While the importance of professional support following very preterm delivery (VP) is established, the parental experience of support still warrants deeper understanding. Evaluation of a Dutch one-year post-discharge responsive parenting intervention following VP suggested that parents with lower educational levels benefitted less from the program. This idiographic phenomenological study investigated the lived experiences of two mothers with differing educational backgrounds receiving professional support during hospitalization and post-discharge. In-depth interviews with the mothers were analyzed using Interpretative Phenomenological Analysis. We formulate three impressions: (1) How the mothers made sense of their experiences resonated with the findings of research on class differences in parenting. (2) The mothers valued professionals who struck a personalized balance between supporting their maternal agency and attending to their vulnerability and needs for help and perspective. (3) The mothers experienced greater trust in professionals who could suspend pre- conceived assumptions and take their personal characteristics into consideration. Practice suggestions are extrapolated for social work professionals. The study has relevance to educational diversity and recommends an overarching sensitivity to positionality in professional work with parents.
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The use of growth monitoring and promotion (GMP) has become widespread. It is a potential contributor towards achieving the Millennium Development Goals of halving hunger and reducing child mortality by two-thirds within 2015. Yet, GMP appears to be a prerequisite for good child health but several studies have shown that there is a discrepancy between the purpose and the practice of GMP. The high prevalence of malnutrition in many developing countries seems to confirm this fact. A descriptive qualitative study was carried out from April to September 2011. Focus group discussions and in-depth interviews were conducted amongst mothers and health workers. Data were analyzed using a qualitative content analysis technique, with the support of ATLAS.ti 5.0 software. The results suggest that most mothers were aware of the need for regular weight monitoring while health workers also seemed to be well-aware and to practise GMP according to the international guidelines. However, there was a deficit in maternal knowledge with regard to child-feeding and a lack of basic resources to keep and/or to buy healthful and nutritionally-rich food. Furthermore, the role of the husband was not always supportive of proper child-feeding. In general, GMP is unlikely to succeed if mothers lack awareness of proper child-feeding practices, and if they are not supported by their husbands.
BackgroundThe challenging combination of breastfeeding and work is one of the main reasons for early breastfeeding cessation. Although the availability of a lactation room (defined as a private space designated for milk expression or breastfeeding) is important in enabling the combination of breastfeeding and work, little is known about the effects of lactation room quality on mothers’ feelings and thoughts related to breastfeeding and work. We hypothesized that a high-quality lactation room (designed using the Theory of Supportive Design) would cause mothers to experience less stress, have more positive thoughts about milk expression at work, perceive more organizational support, and report more subjective well-being, than a low-quality lactation room.MethodsIn an online randomized controlled trial (Study 1), Dutch mothers (N = 267) were shown either a high-quality or a low-quality lactation room (using pictures and descriptions for the manipulation) and were then asked about their feelings and thoughts. In a subsequent field experiment (Study 2) we modified the lactations rooms in a large organization in Groningen, the Netherlands, to manipulate lactation room quality, and asked mothers (N = 61) who used either a high-quality or low-quality lactation room to fill out surveys to assess the dependent variables.ResultsThe online study showed that mothers exposed to the high-quality lactation room anticipated less stress, more positive cognitions about milk expression at work, more perceived organizational support, and more subjective well-being than mothers exposed to the low-quality lactation room (p < 0.05). Moreover, the effect of lactation room quality on perceived organizational support was especially pronounced for mothers who were higher in environmental sensitivity. The field experiment showed that use of the high-quality room led to less reported stress than use of the low-quality room (p < 0.05). We also found that mothers who were higher in environmental sensitivity perceived more control over milk expression at work and experienced more subjective well-being in the high-quality condition than in the low-quality condition (p < 0.05).ConclusionThe current studies show that not only the availability, but also the quality of lactation rooms is important in facilitating the combination of breastfeeding and work.
Pre-eclampsia (PE) is a common and severe pregnancy complication and is associated with substantial perinatal morbidity and mortality in mothers and infants. The disease is often characterized by a non-specific presentation which makes it challenging for physician to diagnose PE during regular pregnancy check-ups. To date, there are no diagnostic tests on the market for detection of PE early in pregnancy (first trimester). In this project, we will develop a platform to sensitively analyse calcium-binding proteins (CBPs) which will unlock the full potential of CBPs as predictive PE markers. The technology will also be applicable for other diseases (e.g., dementia and cancer) where CBPs are also known to play a key role in disease pathophysiology. We will develop with phage display antibodies that can recognize calcium binding to specific motifs in proteins. To this end we will synthesize peptide motifs with and without calcium to select antibodies that are specific for calcium bound proteins. These antibodies will be validated for their clinical use. For this goal we will use serum samples from the Improved studie (EU subsidised study) to determine if we can recognize pre-eclampsia in a very early stage. This knowledge can lead to a better treatment of pregnant women suffering from this disease and also will probably increase the well-being for the baby born and the development further in life.
Vulnerable pregnant women are an important and complex theme in daily practice of birth care professionals. Vulnerability is an important risk factor for maternal and perinatal mortality and morbidity. Providing care for these women is often complex. First, because it is not always easy to identify vulnerability. Secondly, vulnerable women more often cancel their appointments with midwives and finally, many professionals are involved while they do not always know each other. Even though professionals are aware of the risks of vulnerability for future mothers and their (unborn) children and the complexity of care for these women, there is no international definition for ‘vulnerable pregnancies’. Therefore, we start this project with defining a mutual definition of vulnerability during pregnancy. In current projects of Rotterdam University of Applied Sciences (RUAS) we define a vulnerable pregnant woman as: a pregnant woman facing psychopathology, psychosocial problems, and/or substance abuse combined with lack of individual and/or social resources (low socioeconomic status, low educational level, limited social network). In the Netherlands, care for vulnerable pregnant women is fragmented and therefore it is unclear for birth care professionals which interventions are available and effective. Therefore, Dutch midwives are convinced that exchanging knowledge and best practices concerning vulnerable pregnancies between midwifery practices throughout Europe could enhance their knowledge and provide midwives (SMB partners in this project) with tools to improve care for vulnerable pregnant women. The aim of this project is to exchange knowledge and best practices concerning vulnerable pregnancies between midwifery practices in several European countries, in order to improve knowledge and skills of midwives. As a result, guidelines will be developed in order to exchange selected best practices which enable midwives to implement this knowledge in their own context. This contributes to improving care for vulnerable pregnant women throughout Europe.
