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What is this campaign about? Putting midwives in the lead to help all moms-to-be relax and enjoy pregnancy more while fostering strong bonds and baby’s healthy development.
Who’s involved? The American College of Nurse-Midwives (ACNM) has partnered with Developing Hearts Systems, a non-profit educational publisher, to provide your practice with a new, specially-developed, midwife-friendly program to support your clients through pregnancy, labor, birth and into parenthood.
What is this new program exactly? It’s called Nurturing Baby and Me During Pregnancy --a 9-month, week-by-week program and set of patient education and wellness tools consisting of a guidebook, exercises, a pregnancy coach on audio CD and music. The program was developed and tested in the Healthy Families America prenatal home visitation program and was co-written by an expert in pregnancy stress-reduction and a nurse-midwife with twenty-years experience.
How does Nurturing Baby and Me During Pregnancy work? Starting from conception, the program’s colorful, easy-to-follow guidebook teaches moms-to-be about each stage of baby’s development, how to take an active role and provide a good womb environment. The program contains a series of weekly exercises and activities, guided by the soothing voice of a pregnancy coach, to help women get in touch with their new selves and their growing baby. The program also features specially-composed music to soothe mom and stimulate baby during pregnancy and to comfort both during labor and birth.
How will Nurturing Baby and Me During Pregnancy help my clients? The program can help moms-to-be:
Take regular quiet time and better care of herself
Release and worries and stress hormones
Build inner strength and confidence
Foster baby’s healthy development and build early bonds
In the words of Deanne Williams, ACNM Executive Director, “It will engage your inner spirit and help you begin to connect with your baby and grow in ways you didn’t think you could.”
How will this program and campaign benefit my practice? By your participation you’ll be:
Providing the latest in tools and techniques for pregnancy wellness
Enhancing patient relations by promoting a healthier, happier pregnancy
Advancing personalized care by providing emotional support when you can’t be there
Gaining greater recognition for community service by helping low-income patients
Promoting midwifery through midwife-positive publicity and contribution to ACNM
How does the campaign and program work? All the midwife has to do is put up a poster in the waiting room and hand out a flyer to their new clients. Your client then goes on-line to the ACNM Web site to learn more and order the program for herself at a special price exclusive to ACNM members and their patients ($14.95 +S&H).
What makes this an outreach campaign? As part of a special arrangement with the publisher, for every one program that is ordered by a client who can afford it, the publisher will send you a free copy of the program to your practice to give to a mom in need. In addition, the publisher will be making a contribution to ACNM to further midwifery education and practice.
When will this campaign start? It will be officially announced at the ACNM Annual Meeting from May 27 to June 1 in Salt Lake City and the program will be made available to ACNM members starting June 1, 2006. Be on the look out for more information in Quickening, e-mails etc.
How do I sign-up to participate? On-line (www.midwife.org) is the best way, but check with your chapter chair who will be receiving materials to get you started.
What ACNM’s Deanne Williams says about Nurturing Baby and Me During Pregnancy
Having a baby these days can be a stressful undertaking. Health researchers continue to see the adverse affects of that stress on a pregnant woman’s body, her baby, and her important relationships.
Supporting a woman to relax, enjoy pregnancy as a natural process and prepare mentally for parenthood is as important as good prenatal care. This is where the experienced and gentle hand of a nurse-midwife can ease both the physical and emotional journey of pregnancy.
Unfortunately, your midwife can’t be with you 24 hours a day, but the physical and psychological benefits that come with a regular practice of emotional relaxation are the next best thing! Special tools, like the Nurturing Baby and Me During Pregnancy program, provide easy and enjoyable exercises you can use to release your daily stressors.
This program will engage your inner spirit and help you begin to connect with your baby and grow in ways you didn’t think you could. Midwives know that these early bonds set the stage for the emotional health of your family. So take an active role! Join us and start enjoying your pregnancy as you prepare to enjoy your new baby. --Deanne Williams, CNM Executive Director, American College of Nurse-Midwives
How Nurturing Baby and Me promotes good prenatal care and fetal development
Advances in prenatal technology and brain science research are changing how we think about pregnancy and the womb world. We are only beginning to explore whether, and if so how, babies can sense, feel and learn during the prenatal period. Early evidence suggests that the unborn are more aware than many of us thought.
This book is designed to help you know some special ways to love and get to know your new family member, and how to have a more peaceful and relaxed pregnancy. Our program will introduce you to stress-reduction techniques, visualization and breathing exercises, stimulation of the fetus through music, talking and touch, and ways to involve the baby’s father in the pregnancy journey.
Though it’s tough to draw firm scientific conclusions in this area yet, it’s interesting to think about whether a program in prenatal enrichment can help babies to get the best start in life. For many parents, it’s not so important to have “scientific proof” – what’s important is to start your journey knowing you are parents already.
In places where programs like this one have been tried (see the Resource List at the back of the book for more information), researchers felt they saw benefits like this:
Benefits For Mothers:
Were better able to handle labor
Had greater success at breastfeeding
Felt more attuned to baby’s signals and needs
Were more confident as a parent
Benefits For Baby:
Enhanced motor development
Enhanced language development
Earlier social engagement (smiling, playing peek-a-boo)
More content and better able to control emotions
Benefits For Family:
Showed greater bonding
Provided greater family cohesion
What midwives and experts are saying about Nurturing Baby and Me
“This book goes beyond giving good information –it fills the heart and sends love, through Mom, to baby.”
-- William Sears MD and Martha Sears RN, co-authors The Baby Book and The Birth Book
“I highly recommend this important resource to all parents-to-be.”
--Dr. Glade Curtis, OB/GYN and author of Your Pregnancy Week by Week
"This program will engage your inner spirit and help you begin to connect with your baby and grow in ways you didn't think you could."
--Deanne Williams, CNM Executive Director, American College of Nurse-Midwives
“ An elegant book with valuable measures to pleasurably strengthen the parental bond”
--Dr. Clark Gillespie, M.D., American College of Obstetricians and Gynecologists Life Fellow and author of Your Pregnancy Month by Month.
“ Nurturing Baby and Me During Pregnancy is a vital concept presented in a refreshing, rewarding method.”
–Dr. Richard Crandall III, Family Physician, Landisville, PA.
“…especially good for women who may have ambivalent feelings or little support. The parent’s stories share good insights and the journal helps get out true feelings.”
--Angela Bonner, RN, Childbirth and Breastfeeding Educator, Irving, Texas
“ This program will help make parents more confident and give them coping and relaxing skills for after baby arrives.”
–Jennifer Wilson, BA, LBSW, Parenting and Child Development Teacher, Spirit Lake, Iowa.
"...the exercises helped me shift my focus from the pain to imagining my baby and it always puts a smile on my face."
--Elena D., New Britain, CT
Research results suggest improved prenatal care and development (summary of field pilot test)
Nurturing Baby and Me During Pregnancy Program
Healthy Families Hampton Pilot Field Study
Summary Report (4/28/06)*
Introduction:
Science has shown that unborn children are aware, react to the environment, learn and feel in the womb. Therefore, everything a pregnant woman thinks and feels is communicated to her unborn child. Because of this: parenting starts at conception.
A recent Center for Disease Control (CDC) report stated that American women are becoming sexually active at earlier ages and are marrying later, increasing both the risk and hazard of unmarried childbearing in the US. One of every three births in America is to an unwed mother. In 1992 there were 1.2 million births to unmarried women, almost double that in 1980. Unmarried mothers tend to have poorer birth outcomes than married mothers because they are disproportionately young, poorly educated, and more likely to be poor. Although teenage birth rates declined again in 2004, it was at a much slower pace then seen in years past suggesting the possibility of a future increase. 41.2 births per 1,000 in 2004 were to females aged 15-19. With an increasing number of mothers being unwed, young, poorly educated, and financially unstable, the statistics on these populations becomes increasingly important.
A new report from the National Center for Health Statistics, Centers for Disease Control and Prevention, shows that a substantial number of U.S. adolescents and young adults, aged 12-21 years, are engaged in behaviors such as smoking, binge-drinking, and violence that can influence health and longevity, both in the short term and later in life. If these behaviors are being practiced by pregnant teens, this ultimately affects the unborn child as well. These effects transcend the birth and infancy of these children. Research has shown that these “high risk” mothers (low income, low education, adolescent) have tendencies for child abuse and neglect (Lesser, et. al., 1999). Furthermore, a 1999 report from the Alan Guttmacher Institute reported that poor and low-income adolescents make up 38 percent of all women ages 15 to 19; yet, they account for 73 percent of all pregnancies in that age group. If these groups of mothers are given an intervention such as an outreach home visitation program prior to birth, it has been shown to greatly decrease probabilities of these behaviors (Honig, et. al., 2001).
In addition to the precarious situations and stressors that the growing population of “high risk” mothers experience, “ordinary” expectant mothers also experience their own share of stressors. A new study, out of Advances in Nursing Science Physiologic Health Outcomes,” indicates that maternal prenatal stress may be hazardous to infant health. Changes in maternal hormonal and immune function as a result of stress may adversely affect the immune function and neurodevelopment of the fetus (Ruiz, et.al., 2005). By affecting neurological development, this has the potential to have profound effects on the baby’s later growth and future relationships. This prenatal stress may have many contributors including the traditional “American Lifestyle”. More and more often, women are taking high level, strenuous jobs or jobs involving long hours on working on your feet. Research has shown that these behaviors can increase preterm births and low birth weights (Gabbe, and Turner, 1997).
By giving all mothers both “high risk” and “ordinary” a tool to promote stress reduction and prenatal bonding, mothers are potentially less likely to engage in harmful behaviors and more likely to engage in behaviors that promote healthy development and secure attachment.
Currently, little has been done to focus on mothers and the possible benefits of a prenatal intervention. One major study (Manrique, et.al., 1998), conducted in Venezula with 680 low-income, at-risk families over a period of six years, demonstrated that a prenatal program consisting of stress-reduction techniques, visualization and breathing exercises, stimulating the fetus through music, talking and touch and involving the father, provided the following benefits:
For Mothers: 1) better able to handle labor, 2) had greater success at breastfeeding, 3) felt more attuned to baby’s signals and needs, and 4) had more confidence as a parent.
For Baby: 1) enhanced motor development, 2) enhanced language development, 3) earlier social engagement (smiling, playing peek-a-boo), and 4) more content and better able to control emotions.
For Family: 1) showed greater bonding, 2) provided great family cohesion.
These outcomes demonstrated that an at-risk population could benefit from a program incorporating many of the characteristics used in the Manrique study. This led to the development of the “Nurturing Baby and Me During Pregnancy Program” (formerly named “I’m Right Here Baby…Parenting from Conception” book and CD) to be used by mothers to relax during pregnancy and build stronger emotional bonds with their unborn babies, and in hopes of eventually being used as a tool by social workers, and other agencies working with this high-risk population and with pregnant women under stress.
Program Goals
The prime objective of the study is to determine if the “Nurturing Baby and Me During Pregnancy Program” would add value to the current HF prenatal curriculum used by well trained home visitors: “Great Beginnings start before birth” curriculum. The program consists of a guidebook and audio CD aimed at improving maternal/child relationships after birth (see Tools below). Since we are measuring the differences between parents receiving the guidebook and parents who did not, we need to gather all the survey data from both groups and compare. The study was designed to have parents use the guidebook for a period of about six months and take the first survey at the eighth month of pregnancy. Additionally, a second follow-up survey will be given to all mothers at 2 months after birth to assess the long-term effectiveness of the tools.
Hence, programs and tools which are effective at building strong emotional bonds between a parent-to-be and her unborn child will help to protect that child after birth and enhance development throughout life. The hypothesis is that if a pregnant woman communicated with and felt more bonded their unborn child, they would become more involved in their pregnancy and it would help them become a more skilled, responsive and nurturing parents and this could be beneficial to all parents after birth and to the long-term trajectories of positive child development.
Program Overview
This study/program was funded by a grant form the Freddie Mac foundation to study the effectiveness of a new prenatal parenting tool created by Developing Hearts Systems (“Nurturing Baby and Me During Pregnancy Program”) with high stress expectant moms enrolled in the Healthy Families America Home Visitation Program and using the Great Beginnings Start before Birth Curriculum. The data was survey collected by the HF home visitor during scheduled home visits. The study data was tabulated and analyzed Brooke Huntley, M.A., 3 years as a Clinical Research Coordinator at Walter Reed Army Medical Center, an independent volunteer.
Methods:
Subjects:
31 participants are currently enrolled in the program. The subjects were recruited from new parents enrolled prenatally in the Healthy Families (HF) site in Hampton, Virginia. 17 mothers are currently participating in an evaluation of our new prenatal parenting book, which was given to them by the home visitor and used in conjunction with the HF Great Beginnings Start Before Birth Curriculum. The control group consists of a matching group of 14 parents who did not receive the new book intervention during their enrollment in the HF site, but received the HF Great Beginnings Start Before Birth Curriculum prenatal home visitation program taught by the curriculum-trained home visitors.
Note: The HF Great Beginnings Start Before Birth Curriculum involved a home visitor engaging with these mothers and introducing them to many of the same experimental activities to enhance prenatal bonding and stimulation and information that was contained in the book. Mothers are given stress reduction and strategies for engaging fathers. Fetal growth and development, along with emotional and physical changes experienced by the parents are explored. The curriculum links parents and infants to early preventive medical care, improves service utilization, and results in improvement of overall healthy status. Overall, it helps promote parent-child bonding and attachment, a process that begins even before birth. However, with the curriculum they were NOT given any tangible tools like the book and CD’s themselves which the mothers could use between visits.
Based on data from HF, it is known that the parents participating in the Healthy Families Home Visitation programs are more likely to be immigrants, single or teen parents who have been screened for and face multiple challenges including isolation, housing, poverty, substance abuse and domestic violence. These parents are under extraordinary personal and social stress that can drain much of their emotional energy and put their child at greater risk for abuse.
Tools:
“Nurturing Baby and Me During Pregnancy Program”: Nurturing Baby and Me During Pregnancy Program consists of a 128-page printed guidebook with 94 color photos and an audio CD with 12 exercises and 45 minutes of music. The guidebook follows a week-by-week framework with information and exercises keyed to typical developmental stages. The program content is broken down into simple weekly goals, easy-steps and a daily 15-minute exercise. The key, unique features of the program include: An 80-minute audio CD featuring a soothing pregnancy coach that guides moms through the exercises. In greater detail, the book/CD have 1) interactive massage, games and dancing exercises, 2) scientific research, written in simple language, explaining what baby can hear, feel and respond to in the womb, 3) 3-D sonograms which show baby's developmental milestones, 4) stories from real parents who have enjoyed connecting with their unborn children, 5) original four-color photography featuring a broad mix of women and families modeling the exercises and connecting with their unborn babies (and the reader), 6) journal pages to express feeling and make treasured memories to look back on, and 7) specially composed music to soothe Mom and stimulate baby during pregnancy and comfort both of them during delivery. This tool was given to the 17 mothers assigned to this group shortly after enrollment in the program sometime before the fourth month of pregnancy allowing at least 5 months of usage prior to the pre-natal survey.
Pre Natal Survey: A pre-natal survey was given to all 31 participants during a visit from a HF visitor at approximately the 8th month of pregnancy. The survey consisted of 12 questions. The 5 demographic questions asked for current month of pregnancy, age of parent, baby’s birth number, father involvement, and family support. The 7 assessment questions consisted of: 6 multiple choice and one open ended question. The questions were geared to assess the mothers interactions with their baby through massages, reading, and singing and to assess the mothers self report of her knowledge of the baby’s development and the mother’s feelings about being able to communicate and bond with her unborn baby. The final question was an open ended question for comments from the mother. In addition, the mothers receiving the tool, were asked 2 additional questions assessing their use of the book and a question was listed for the home visitor to assess the helpfulness of the tool with the client.
Post-Natal Survey: A post-natal survey was/will be given to all 31 participants during a visit from a HF visitor approximately 2 months after birth. The survey consists of 4 questions. There are 3 multiple choice questions assessing the bond between the mother and child, parenting abilities, and the baby’s development. There was one open-ended question for comments from the mother. In addition, the mothers receiving the tool were asked 4 additional questions and the home visitor was asked 1 inquiring about the helpfulness of the tools and whether the CD was used during delivery.
Results/Discussion:
All samples were small; therefore the study did not have robust power which made achieving statistically significant results difficult. Thus, the results will be presented descriptively. The sample size completing the pre-natal survey was 31. The total number of subjects completing both the pre-natal survey and the post-natal survey was 20 (12 received the tool and 8 who did not).
Pre-natal Demographics: The experimental group (the mothers receiving the book/CD) ranged in age from 15-31 years of age with the mean age being 20.5. The control group (mothers not receiving the tool) ranged in age from 16-32 with the average age being 22 years old. For the experimental group, 75% of the mothers were first time moms whereas the control group only had 66.7% first time moms. Of the mothers in the experimental group, 75% of them had support from the baby’s father and 94.1% had family support. In contrast, of the mothers in the control group, 69.2% had support from the father and 100% had family support.
Post-natal Demographics (subjects completing both pre and post): The experimental group ranged in age from 15-28 years of age with the mean age being 19.5. The control group ranged in age from 16-29 with the average age being 21.2 years old. For the experimental group, 73% of the mothers were first time moms whereas the control group only had 63% first time moms. Of the mothers in the experimental group, 64% of them had support from the baby’s father and 100% had family support. In contrast, of the mothers in the control group, 57% had support from the father and 100% had family support. The post-natal survey was completed 1.9 months after birth for the experimental group and 2.1 months after birth for the control group on average.
Pre-natal Results/Discussion:
Education Results: Larger numbers of parents who were given access to the Bonding with Baby book and CD reported connections with their baby. 64.7 % of the mothers given the book vs. 37.7% not given the book strongly agreed they could communicate with their unborn baby. All mothers receiving the book strongly agreed or agreed that they could communicate with their baby. Similarly, 64.7% of the mothers give the book vs. 57.1% not given the book strongly agreed that they could develop a bond with their baby before birth. This result would suggest that the book helped moms communicate more and feel more connected to their unborn babies than the control group. However, the results on the question of the books help in giving mothers a good understanding of baby’s development in the womb were inconsistent with the role of the book in communicating and bonding as 47.1% of the mothers given the book vs. 57.1% of the mothers not given the book strongly agreed that they have a good understanding of their baby’s development in the womb. This unexpected result, which is a mothers self-report regarding her belief not actual knowledge, instigated further analysis into the demographics of the two groups. One major difference was that the group receiving the book had more first time moms who could be expected to have less developmental knowledge and confidence.
It was revealed that when the “mothers receiving the book” group was broken down into first time moms and mothers with previous children, 75% of the mothers who have had previous births vs. 41.7% of the moms who were first time moms strongly agreed that they had a good understanding of the baby’s development. Although, this may not account for the entire discrepancy, it seems to account for much of it.
Other factors that may explain the result: 1) there was less family support in the group of mothers receiving the tool, so these family members (mothers, sisters, etc.) may contribute to the mothers understanding of development, 2) the mothers receiving the tool are on average younger than their counterparts, which could contribute to overall developmental knowledge, or 3) it is possible that the mothers receiving the book became more knowledgeable from the tool, but it left them realizing how much they still should know about the baby’s development, therefore producing the low self report score of development in the womb.
Further results are seen in the following table.
Mothers receiving book
Mothers not receiving book
I believe I can communicate with my baby in the womb.
Strongly Agree
64.7%
37.7%
Agree
35.3%
14%
Disagree
0%
35.3%
Strongly Disagree
0%
0%
Don’t Know
0%
0%
I believe I can develop a bond with my baby before birth.
Strongly Agree
64.7%
57.1%
Agree
35.3%
37.5%
Strongly Disagree
0%
0%
Disagree
0%
0%
Don’t Know
0%
7.1%
I believe I have a good understanding of my baby’s development in the womb.
Strongly Agree
47.1%
57.1%
Agree
47.1%
35.7%
Strongly Disagree
0%
0%
Disagree
0%
0%
Don’t Know
5.9%
7.1%
Physical Bonding Results: The book is also developing as a tool encouraging the mothers to establish a bond physically with their baby. All mothers receiving the book massaged or played the kick game with heir baby at least once a week with over 94% playing 2-3 times or more weekly. Additionally, in looking at each exercise, at least 9% more mothers who were given the book vs. not given the book performed each exercise at least 2-3 times per week. There does not appear to be a significant difference across the two groups, this lack of difference may be due to mother’s age, family support, and birth number, or outside factors not accounted for in this survey. Although, more mothers who did not receive the book reported doing the exercises everyday slightly more often, more of the non-book mothers reported never doing the exercises or only once a week. This may be attributed to the fact that there were more older moms who already had children and that talking and singing in the home would be more natural. The trend developing suggests that mothers who may have other means of learning how to communicate with their baby are doing so, whereas, the mothers who don’t have an outside tool (like the book) are not learning that that physical connection is important. It should also be noted that the home visitor plays an important trusted role in their clients lives and that their recommendations and support for doing the exercises (talking, singing, etc.) was likely very influential. Conversely, it may be that home visitors using the book as the main tool to promote the exercises may not have been as proactive in recommending the exercises.
Mothers receiving book
Mothers not receiving book
How often did you massage your baby or play the kick game with your baby?
Never
0%
7.1%
Once per Week
5.9%
7.1%
2-3 Times per Week
35.3%
7.1%
Everyday
58.8%
76.6%
How often did you read or talk to your baby?
Never
0%
7.1%
Once per Week
11.8%
14.3%
2-3 Times per Week
29.4%
7.1%
Everyday
58.8%
71.4%
How often did you sing songs or play music to your baby?
Never
5.9%
21.4%
Once per Week
23.5%
21.4%
2-3 Times per Week
47.1%
14.3%
Everyday
23.5%
42.9%
Further analyses: When the physical bonding questions were looked at collapsing across group, noteworthy results were revealed. The entire sample was separated by age. An arbitrary cut-off of 20 years old was chosen since the age of 19 is a common age when children leave their parent’s home. The mothers under the age of 20 tended to report having slightly less physical contact and interaction with their baby. This may be due to younger moms feeling shy or uncomfortable talking, singing, or playing with their unborn baby. See below.
In addition, the one mom lacking family support, reported never singing to the baby, reading once per week to her baby, and massaging the baby 2-3 times per week.
Young Moms (<20)
Older Moms (= 20)
How often did you massage your baby or play the kick game with your baby?
Never
7.1%
0%
Once per Week
7.1%
7.7%
2-3 Times per Week
28.6%
15.4%
Everyday
57.1%
76.9%
How often did you read or talk to your baby?
Never
0%
7.7%
Once per Week
21.4%
0%
2-3 Times per Week
21.4%
15.4%
Everyday
57.1%
76.9%
How often did you sing songs or play music to your baby?
Never
7.1%
15.4%
Once per Week
14.3%
23.1%
2-3 Times per Week
42.9%
30.8%
Everyday
35.7%
30.8%
Mothers Recommendation Results: Overall, the mothers who received the book and CD found the materials to be a very useful and helpful tool during their pregnancy. One hundred percent of the mother’s receiving the bonding with Baby book/CD reported reading the book and using the book. Over 88% of the mothers receiving the book found it to be helpful with only one mother reporting that it was unhelpful. This mother’s response may be a result of her due date calendar her doctor gave her being 5 weeks off (self reported in the comments section). The CD was found to be helpful or very helpful in reducing stress by 76% of the mothers who received it. Again, only one mother reported the CD being unhelpful in reducing stress. Correspondingly, over 94% of the mothers agreed or strongly agreed that they would recommend the tool to other moms-to-be. Results are in the following table.
Mothers receiving book
In preparing you mentally for motherhood, did you find the book “Nurturing Baby and Me During Pregnancy Program” …
Very Helpful
41.2%
Helpful
47.1%
Made No Difference
0%
Unhelpful
5.9%
Don’t Know /No Response
5.9%
In reducing your stress during pregnancy did you find the CD that came with the book…
Very Helpful
41.2%
Helpful
35.3%
Made No Difference
5.9%
Unhelpful
5.9 %
Don’t Know /No Response
11.8%
I would recommend “Nurturing Baby and Me During Pregnancy Program” to other moms-to-be.
Strongly Agree
64.7%
Agree
29.4%
Disagree
0%
Strongly Disagree
5.9%
Don’t Know /No Response
0%
Home Visitor Results: Of the at home visitors who answered the question regarding the usefulness of the book and CD, they all reported the book helpful in working with the mothers. Over 33% reported it was very helpful, 47% reported it was helpful, and only 14% reported that it made no difference. No visitors reported that it was unhelpful.
Looking at trends in responses, the results lend support for the validity and effectiveness of the “Nurturing Baby and Me During Pregnancy Program” . The prenatal goals were met. A greater portion of the mothers receiving the tool 1) participated more often in the prenatal exercises(70.6% vs. 57.2% performed all the activities at least 2-3 times per week), 2) were stimulated to believe they can communicate and bond with their unborn baby (100% vs. 87.7%), 3) found the book satisfying (94.1% would recommend it) and helped inform and prepare them mentally for childbirth (88.3%).
Post-Natal Results/Discussion:
Education Results: A larger number of mothers receiving the book reported a very close bond with their baby following birth than those not receiving the tools. 75% of the mothers given the book/CD vs. 62.5% of the mothers not given the tools reported a very close bond with their baby. 25% of each group reported a close bond with their baby and where none of the mothers receiving the tools felt anything other than a close/very close bond, 12.5% of the mothers not receiving the book felt an average bond with their baby. Similarly, the mothers receiving the book/CD rated their parenting abilities better than their counterparts not receiving the tools. 41.7% of the mothers receiving the book vs. 37.5% of those not receiving the book reported an excellent parenting ability. In contrast, 58.3% who received the tools vs. 62.5% not receiving the tools reported their parenting abilities as only “good”. Likewise, mothers receiving the book reported feeling better about their baby’s development than those mothers not receiving the book. 91.7% vs. 87.5% reported being happy about their baby’s development for the mothers receiving the book and those not receiving the tools, respectively. Only one mother in the group receiving the book reported their baby’s development as “okay” whereas, one mother in the group not receiving the book reported being worried about their baby’s development. These results would suggest that the tools helped in fostering a bond between mother and baby and led to greater confidence in parenting and thus potentially healthier development.
In addition to the tools (book/CD) promoting and fostering a closer bond and better development of the baby, other factors may contribute to the above results as well. The control group (the mothers not receiving the book/CD) may in fact feel a more distant bond, poorer parenting abilities, and worse development due to a greater number of these mothers having other children to take care of. This may have allowed less time for the mother to bond with the new baby. Similarly, these mothers were also less likely to have father involvement. Without the father being involved and assisting the mothers with other duties these single parents may have less time to devote to communicating with the baby. In addition, the mother reporting being worried about her baby’s development commented that the baby had developmental disabilities due to complications during the birth. In contrast, the mothers receiving the book/CD were on average 2 years younger and were more likely to be first time mothers. Despite these potential hindrances, they reported feeling closer to their baby, and more confident in their parenting abilities.
The above results are seen in the following table.
Which best describes your bond with your baby?
Mothers receiving book
Mothers not receiving book
Very Close
75%
62.5%
Close
25%
25%
Average
0%
12.5%
Somewhat Close
0%
0%
Not very Close
0%
0%
How would you rate your parenting abilities?
Excellent
41.7%
37.5%
Good
58.3%
62.5%
OK
0%
0%
Not very good
0%
0%
Please tell me which answer best describes how you feel about your baby’s development?
I am happy about my baby’s development
91.7%
87.5%
My baby is developing ok
8.3%
0%
I am worried about my baby’s development
0%
12.5%
The mothers receiving the book/CD reported the book being helpful in preparing for motherhood. 50% reported it being very helpful and 50% reported it being helpful. Similarly, 83.3% of the mothers reported the book being helpful in making the mothers feel closer to the baby, whereas, 16.7% reported no difference. Only one mother was able/elected to use the CD during the birth. She reported it as being helpful during delivery.
Overall Discussion:
Evaluating the responses on both the prenatal and postnatal surveys, the results support the “Nurturing Baby and Me During Pregnancy Program” and it’s validity and effectiveness. As mentioned above, all prenatal goals were met: a greater portion of the mothers receiving the tool, 1) participated more often in the prenatal exercises, 2) were stimulated to believe they can communicate and bond with their unborn baby, 3) found the book satisfying and reported that it helped inform and prepare them mentally for childbirth. Similarly, following the birth all program goals were met: a greater portion of the mothers receiving the tool, 1) reported a closer bond with their baby 2) rated their parenting abilities as superior and, 3) reported being happier about their baby’s development. In addition, the home visitors commented that the tools “were user friendly” and “were really helpful”.
Although the small sample size and the differences between the sample groups lead to results that were not statistically significant, the statistics suggest that the program was successful. A positive benefit was evident from using the Nurturing Baby and Me During Pregnancy prenatal tools. These results provide great support for conducting a larger scale study, better controlling for sample differences in the future.
*Research study designed by Erika Jones, Surveys and data collected by Healthy Families Hampton Family Support Workers Data tabulated, analyzed and reported by Brooke M. Huntley, MA, Clinical Research Coordinator, Walter Reed Medical Center
References:
Alan Guttmacher Institute. Teenage Pregnancy and the Welfare Reform Debate. [Issues in Brief]. New York: The Institute, 1998.
Gabbe, S., and Turner, L.P. Reproductive Hazards of the American Lifestyle: Work During Pregnancy. American Journal of Obstetrics & Gynecology, April 1997; 176(4): 826-832.
Honig, Alice S., and Morin, Christine. When Should Programs for Teen Parents and Babies Begin? Longitudinal Evaluation of a Teen Parents and Babies Program. The Journal of Primary Prevention, Summer 2001; 21,4; Health & Medical Complete pg. 447.
Lesser, J. and Escoto-Lloyd S. Health-related Problems in a Vulnerable Population: Pregnant Teens and Adolescent Mothers. Nursing Clinics of North America, Jun. 1999; 34(2): 289-99.
Manrique, B., et.al. A controlled experiment in prenatal enrichment. Journal of Prenatal and Perinatal Psychology and Health, Spring/Summer 1998; 12 (#-4).
Ruiz, R., and Avant, K. Effects of Maternal Prenatal Stress on Infant Outcomes: A Synthesis of the Literature. Advances in Nursing Science. Physiologic Health Outcomes, October/December 2005; 28(4): 345-355.
Download the entire Nurturing Baby and Me guidebook (for ACNM members only - COMING SOON)
COMING SOON Adobe File with reader so can download. Add statement. For review only. No reproduction allowed without permission. C 2006 Developing Hearts Systems, Inc. All rights reserved.
Submit your practice and patient experience with Nurturing Baby and Me
Share your experiences/feedback about Mothers & Midwives Campaign and Nurturing Baby and Me
Please share yours’ and your patients’ experiences with this campaign and program. The publisher and our partners ACNM, want to know how this program worked for you so we can improve it and share it with other midwives to make it even more effective. Please fill out the feedback form and we’ll acknowledge your contribution.
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Participate in Mothers & Midwives Campaign outreach and publicity program in your community
Participate in Mothers & Midwives Campaign outreach and publicity program in your community.
If you and your practice are interested in obtaining some local news coverage about your practice and the campaign and program and you and your patients who have participated would be available for interviews, please complete the form. Our News Bureau will get back to you after we’ve contacted your local paper to arrange for an interview:
ACNM Member? We
have a special offer for you along with free posters
and flyers.
Take regular quiet time and better care of herself
How does the campaign and program work? All the midwife has to do is put up a poster in the waiting room and hand out a flyer to their new clients. Your client then goes on-line to the ACNM Web site to learn more and order the program for herself at a special price exclusive to ACNM members and their patients ($14.95 +S&H).
Having a baby these days can be a stressful undertaking. Health researchers continue to see the adverse affects of that stress on a pregnant woman’s body, her baby, and her important relationships.
Advances in prenatal technology and brain science research are changing how we think about pregnancy and the womb world. We are only beginning to explore whether, and if so how, babies can sense, feel and learn during the prenatal period. Early evidence suggests that the unborn are more aware than many of us thought.
Benefits For Mothers:
