Question

what health promotions recommendations can u offer a postpartum mum..pls include references and be more in depth

Answer 1

Physical Recovery From Pregnancy and Childbirth

Assessing for normal reproductive system involution (eg, return of the uterus to nonpregnant size, complete shedding of the pregnant decidua) and the reestablishing of the nonpregnant physiology (eg, normalization of glucose metabolism, return to baseline blood pressure) is the traditional focus of the routine postpartum visit with health care providers. There is some variation among women in how long most body systems take in returning to a nonpregnant state, but for most women this will have taken place by 6 to 8 weeks postpartum. However, while most women's bodies return to what is considered nonpregnant anatomy and physiology within 2 months, results of population‐based surveys of women in the postpartum period reveal that many women have physical concerns directly related to pregnancy or childbirth at 3, 6, and even 12 months postpartum.From a health promotion perspective, successful interventions to address these health concerns would be aimed not at increasing the frequency of contacts with the health care system for all women, as has sometimes been proposed, but at helping women acquire the knowledge and skills to mobilize available resources to prevent or address health concerns, including the ability to seek care when necessary.

Individual Health‐Enhancing Skills

Four skills consistently emerge in the literature as necessary for women to successfully exercise control over their health and the health of their infants and other family members in the postpartum period: effective mobilization of social support, self‐efficacy, positive coping, and the setting of realistic expectations and goals.

Effective Mobilization of Social Support

Social support is the assistance that individuals provide and receive from others. The role of social support in health behaviors and outcomes has been studied extensively. Social support provided by close relations and professionals appears to have a positive effect on physical health and psychological well‐being; a lack of social support is associated with unhealthy behaviors such as smoking and a sedentary lifestyle. In the postpartum period, social support can be broadly divided into 2 categories: emotional support and instrumental support. Emotional support is what individuals do or say to make other individuals feel loved, supported, or encouraged. Instrumental support is when individuals provide needed material resources or assist with or complete a task for another individual. A third category of support, informational support, is sometimes mentioned in the literature. Informational support is included in the model as an external or enabling factor rather than an individual skill. In addition to the direct effects of receiving instrumental assistance with tasks, social support is also thought to impact health positively by reducing the degree to which life events are perceived as stressful by an individual and by enhancing feelings of self‐esteem and self‐efficacy. The ameliorating effect of social support on perceptions of stressful events is often referred to as a “buffering effect.”

Social support emerges as a key need of women during the postpartum period. Women express a need for both emotional and instrumental support; however, they may prioritize the need for instrumental assistance, especially during the first few postpartum weeks following the postpartum period. Throughout this time period, women report a need for assistance with infant, child, and household care so that they can complete basic tasks of self‐care such as bathing, eating, and sleeping. Assistance with cleaning and cooking are also given high priority. Women report anger, stress, and anxiety when they perceive that others are failing to meet their need for support. Particularly stressful to women appears to be a dissonance between the support she expects to receive and the amount of support she perceives to receive. This finding that the perceptions of the support received can be as important as the actual support received is consistent with findings by researchers in other fields of health. How social support is mobilized, the perception of who should provide this support, and the degree of support that is expected may vary by race and ethnicity

Women from some ethnic or racial groups may be more likely to rely on their social network for assistance in the postpartum period. These women may be more likely to feel frustrated when their social network fails to meet their needs, whereas other groups of women may be less likely to involve anyone in their social network other than their partner in the care of the infant or household, and they are also less likely to express frustration at a lack of support.

Barriers to effective mobilization of social support in the postpartum include maternal perceptions that asking for help will reflect poorly on her parenting abilities, fears of being perceived as a burden, fear of hurting people's feelings (eg, by asking for instrumental assistance different than what is being offered), and a perception that others would not be able to relate to her experience and thus not be able to offer adequate support. Helping women overcome these barriers can be a key intervention by health care providers that helps promote postpartum health.

Self‐Efficacy

In Bandura's classic definition, self‐efficacy is a person's beliefs in their ability to perform a particular behavior successfully. An expanded definition of self‐efficacy as an individual's ability to achieve goals has been proposed by others and is used here. In the postpartum period, self‐efficacy is positively related to health‐seeking behaviors and inversely related to maternal stress and depression.Self‐efficacy is also a key skill in maternal role attainment and a woman's ability to competently perform infant care and other parenting tasks that depend on her confidence in her mothering abilities. Maternal self‐efficacy is also closely linked to child development.

Direct experience with a task or similar tasks strongly influences self‐efficacy. This is reflected in findings that multiparas have a higher level of self‐efficacy than primiparas and that maternal self‐efficacy increases as the postpartum period progresses.2 While direct experience with a task has the strongest correlation with ratings of self‐efficacy, vicarious experiences (seeing others perform the task) are also associated with increased self‐efficacy.

Another important determinant of maternal self‐efficacy in the postpartum period is infant temperament. Women with infants who are difficult to soothe lose confidence in their ability to take care of their infants’ needs and are more likely to report fewer efforts to soothe their infant. This highlights an important snowball effect of self‐efficacy: when confronted with a difficult task, individuals with lower self‐efficacy will avoid or give up more easily, which in turn further decreases their self‐efficacy. Alternately, success at a task that is important or difficult enhances self‐efficacy and improves the probability that an individual will persist at a task, even when it becomes difficult.

Positive Coping

Although sometimes defined as an adaptive response by an organism to adverse circumstances, from a human behavioral perspective, coping can best be defined as an effort to manage and overcome demands or experiences that pose a challenge or a threat of harm, loss, or benefit to a person. Coping can occur in response to (reactive) or in anticipation of (proactive) demands or problems. Coping strategies can be divided into 3 broad categories: appraisal‐focused coping, problem‐focused coping, and emotion‐focused coping. Individuals can modify the way that they think about the problem/stressor, such as by redefining or accepting the stressful situation. These are appraisal‐focused strategies. Individuals can also cope by taking direct action to change the situation by reducing or eliminating the stressor. This is known as problem‐focused coping. Individuals may also purposefully change the way in which they react to a stressor, using strategies such as meditation, relaxation, or prayer. These are examples of emotion‐focused coping strategies.

Coping seems to be a highly individualized response dependent on the nature of the situation and disposition of the people involved. Women use a variety of coping strategies to deal with the stressors of the postpartum period. However, several common themes emerge regarding coping in the time following childbirth. Reaching out for social support is a positive coping strategy, particularly in the early postpartum period.35 Unfortunately, women also tend to use negative coping strategies such as avoidance or minimization to deal with issues related to their own health in the postpartum period. This is consistent with findings that many maternal health problems in the postpartum period go unaddressed.

Realistic Expectations

The development of expectations is a normal adaptive human response that helps modulate individual behavior and allow for efficient and effective interpersonal interactions. However, when expectations are based on incomplete or incorrect information and conflict with the reality of a situation, the dissonance that results can be disruptive to the individual and to relationships. Whether or not expectations are met in the postpartum period affects a woman's ability to adjust to motherhood and to other transitions following childbirth. Similarly, women who report feeling unprepared for the postpartum period may be at increased risk for postpartum depressive symptoms, physical ailments, and functional limitations.In addition, postpartum adjustment is rated as more difficult by women whose experiences are worse than what they expected. Unmet expectations regarding parenting tasks are associated with compromised ability to cope, increased maternal distress, increased marital disruption, and decreased ability to effectively mobilize social support. Previous experience with a task or a similar situation and accurate and timely information are associated with a better match between expectations and reality.Finding ways for women, particularly those expecting their first child, to practice some of the tasks of new parenthood, such as soothing a fussy infant, may help ameliorate some of the stress of this time period. Additional ways to promote the setting of realistic expectations and to support the other individual health‐enhancing skills are described later in this article.