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Maternal Health Well-Being & Beyond. Dr Mary Steen Research Fellow in Midwifery RCM/UCLan (joint apt). Introduction. Exercising during pregnancy and after birth has many positive effects Minimise minor discomforts associated with pregnancy Improve self-esteem and self-image

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Maternal Health Well-Being & Beyond

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Maternal health well being beyond l.jpg

Maternal Health Well-Being & Beyond

Dr Mary Steen

Research Fellow in Midwifery RCM/UCLan (joint apt)

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  • Exercising during pregnancy and after birth has many positive effects

  • Minimise minor discomforts associated with pregnancy

  • Improve self-esteem and self-image

  • Prepare the body for strenuous exercise

  • Speed post-partum recovery

    Ref: Hatch et al,1993; Wolfe et al, 1994; Dunkley; 2000

    Zeanah & Schlosser, 1993; Horns et al, 1996)

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Introduction (2)

  • A review - women who exercise regularly are more likely to have shorter labours

  • Less intervention and recover more quickly after birth (ref: Clapp,2000)

  • Safety parameters whilst exercising important (ref: ACOG, 1994)

  • Low impact, Pilate-based exercises and relaxation techniques are safe

  • These can play an important part in promoting and maintaining health

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New Initiative

  • An antenatal & postnatal health & fitness programme has been developed

  • Women identified a need for this service

  • Health & Leisure services of the local authority identified the need

  • Maternity services in Leeds identified the need to develop a community-based initiative

  • That would promote the normality of childbirth and also meet the governments public health agenda.

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  • Liaise with the health & fitness manager at South Leeds Stadium

  • Already provided specialised classes for ‘Cardiac Rehab’ ‘Active Living’

  • Under a local scheme that involved GP’s referring patients to undertake exercise

  • Via a ‘Prescription for Activity’ Pass

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Prescription for Activity

  • Relatively new idea

  • Several GP’s are involved in the scheme

  • Concession price of £1.25

  • Decided to opt into this scheme

  • Midwife referral

  • At the final session of the postnatal classes women receive a ‘Prescription for Activity’ Pass

  • Women can attend for another 3 months at the concession price.

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Aims of the Initiative

  • To promote health & fitness during pregnancy

  • Prepare for Birth

  • Maintain health & fitness after childbirth

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  • Successfully piloted in April/May 2004

  • Women had to attend at least 4 sessions

  • Completed an evaluation form:

  • 10 women (antenatally)

  • 11 women (postnatally)

  • Both programmes evaluated very highly

  • Evidence that women’s self-esteems had increased

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Continuation of the programme:

  • The health & leisure services trained the midwife to undertake exercise to music course

  • Two of their fitness instructors were funded to undertake Pilate-based exercise training and an antenatal and postnatal exercise course

  • 5 more midwives were funded to undertake the Pilate-based training

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Main programme:

  • 15 month period (June 2004/Sept 2005)

  • 10 Antenatal sessions: 6 workshop/exercise classes

  • 10 Postnatal sessions: 6 workshop/exercise classes

  • Attendance varied from 6 to 12 women

  • Women had to attend at least 4 of 6 sessions

  • To complete an evaluation form

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Evaluation of main programmeAge Range

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Ethnic Groups:

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Exercise before Pregnancy

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Antenatal workshops – helpful?

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Postnatal workshops – helpful?

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Exercise Classes- helpful?

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Women’s Views - Antenatal:

  • ‘Very helpful to have a midwife help you exercise who knows what correct exercises to do’

  • ‘Every pregnant woman should come to the classes, you meet other pregnant mums and exercise, Tuesday’s don’t come round fast enough!

  • ‘I’m more sure about everything to do with my pregnancy and birth’

  • ‘I feel good about myself and I have more confidence’

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Women’s Views - Postnatal

  • ‘I couldn’t do my the pelvic floor exercises properly before I can now’

  • ‘I did some of the exercises in early labour and used the positions I was shown, it really helped’

  • ‘I was going to have an epidural but after attending the antenatal sessions I opted for a home birth, I’m so pleased I did’

  • ‘I always go home feeling good about myself and fit and healthy’

  • ‘I bring my mum as well we both have enjoyed it’

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It’s Fun

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Are u doing your Pelvic Floor Exercises?

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Future Plans

  • The midwife ‘champion’ started a new role in Sept 2005,

  • Manages to still be involved and when in Leeds goes to the sessions and is available to chat to women and promotes normal birth, health and well-being

  • The fitness instructors have continued to undertake the exercise classes and promote active birth

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