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Maternal Health Well-Being & Beyond

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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  1. Maternal Health Well-Being & Beyond Dr Mary Steen Research Fellow in Midwifery RCM/UCLan (joint apt)

  2. Introduction • 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)

  3. 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

  4. 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.

  5. Collaboration • 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

  6. 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.

  7. Aims of the Initiative • To promote health & fitness during pregnancy • Prepare for Birth • Maintain health & fitness after childbirth

  8. Piloted: • 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

  9. 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

  10. 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

  11. Evaluation of main programmeAge Range

  12. Ethnic Groups:

  13. Exercise before Pregnancy

  14. Antenatal workshops – helpful?

  15. Postnatal workshops – helpful?

  16. Exercise Classes- helpful?

  17. 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’

  18. 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’

  19. It’s Fun

  20. Are u doing your Pelvic Floor Exercises?

  21. 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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