DiBari Jessica N, Yu Stella M, Chao Shin M, Lu Michael C
Health Resources Services Administration, Maternal and Child Health Bureau, Office of Epidemiology and Research, Division of Research, 5600 Fishers Lane, Room 18A-55, Rockville, MD 20857, USA ; Los Angeles County Department of Public Health, Maternal, Child, and Adolescent Health Programs, Research Evaluation and Planning Division, 600 S. Commonwealth Avenue, 8th Floor, Los Angeles, CA 90005, USA.
Health Resources Services Administration, Maternal and Child Health Bureau, Office of Epidemiology and Research, Division of Research, 5600 Fishers Lane, Room 18A-55, Rockville, MD 20857, USA.
J Pregnancy. 2014;2014:530769. doi: 10.1155/2014/530769. Epub 2014 Feb 20.
This study aimed to identify actual and perceived barriers to postpartum care among a probability sample of women who gave birth in Los Angeles County, California in 2007. Survey data from the 2007 Los Angeles Mommy and Baby (LAMB) study (N = 4,075) were used to identify predictors and barriers to postpartum care use. The LAMB study was a cross-sectional, population-based study that examined maternal and child health outcomes during the preconception, prenatal, and postpartum periods. Multivariable analyses identified low income, being separated/divorced and never married, trying hard to get pregnant or trying to prevent pregnancy, Medi-Cal insurance holders, and lack of prenatal care to be risk factors of postpartum care nonuse, while Hispanic ethnicity was protective. The most commonly reported barriers to postpartum care use were feeling fine, being too busy with the baby, having other things going on, and a lack of need. Findings from this study can inform the development of interventions targeting subgroups at risk for not obtaining postpartum care. Community education and improved access to care can further increase the acceptability of postpartum visits and contribute to improvements in women's health. Postpartum care can serve as a gateway to engage underserved populations in the continuum of women's health care.
本研究旨在确定2007年在加利福尼亚州洛杉矶县分娩的女性概率样本中产后护理的实际障碍和感知障碍。利用2007年洛杉矶母婴(LAMB)研究的调查数据(N = 4,075)来确定产后护理使用的预测因素和障碍。LAMB研究是一项基于人群的横断面研究,考察了孕前、孕期和产后的母婴健康结局。多变量分析确定低收入、分居/离婚和未婚、努力备孕或避孕、参加医疗补助保险以及缺乏产前护理是产后护理未使用的风险因素,而西班牙裔则具有保护作用。报告最多的产后护理使用障碍是感觉良好、忙于照顾宝宝、有其他事情要做以及没有需求。本研究结果可为针对有未获得产后护理风险的亚组制定干预措施提供参考。社区教育和改善就医机会可进一步提高产后访视的可接受性,并有助于改善女性健康。产后护理可作为让服务不足人群参与女性连续医疗保健的途径。