Postpartum Affects of Transition to Motherhood Program
Condition: Pregnancy
Study type: Interventional

Summary: 
      It has been seen that primiparous pregnant women experience similar problems during the
      transition to motherhood, and these problems affect both their self-evaluation, physical
      problems in the postpartum period, and maternal attachment. It is thought that the correct
      and adequate care and training received from health professionals will be effective in the
      solution of all these interconnected situations.

      The study aims to determine the effect of the "Transition to Motherhood Program (TMOP)"
      applied to primiparous pregnant women on self-assessment, postpartum problems, and maternal
      attachment.

      MethoThis research method is a randomized, control group pretest-posttest experimental
      research. The population of the study consisted of pregnant women who were registered to two
      Family Health Centers between December 2019 and December 2021 and met the inclusion criteria,
      the sample consisted who agreed to participate in the study (experimental group: 38, control
      group: 38).In the study, Personal Information Form, Prenatal Self-Assessment Scale, Prenatal
      Attachment Scale were applied to all pregnant women in the sample group as pre-test
      applications. Based on Meleis' Transition Theory, the Transition to Motherhood Program was
      applied to the pregnant women in the experimental group. The post-test application of the
      research was carried out in the sixth weeks and fourth postpartum months. At the sixth week
      of the postpartum period, the Postpartum Self-Assessment Scale, Postpartum Physical Symptom
      Scale, Maternal Attachment Scale; at the fourth month of the postpartum period, the Maternal
      Attachment Scale was used. In data analysis, dependent sample t test, ki square, mann whitney
      u tests will use. Necessary permissions were obtained for the study.
    

Detailed description: 
      Pregnancy, which most women experience at least once, is defined as an active part of life in
      which natural and pathological processes are intertwined. Pregnancy begins with fertilization
      due to the union of male and female reproductive cells. The standard duration of pregnancy is
      accepted as an average of 280 days or 40 weeks from the last menstrual period. The period
      from the first moment of fertilization to the 12th week of pregnancy is considered the first
      trimester, and it is known that the risk of miscarriage is highest in this period. The period
      between 13 and 28 weeks is regarded as the second trimester, and the risk of pregnancy is
      decided in this trimester. The third trimester is between 29 weeks and approximately 40 weeks
      and ends with birth. The third trimester is considered to be the most trouble-free period of
      pregnancy. Although it is accepted as a normal physiological process, various problems such
      as nausea, back pain, bowel and bladder issues, skin changes, fatigue, headache, and prenatal
      anxiety can be experienced during pregnancy. For pregnant women who cannot cope with these
      problems, a psychologically damaging situation may occur during pregnancy and in the
      postpartum period. It is emphasized that having previous pregnancy and birth experience can
      reduce this effect, but primiparous (first pregnancy) pregnant women are more affected by
      these problems.

      Those who have been pregnant for the first time or have given birth only once; women with no
      previous pregnancy and motherhood experience are defined as primiparous pregnant women.
      Studies have reported that primiparous women need training in fulfilling their roles and
      responsibilities in newborn care, and it takes longer for these mothers to take care of their
      babies. In a study conducted with primiparous pregnant women, About 82% of the participants
      experienced fear of childbirth, 75% were worried about body image, 74% experienced mood
      swings, 79% changed their lifestyle after conception, and 86% experienced depression,
      anxiety, stress. It has been stated that there are psychological problems. In another study,
      the causes of the issues experienced by primiparous pregnant women in this process; It was
      found that they felt inadequate, had difficulties in coping, and could not fully adapt to the
      transition to motherhood.

      "The Transition to Motherhood" is one of the most significant developmental life events of
      women's lives. According to Meleis, the concept of being a mother expresses a new role
      transition from a known situation to another strange case. The transition to motherhood
      requires re-meaning the goals, behaviors, and responsibilities to gain new meanings. This
      transition requires reinterpreting goals, behaviors, and commitments to acquire new
      definitions. Transition to motherhood; It is affected by the importance that pregnant women
      ascribe to the process, their characteristics, their level of knowledge, skills, and
      well-being. Support from unsafe sources about pregnancy and motherhood can be challenging for
      a healthy transition to motherhood. Insufficient support, undesirable or harmful suggestions,
      unreliable and contradictory information, being forced to be stereotyped, negative attitudes
      from those around, care that ignores individuality are considered as complicating factors in
      this process. Facilitating factors in the transition to motherhood are listed as being ready
      for motherhood, receiving adequate social support, training and counseling services specific
      to personality traits, good role models, and being physically healthy. In addition, the
      definition of the role of motherhood, the positive contribution of social networks, easy
      access to resources, and support are shown as other facilitating factors. It is stated that
      pregnant women who cannot complete the transition to motherhood in a healthy way have more
      difficulty in adapting to motherhood. They experience a lot of fear about childbirth and
      evaluate themselves negatively. Although there is not enough information about the transition
      process and the answers given to the transitions, Meleis assumed that the area that needs
      improvement is not transitions but what nurses can do for these individuals to get healthy
      outputs after the transitions.

      Since the self-evaluation status of the pregnant will affect her and her baby's mental health
      during the transition to motherhood, It is thought that it is essential to make positive
      interventions.

      Research Questions

        1. What descriptive and pregnancy-related characteristics of primiparous pregnant women
           participating in the study?

        2. Does the application of "ANGEP" prepared according to Meleis' Transition theory to
           primiparous pregnant women affect their postpartum self-evaluation?

        3. Does the application of "ANGEP," which is prepared according to Meleis' Transition
           theory, to primiparous pregnant women affect their physical problems in the postpartum
           period?

        4. Does the application of "ANGEP" prepared according to Meleis' Transition theory to
           primiparous pregnant women affect maternal attachment status?
    

Intervention name(s): Transition to Motherhood Program
Intervention type(s): Behavioral
Intervention description(s): Transition to Motherhood program includes 5 sessions. The first session covers the pregnancy process, the second session deals with the birth process, the third session deals with the postpartum period, the fourth session deals with infant care, and the fifth session deals with breast milk and breastfeeding and immunity. Trainings are online. In addition to the lecture technique, the training includes auxiliary techniques such as models, videos, case studies, training cards, and applied demonstrations. The program was completed by telephone follow-up in the first and fourth weeks postpartum.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Randomized controlled experimental design
Masking: Single (Participant)
Primary purpose: Supportive Care
Keywords: Pregnancy; transition to motherhood; postpartum problems; maternal attachment