Original Article
Postpartum fatigue, baby-care activities, and maternal–infant attachment of vaginal and cesarean births following rooming-in

https://doi.org/10.1016/j.apnr.2014.08.002Get rights and content

Abstract

Aim

This study compares women's postpartum fatigue, baby-care activities, and maternal–infant attachment following vaginal and cesarean births in rooming-in settings.

Background

Postpartum women admitted to baby-friendly hospitals are asked to stay with their babies 24 hours a day and to breastfeed on demand regardless of the type of childbirth.

Methods

The study used a descriptive cross-sectional study design. A total of 120 postpartum women were recruited from two accredited baby-friendly hospitals in southern Taiwan. Three structured questionnaires were used to collect data, on which an analysis of covariance was conducted.

Results

Women who experienced a cesarean birth had higher postpartum fatigue scores than women who had given birth vaginally. Higher postpartum fatigue scores were correlated with greater difficulty in baby-care activities, which in turn resulted in weaker maternal–infant attachment as measured in the first 2 to 3 days postpartum.

Conclusions

Hospitals should implement rooming-in in a more flexible way by taking women's postpartum fatigue and physical functioning into consideration.

Section snippets

Research design

The study used a descriptive cross-sectional design and three structured questionnaires for data collection.

Study participants

Under the diagnosis-related group-based (DRG-based) coverage policy used by the Bureau of National Health Insurance in Taiwan, women undergoing VB are eligible for daily co-payments for hospitalization expenses for a maximum of 3 days, while a maximum of 5 days is entitled to those undergoing CB. However, women with VB are likely to be discharged as early as 48 hours postpartum. For this

Demographic differences between women following VB and CB

The demographic variables of the two groups are shown in Table 1. They were analyzed using a t-test, chi-square test, and Fisher's exact test. Only age and educational level significantly differed between the two groups (Table 1).

Levels of postpartum fatigue, baby-care activities, and maternal–infant attachment between women following VB and CB

The mean scores for women's postpartum fatigue, baby-care activities, and maternal–infant attachment were 5.25 (SD = 2.18), 26.77 (SD = 6.78), and 93.07 (SD = 10.59) for the VB group, and 6.26 (SD = 1.78), 25.03 (SD = 7.57), and 94.72 (SD = 11.29) for the CB group.

Relationships between postpartum fatigue and difficulty with baby-care activities and maternal–infant attachment for women following VB and CB

Postpartum

Discussion

Postpartum fatigue is a common condition following VB and CB. Women with greater perceived postpartum fatigue had greater difficulty carrying out baby-care activities in a rooming-in setting, regardless of whether they had undergone VB or CB. This agrees with previous findings that postpartum fatigue not only influences but also predicts the level of difficulty with which baby-care activities are carried out (McQueen & Mander, 2003) and that fatigued mothers find it difficult to room-in with

Acknowledgments

This study was supported in part by a grant from the Kaohsiung Medical University Hospital (KMUH96-6R32). The authors thank the help from the Statistical Analysis Laboratory, Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University.

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      When the fatigue seen in women in the postpartum period is not identified in the early period, and the support needed for these women is not provided, it causes the delayed adoption of motherhood roles, inadequate self-care agency, increased risk of postpartum depression, decreased quality of life, and a negative effect on newborn care.11,33,34 Additionally, studies have reported that postpartum fatigue may be associated with women's difficulty in maintaining baby care and the early cessation of breastfeeding.9,35,36 It should also be noted that postpartum fatigue is one of the most important factors affecting quality of life.37

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