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Parent‐identified gaps in preparation for the postpartum period in the United States: An integrative review
Birth: Issues in Perinatal Care ( IF 2.8 ) Pub Date : 2024-05-27 , DOI: 10.1111/birt.12832 Danielle N Nazarenko 1 , Ariel L Daniel 1 , Stephanie Durfee 1 , Kafuli Agbemenu 1
Birth: Issues in Perinatal Care ( IF 2.8 ) Pub Date : 2024-05-27 , DOI: 10.1111/birt.12832 Danielle N Nazarenko 1 , Ariel L Daniel 1 , Stephanie Durfee 1 , Kafuli Agbemenu 1
Affiliation
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BackgroundIn the United States, 35% of all pregnancy‐related deaths occur between 24 h and 6 weeks after delivery, yet the first outpatient visit is not typically scheduled until 6 weeks postpartum. Thus, the ability to independently navigate this period is critical to maternal well‐being and safety. However, previous research suggests that many women feel unprepared to manage the challenges they encounter during this time, and there is a current need to synthesize the existing evidence. Therefore, the purpose of this integrative review is to describe parent‐identified gaps in preparation for the postpartum period in the United States.MethodsUsing the Integrative Review framework by Whittemore and Knafl, a systematic search of Medline, CINAHL, PsychInfo, Web of Science, and a hand‐search was conducted for peer‐reviewed articles published in English between 1995 and 2023. Results were reported according to PRISMA 2020 guidelines. Studies that met eligibility criteria were synthesized in a literature matrix.ResultsTwenty‐two studies met inclusion criteria. Four themes were identified: Mental Health Concerns, Physical Concerns, Infant Feeding and Care Concerns, and General Concerns and Recommendations. Many women, regardless of parity, reported feeling unprepared for numerous postpartum experiences, including depression, anxiety, physical recovery, breastfeeding, and infant care. Parents reported difficulty differentiating normal postpartum symptoms from complications. Hospital discharge teaching was viewed as simultaneously overwhelming and inadequate. Parent recommendations included the need for earlier and more comprehensive postpartum preparation during pregnancy, delivered in multiple formats and settings. Parents also reported the need for earlier postpartum visits and improved outpatient support.ConclusionsOur findings indicate that many parents in the United States feel unprepared to navigate a wide variety of emotional, physical, breastfeeding, and infant‐care experiences. Future research should explore innovative educational approaches to postpartum preparation during pregnancy as well as outpatient programs to bridge the current gaps in postpartum care.
中文翻译：
美国父母发现的产后期准备方面的差距：综合审查
背景在美国，35% 的妊娠相关死亡发生在产后 24 小时至 6 周之间，但第一次门诊通常要到产后 6 周才会安排。因此，独立度过这一时期的能力对于孕产妇的健康和安全至关重要。然而，之前的研究表明，许多女性感觉没有准备好应对这段时间遇到的挑战，目前有必要综合现有证据。因此，本综合审查的目的是描述美国父母在为产后准备方面确定的差距。方法使用 Whittemore 和 Knafl 的综合审查框架，对 Medline、CINAHL、PsychInfo、Web of Science、对 1995 年至 2023 年间以英文发表的同行评审文章进行了手工检索。结果根据 PRISMA 2020 指南报告。符合资格标准的研究被合成在文献矩阵中。结果 22 项研究符合纳入标准。确定了四个主题：心理健康问题、身体问题、婴儿喂养和护理问题以及一般问题和建议。许多女性，无论胎次如何，都表示对许多产后经历感到措手不及，包括抑郁、焦虑、身体恢复、母乳喂养和婴儿护理。父母报告说很难区分正常的产后症状和并发症。出院教学被认为既压倒性又不充分。家长的建议包括需要在怀孕期间以多种形式和环境进行更早、更全面的产后准备。 父母还报告需要更早的产后就诊和改善门诊支持。结论我们的研究结果表明，美国的许多父母感觉没有准备好应对各种情感、身体、母乳喂养和婴儿护理经历。未来的研究应探索怀孕期间产后准备的创新教育方法以及门诊项目，以弥补目前产后护理方面的差距。
更新日期：2024-05-27
中文翻译：
美国父母发现的产后期准备方面的差距：综合审查
背景在美国，35% 的妊娠相关死亡发生在产后 24 小时至 6 周之间，但第一次门诊通常要到产后 6 周才会安排。因此，独立度过这一时期的能力对于孕产妇的健康和安全至关重要。然而，之前的研究表明，许多女性感觉没有准备好应对这段时间遇到的挑战，目前有必要综合现有证据。因此，本综合审查的目的是描述美国父母在为产后准备方面确定的差距。方法使用 Whittemore 和 Knafl 的综合审查框架，对 Medline、CINAHL、PsychInfo、Web of Science、对 1995 年至 2023 年间以英文发表的同行评审文章进行了手工检索。结果根据 PRISMA 2020 指南报告。符合资格标准的研究被合成在文献矩阵中。结果 22 项研究符合纳入标准。确定了四个主题：心理健康问题、身体问题、婴儿喂养和护理问题以及一般问题和建议。许多女性，无论胎次如何，都表示对许多产后经历感到措手不及，包括抑郁、焦虑、身体恢复、母乳喂养和婴儿护理。父母报告说很难区分正常的产后症状和并发症。出院教学被认为既压倒性又不充分。家长的建议包括需要在怀孕期间以多种形式和环境进行更早、更全面的产后准备。 父母还报告需要更早的产后就诊和改善门诊支持。结论我们的研究结果表明，美国的许多父母感觉没有准备好应对各种情感、身体、母乳喂养和婴儿护理经历。未来的研究应探索怀孕期间产后准备的创新教育方法以及门诊项目，以弥补目前产后护理方面的差距。
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