Policy Research Unit in Maternal Health and Care, National Perinatal Epidemiology Unit, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, UK.
BMC Pregnancy Childbirth. 2019 Jan 10;19(1):21. doi: 10.1186/s12884-018-2170-x.
Disadvantaged pregnant women and new mothers are at increased risk of psychosocial stress, anxiety and depression. As well as affecting birth outcomes and child development, poor maternal emotional wellbeing can inhibit the development of parenting self-efficacy and successful adjustment to the maternal role. Social support is a protective factor against antenatal and postnatal depression, anxiety and stress, and improves mothers' confidence in infant care. Community doula programmes have been developed to meet the social support and information needs of disadvantaged women. In these programmes trained volunteer doulas support mothers during pregnancy, at birth and for a short period postnatally.
This was a descriptive qualitative study, informed by phenomenological social psychology, exploring mothers' and doulas' experiences of antenatal and postnatal community doula support. Semi-structured qualitative interviews were undertaken with 13 disadvantaged mothers and 19 doulas at three community volunteer doula projects in England. Interviews were audio-recorded and transcripts were analysed using inductive thematic analysis.
The overarching theme emerging from the analysis was "Supporting the mother to succeed and flourish". There were five subthemes: "Overcoming stress, anxiety and unhappiness", "Becoming knowledgeable and skilful", "Developing self-esteem and self-efficacy", "Using services effectively", and "Becoming locally connected". Doulas believed that their community role was at least as important as their role at births. Their support was highly valued by vulnerable mothers and helped to improve their parenting confidence and skills.
Volunteer doula support before and after birth can have a positive impact on maternal emotional wellbeing, by reducing anxiety, unhappiness and stress, and increasing self-esteem and self-efficacy. Doulas help mothers feel more knowledgeable and skilful, support them to make effective use of maternity services, and enable them to build social ties in their community. To facilitate the best service for vulnerable mothers at the end of doula support, doula projects should consider formalising their relationship with other community organisations that can offer ongoing one-to-one or group support. They might also alleviate some of the potential distress caused by the ending of the doula relationship by increasing the flexibility of the ending, or by organising or permitting informal low level contact.
处于不利地位的孕妇和新妈妈面临着更高的心理社会压力、焦虑和抑郁风险。除了影响分娩结果和儿童发育外，母亲情绪健康状况不佳还会抑制育儿自我效能感的发展和成功适应母亲角色。社会支持是预防产前和产后抑郁、焦虑和压力的保护因素，并提高母亲对婴儿护理的信心。社区导乐员计划旨在满足弱势妇女的社会支持和信息需求。在这些计划中，经过培训的志愿者导乐员在怀孕、分娩和产后短期期间为母亲提供支持。
这是一项描述性定性研究，受现象学社会心理学的启发，探讨了母亲和导乐员在产前和产后社区导乐员支持方面的经验。在英格兰的三个社区志愿者导乐员项目中，对 13 名弱势母亲和 19 名导乐员进行了半结构式定性访谈。访谈进行了录音，并使用归纳主题分析对转录本进行了分析。
分析得出的总体主题是“支持母亲成功和繁荣”。有五个子主题：“克服压力、焦虑和不快乐”、“变得有知识和熟练”、“培养自尊和自我效能感”、“有效利用服务”和“在当地建立联系”。导乐员认为他们的社区角色至少与他们在分娩时的角色一样重要。他们的支持深受弱势母亲的重视，有助于提高她们的育儿信心和技能。
产前和产后的志愿者导乐员支持可以通过减轻焦虑、不快乐和压力，以及提高自尊和自我效能感，对母亲的情绪健康产生积极影响。导乐员帮助母亲感到更有知识和熟练，支持她们有效地利用产妇服务，并使她们能够在社区中建立社会联系。为了在导乐员支持结束时为弱势母亲提供最佳服务，导乐员项目应考虑正式确定与其他能够提供持续一对一或小组支持的社区组织的关系。他们还可以通过增加结束的灵活性，或者组织或允许非正式的低水平接触，来减轻导乐关系结束可能带来的一些潜在困扰。
