Fahey Jenifer O, Shenassa Edmond
J Midwifery Womens Health. 2013 Nov-Dec;58(6):613-21. doi: 10.1111/jmwh.12139. Epub 2013 Dec 9.
A new model for the care of women in the postpartum focuses on the development of life skills that promote complete well-being. The year following childbirth is a time of significant transition for women. In addition to the physiologic changes associated with the postpartum period, a woman undergoes marked psychosocial changes as she transitions into a motherhood role, reestablishes relationships, and works to meet the physical and emotional needs of her infant and other family members. It is a time when women are vulnerable to health problems directly related to childbirth and to compromised self-care, which can manifest in the development or reestablishment of unhealthy behaviors such as smoking and a sedentary lifestyle. In addition to long-term implications for women, compromised maternal health in the postpartum period is associated with suboptimal health and developmental outcomes for infants. Maternal health experts have called for a change in how care is provided for women in the postpartum period. This article presents the rationale for a health promotion approach to meeting the needs of women in the postpartum period and introduces the Perinatal Maternal Health Promotion Model. This conceptual framework is built around a definition of maternal well-being that asserts that health goes beyond merely the absence of medical complications. In the model, the core elements of a healthy postpartum are identified and include not only physical recovery but also the ability to meet individual needs and successfully transition into motherhood. These goals can best be achieved by helping women develop or strengthen 4 key individual health-promoting skills: the ability to mobilize social support, self-efficacy, positive coping strategies, and realistic expectations. While the model focuses on the woman, the health promotion approach takes into account that maternal health in this critical period affects and is affected by her family, social network, and community. Clinical implications of the model are addressed, including specific health promotion strategies that clinicians can readily incorporate into antepartum and postpartum care.
一种新的产后妇女护理模式侧重于培养促进全面福祉的生活技能。产后的一年对女性来说是一个重大转变的时期。除了与产后期相关的生理变化外，女性在转变为母亲角色、重新建立人际关系以及努力满足婴儿和其他家庭成员的身体和情感需求时，还会经历显著的心理社会变化。在这个时期，女性容易出现与分娩直接相关的健康问题以及自我护理不足的情况，这可能表现为吸烟和久坐不动的生活方式等不健康行为的发展或重新出现。除了对女性有长期影响外，产后母亲健康受损还与婴儿的健康和发育结果不理想有关。孕产妇健康专家呼吁改变产后妇女的护理方式。本文阐述了采用健康促进方法来满足产后妇女需求的基本原理，并介绍了围产期孕产妇健康促进模式。这个概念框架围绕着孕产妇福祉的定义构建，该定义认为健康不仅仅是没有医学并发症。在该模式中，确定了健康产后的核心要素，不仅包括身体恢复，还包括满足个人需求并成功转变为母亲的能力。通过帮助女性发展或强化4项关键的个人健康促进技能，这些目标能够得到最佳实现：调动社会支持的能力、自我效能感、积极的应对策略以及现实的期望。虽然该模式侧重于女性，但健康促进方法考虑到在这个关键时期，孕产妇健康会受到其家庭、社交网络和社区的影响，同时也会对它们产生影响。文中探讨了该模式的临床意义，包括临床医生可以轻松纳入产前和产后护理的具体健康促进策略。
