New Mothers Speak Out Report Paints A Troubling Picture Of American Women In Postpartum Period

Childbirth Connection, a leading national not-for-profit organization that works to improve the quality of maternity care, today released New Mothers Speak Out, National Survey Results Highlight Women's Postpartum Experiences. The report is based on new data from the national Listening to Mothers II Postpartum survey, and includes relevant results from the national Listening to Mothers II survey, which was conducted six months earlier and focused on childbearing experiences of the same women. Combined survey results from these landmark surveys provide an in-depth look at women's postpartum experiences during the first eighteen months after giving birth.


Persistent Physical and Emotional Health Problems


Many mothers grappled with ongoing physical and emotional health problems while caring for their baby. The women reported high rates of newly experienced problems in the first two months after birth. At six or more months after birth, substantial proportions of mothers were still feeling stressed (43%), had problems with weight control (40%), experienced sleep loss (34%), lack of sexual desire (26%) and backache (24%). Among those who had a cesarean birth, 31% reported numbness and 18% reported continued pain at the incision site after at least six months. One-third of mothers reported that during the first two months after birth, their postpartum physical health (33%) or emotional health (30%) interfered at least "some" with their ability to care for their baby, with 44% of all mothers reporting that physical and/or emotional health impairment had interfered with the care of their babies. A year after giving birth mothers reported a net weight gain of six pounds from their pre-pregnancy weight.


"Postpartum mothers experience a troubling burden of physical and emotional health challenges after giving birth. Although many of these problems abate over time, far too many women were still experiencing them from 6 to 18 months after birth. With more than 4.3 million births each year in the United States, it is an urgent priority to better understand the reason for these challenges, their implications for women and their families, ways to prevent distress and morbidity, and ways to help women and families before they experience detrimental effects," stated Maureen Corry, MPH, Executive Director of Childbirth Connection.


Breastfeeding Experiences


Although 61% of the mothers had intended to exclusively breastfeed as they neared the end of their pregnancies, just 51% were doing so a week after the birth. Those mothers had experienced high rates of hospital practices that can disrupt breastfeeding such as water or formula supplementation and formula samples or offers. Fewer than half (46%) of the mothers who were breastfeeding at one week and not breastfeeding at the time of the Listening to Mothers II Postpartum survey reported that they had breastfed as long as they wanted. One-third or fewer of black non-Hispanic women, younger women and women with lower incomes breastfed as long as they wished.















Co-sleeping and Demographic Variation


The study reveals significant disparities in experiences across major U.S. race/ethnicity subgroups in a practice that has been the subject of considerable attention - infants sleeping in the same bed as their parents. Overall 18% of mothers reported that their baby "always" slept in bed with them and another 10% reported their infant "often" did in the first six months after birth. Among black non-Hispanic mothers more than a third (36%) reported their baby slept with them "always" compared to 30% of Hispanic mothers and 12% among white non-Hispanic mothers. Dr. Eugene Declercq of Boston University School of Public Health and lead author of the report stated, "Co-sleeping was one of the many areas, including breastfeeding, pregnancy intention and circumcision rates, in which we found postpartum experiences of mothers varying widely by race/ethnicity. These variations merit further research."


Nonexistent or Insufficient Social Support from Husbands, Partners and Others


Having a spouse or partner did not necessarily ensure that women received various forms of support. Overall, most of the mothers (73%) said that they provided more of the child care than their husband or partner. Even among mothers who were employed full time, 49% reported they provided most of the child care, in contrast to just 3% of husbands or partners who provided most of the child care and 48% who shared it equally. About 20 percent of women with a husband or partner reported that person provided affectionate, emotional, enjoyment or practical support "none" or "little" of the time.


Meager Paid Maternity Leave Benefits and Multiple Employment Challenges


Of those mothers who had been employed by someone else during pregnancy, 40% said that their employer provided paid maternity leave benefits, with 50% of those working full-time and 14% working part-time receiving these benefits. Among mothers who received paid maternity benefits, 50% indicated they received 100% of pay. Thus for the entire survey sample, the results indicate that of those women employed full-time outside of their home while pregnant, 23% received at least six weeks of their full pay as a maternity benefit and 38% received at least six weeks of half-pay or more as a maternity benefit.


Almost 3 in 10 (29%) of the mothers in the postpartum survey said they were currently employed full-time. Another 14% were employed part-time. Those mothers currently employed were more likely to have one child rather than two or more and be unmarried with a partner rather than married. Among formerly employed mothers more than a third had returned to work by 6 weeks, and most (84%) were back to work by 12 weeks. About half (48%) of mothers who had returned to work by the time of the survey said they had not stayed home as long as they wanted. The leading reason cited for returning to work prematurely (81%) was because they could not afford more time off. When we asked employed mothers and mothers on maternity leave what would be the ideal amount of time off with their baby, the overall average was seven months, with 60% of mothers naming six months or more as the ideal maternity leave. By contrast, just 1% of mothers who had been employed outside the home during pregnancy had fully paid leave of four or more months.


Mothers returning to work reported facing numerous challenges. For example, 79% reported that being apart from their baby was a major or minor challenge in their transition to employment, followed in frequency by childcare arrangements (50%), breastfeeding issues (37%), amount of support by partner/spouse (36%) and lack of support in the workplace as a new mother (29%).



"This important new study underscores the urgent need to improve maternity and pregnancy-related benefits for women in the United States," said National Partnership for Women & Families President Debra L. Ness. "While nearly every other economically competitive nation provides paid maternity leave and stronger supports for working mothers, women here struggle to cobble together the time off, income and childcare they need. This survey shows the toll that is taking on mothers and families. We can and must do better."


"The overall picture is of recent mothers engaged in a juggling act, carrying multiple and sometimes conflicting responsibilities while experiencing high levels of social, physical and emotional health challenges. There are concerns about whether large segments of this population have access to adequate health and social services and social support. We are letting our mothers and babies down at one of the most critical and vulnerable times in their lives. These survey results are a clarion call to action for programs, policies, clinical services, and research to better understand and improve the experiences of new mothers and their families," said Corry.


About New Mothers Speak Out


New Mothers Speak Out, National Survey Results Highlight Women's Postpartum Experiences, is based on new data from the national Listening to Mothers II Postpartum survey and includes relevant results from the national Listening to Mothers II survey, which was conducted six months earlier and focused on women's childbearing experiences. Combined survey results from these landmark surveys provide an in-depth look at women's postpartum experiences during the first eighteen months after giving birth.


The Listening to Mothers Postpartum survey reached 903 U.S. women, ages 18-45, who gave birth in a hospital to a single infant in 2005, with the infant still living at the time of the survey. The survey was carried out in partnership with Lamaze International and conducted by Harris Interactive®.


The New Mothers Speak Out report, along with survey questionnaires, details about the survey methodology and related documents, are available at www.childbirthconnection/newmothersspeakout


About Childbirth Connection


Childbirth Connection is a national not-for-profit organization that was founded in 1918 as Maternity Center Association. Our mission is to improve the quality of maternity care through research, education, advocacy and policy. Childbirth Connection is a voice for the needs and interests of childbearing families. More information about Childbirth Connection may be obtained at www.childbirthconnection


About Lamaze International


Since its founding in 1960, Lamaze International has worked to promote, support and protect normal birth through education and advocacy through the dedicated efforts of professional childbirth educators, providers and parents. An international organization with regional, state and area affiliates, its members and volunteer leaders include childbirth educators, nurses, nurse midwives, physicians, students and consumers. More information about Lamaze International may be obtained at www.lamaze

GE Healthcare Launches Diagnostic Advancements On Premier Women's Health Ultrasound System At AIUM 2008

GE Healthcare launched enhancements to its premier ultrasound system for obstetrics and gynecology, the Voluson E8 Breakthrough 2008, at the American Institute of Ultrasound in Medicine (AIUM) Annual Meeting, March 12-15 in San Diego. GE's new proprietary software program, Sonography-based Automated Volume Count (SonoAVC), delivers an efficient method of calculating the number and volume of ovarian follicles. This is an initial step in assisted reproductive medicine. The Voluson E8 Breakthrough 2008 also features improved probe imaging capabilities, which enable clinicians to see more anatomical detail. GE, the global leader in ultrasound, also showcased its leading console and compact LOGIQ systems to improve patient care in radiology and emergency medicine.


The dilemma of infertility affects approximately 80 million people globally; in the U.S., approximately 6.1 million couples have difficulty conceiving, about 10-15 percent of the U.S. population, according to the National Institute of Health (NIH) and the National Women's Health Resource Center (NWHRC).


In assisted reproductive medicine, ultrasound is part of baseline evaluation with the patient. Ultrasound imaging can include an assessment of the anatomy such as the uterus, fallopian tubes, ovaries and endometrium. Ultrasound can help in surgery planning, as well as helping to detect abnormalities and cysts. GE's new exclusive software, SonoAVC, automatically measures and calculates the number and volume of hypoechoic structures, such as ovarian follicles, in a volume sweep. This is a critical diagnostic step in assisted reproductive medicine, because each fluid-filled follicle contains hormone producing cells and a maturing ovum (egg).


Bringing automation to the exam can significantly reduce a physician or clinician's time for follicular assessment and reporting, as much as 7.6 minutes per patient. SonoAVC's automation and standardization of the exam increases efficiency and consistency between physicians across clinics, and patient to patient. SonoAVC also generates instant results a patient can see in an easy-to-view report format.


"The ability to automate the follicular assessment using ultrasound enhances the efficiency of follicular volume measurement," said Alfred Z. Abuhamad, M.D., Chairman of Obstetrics and Gynecology at Eastern Virginia Medical School. "Displaying ovarian follicles in a 3-D mode allows for an easy visual depiction of the geometric shape of individual follicles and thus enhances the optimal evaluation of the stimulated ovary. A software system that automates and simplifies follicular assessment has great promise in clinical practice. SonoAVC represents a giant step towards that goal."


Voluson E8 Breakthrough 2008 highlights for Obstetrics and Gynecology















GE also introduced new abdominal and transvaginal transducers with an expanded 195-degree field of view, compared to the previous 120-degree field of view, to help clinicians image more of the reproductive anatomy in a single view. GE's proprietary ultrasound beam-steering technology helps give clinicians a larger field of view to see more in one image. This helps in evaluating anatomy, such as the uterus, both ovaries, or abnormalities. In addition, Voluson's new 4D high frequency transvaginal probe can detect anatomical detail earlier in the first trimester and in gynecological exams.


New on the Voluson 730 Expert system is the proprietary software that can automate the acquisition of ultrasound images used by physicians to diagnose fetal heart defects. This software, called Sonography based Volume Computer Aided Diagnosis (SonoVCAD), was first launched on the Voluson E8 in 2006. GE licensed SonoVCAD, patented by Dr. Abuhamad, who developed the automation protocol. Abuhamad's protocol automates the acquisition of images to display the planes that are needed for a complete ultrasound evaluation with a four-chamber view of the fetal heart. Dr. Abuhamad has created algorithms that allow the other planes to be generated from that four-chamber view. Those views allow physicians to identify the type and severity of fetal heart defects.


LOGIQ Care Area Series for Radiology


The LOGIQ Care Area Series ultrasound systems, introduced at RSNA 2007, are customized to radiology specialty areas such as pediatric radiology, vascular laboratories and breast imaging. Built on the multi-specialty LOGIQ platform, the Care Area Series provides specialty-specific tools for advanced care areas: ventricular volume measurements of hydrocephalus in the newborn; real-time ultrasound imaging of the hemodynamics of a pseudoaneurysm in the elderly; and women undergoing ultrasound imaging of breast lesions in the coronal plane are all examples of this Care Area focus.
GE designed the new care area systems with two objectives in mind: excellent imaging performance optimized for each clinical area, and optimal clinical workflow designed to improve healthcare quality and efficiency. LOGIQ continues to be based on GE's raw data approach to ultrasound imaging. Rather than storing ultrasound images as video pixels, the data is stored as digitized ultrasound waveforms. GE's experience has been that this architecture gives extremely high ultrasound fidelity. In the LOGIQ Care Area Series systems, this raw data can be captured in three dimensions in near real-time. This makes ultrasound imaging much like CT or MR imaging in that clinicians, regardless of care area, can view, reprocess, re-slice, and review images even after the patient has left the building.


LOGIQ e Breakthrough 2008 Emergency Medicine Edition


This compact system is designed with dedicated software specifically for unique clinical needs, and automatic image optimization with one-button operation. The report package can automatically send clinical images to a network folder where a PDF can be picked up by the patient's electronic medical record (EMR), a key need in emergency medicine. This laptop-style system can be moved quickly from room to room for imaging traumatic injuries, internal bleeding, pregnancy related complaints, soft tissue infections, and certain cardiac conditions.


"Each field of medicine uses ultrasound in a unique way. GE offers a broad range of ultrasound systems that cater to the unique needs of different medical practitioners," said Omar Ishrak, CEO and president of GE Healthcare's Clinical Systems business unit. "We are helping improve clinicians' diagnostic capabilities and their care for patients across women's healthcare, radiology and emergency medicine. In each field, GE delivers the premium image quality, workflow efficiencies and portability with compact systems that are suited for each unique user."


About GE Healthcare


GE Healthcare provides transformational medical technologies and services that are shaping a new age of patient care. Our expertise in medical imaging and information technologies, medical diagnostics, patient monitoring systems, performance improvement, drug discovery, and biopharmaceutical manufacturing technologies is helping clinicians around the world re-imagine new ways to predict, diagnose, inform, treat and monitor disease, so patients can live their lives to the fullest.


GE Healthcare's broad range of products and services enable healthcare providers to better diagnose and treat cancer, heart disease, neurological diseases and other conditions earlier. Our vision for the future is to enable a new "early health" model of care focused on earlier diagnosis, pre-symptomatic disease detection and disease prevention. Headquartered in the United Kingdom, GE Healthcare is a $17 billion unit of General Electric Company (NYSE: GE). Worldwide, GE Healthcare employs more than 46,000 people committed to serving healthcare professionals and their patients in more than 100 countries.

GE Healthcare

Anonymous Private Donation Will Boost Services Under Colorado Family Planning Program

Colorado's family planning budget has received a $3 million confidential private grant, which will be disbursed over three to five years as part of an effort to reduce unintended pregnancies in the state, the Denver Post reports. The grant will allow Colorado to provide thousands more low-income residents with low or no-cost contraception, vasectomies and tubal ligation procedures. The funding also will allow the state to provide more family planning program participants with long-acting reversible contraceptive methods, such as intrauterine devices and the NuvaRing, which are more effective than birth control pills but also more costly. The Post reports that the state currently spends about $4 million annually on the program, while local health agencies contribute about $10 million. The subsidies allow state clinics to offer procedures, such as vasectomies, at a reduced cost. For example, vasectomies are offered for about $200, compared with the $900 cost at many private providers, the Post reports.

Currently, the family planning program serves about 52,000 of the 200,000 low-income residents who qualify for the assistance, according to Candace Grosz, director of women's health for the Colorado Department of Public Health and Environment. The state estimates that for every dollar spent toward family planning services, it saves about $2.48 in costs related to prenatal care, deliveries and other services that result from unintended pregnancies. According to a federal study, 40% of pregnant women surveyed in Colorado said they did not intend to become pregnant. Grosz said, "It's important for clients to be pregnant when they want to be pregnant and when they're able to care for their children" (Booth, Denver Post, 12/3).


Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.


© 2008 The Advisory Board Company. All rights reserved.






View drug information on NuvaRing.

Most Recent Mammography Recommendations Confuse Public

When the U.S. Preventive Services Task Force (USPSTF), an independent panel of experts in primary care and prevention, released its recommendations on mammography screenings for US women on November 16, 2009, there was immediate and considerable controversy. In a study published in the May 2011 issue of the American Journal of Preventive Medicine, investigators report that these new recommendations confused women (30.0%) more than they helped them understand when to get a mammogram (6.2%). Confusion was greatest among women aged 40-49 years and women who had never had a mammogram or who had one more than 2 years ago.



The USPSTF announcement included three sets of recommendations for women aged 40-49, 50-74 and 75 and over. Investigators from RTI International (Bethesda, MD, and Research Triangle Park, NC) assessed the volume and framing of the public discourse around the mammography recommendations to determine if women were knowledgeable about the new recommendations.



According to Linda B. Squiers, PhD, senior health communication analyst, RTI, Bethesda, MD, and her co-authors, results from this study will allow public health professionals to understand how the USPSTF's 2009 mammography screening recommendations were discussed in the media and whether women understood the reason for the debate and the new recommendations approximately one month after their release. Media coverage of the new recommendations peaked immediately following their release and was unbalanced. The majority of news articles and social media posts were unsupportive of the recommendations. The new recommendations were released during the heated debate about healthcare reform legislation, so it is not surprising that they were portrayed by some as an example of how the Obama administration planned to ration health care if the legislation passed.



RTI researchers analyzed news reports and social media posts around the time of the announcement, both of which shape public perceptions of and opinions about new information and topics. In addition, they surveyed 1,221 women for two months beginning one month after the announcement.



From 233 newspaper articles, blog posts, and tweets analyzed, 51.9% were unsupportive, and only 17.6% were supportive. Most newspaper articles and blog posts expressed negative sentiment (55.0% and 66.2%, respectively), whereas tweets were predominantly neutral (48.8%). The most common reasons mentioned for being unsupportive of the new recommendations were the belief that delaying screening would lead to later detection of more advanced breast cancer and subsequently more breast cancer-related deaths (22.5%) and the belief that the recommendations reflected government rationing of healthcare (21.9%).



In the web-based survey, the majority of respondents reported paying attention to the recommendations and those who paid more attention understood better the reasons for the controversy. However, despite the media flurry, only 20.3% of women aged 40-49 years and 23.4% of all women in the sample correctly identified the mammography recommendation for women aged 40-49 years. Overall, the new recommendations confused women more than they helped them understand when to get a mammogram. Women aged 40-49 years were significantly more likely to be confused about when they should get a mammogram than the older age group.
















"The USPSTF plays a vital role in reviewing the latest scientific evidence and advising providers and consumers about prevention," concluded Squiers and her co-investigators. "For recommendations to be accepted by both groups, they first must be understood. In the field of health communication, message testing with individuals is frequently used to ensure that messages are understandable, credible, and use language that resonates with the target audience. Using message testing in the future may help identify specific components or words (e.g., routine, against) within the recommendations that could cause providers, consumers, and advocacy agencies to be confused or concerned."



In an accompanying commentary, Diana B. Petitti, MD, MPH, from Arizona State University and Ned Calonge, MD, MPH, from the Colorado Trust, note that while the USPSTF has played a leadership role in the evidence-based medicine movement, there seems to be "a media bias in favor of mammography screening" which may be due to vested interests in the women's health and breast cancer advocacy groups. They suggest that "further application of qualitative research methods to the data on media coverage of the mammography screening guidelines might yield insights into the kinds of interests that underlay the most negative media accounts about the mammography recommendations. This information might contribute to a better understanding of the sources of negative media responses to evidence and evidence-based recommendations."



The article is "The Public's Response to the U.S. Preventive Services Task Force's 2009 Recommendations on Mammography Screening" by Linda B. Squiers, PhD, Debra J. Holden, PhD, Suzanne E. Dolina, MPH, Annice E. Kim, PhD, Carla M. Bann, PhD and Jeanette M. Renaud, PhD (doi: 10.1016/j.amepre.2010.12.027). The commentary is "Media Coverage of U.S. Preventive Services Task Force Recommendations" by Diana B. Petitti, MD, MPH, and Ned Calonge, MD, MPH (doi: 10.1016/j.amepre.2011.02.009).


Source:

Elsevier

Kansas Breast And Cervical Cancer Screening Program For Low-Income, Uninsured Women Runs Out Of Funding

The Kansas Early Detection Works program, which provides uninsured low-income women in the state with breast and cervical cancer screenings at no cost, has depleted its operating funds and will delay almost all cancer screenings until July 1, the Wichita Eagle reports. Janet Neff, director of the Cancer Prevention and Control Program at the Kansas Department of Health and Environment, said the program has received about $2.3 million annually in recent years from CDC. The program also receives some funding from the state and the Mid-Kansas affiliate of the Susan G. Komen for the Cure Foundation.

The screening program depleted its funds in March. However, program officials reserved a limited amount of funding to provide diagnostic tests until the new fiscal year begins on July 1 to women who display symptoms of breast or cervical cancer. Women who inquire about the program will be placed on a waiting list and will be screened when funding becomes available. Kansas women ages 40 to 64 who are uninsured and meet income guidelines are eligible for the program. According to Neff, about 5,800 of the at least 27,000 women in Kansas who qualify to receive no-cost screenings have done so since July 1, 2007.

Neff said she requested slightly more than $2.3 million in federal funds for FY 2009 (Shideler, Wichita Eagle, 5/5).


Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.