-centred support and lack of parental groups. The third category, Informal support, encompasses support from family, friends, and social media. Conclusions The findings indicate that under the restrictions imposed by the pandemic, first-time mothers expressed the need for person-centred support to both parents which will ensure that all parents get the support they expect and need. The participants also expressed a desire for adapted parental groups that are feasible despite the restrictions to allow them to connect with other parents and build networks.

Objective: The aim of this qualitative study was to examine experiences and meanings of maternal ambivalence in first-time mothers with young children. Background: In contrast with normative expectations surrounding contemporary motherhood, there is growing recognition that becoming and being a mother involves ambivalent feelings, and that these feelings are normal and have positive psychological consequences. Yet, little attention has been paid to women's subjective experiences of maternal ambivalence, and capacity to acknowledge and manage ambivalent feelings. Methods: Eleven semi-structured online interviews, with first-time mothers, were conducted and analysed using Interpretative Phenomenological Analysis (IPA) methodology. Results: Two group experiential themes were identified: Crossing boundaries of acceptable mothering feelings and Mothering from a place of 'enough'. Ambivalent mothering feelings challenged participants' expectations about motherhood and themselves as mothers, producing anxiety, self-doubt and feelings of failure. Distress accompanying maternal ambivalence was especially acute when participants perceived their feelings to be unacceptable. Viewing conflicting feelings with compassion, however, helped participants to cope with their diverse and fluctuating emotional mothering experiences, allowing them to mother with a greater sense of equanimity, agency and competence. Conclusion: The study's findings indicate the potential benefits of providing information about the emotional turbulence of early motherhood as part of routine maternity care, as well as the potential value of offering parenting interventions that promote self-compassion to mothers struggling to manage feelings of ambivalence. [ABSTRACT FROM AUTHOR]

Abstract Background Experiencing childbirth as traumatic is common and can have long-lasting negative consequences for women’s mental health. However, fostering a sense of social identity has been shown to protect psychological wellbeing and mental health during life transitions, such as entering parenthood. This study therefore investigated the relationship between traumatic childbirth and first-time mothers’ social identity and their psychological wellbeing, and more specifically whether strength of identity as a first-time mother protected psychological wellbeing following traumatic childbirth. Method Women over the age of 18 who were living in the UK and had given birth to their first child in the past nine months were recruited to the study from clinical and community settings. They completed digital self-report questionnaires about their birth experience, social identity, mental health, and psychological wellbeing. Women who perceived themselves to have had a traumatic birth (the trauma group; N = 84) were compared to women who did not perceive themselves to have had a traumatic birth (the control group, N = 39). T-tests and chi square tests assessed preliminary group differences before multivariate analyses of covariance controlled for covariates. Post-hoc tests identified the direction of differences. Multiple regression and moderation analyses analysed interaction effects. Results The trauma group had significantly lower psychological wellbeing (mean = 41.5, 95% CI [39.4–43.7], p = .008, partial η2 = 0.059), compared to the control group (mean = 48.4, 95% CI [45.3–51.5]), but the two groups did not differ in the strength of their first-time mother identity, which was high across both groups. Strength of identity did not moderate the relationship between traumatic childbirth and psychological wellbeing. Giving birth by caesarean section independently reduced the strength of the first-time mother identity (p = .017, partial η2 = 0.049). All analyses controlled for emotional and practical support, perceptions of healthcare staff, and mode of birth. Conclusions Having a traumatic birth was associated with lower psychological wellbeing, and the strength of first-time mother identity does not appear to moderate this relationship. Factors such as mode of birth may be more important. Further research, including longitudinal designs, is needed to understand the relationship between these constructs and identify more effective ways of protecting first-time mothers’ mental health.

Objectives: Schema Therapy, an approach that integrates cognitive-behavioural and attachment principles, helps us understand the impact of early interactions with caregivers on adult mental health. These early interactions can be assessed through Schema Therapy-informed tools; however, these tools have yet to be used with a postnatal population, which represents a period of vulnerability for new mothers. Therefore, the present study aimed to evaluate the impact of positive and negative early parenting interactions on a first-time mother’s mental health and her sense of competence during the postnatal period, using recently revised and newly developed Schema Therapy-informed tools. Design: This is a cross-sectional study. Method: First-time mothers (N = 220) participated in an online survey within 12 months post-birth. Participants completed the Positive Parenting Schema Inventory (PPSI), Young Parenting Inventory—Revised (YPI-R2), Edinburgh Postnatal Depression Scale (EPDS), and Parenting Sense of Competence (PSOC) scale. The data were analysed using hierarchical multiple regression and mediational analysis. Results: Negative early interactions with mothers and fathers led to greater postnatal depressive symptomology, while positive early interactions with mothers led to fewer postnatal depressive symptoms. Mediation analyses revealed that postnatal depressive symptoms mediated early parenting interactions and participants’ sense of parenting competence as a new mother. Conclusions: The protective effects of positive early interactions with caregivers can help first-time mothers’ postnatal emotional adjustment and their sense of competence through diminished postnatal depressive symptoms. However, the enduring effects of negative early interactions with caregivers can contribute to a first-time mother’s risk of developing postnatal depression and negatively affect her sense of parental competence.

IntroductionEvidence shows that an expanded range of contraceptive methods, client-centered comprehensive counseling, and voluntary informed choice are key components of successful family planning programs. This study assessed the effect of the Momentum project on contraceptive choice among first-time mothers (FTMs) age 15-24 who were six-months pregnant at baseline in Kinshasa, Democratic Republic of the Congo, and socioeconomic determinants of the use of long-acting reversible contraception (LARC).MethodsThe study employed a quasi-experimental design, with three intervention health zones and three comparison health zones. Trained nursing students followed FTMs for 16 months and conducted monthly group education sessions and home visits consisting of counseling and provision of a range of contraceptive methods and referrals. Data were collected in 2018 and 2020 through interviewer-administered questionnaires. The effect of the project on contraceptive choice was estimated using intention-to-treat and dose-response analyses, with inverse probability weighting among 761 modern contraceptive users. Logistic regression analysis was used to examine predictors of LARC use.ResultsProject effect was detected on receipt of family planning counseling, obtaining the current contraceptive method from a community-based health worker, informed choice, and current use of implants vs. other modern methods. There were significant dose-response associations of the level of exposure to Momentum interventions and the number of home visits with four of five outcomes. Positive predictors of LARC use included exposure to Momentum interventions, receipt of prenatal counseling on both birth spacing and family planning (age 15-19), and knowledge of LARCs (age 20-24). The FTM's perceived ability to ask her husband/male partner to use a condom was a negative predictor of LARC use.DiscussionGiven limited resources, expanding community-based contraceptive counseling and distribution through trained nursing students may expand family planning access and informed choice among first-time mothers.

Background: Experiencing childbirth as traumatic is common and can have long-lasting negative consequences for women's mental health. However, fostering a sense of social identity has been shown to protect psychological wellbeing and mental health during life transitions, such as entering parenthood. This study therefore investigated the relationship between traumatic childbirth and first-time mothers' social identity and their psychological wellbeing, and more specifically whether strength of identity as a first-time mother protected psychological wellbeing following traumatic childbirth. Method: Women over the age of 18 who were living in the UK and had given birth to their first child in the past nine months were recruited to the study from clinical and community settings. They completed digital self-report questionnaires about their birth experience, social identity, mental health, and psychological wellbeing. Women who perceived themselves to have had a traumatic birth (the trauma group; N = 84) were compared to women who did not perceive themselves to have had a traumatic birth (the control group, N = 39). T-tests and chi square tests assessed preliminary group differences before multivariate analyses of covariance controlled for covariates. Post-hoc tests identified the direction of differences. Multiple regression and moderation analyses analysed interaction effects. Results: The trauma group had significantly lower psychological wellbeing (mean = 41.5, 95% CI [39.4–43.7], p =.008, partial η2 = 0.059), compared to the control group (mean = 48.4, 95% CI [45.3–51.5]), but the two groups did not differ in the strength of their first-time mother identity, which was high across both groups. Strength of identity did not moderate the relationship between traumatic childbirth and psychological wellbeing. Giving birth by caesarean section independently reduced the strength of the first-time mother identity (p =.017, partial η2 = 0.049). All analyses controlled for emotional and practical support, perceptions of healthcare staff, and mode of birth. Conclusions: Having a traumatic birth was associated with lower psychological wellbeing, and the strength of first-time mother identity does not appear to moderate this relationship. Factors such as mode of birth may be more important. Further research, including longitudinal designs, is needed to understand the relationship between these constructs and identify more effective ways of protecting first-time mothers' mental health. [ABSTRACT FROM AUTHOR]

This study assessed depression and fatigue among first-time mothers in Japan who were less than one year postpartum and attended parenting classes. A total of 673 mothers (mean age ± standard deviation = 33.5 ± 3.98 years) participated. The mean Edinburgh Postnatal Depression Scale (EPDS) and Subjective Fatigue Symptom Scale (SFSS) scores showed multiple comparisons based on the number of months postpartum and the maternal age. Multiple regression analyses were performed using the EPDS scores as the outcome variable and the SFSS items as explanatory variables. The results showed that current age was inversely associated with the EPDS score (β = −.185, p <.0001) and three fatigue-related variables were positively associated with the EPDS score: lower back pain (β =.201, p =.0014), eyestrain (β =.338, p =.0108), and hand/finger pain (β =.508, p =.0261). The explanatory variable accounting for the largest amount of variance in the postpartum depression scores was lower back pain. Regarding parenting support activities provided by local public agencies, it is important to implement initiatives to promote the mental and physical health of postpartum mothers by partnering with various specialist organizations. The study findings are significant as they reveal, from a fact-finding survey, the inadequacy of support toward mothers after two months postpartum. [ABSTRACT FROM AUTHOR]

Interest in exploring women's new experiences as they step into motherhood and their information behaviour has increased over the last decade. However, little attention has been given to vulnerable first-time mothers, specifically those with visual impairment. This study aims to provide an insight into the information needs of first-time mothers with visual impairments as they embrace motherhood. A case study design was employed to capture the information experiences of first-time mothers with visual impairment during their first year of motherhood. Three data collection techniques were employed, namely interviews, observations and audio diary, that provided rich and deep insights into the experiences of these mothers. The codes-to-theory model for qualitative inquiry resulted in identifying five main facets of information needs, namely baby care, mother care, family welfare, daily living and disability rights. Wilson's model of information behavior is used to provide an understanding of how these mothers' personal factors, role demands and environmental context shape their information needs as they take on the role as mothers. The findings raise implications for strategies to facilitate this vulnerable community's information provisions, specifically in the context of visually impaired mothers. [ABSTRACT FROM AUTHOR]

Objectives: Schema Therapy, an approach that integrates cognitive-behavioural and attachment principles, helps us understand the impact of early interactions with caregivers on adult mental health. These early interactions can be assessed through Schema Therapy-informed tools; however, these tools have yet to be used with a postnatal population, which represents a period of vulnerability for new mothers. Therefore, the present study aimed to evaluate the impact of positive and negative early parenting interactions on a first-time mother's mental health and her sense of competence during the postnatal period, using recently revised and newly developed Schema Therapy-informed tools. Design: This is a cross-sectional study. Method: First-time mothers (N = 220) participated in an online survey within 12 months post-birth. Participants completed the Positive Parenting Schema Inventory (PPSI), Young Parenting Inventory—Revised (YPI-R2), Edinburgh Postnatal Depression Scale (EPDS), and Parenting Sense of Competence (PSOC) scale. The data were analysed using hierarchical multiple regression and mediational analysis. Results: Negative early interactions with mothers and fathers led to greater postnatal depressive symptomology, while positive early interactions with mothers led to fewer postnatal depressive symptoms. Mediation analyses revealed that postnatal depressive symptoms mediated early parenting interactions and participants' sense of parenting competence as a new mother. Conclusions: The protective effects of positive early interactions with caregivers can help first-time mothers' postnatal emotional adjustment and their sense of competence through diminished postnatal depressive symptoms. However, the enduring effects of negative early interactions with caregivers can contribute to a first-time mother's risk of developing postnatal depression and negatively affect her sense of parental competence. [ABSTRACT FROM AUTHOR]

Abstract Background First-time motherhood is characterized by high psychosocial distress, which untreated, has serious consequences. Informal social support provided by specially trained mentors may be protective against postpartum depressive symptoms but may vary by women’s social relationship with the mentor. The objective of this study was to evaluate the association of types of mentors on women’s depressive symptoms between late pregnancy to 6-months postpartum and the characteristics of women associated with mentor type. Methods This study was a secondary analysis of data from a community sample of 312 primiparous women from a single-group, longitudinal intervention study of Welcome to Parenthood. Welcome to Parenthood provided education and mentorship for women during the transition from pregnancy to postpartum. Women completed the Edinburgh Postnatal Depression Scale (EPDS) in late pregnancy, and 2- and 6-months postpartum. Results Women who recently relocated were less likely to be mentored by their mothers and more likely to be mentored by friends or volunteers. Women who were mentored by their mothers or sisters scored the lowest on the EPDS; those mentored by their mothers-in-law scored the highest. Women who were mentored by other family, friends, or volunteers scored between the two extremes. EPDS scores of women mentored by each type of mentor decreased from pregnancy to 6-months postpartum; only for mother-, sister-, and volunteer-mentored groups was this decrease significant. Conclusions During transition to parenthood, support provided by mothers or sisters is best for women’s mental health but may not always be available to women who have recently relocated. In such situations, specially trained community volunteers may be the second-best option.

This study examined the association between prenatal role overload and maternal responsiveness, with postnatal depressive symptoms as a mediator. Participants were 127 first-time mothers in Hong Kong (M = 32.8, SD = 4.0). Participants completed data collection for self-report on prenatal role overload (Time 1) in the third trimester of pregnancy, postnatal depressive symptoms (Time 2) at 4-month postpartum and maternal responsiveness (Time 3) at 9-month postpartum. The hypothesised mediation model was tested with the Hayes PROCESS macro (model 4). Time 1 prenatal role overload was not directly predictive of later responsiveness (B = −0.06, p =.270). However, the indirect effect of Time 2 postnatal depressive symptoms in the association between Time 1 prenatal role overload and Time 3 responsiveness was significant (unstandardised effect = −0.03, 95% Bootstrapping CI = [−0.081, −0.001]; standardised effect = −0.06, 95% Bootstrapping CI = [−0.152, −0.002]). Findings highlighted that more attention is required to the support provided to first-time expectant mothers to prevent role overload, and that intervention for postnatal depressive symptoms may focus on role overload. The findings also highlighted that postnatal depressive symptoms could be a promising way to increase maternal responsiveness. [ABSTRACT FROM AUTHOR]

Background/Aims: Assessing maternal satisfaction with care improves healthcare professionals' understanding of women's needs at maternal healthcare services and can encourage future use of hospital-based intrapartum care. This study's aim was to explore predictors of maternal satisfaction with their childbirth experience at health facilities in Phalombe District, Malawi. Methods: A cross-sectional study was conducted with 254 first-time mothers, recruited using systematic random sampling. Data were collected using questionnaires and analysed using bivariate and multivariate analyses to determine predictors of maternal satisfaction. Results: Only half (49.2%) of participants were satisfied with their childbirth experience. Welcoming and encouraging doctors/midwives (P<0.001) and being kept informed during labour (P=0.001) were the main predictors of maternal satisfaction. Conclusions: Maternal satisfaction is impacted by a woman's relationship with her care providers and the information imparted during care. To improve maternal satisfaction with care at the study site, there is a need for healthcare providers to improve their interpersonal relationships with labouring women and provide adequate information during care. [ABSTRACT FROM AUTHOR]

There is seemingly no clear path to obtain the relevant information during postpartum as there is limited understanding of the information-seeking behaviour of postpartum women in recent times and difficulty in getting adequate healthcare information in sub-Saharan Africa. In Ghana, numerous studies exist on information needs and information-seeking behaviour in the health sector, but none emphasized both the health information needs and information-seeking behaviour of postpartum women.

Despite the challenges associated with motherhood, studies have not consistently identified factors contributing to first-time mothers’ dissatisfaction with motherhood in resource-limited regions. To fill this research gap, this study investigates how adverse childhood experiences (ACEs) result in first-time mothers’ dissatisfaction with motherhood through emotional distress in Nigeria. Results from the partial least square structural equation model suggests that ACEs are associated with dissatisfaction with motherhood ( $ \beta $ = 0.092; p

This study examines the association between posttraumatic growth (PTG) and two psychological attributes, resilience and optimism, in first‐time mothers, after controlling for demographic and motherhood‐related characteristics. PTG, the self‐examination triggered by life‐changing events, contains five factors: (1) relating to others, (2) new possibilities, (3) personal strength, (4) spiritual change, and (5) appreciation of life. Outcomes from studies conflict on whether PTG is associated with the two psychological attributes of resilience (the ability to resume one's life after adversity) and optimism (viewing life in a positive light). This study used a cross‐sectional design. A convenience sample of first‐time mothers whose infants were between 3 months and 1 year (N = 415) completed questionnaires containing several standardized and reliable instruments including those measuring the independent variables of resilience and optimism, and the dependent variable of PTG. A STROBE checklist guided the reporting of this study. Resilience was associated with overall PTG and four of its five factors. Optimism also was associated with overall PTG but only associated with two of its five factors. PTG profiles and squared semipartial correlations indicated that resilience had the stronger association, compared to optimism, with PTG and most of its factors. Our study's findings on the strong link between resilience and PTG suggest the need for research examining the impact of specific psychosocial nursing activities (e.g., providing emotional support; assisting others to identify their own strengths; encouraging the mobilization of one's internal resources; furnishing needed resources and referrals; and supplying health education and information), as these activities may not only promote resilience but also may contribute to PTG. Patient or Public Contribution: First‐time mothers responded to online questionnaires, otherwise there was no patient or public contribution. [ABSTRACT FROM AUTHOR]

First-time mothers often lack effective breastfeeding techniques and may perceive they have insufficient milk due to inadequate experience in breastfeeding. There are limited programs for enhancing effective breastfeeding and perceived sufficient milk among first-time mothers in Thailand. This randomized controlled trial study investigated the effects of the Breastfeeding Self-Efficacy and Family Support Enhancement Program on effective breastfeeding and perceived sufficient milk among first-time mothers. The participants included 64 pairs of first-time mothers with normal labor and their family members. They were recruited from an antenatal clinic in a province of Thailand and randomly assigned to the experimental arm (n = 32) to receive the program in addition to standard care or the control arm (n = 32) to receive only standard care. Data were collected using the Demographic and Obstetric Data Questionnaires, the Bristol Breastfeeding Assessment Tool, H&H Lactation Scale for firsttime mothers, and a demographic data questionnaire for family members. Data analysis was performed with descriptive statistics, Chi-square test, and two-way mixed ANOVA. The results indicated that, after receiving the program, the mean scores on effective breastfeeding and perceived sufficient milk at days 3, 10, and 28 postpartum in the experiment group were significantly higher than before receiving the program and significantly higher than that of the control group. Nurses can integrate this program to train family members to support first-time mothers in breastfeeding continuously and increase first-time mothers' confidence in their ability to breastfeed effectively and perceive milk sufficiency. However, further testing of the program effectiveness is warranted. [ABSTRACT FROM AUTHOR]

Postpartum depression among first-time mothers is a sensitive issue and few studies were conducted related to this topic in developing countries including Jordan. Thus, this study purposed to assess postpartum depression levels and associated factors among Jordanian first-time mothers. A cross-sectional design was adopted, and 193 postpartum first-time mothers living in Amman governorate were recruited. A questionnaire consisting of two parts was used to record data, sociodemographic and maternal health, and Patient Health Questionnaire (PHQ-9). Findings showed that 34.1% of the women experienced postpartum depression. The employment, gravida, antenatal health problems, breastfeeding problems, newborn health problems, and availability of assistance during the postpartum period significantly correlated with postpartum depression. Thus, the understanding of postpartum depression and related factors would provide important empirical evidence for healthcare professionals and policy-makers when planning to develop strategies and measures to minimize postpartum depression among first-time mothers. [ABSTRACT FROM AUTHOR]

Abstract Background Teenagers have higher risks for complications during the intrapartum and postpartum periods. Although facility-based postpartum care focusses on preventing complications in mothers and babies, it is not understood what teenage-mothers’ perceptions are about their health care needs in the early postpartum period. Methods An exploratory descriptive qualitative study was conducted in four health facilities in Uganda. In-depth interviews with 42 first-time teenage mothers aged 14 to 19 years were conducted between March and April 2020. Thematic analysis was done. Results Two themes emerged, Health promotion and Rehabilitation and counseling. Teenage first time mothers desired to receive information about key issues like self and newborn care, breast feeding, immunization and family planning. They noted that health workers need to monitor their vital signs which aids in early diagnosis of complications, disease prevention/treatment of current conditions. Others felt that health workers are key in arbitrating between them and their estranged parents and also help to link them to community based organizations that can provide them with counseling and life skills. Conclusions Teenage first-time mothers have many health care needs during the immediate and early postpartum period. This is a missed opportunity to provide health education and link them to sexual reproductive health services including family planning, breastfeeding clinics and other community based programs which provide life skills or continuing education for girls. Focusing on these needs and integration of services is key in providing holistic care to the teenagers. We propose that further research be done to explore how their health care needs change at 6 months post-delivery.

Almost all babies are breastfed in Papua New Guinea (PNG); yet appropriate breastfeeding practices are not always followed. To explore the perspectives of first-time mothers in rural PNG on how the language and discourse of grandmothers about infant feeding influence their breastfeeding practices. A critical discourse analysis (CDA) approach was used to theoretically frame the analysis of twenty first-time mothers' narratives. Analysis revealed three themes: (i) prescribed knowledge repository, (ii) social control and dominance, and (iii) disapproval and role conflict, which provides an understanding of grandmothers' differing views and positions on infant feeding practices and their influence on breastfeeding. This study shows that grandmothers remain influential in infant feeding practices in rural PNG. There appears to be a societal expectation that empowers grandmothers in the maternal decision-making processes regarding breastfeeding practice. Grandmothers' influence includes the early introduction of complementary foods to infants less than six months old. Interventions aimed at promoting, protecting, and supporting breastfeeding need to include grandmothers. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the effectiveness of a childbirth education program on self-efficacy and state anxiety among first-time Jordanian mothers. Methods: A randomized controlled trial was conducted using pretest/posttest design with 128 low-risk, first-time Jordanian mothers. The experimental group (N = 64) received a childbirth education program, while those in the control group (N = 64) received standard care in antenatal clinics. Data were collected at two different time points: at recruitment and 3 weeks after attending the program. Results: The mean score of the experimental group on outcome expectancy (posttest) (139.91, SD = 15.586) was significantly higher than that of the control group (110.16, SD = 28.33) (F = 72.356, P =.003, partial Eta squared =.37). On the efficacy expectancy, the mean score of the experimental group (133.33, SD = 16.246) was also higher than that of the control group (92.06, SD = 27.07) (F = 144.282, P =.000, partial eta squared =.54). On the state anxiety scale, the mean score of the experimental group was significantly lower than that of the experimental group (F = 89.715, P =.002, partial eta squared =.42). Conclusion: The childbirth education program improved the coping ability of mothers during childbirth and decreased their state of anxiety. [ABSTRACT FROM AUTHOR]

In this autoethnographic article, I discuss the consequences of being exposed to two competing breastfeeding discourses during my first mothering experience—the “self-regulated dyad” and the “externally regulated dyad” discourse. The former represents the ideal scenario and the evidence-based practices recommended by the World Health Organization (i.e., breastfeeding on demand, internally regulated by the dyad). The externally regulated discourse refers to the standardized health interventions that take over when difficulties arise (e.g., weight gain deviations and latching issues). Building on Kugelmann's critique about our blind reliance on “standardized health,” existing evidence, and my breastfeeding journey, I argue that unqualified and unindividualized breastfeeding interventions are highly counterproductive. To illustrate these points, I discuss the implications of the polarized interpretation of pain and the limited dyadically focused support. I then move on to analyze how ambivalent social positioning around breastfeeding impacts our experience. In particular, I found that I was highly regarded as a “good, responsible mum” up till my baby was 6 months, and how breastfeeding became increasingly challenged by others when my daughter was approaching her first birthday. Here, I discuss how performing attachment mothering identity work allowed me to navigate these challenges. Against this backdrop, I reflect upon feminist ambivalent positionings on breastfeeding and the complexity of balancing the promotion of women's hard-earned rights while supporting them to engage in whatever baby-feeding choice they feel appropriate. I conclude that unless we acknowledge the physical and social complexities of the process, and our healthcare systems seriously invest in allocating human resources and training them appropriately, breastfeeding rates may continue to suffer and women continue to interiorize it as their own failure.

IntroductionEvidence shows that an expanded range of contraceptive methods, client-centered comprehensive counseling, and voluntary informed choice are key components of successful family planning programs. This study assessed the effect of the Momentum project on contraceptive choice among first-time mothers (FTMs) age 15–24 who were six-months pregnant at baseline in Kinshasa, Democratic Republic of the Congo, and socioeconomic determinants of the use of long-acting reversible contraception (LARC).MethodsThe study employed a quasi-experimental design, with three intervention health zones and three comparison health zones. Trained nursing students followed FTMs for 16 months and conducted monthly group education sessions and home visits consisting of counseling and provision of a range of contraceptive methods and referrals. Data were collected in 2018 and 2020 through interviewer-administered questionnaires. The effect of the project on contraceptive choice was estimated using intention-to-treat and dose-response analyses, with inverse probability weighting among 761 modern contraceptive users. Logistic regression analysis was used to examine predictors of LARC use.ResultsProject effect was detected on receipt of family planning counseling, obtaining the current contraceptive method from a community-based health worker, informed choice, and current use of implants vs. other modern methods. There were significant dose-response associations of the level of exposure to Momentum interventions and the number of home visits with four of five outcomes. Positive predictors of LARC use included exposure to Momentum interventions, receipt of prenatal counseling on both birth spacing and family planning (age 15–19), and knowledge of LARCs (age 20–24). The FTM's perceived ability to ask her husband/male partner to use a condom was a negative predictor of LARC use.DiscussionGiven limited resources, expanding community-based contraceptive counseling and distribution through trained nursing students may expand family planning access and informed choice among first-time mothers.

Background: Teenagers have higher risks for complications during the intrapartum and postpartum periods. Although facility-based postpartum care focusses on preventing complications in mothers and babies, it is not understood what teenage-mothers' perceptions are about their health care needs in the early postpartum period.Methods: An exploratory descriptive qualitative study was conducted in four health facilities in Uganda. In-depth interviews with 42 first-time teenage mothers aged 14 to 19 years were conducted between March and April 2020. Thematic analysis was done.Results: Two themes emerged, Health promotion and Rehabilitation and counseling. Teenage first time mothers desired to receive information about key issues like self and newborn care, breast feeding, immunization and family planning. They noted that health workers need to monitor their vital signs which aids in early diagnosis of complications, disease prevention/treatment of current conditions. Others felt that health workers are key in arbitrating between them and their estranged parents and also help to link them to community based organizations that can provide them with counseling and life skills.Conclusions: Teenage first-time mothers have many health care needs during the immediate and early postpartum period. This is a missed opportunity to provide health education and link them to sexual reproductive health services including family planning, breastfeeding clinics and other community based programs which provide life skills or continuing education for girls. Focusing on these needs and integration of services is key in providing holistic care to the teenagers. We propose that further research be done to explore how their health care needs change at 6 months post-delivery. [ABSTRACT FROM AUTHOR]

Background/Aims: Danger signs are indicators of complications easily recognised by non-clinical personnel that may occur during pregnancy, childbirth or in the postpartum period. Some maternal deaths can be attributed to a lack of information about postnatal danger signs. Most studies on knowledge of danger signs have investigated groups of participants with mixed parities, meaning there is limited research on knowledge among first-time mothers. The aim of this study was to determine first-time mothers' knowledge of postnatal danger signs and associated factors in Uganda. Methods: This was a cross-sectional study that recruited 358 primigravidas. Data on knowledge of postnatal danger signs and the participants' obstetric and sociodemographic factors were collected through interviewer-administered questionnaires. A multivariable logistic regression model was used to determine factors associated with knowledge of postnatal danger signs. Results: Of the 358 participants, 63.4% could name at least one postnatal danger sign. Factors associated with knowledge of postnatal danger signs were having secondary or tertiary education (P=0.002), attending more than four antenatal care visits (P<0.001) and having access to information platforms (P<0.001). Conclusions: There is insufficient knowledge of postnatal danger signs among first-time mothers at Tororo General Hospital. First-time mothers require health education as they lack experience and knowledge of danger signs. The use of media sources to convey health information should be strengthened in the healthcare system. [ABSTRACT FROM AUTHOR]

Within South Africa, approximately 1.5 million children suffer from malnutrition and stunting with dire effects on their early development and thriving potential. Nutritional care within the first 1000 days of children's life plays pivotal role in their holistic development when a stable, safe, nurturing and responsive relationship is provided by their mothers. This study explored first-time mothers' understanding and experiences of nutrition within the first 1000 days of their child's life. A total of 12 first-time mothers with infants aged 4–21 months living in low-income communities in Cape Town completed semi-structured interviews. A thematic analysis suggested that mothers generally acknowledged nutrition as crucial for the development of young children; however, many were unfamiliar with the phrase 'first 1000 days'. The findings provide contextual grounding for the gap in knowledge and awareness of the first 1000 days within South African low-income communities. [ABSTRACT FROM AUTHOR]

Mothers' social integration with other mothers in the same residential area has been shown to be beneficial for their health and well‐being. The socio‐psychological resources afforded by other mothers aid the transition to motherhood. However, much less is known about the processes whereby mothers integrate with other local mothers. Therefore, we analysed first‐time mothers' experiences of social integration with other mothers in the same neighbourhood. Through three waves of semi‐structured interviews, we followed eight Finnish first‐time mothers' everyday lives for a year. The narrative analysis of these longitudinal interviews revealed three story types – social integration, social exclusion and social disconnection – that depicted mothers' different experiences of integration with other local mothers. The perceived similarity of experiences, goals and interests related to motherhood enhanced the development of a shared sense of identity and supported integration with other local mothers. We discuss our findings in relation to the social identity model of identity change (SIMIC). [ABSTRACT FROM AUTHOR]

BACKGROUND: Psychological issues usually accompany the pregnancy of first-time mothers, and psychoeducational interventions might be effective in addressing these concerns and preparing first-time mothers for childbirth and the postnatal period. OBJECTIVE: This study aimed to identify, analyze, and synthesize the components and determine the effectiveness of psychoeducational interventions that are used for managing psychological issues and enhancing birth preparedness among primigravid women or couples in low- and middle-income countries. STUDY DESIGN: A systematic search of 12 databases (APA PsycINFO, EmCare, Embase, MEDLINE(R), Ovid Nursing, British Nursing Index, Health & Medical Collection, ProQuest, CINAHL, Cochrane, Hinari, and PubMed) was conducted to identify relevant studies published between 1946 and October 2021. The quality of the included studies was appraised by the Joanna and Briggs Institute critical appraisal tool, and a narrative synthesis was performed to analyze data extracted from included articles. The systematic review protocol is registered with the International Prospective Register of Systematic Reviews (registration number: CRD42021237896). RESULTS: The initial search yielded 8658 articles. Of note, 16 articles, including 7 randomized controlled trials and 9 nonrandomized trials, met the inclusion criteria and were selected and reviewed for quality. In addition, 31 outcomes were measured in the studies, including psychological outcomes, birth preparedness outcomes, and other outcomes. The design of the interventions included antenatal education that was delivered through lectures, role plays, trainings, and antenatal counseling. All the psychoeducational interventions had a significant effect (P

The adjustment process to becoming a mother is affected by culture. However, earlier studies have not clarified the relationship between parenting stress, social support, and maternal confidence in non-Western women. This study examined the associations between different types and sources of social support, maternal confidence, and parenting stress experienced by first-time mothers. The sample consisted of first-time mothers with a child under one year of age in northern Taiwan, and a total of 205 valid questionnaires were collected. The results supported the stress-buffering hypothesis, which suggests that social support reduces the adverse effect of stress on maternal confidence. Although previous studies have suggested that spouses and maternal relatives are critical in supporting first-time mothers' transition into their new roles, each source did not show a mediator effect in our study. The beneficial effect of social support was found only when all social network members collectively participated. Regarding the types of social support, only appraisal support had a significant mediator effect; no effect was found for emotional, instrumental, or informational support. These findings add to our understanding of how different types and sources of social support play a role in helping first-time mothers adapt. [ABSTRACT FROM AUTHOR]

Background: Global recommendations suggest mothers provide the first complementary food to infants when they reach six months of age. Failure to introduce complementary foods promptly may put infants in adverse health and nutrition outcomes. Objective: This study aimed to analyze factors associated with inappropriate timing of complementary foods introduction in Kebumen Regency. Methods: This study used a cross-sectional design. A multistage cluster sampling was employed to select 355 mothers of children aged 6-23 months in Kebumen Regency. Our dependent variable was the timing of complementary food introduction. Meanwhile, independents variables included factors at the child, parental, and household levels. Univariate and multiple logistic regressions were performed in this study. Results: There was 39.15% of young children received inappropriate timing of complementary feeding. Being the second-born child or above (OR=0.56; 95%CI: 0.33-0.95) and coming from high-income households (OR= 0.57; 95%CI: 0.36-0.90) were protective factors of inappropriate timing of complementary foods introduction. Other variables such as maternal age, maternal education, maternal occupation, father’s education, and family support were not significantly associated with incorrect timing of complementary feeding. Conclusions: The proportion of inappropriate timing of complementary foods introduction in Kebumen Regency is alarming and is mainly explained by child’s birth rank and household economic status suggesting the importance of targeting nutritional education to first-time mothers as well as poor households.

Exclusive breastfeeding confers multiple maternal and child health benefits. Although breastfeeding initiation following birth is common in Papua New Guinea, many first-time mothers may not achieve optimal breastfeeding duration. This study aims to explore and describe factors influencing early weaning and breastfeeding duration among first-time mothers in Papua New Guinea's rural eastern highlands. A qualitative descriptive approach was adopted in this study. Data were collected through semi-structured in-depth interviews with 20 first-time mothers. The interviews transcripts were then thematically analysed. Three key themes identified were: source of breastfeeding information and support; social networks and breastfeeding communication; and balancing perceived gender and maternal roles. The study further identified a lack of fathers' involvement in supporting breastfeeding. Social and relational networks, and maternal factors need to be considered to better understand breastfeeding practices. Efforts to achieve optimal breastfeeding outcomes entail targeted and culturally appropriate programs, including fathers' involvement as they play important roles in breastfeeding and infant feeding practices. [ABSTRACT FROM AUTHOR]

Increases in early marriage and pregnancy resulting from Syria's humanitarian crisis highlight a critical gap in adolescents' access to life-saving sexual and reproductive health information and services, and a larger need for adolescent-specific interventions grounded in gender transformative approaches. Seeking to address this, CARE, UNFPA and Syria Relief and Development adapted global evidence-based approaches to humanitarian contexts to create the Adolescent Mothers Against all Odds (AMAL) Initiative for pregnant girls and first-time mothers aged 10 to 18 years. Designed to improve the lives of young girls through responsive health systems and enabling environments, AMAL includes three components: a Young Mothers Club for first-time mothers and pregnant girls, participatory dialogues with health providers, and reflective dialogues with girls' marital family and community members. The AMAL Initiative intends to ensure responsiveness to the unique vulnerabilities of adolescent sub-groups by co-implementing with them. Select girls undergo additional leadership training and serve as adolescent representatives on community advisory groups sharing feedback for program improvement. One hundred-four first-time mothers and pregnant girls, 219 community members, and 120 health providers participated in AMAL in northwest Syria. In a mixed methods evaluation, facilitators administered monitoring tools to identify program improvements, pre-post surveys to assess outcomes, and end-line discussions to gather perceptions of impact. Girls reported a 47% overall increase in self-esteem, confidence, health-seeking capacity, and communication ability. Community support for girls' use of family planning increased by 27% and girls' equal access to services by 35%. Findings across all participant groups demonstrate decreased expectations of early marriage and increased acceptance of family planning post-marriage. Areas that participants cited for potential improvement included programming for girls/women above the age of 18 years, and additional training for health providers on long-acting contraceptive methods. These results show that participatory adolescent-centered sexual and reproductive health programming is not only feasible in crisis settings but can improve the self-efficacy of vulnerable adolescents to overcome barriers to accessing healthcare and improving well-being. The AMAL Initiative is now being scaled up through local partners in Syria and piloted in northern Nigeria. [ABSTRACT FROM AUTHOR]

Abstract Background For optimal growth and development, the World Health Organization recommends that children be exclusively breastfed for the first 6 months of life. However, according to the nationally-representative 2013–2014 Demographic and Health Survey, under 50% of babies in the Democratic Republic of Congo are exclusively breastfed. Although breastfeeding was common in the capital city of Kinshasa, one in five newborns received alternatives to breastmilk during the first 3 days of life. This analysis aimed to identify social norms influencing exclusive breastfeeding, the role of a young first-time mother’s (FTM’s) social network for her choice to exclusively breastfeed, and perceived social sanctions associated with breastfeeding practices in Kinshasa. Methods The qualitative analysis was based on a vignette presented during 14 focus group discussions, with a purposively selected sample (n = 162) of FTMs age 15–24, and the male partners, mothers and mothers-in-law of FTMs age 15–24 in three health zones in Kinshasa in 2017. Thematic content analysis was performed to identify concepts and patterns in the participants’ discussions. Results Overall, community norms were not supportive of exclusive breastfeeding. The main barriers to exclusive breastfeeding were the belief held by most FTMs that exclusive breastfeeding was an uncommon practice; the desire to avoid negative sanctions such as name-calling and mockery for refusal to give babies water in the first 6 months of life; the desire to please key members of their social networks, specifically their mothers and friends, by doing what these influencers expected or preferred them to do; FTMs’ own lack of experience with infant feeding; and trust placed in their mothers and friends. Conclusion Social norms can be maintained by the belief about what others do, perceived expectations about what individuals ought to do, the negative sanctions they can face and their preference to conform to social expectations. Thus, addressing cultural beliefs and targeting sensitization efforts to key influencers that provide support to FTMs are needed to promote exclusive breastfeeding in Kinshasa. In doing so, strategies should address the barriers to exclusive breastfeeding including related misconceptions, and improve FTMs’ self-efficacy to overcome the influence of others.

Abstract Background Exclusive Breastfeeding (EBF), for the first 6 months of life, is globally accepted as the preferred method for infant feeding. In Ghana, an estimated 84% of children

Abstract Background Pregnancy is an important period to promote healthy behaviors, prevent and identify diseases early and treat them to maximize the health and development of both the woman and her unborn child. A new World Health Organization antenatal care model recommends the initiation of antenatal care visit within the first trimester of gestation. This study sought to examine the timing of initiation of antenatal care among first-time mothers and associated factors in rural Southern Ghana. Methods Information on gestational age, timing of antenatal care, demographic and socioeconomic status of 1076 first-time mothers who gave birth in 2011 to 2013 in the Dodowa Health and Demographic Surveillance System were included in the study. The time of initiation of antenatal clinic attendance was calculated. The associations between dependent and independent variables were explored using logistic regression at 95% confidence interval in STATA version 14.2. Results The mean gestational age at which the first-time mothers initiated antenatal care attendance was 3 month. Maternal age, level of education and household socioeconomic status were statistically significantly associated with timing of initiation of antenatal care attendance. Conclusion Although more than half of the study participants initiated ANC visit in the first trimester of pregnancy, a high proportion also started ANC attendance after the World Health Organization recommended period. Maternal age is significantly associated with timing of initiation of antenatal care visit among first-time mothers; older women were more likely to initiate antenatal care visit in the first trimester of gestation compared to the younger women.

Increases in early marriage and pregnancy resulting from Syria's humanitarian crisis highlight a critical gap in adolescents' access to life-saving sexual and reproductive health information and services, and a larger need for adolescent-specific interventions grounded in gender transformative approaches. Seeking to address this, CARE, UNFPA and Syria Relief and Development adapted global evidence-based approaches to humanitarian contexts to create the Adolescent Mothers Against all Odds (AMAL) Initiative for pregnant girls and first-time mothers aged 10 to 18 years. Designed to improve the lives of young girls through responsive health systems and enabling environments, AMAL includes three components: a Young Mothers Club for first-time mothers and pregnant girls, participatory dialogues with health providers, and reflective dialogues with girls' marital family and community members. The AMAL Initiative intends to ensure responsiveness to the unique vulnerabilities of adolescent sub-groups by co-implementing with them. Select girls undergo additional leadership training and serve as adolescent representatives on community advisory groups sharing feedback for program improvement. One hundred-four first-time mothers and pregnant girls, 219 community members, and 120 health providers participated in AMAL in northwest Syria. In a mixed methods evaluation, facilitators administered monitoring tools to identify program improvements, pre-post surveys to assess outcomes, and end-line discussions to gather perceptions of impact. Girls reported a 47% overall increase in self-esteem, confidence, health-seeking capacity, and communication ability. Community support for girls' use of family planning increased by 27% and girls' equal access to services by 35%. Findings across all participant groups demonstrate decreased expectations of early marriage and increased acceptance of family planning post-marriage. Areas that participants cited for potential improvement included programming for girls/women above the age of 18 years, and additional training for health providers on long-acting contraceptive methods. These results show that participatory adolescent-centered sexual and reproductive health programming is not only feasible in crisis settings but can improve the self-efficacy of vulnerable adolescents to overcome barriers to accessing healthcare and improving well-being. The AMAL Initiative is now being scaled up through local partners in Syria and piloted in northern Nigeria.

Becoming a mother is a fundamental life-transforming event characterized by high psychosocial distress. Most prenatal programming leaves women feeling unprepared for the realities of early parenthood. The purpose of this study was to design, implement, and evaluate a brief enhancement to existing prenatal programming, Welcome to Parenthood® (W2P). Using a single-group, longitudinal design, we implemented W2P with a community sample of 454 primiparous women via 11 Parent Link Centres in Alberta, Canada. The women completed questionnaires during late pregnancy, and 2 and 6 months postpartum to capture adverse childhood experiences (ACE), depressive symptoms (Edinburgh Postpartum Depression Scale; EPDS), and infant development (Ages and Stages Questionnaires; ASQs). Outcomes were compared with the naturalistic values from All Our Families community cohort from the same province and to the ASQ reference samples. By the end of W2P, depressive symptoms decreased significantly (p <.0001). The number of women with high depressive symptoms (EPDS ≥ 10) decreased almost by half, from 80 (17.6%) at enrollment to 41 (9.0%) at 6 months postpartum. Women with higher ACE had the greatest decrease in depressive symptoms. Infants in W2P had significantly better development than infants in reference samples. W2P is associated with improved maternal mood and infant development. Given that W2P is brief and uses natural supports, it may be integrated into existing prenatal programming for first-time mothers. [ABSTRACT FROM AUTHOR]

Parity modulates the way in which women respond to infant's affective cues. It is known that the cognitive processing of mothers is affected by a baby crying; however, little information is available regarding the effect of reproductive and caregiving experience on efficiency in managing babies' emotional stimuli while other tasks are being attended. This study characterized the affective score, cognitive performance, and electroencephalographic correlation (rEEG) between prefrontal and parietal cortices in first- (FM) and second-time mothers (SM) while solving a working memory task (vsWM) and simultaneously listening to either an emotional or neutral distractor stimulus. During the vsWM-baby crying condition, both groups reported higher arousal. However, SM reported a lower valence and FM lower dominance. In the vsWM-baby crying condition did SM need less time to solve the cognitive task and present a decreased rEEG between prefrontal areas, and between left prefrontal and parietal areas, though an increased rEEG between parietal areas was observed while listening to both distractor stimuli during performance of the vsWM task. These degrees of cortical synchronization could constitute a cerebral mechanism required to achieve better information maintenance and enhance suppression of distractor effects, which allow the SM women to solve the vsWM task more efficiently. [ABSTRACT FROM AUTHOR]

Introduction: An association between a history of induced abortion and psychological well‐being post‐abortion has been demonstrated in recently published studies, which is contrary to the findings of existing known high‐quality studies. Material and methods: An evaluation was conducted to determine whether a history of abortion affected the psychological well‐being and parental self‐efficacy of first‐time mothers and their partners; this assessment was performed when the child was aged 18 months. Questionnaires were administered to 492 first‐time mothers, 37 of whom had a history of abortion, and their partners (n = 436). Women with previous miscarriages, ectopic pregnancies, and deliveries were excluded. The women were allocated to an abortion group or a comparison group, depending on each woman's abortion history obtained from medical birth registry data. Psychological well‐being, which encompassed social and emotional loneliness, marital satisfaction, social phobia, and depression, was evaluated as a predictor of maternal and paternal self‐efficacy within the two groups. The analysis was conducted using multi‐group structural equation modeling. Results: Induced abortion was not predictive of maternal or paternal well‐being or parental self‐efficacy. Overall, maternal and paternal psychological well‐being was predictive of parental self‐efficacy when an assessment was performed, regardless of an abortion history. After testing the invariance of multi‐group models, psychological well‐being was similarly found to predict parental self‐efficacy in both the abortion history and comparison groups. Conclusions: These findings suggest that the psychological well‐being of parents is an important predictor of maternal and paternal self‐efficacy during toddlerhood. Abortion history was not demonstrated to negatively impact the psychological well‐being of parents with respect to their capacity for parental self‐efficacy. [ABSTRACT FROM AUTHOR]

Background: Among breastfeeding determinants, the unique emotional breastfeeding experience has been poorly explored. The present study aimed to investigate the emotional breastfeeding experience in a cohort of first-time mothers.Materials and methods: We conducted a prospective observational study that enrolled primiparas having delivered singleton healthy term newborns, and exclusively breastfeeding at hospital discharge. At 3 months post-delivery mothers accessed an online questionnaire investigating their emotional breastfeeding experience. The chi-squared test was used to assess the association between the feelings experienced during breastfeeding and feeding outcomes at 3 months.Results: Out of the 421 enrolled mothers, 273 (65%) completed the questionnaire. At 3 months post-delivery exclusive breastfeeding was reported by a 66% of mothers, a 19% reported complementary feeding, and a 15% of mothers reported exclusive formula feeding. Breastfeeding experience was described as positive by 62% of mothers although breastfeeding difficulties were reported by 80% of the mothers. The mothers that had experienced fear, sadness, anger or concern during breastfeeding showed a significant higher exclusive formula feeding rate at 3 months post-delivery than those who did not (25.5 vs. 12.8%, p = 0.021; 28.6 vs. 13.4%, p = 0.02; 40 vs. 13.4%, p = 0.005; 20.5 vs. 11.8%, p = 0.049, respectively). An 85% of mothers stated that their breastfeeding experience was different from what they would have expected, blaming for this discrepancy the occurrence of difficulties during breastfeeding and the complexity of breastfeeding itself (50%), pain experience (8%), being dependent from the baby (6%), and breastfeeding failure (11%). A total of 25% of mothers, however, reported they found breastfeeding to be a much more positive experience than what they had expected.Conclusion: Breastfeeding care should include a tailored emotional support of first time-mothers in addition to the implementation of their breastfeeding knowledge and skills.

Khadeejeh Al dasoqi,1 Reema Safadi,1 Eman Badran,2 Asma Sa’d Basha,3 Sue Jordan,4 Muayyad Ahmad5 1Department of Maternal and Child Health Nursing, School of Nursing, University of Jordan, Amman, Jordan; 2Department of pediatrics, School of Medicine, University of Jordan, Amman, Jordan; 3Department of Obstetrics and Gynecology, School of Medicine, University of Jordan, Amman, Jordan; 4Department of Nursing, Swansea University, Swansea, UK; 5Clinical Nursing Department, School of Nursing, University of Jordan, Amman, Jordan Objective: This study aimed to examine the rates of initiation and continuation of breastfeeding (BF) and their relationship with mothers’ sociodemographic, obstetric, neonatal, and medical interventions.Methods: Data were collected from 199 first-time Jordanian mothers using medical records, face-to-face interviews within 24 hours of birth, and two telephone interviews at 6 weeks and 6 months after birth.Results: The rate of BF initiation within the first 4 hours after birth was only 13%. The rate of exclusive BF at 6 weeks was 25.5%, and this rate dropped to 2.1% at 6 months. Mothers who initiated BF before discharge were older, were employed, had normal vaginal birth, and had undergone antenatal or after-birth BF education. Infants’ birth weight or gender was not interrelated with BF initiation. There was no relationship between initiation and continuation of BF and use of medications for labor pain or for induction/augmentation. The only significant relationship was found between the dose of ergometrine and BF failure and painful BF at 6 weeks.Conclusion: There is a need for increasing health care providers and public awareness about the role of intrapartum medications and procedures on the initiation and continuation of BF at 6 weeks and 6 months after birth. Keywords: exclusive breastfeeding, ergometrine, obstetric procedures, intrapartum medication, Jordan

Abstract Background For first-time mothers, not knowing how to interact with newborn infants increases anxiety and decreases the quality of the parent–infant interactions. A substantial lack of interactional knowledge can ultimately limit the adjustments necessary for a stable transition into motherhood. This study investigated how postpartum parenting education influenced first-time mothers’ mother–infant interaction quality and parenting sense of competence. Methods Eighty-one healthy first-time-mother and infant dyads were recruited. The control group (n = 40) received postpartum care based on the medical and cultural norms practiced in Taiwan, while the experimental group (n = 41) received, on top of typical care, education by way of a 40-min videotape on infant states, behaviors, and communication cues, as well as a handout on play practices. Data were collected at five points: within the first week, and during follow-ups in the first, second, third, and sixth months after birth. We administered the Chinese versions of the Parenting Sense of Competence Scale and Edinburgh Perinatal Depression Scale, and used the Nursing Child Assessment Teaching Scale to score videotaped mother–infant interactions. Results We observed an increase in the quality of mother–infant interaction within the experimental group only. Furthermore, at the five assessment points, we observed no significant changes in perceived parenting competence. Among all subjects, there were correlations between postpartum depression scores, parenting competency, and quality of mother–infant interaction. Conclusions Our results indicate that first-time mothers in Taiwan who are provided with extra education on infants’ abilities and how to effectively play with infants are likely to exhibit improvements in quality of interaction.

Abstract Background The use of synthetic oxytocin for augmentation of labor is rapidly increasing worldwide. Hyper-stimulation is the most significant side effect, which may cause fetal distress and operative delivery. We performed an intervention consisting of an educational program and modified guidelines to achieve a more appropriate use of oxytocin. Methods This prospective intervention study included 431 first-time mothers at term with spontaneous onset of labor before (October 2012 to May 2013), and 664 after the intervention (April 2014 to April 2015). Our outcomes were prevalence and duration of oxytocin treatment, mode of delivery, indication for operative delivery, episiotomy, anal sphincter tears, bleeding, labor duration, pain relief and the effect of oxytocin on mode of delivery. Results After the intervention, 52.9% were diagnosed with dystocia, compared with 68.9% before (p

An antenatal/postnatal intervention involving proactive telephone support and written materials was conducted among primiparas. Four hundred women, from the Split‐Dalmatia County, Croatia, were randomized between November 2013 and December 2016 into three groups: intervention (IG), active control (ACG) and standard care (SCG). Primary outcome was exclusive breastfeeding (EBF) at 3 months. Secondary outcomes included breastfeeding difficulties, attitudes towards infant feeding, breastfeeding self‐efficacy and social support. Practice staff were blinded to group allocation. Of 400 women, 45 (11%) were lost to follow‐up, and final analyses were conducted on 129 (IG), 103 (ACG) and 123 (SCG) participants. EBF rates at 3 months were significantly higher for the IG (odds ratio [OR] 4.6, 95% confidence interval [CI], 2.7 to 8.1; EBF 81%) as well as at 6 months (OR 15.7, 95% CI, 9.1 to 27.1; EBF 64%) compared with SCG (EBF 47% at 3 months and 3% at 6 months). Higher rates were also observed for the ACG at 3 months (OR 2.2, 95% CI, 1.3 to 3.8, EBF 68%) and 6 months (OR 2.3, 95% CI, 1.4 to 3.9, EBF 16%). Participants in the IG had the highest increase in positive attitudes towards infant feeding, in comparison to baseline, and significantly higher breastfeeding self‐efficacy. Participants in SCG experienced significantly more breastfeeding difficulties, both at 3 and 6 months, in comparison to AC and IGs. Written breastfeeding materials and proactive telephone support among primiparas are an effective means of increasing breastfeeding rates, decreasing breastfeeding difficulties and improving self‐efficacy and attitudes towards infant feeding. [ABSTRACT FROM AUTHOR]