Background: To date, little is known about the perspectives of healthcare and social service providers on the acceptability of long-term home visiting programs serving low-income, first-time mothers within a community. The present study reports on the experiences and perspectives of community professionals who participate in program referrals or deliver auxiliary services to these mothers who are enrolled in the Nurse-Family Partnership (NFP), a targeted nurse home visitation program. Methods: The present study comprised two phases. In phase one, a secondary qualitative data analysis was conducted to analyze a purposeful sample of 24 individual interviews with healthcare and social service providers, which was part of a larger qualitative case study examining adaptations required to increase the acceptability of NFP for families and service providers in Hamilton, Ontario, Canada. In phase two, identified themes from phase one were further explored and confirmed through individual, semi-structured interviews with service providers using a qualitative descriptive approach. Findings: Healthcare and social service providers recognized the added value of NFP to existing community services for low-income, first-time mothers. The public health nurses (PHNs) who delivered the NFP intervention were perceived as playing a crucial role in connecting the first-time mothers to community services, preparing them for motherhood, and for preventing or ending the involvement of child protection services. NFP services were not perceived as interfering with the logistics of existing services being delivered; they were viewed as addressing an important service gap. Discussion: This is the first qualitative study to examine the acceptability of a home visiting intervention from the perspectives of healthcare and social service providers in a community context. The study findings have relevance for policymakers by informing the general understanding of how a new early childhood prevention program is integrated among existing community-based supports servicing low-income, first-time mothers. / Thesis / Master of Health Sciences (MSc)

Förstagångsmammors välbefinnande är ett diskuterat ämne med mycket tidigare forskning bakom sig. Studiens syfte var att undersöka huruvida det finns ett samband mellan förstagångsmammors fysiska och psykiska välbefinnande och olika faktorer som relationer samt stöd från social omgivning och sjukvård med en kvantitativ analysmetod. Enkäter skickades ut till sociala medier och utefter det sammanställdes resultatet via SPSS. Resultatet av denna studie visar att förstagångsmammor är i behov av stöd från sjukvård och social omgivning. En bra relation till framförallt partner och vänner är viktigt för det mentala måendet. Tidigare psykiska besvär, medicinering för psykiska besvär och diagnostisering av personlighetsstörning påvisar en stor risk att drabbas av förlossningsdepression. En besvärlig förlossningsupplevelse kan också bidra till en förlossningsdepression och deltagarna upplevde att de fått bättre information från sjukvården kring de psykiska bieffekterna av att föda barn än de fysiska bieffekterna, något som sa emot tidigare forskning. / The wellbeing of first-time mothers is a well discussed subject with previous research from all over the world. The aim of this study was to see whether there is a connection between the physical and mental wellbeing of first-time mothers and several factors such as relationships, social support and support from healthcare with a quantitative analysis method. Surveys were sent out on social media and the results were compiled via SPSS. The results of this study indicates that first-time mothers are in need of both support from healthcare and their social surrounding. A good relationship to especially partner and friends are important for their mental health. Previous mental disorders, medication for mental disorders or that the person is diagnosed with a personality disorder could increase the risk of experiencing postpartum depression. A difficult birth experience could also contribute to a postpartum depression and the participants experienced that they received better information about the mental side effects of giving birth rather than the physical side effects, which contradicts previous research.

Becoming a mother is a transition that leads the woman from a known to an unknown existence, both social and professional support can facilitate this revolutionary event. In order to offer a good support, more knowledge about women's thoughts on the birth of their first child is needed. Aim:To describe pregnant women's thoughts before the birth of their first child. Method: Qualitative content analysis with inductive approach. Qualitative questionnaires were answered by 18 informants. Findings: Four main categoriesreveal; thoughts about their own ability and experience, thoughts about the childbirth environment, thoughts about the partnerand thoughts about the unborn child. The theme that reveals is that pregnant women's thoughts about the birth of their first child commute between trust and doubt.Conclusion: Women have confidence in their own ability but at the same time concern about the unknown. Thoughts that the delivery may affect the experience, therefore it is important that the midwife helps the woman to handle her thoughts so that she gains realistic expectations. Women have ambivalent thoughts about the support she will be offered. Professional and social support is important for achieving a positive childbirth experience and therefore continuous support should be offered during childbirth. / Att vänta barn och att bli mamma är en transition som leder kvinnan från en känd till en okänd tillvaro och både socialt och professionellt stöd kan underlätta vid denna omvälvande händelse. För att bättre kunna erbjuda kvinnorna ett gott stöd behövs mer kunskap om kvinnornas tankar inför deras första barns födelse, då detta område är relativt outforskat. Syfte: Att belysa gravida kvinnors tankar inför sitt första barns födelse. Metod: Kvalitativ innehållsanalys med induktiv ansats.Kvalitativa frågeformulär besvarades av 18 informanter. Resultat: Det framkommer fyra huvudkategorier; tankar om den egna förmågan och upplevelsen, tankar om förlossningsmiljön, tankar kring partnern och tankar om det ofödda barnet.Temat som genomsyrar resultatet är att gravida kvinnors tankar kring sitt första barns födelse pendlar mellan tillit och tvivel.Konklusion: Kvinnorna har tilltro till den egna förmågan men samtidigt en oro inför det okända.Tankar inför förlossningen kan påverka upplevelsen, därför är det viktigt att barnmorskan hjälper kvinnan att hantera sina tankar så att hon får realistiska förväntningar. Kvinnorna har ambivalenta tankar om det stöd hon kommer att erbjudas. Professionellt och socialt stöd är viktigt för att uppnå en positiv förlossningsupplevelse och därför bör kontinuerligt stöd erbjudas till alla födande kvinnor.

Doctor of Philosophy / Department of Family Studies and Human Services / Bronwyn S. Fees / When compared to adult mothers, adolescent mothers are more prone to parenting challenges (Whitman et al., 2001). Age is considered influential on a mother’s belief in her ability to successfully organize and execute her parenting plan (Bandura, 1999). The purpose of this study was to examine potential predictors of self-efficacy (determinant of parenting) among first-time mothers applying Belsky’s (1984) parenting framework. Maternal age, maternal depression, available social support and infant temperament were all considered to be potential predictors of maternal self-efficacy. A sample of first-time mothers (N = 115) with no other children in the home with an infant between the ages of four and six months was recruited from local alternative high schools, home and center child care facilities, and various other social services agencies and programs that typically serve new mothers. Participants self-reported on the above variables by completing a survey measuring self-efficacy as well as the hypothesized predictors. Responses were analyzed using group mean comparisons between 3 age groups: mothers 19 years and under (23%); mothers 20-26 years of age (29%); and mothers 26 years of age and older (48%). No significant differences in self-efficacy, perceived infant temperament, social support were found between age groups. Age differences in maternal depression fell just below significance. Maternal income level was significantly (and negatively) correlated with maternal depression, therefore was controlled for in additional analyses. Annual income, depression, and self efficacy were significantly correlated to perceived infant temperament. Mothers with lower incomes, who perceived less social support, who reported higher levels of depression, or had lower levels of self-efficacy were found to rate their infants as more temperamentally difficult. Regression analyses demonstrated that level of perceived social support significantly predicted maternal self-efficacy levels across all age groups. Additionally, infant temperament and maternal depression levels predicted self-efficacy. These findings provide evidence to support the importance of equal accessibility and affordability of social support for all new mothers to assist with the positive transition to parenthood.

Bakgrund: En förlossning medför fysiska och psykiska förändringar som påverkar nivån av fysisk aktivitet. Det finns många fördelar med fysisk aktivitet och kan med fördel påbörjas kort efter förlossning. Många kvinnor vet inte vart de ska vända sig för vård och söker därför inte vård för sina förlossningsrelaterade besvär. Fysioterapeuten arbetar med individuella biopsykosociala faktorer och tar hänsyn till faktorer som påverkar fysisk aktivitet. Trots detta har fysioterapeuten ingen roll inom eftervården.  Syfte: Var att beskriva nyförlösta förstföderskors upplevelser av råd och stöd för fysisk aktivitet från hälso- och sjukvården efter vaginal förlossning. Metod: Sex nyförlösta förstföderskor rekryterades genom ett bekvämlighetsurval och intervjuades. En kvalitativ innehållsanalys användes för att analysera materialet.  Resultat: Analysen resulterade i fyra kategorier: För generella och otillräckliga råd för fysisk aktivitet från hälso- och sjukvården, Otillräckligt stöd för fysisk aktivitet från hälso- och sjukvården, Avsaknad av råd och stöd skapar osäkerhet och rädsla samt Individanpassad vård är av betydelse.  Slutsats: Resultatet påvisade att deltagarna upplevde brist av råd och stöd för fysisk aktivitet efter förlossning och de få råd som gavs upplevdes som otillräckliga och saknade individanpassning. Det saknas fysioterapeutiska åtgärder i eftervården som skulle kunna möta dessa behov. / Background: Childbirth entail physical and psychological changes that affect the level of physical activity. There are many benefits to physical activity and can advantageously be started shortly after delivery. Many women don’t know where to go for care and therefore don’t seek medical care for their childbirth-related problems. Physiotherapists work with individual biopsychosocial factors and takes heed of factors that affect physical activity. Despite this, physiotherapists don’t have a role in the postpartum care. Aim: To describe the experiences of newly delivered first-time mothers of advice and support for physical activity from healthcare after vaginal delivery. Method: Six newly delivered first-time mothers were recruited through a convenience sample and interviewed. A qualitative content analysis was used to analyze the material. Results: The analysis resulted in four categories: Too general and insufficient advice for physical activity from healthcare, Insufficient support for physical activity from healthcare, Lack of advice and support creates uncertainty and fear, and Individualized care is important. Conclusion: The results showed that the participants experienced a lack of advice and support for physical activity after childbirth and the few advice that was given was perceived as insufficient and missing individual adaptation. There´s a lack of physiotherapeutic measures in the postpartum care where these needs could be met.

Antigua and Barbuda, in the eastern Caribbean, is one of several countries with exclusive low breastfeeding rates and premature weaning. Researchers have demonstrated that babies exclusively breastfed for the first 6 months of life are better protected from childhood diseases and experience a better quality of life into adulthood, while early weaning is associated with morbidity and mortality. However, at 6 weeks postpartum, only 30% of Antiguan and Barbudan mothers are exclusively breastfeeding. Researchers have explained why mothers in general cease exclusive breastfeeding prematurely: insufficiency of breast milk, returning to paid employment, lack of social support; but an explanation specific to Antigua and Barbuda has not been identified. This qualitative phenomenological study, therefore, initiates research concerning breastfeeding attitudes and practices specific to this country. It explores the experiences and perceptions of 13 Antiguan and Barbudan 1st-time mothers on exclusive breastfeeding and weaning. The theory of planned behavior provided the theoretical framework. Data collected from semistructured interviews were coded using key word as themes. Manual analysis of the research data was also conducted. The findings indicated inadequate lactation education and counselling for mothers, poor levels of lactation education among nurses, and minimal statutory maternity leave as the reasons for premature weaning among the research participants. The findings of this research can contribute to social change in Antigua and Barbuda by providing evidence-based information to strengthen breastfeeding policies and interventions and become part of regional scholarship on this issue.

Kvinnans amning har många olika hälsofördelar både för den nya mamman men också för hennes nyfödda. Amning har ett antal olika hälsofördelar, till exempel utvecklingen av barnets immunsystem och tarmflora. Genom kvinnans amning främjas deras första kopplings- och interaktionsfas mellan modern och det nyfödda och därmed en större möjlighet till framgångsrik amning. / The woman's breastfeeding has many different health benefits both for the new mother but also for her newborn. Breastfeeding has a number of different health benefits, such as the development of the baby's immune system and intestinal flora, for example. Through the woman's breastfeeding, their first connection and interaction phase between the mother and the newborn is promoted and thus a greater opportunity for successful breastfeeding.

Abstract in English, IsiZulu and Sepedi / Business Management / M. Com

Bakgrund: Barnhälsovården har funnits i Sverige sedan 1937, sedan dess är flera studier gjorda för att utveckla barnhälsovården och stärka föräldraskapet. Tidigt hembesök stärker relationen mellan förälder och BVC sköterska och är uppskattat av föräldrarna. Syfte: Syftet med examensarbetet var att jämföra förstföderskor och omföderskors förväntningar och upplevelser av barnhälsovårdens innehåll de första två månaderna. Metod: Prospektiv longitudinell kohortstudie användes och resulterade i projekt ”Föda barn i Västernorrland”, delmaterial från de två inledande frågetillfällena, från mitten av graviditeten och uppföljande två månader efter barnet fötts, ingick i examensarbetet. Resultat: I examensarbetet inkluderades 918 kvinnor, jämförelse gjordes mellan förstföderskor och omföderskor som visade att förstföderskor värderade subjektiv upplevelse, (SU) lägre än omföderskor, lika så upplevd verklighet (UV) i alla frågor men när det gällde prata BB—vård och få stöd och råd de första två månaderna fanns ingen statistisk signifikant skillnad mellan förstföderskor och omföderskor. Balanserad kvalitet eller mer bedömde förstföderskor och omföderskor i frågan om att få prata om föräldrarollen samt att få ställa egna frågor. Slutsats. En betydande stor del av förstföderskorna upplevde bristande kvalitet vid information om amning/uppfödning samt när det gällde att få prata förlossning och BB—vård,vilket bör studeras ytterligare. / Background: Child health services have been in place in Sweden since 1937, since then has several studies been done to develop child health care and strengthen parenting. Early home visits strengthen the relationship between parent and child health care nurse and appreciated by the parents. Aim: The aim of the degree project was to compare first-time mothers and women who are a multiple expectations and experiences of the contents of child health care during the first two months. Method: Prospective longitudinal cohort study was used and resulted in project "Giving birth in Västernorrland", submaterial from the two initial questions, from the middle of pregnancy and follow-up two months after the child was born, was included in the degree project. Results: The degree project included 918 women, a comparison was made between first-time mothers and women who are a multiple which showed that first-time mothers valued Subjective experience (SU) lower than women who are a multiple. Perceived reality (UV) in all matters but when it came to talking BB care and getting support and advice the first two months significant difference between first-time mothers and women who are a multiple. Balanced quality or more assessed first-time mothers and women who are a multiple on the issue of getting to talk about the parental role and to ask their own questions Conclusion: A significant proportion of first-time mothers experienced a lack of quality in information about breastfeeding/rearing, as well as in getting to talk about childbirth and postpartum care, which should be studied further. / <p>Godkännandedatum: 2020-11-23</p>

A notable paucity in practice interventions and literature currently exists in regard to self-support in first-time mothers. Recent literature and practice interventions seem to focus largely on social support resources, highlighting the deficiency in the investigation of self-support in first-time mothers as an integral and holistic concept and/or focus point for intervention. Literature continues to illustrate the many challenges first-time mothers encounter and therefore this study focuses on self-support experiences of the first-time mother in relation to her environment by providing an original stance of enquiry. The investigator aimed to explore and describe the experiences of self-support in first-time mothers in the Cape Metropole. The study was conducted qualitatively and according to an Interpretive Phenomenological Analysis (IPA) research design. This provided the researcher with a dual method of investigation: The first undertaking was to describe actual accounts of the participants‟ self-support experiences, while the second was to give an interpretation of these accounts which would reflect their experiences in an understandable, yet authentic manner. The meta-theoretical framework of Gestalt Therapy Theory (GTT) was applied due to its holistic and integrative nature, while the additional theoretical frameworks of Self Determination Theory (SDT) and Positive Psychology (PP) served as contributors to deepen understanding. The sample consisted of thirteen first-time mothers from moderately diverse socio-economic backgrounds. The study succeeded in giving in-depth exploratory descriptions of their self-support experiences during the first two years of motherhood. Findings displayed that the participants‟ self-support cannot be separated from their constantly shifting environments and that self-support is an integrated and dynamic process of development. Internal elements as well as environmental factors prove to disrupt this process of self-support development. Vital components for developing self-support were assuming responsibility for own well-being as a mother; as well as arriving at insight. Joy and gratefulness as experienced by the participants were proven to serve as motivators to sustain self-support. The study further exhibits that a supportive relationship is able to exist between the first-time mother‟s self-support and her environment when she is able to effectively identify, reach out and utilise social support resources available in her environment. Self-support serves as an experiential process (as an alternative to a fixed outcome) where the first-time mother is able, through experience, to mature and become more self-supportive. Findings argue that ideal self-support during novel motherhood is the capability to be in a mature interactive relationship with the environment, constantly adapting according to the organisation of the environmental field. / MA (Psychology), North-West University, Potchefstroom Campus, 2014