Page 448 - Encyclopedia of Nursing Research

PReGNANCY n 415

counseling approaches for PPD in multiethnic and found two dimensions to their experi-
and multilingual women including interven- ence. The first was a sense that time is up and
tions to enhance the quality of mother–child the second was a shift in expectations from P
interaction; (c) longitudinal studies to exam- the original birth plan. Women varied from
ine the course of maternal depression over welcoming the end of pregnancy to feeling
time using various combinations of counsel- that their body or baby was not ready for birth
ing and follow-up, that is, home visits, pediat- (Gatward et al., 2010). Women in this study
ric encounters, and virtual Internet settings; also identified a lack of meaningful informa-
(d) family research to explore consequences tion related to the process of labor induction.
of PPD on family health and test family- Induction-related worries included concern
oriented interventions; and (e) cross-cultural for both the baby’s and mother’s health and
studies and inclusion of diverse samples to the loss of a natural birth.
document prevalence rates, discern both risk McGrath and Ray-Barruel (2009) exam-
and protective factors, and test innovative ined mothers’ experience with the decision-
culturally relevant interventions. making process regarding subsequent birth
choice when the previous birth was a cesar-
Linda J. Mayberry ean section. The mothers in the study who
June Andrews Horowitz opted for another (elective) cesarean chose it
because of fear and the desire to retain some
control over the birth process. Women made
this decision before or very early in their
PregnanCy pregnancy and did not present themselves as
being open to considering other options.
Stark and Miller (2009) investigated
Nurse researchers continue to be active in barriers nurses face to using hydrotherapy
conducting research related to pregnancy for women experiencing labor pain. Nurses
and its effects on the mother, newborn, fam- perceived institutional factors as significant
ily, and society at large. Some of the most barriers. Individual characteristics of the
recent “hot topics” in pregnancy research nurse (e.g., age, education, and role) were not
include vaginal birth after cesarean section found to be barriers. Nurses in the study who
(vBAC), elective induction of labor and cesar- reported higher rates of epidural anesthe-
ean section “on demand,” pain management, sia and cesarean births at their facility also
outcomes, pregnancy after previous loss, reported more barriers. The perception of
mental health during the childbearing cycle, institutional barriers was seen across differ-
and effects of obesity epidemic on pregnancy ent types of facilities that provided different
weight gain, postpartum weight loss, and levels of maternity services. Nurses reported
outcomes for mothers and infants. fewer barriers in facilities where nurse mid-
Nurse researchers have investigated wives did the majority of deliveries.
women’s experiences with vBAC, hospital Outcomes of pregnancy have been
policies related to vBAC, and cost analyses addressed by nurse researchers in many for-
of the different delivery methods. Nurses mats. lefebvre et al. (2010) examined women’s
have also examined maternal and neonatal perceptions of an integrated model of sub-
outcomes after vBAC when compared with stance abuse treatment during pregnancy.
repeat cesarean section and how to best pre- Women described feeling more comfortable
pare women for the experience. with treatment teams that shared a consis-
Gatward, Simpson, Woodhart, and tent nonjudgmental attitude. Themes that
Stainton (2010) studied women’s perception of emerged from these focus groups included
having labor induced for postdate pregnancy judgment, physician patient communication,