INTRODUCTION

Postnatal period begins immediately after the birth of the newborn and extends up to 6 weeks. It is significant for the mother, for the baby, and for the family as it is a time of physiological adjustment for the mother and the baby and emotional and social adjustment for all involved in the care. During this period, the woman has to make major adjustments as this may in turn be crucial for her present and future ability to function. This period is also the challenging period in her reproductive life. The transition from a nonmother to a mother, or from being a mother of one child to becoming a mother of two children, calls for changes in a woman's role relationships and/or alteration in her behavior and in herself in the social context.^1-4

OBJECTIVES

MATERIALS AND METHODS

A quantitative descriptive survey design was utilized, and the sample size was 500 postnatal mothers which was through purposive sampling technique in postnatal wards of the Department of OBG at Justice K.S. Hegde Hospital by using structured rating scale for postpartum challenges and for coping strategies. Structured checklist of 25 items was used.

RESULTS

The demographic characteristics were as follows: 45.8% were in the age group of 25 to 29 years and 2% were in age group of 18 to 20 years. Most of the participants were of Hindu religion (66.4%) (Table 1). Regarding literacy, 39% studied up to high school and only 0.4% were Christians. Most of the participants were nonworking (84.6%). Regarding family income, 35.4% were between 5,001 and 10,000 INR, and 22% were having an income of more than Rs. 15,000. About 53.2% had more than one child, and 46.8% had one child. Most of the participants had normal vaginal delivery (62%). With regard to gestational age at delivery, 29.2% delivered at 39 weeks and 4.2% more than 40 weeks. 52.8% delivered male baby and 47.2% female baby. Regarding weight of the baby, in 81.4%, the baby weighed more than 2.5 kg. With regard to physiological challenges, most of the mothers had positive adaptation. About 34.2% had pain at the suture site sometimes, and 14.2% of the participants never felt pain. About 36.8% were fatigued sometimes and 36.8% were never able to rest comfortably. About 28.8% had sleep disturbance sometimes and 51.4% had no breast engorgement. About 50.8% never had abdominal pain after delivery. Under emotional challenges, most of the mothers were able to cope up positively with challenges and had good adaptation, and some participants were unable to adapt positively. About 87.8% of mothers never had persistent feelings of not being a good mother. About 64% of mothers were not depressed due to exhaustion. All the mothers had positive feeling toward the sex of the baby. About 72% were not anxious at all always, and 76.4% of the mothers were joyful. About 74% of the mothers were never depressed due to the physical changes of pregnancy and childbirth. About 89% were never disturbed by the sex of the baby. About 74% had positive feeling toward sex of the baby. With regard to environmental challenges, 55% were not distressed with the physical setup and only 10.2% felt most of the time the environment was distressing. About 56.2% never felt that visitors were a hindrance. Only 4.6% felt that there was noise in the ward always. Only 25.6% felt that privacy was maintained always, whereas 36.4% felt that privacy was never maintained, and only 14.8% felt that privacy was maintained most of the time. Only 85.2% were extremely happy with breastfeeding, whereas only 2% were never happy with breastfeeding. 56% had no latching difficulty; 24% expected breastfeeding assistance sometimes and 44.8% never expected breastfeeding assistance. About 89.8% of mothers were never reluctant to feed. With regard to communication challenges, 52.2% expressed that all the health professionals communicated to them always and 6.4% felt that all the health professionals never communicated with them. About 37.8% felt that proper communication by the midwives and student midwives eased their discomfort always, and 13% felt that student midwives were involved in their care always and 27.4% sometimes. Regarding newborn challenges, 73.2% were never irritated when the baby was crying and only 5.2% were irritated always when the baby was crying. About 31.8% were never aware of the newborn care and 35.4% were totally aware of the newborn care always. About 30% of mothers never had the difficulty in pacifying the elder sibling. Regarding employment, 75.6% of the participants were homemakers. Regarding family support, 71.2% of the mothers felt their family members were supportive always and only 4.8% felt never supportive. About 73.2% felt that their in-laws were caring always and 93.4% felt that their spouse was caring always. A structured checklist with yes/no categories was used to assess coping strategies, and it was found that almost all the mothers were able to cope up well. About 98.8% expressed that they were able to console the baby appropriately when the baby was crying. About 94.8% were able to take care of the child and 94.4% did not react hastily or emotionally. There was significant association between physiological challenges and selected demographic variables, such as occupation (0.061, p < 0.05) and family income (0.001, p < 0.05). Regarding association with breastfeeding and selected demographic variables, such as age (0.074, p < 0.05), educational status (0.024, p < 0.05), family income (0.021), parity (0.000), gestational age (0.026), and sex of the baby (0.087, p < 0.05), there was significant association. The data presented in Table 2 shows that there is association with breastfeeding and selected demographic variables, such as age, religion, educational status, family income, parity, gestational age, and sex of the baby (p < 0.05). There was significant association between communication challenges and coping strategies (0.017, p < 0.05). There was significant association between emotional challenges and selected demographic variables, such as family income (0.007, p < 0.05), type of delivery (0.002, p < 0.05), gestational age (0.058, p < 0.05), and sex of the baby (0.060, p < 0.05). Table 3 depicts there was significant association between emotional challenges and selected demographic variables, such as family income, type of delivery, gestational age, and sex of the baby. There was significant association between employment challenges and selected demographic variables, such as educational status (0.000, p < 0.05), occupation (0.000, p < 0.05), and parity (0.000, p < 0.05). There was significant association between environmental challenges and selected demographic variables, such as educational status (0.029, p < 0.05) and type of delivery (0.035, p < 0.05). Table 4 depicts there was significant association between environmental challenges and selected demographic variables, such as educational status and type of delivery. There was significant association between newborn challenges and selected demographic variables, such as age (0.000, p < 0.05), educational status (0.026, p < 0.05), occupation (0.024, p < 0.05), and parity (0.000, p < 0.05). Table 5 depicts there was significant association between newborn challenges and selected demographic variables, such as age, educational status, occupation, religion, and parity. Table 6 depicts there was significant association between physiological challenges and selected demographic variables, such as family income and occupation. Table 7 depicts that there was significant association between coping stratergies and demographic variables, such as occupation (p-value = 0.020; p < 0.05; S) and gestational age (p-value = 0.04; p < 0.05; S). Table 8 depicts that there is difference in the mean in the areas, such as breastfeeding challenges, newborn challenges, and employment status.

CONCLUSION

Findings of the study revealed that majority of the women had a positive adaptation toward various postnatal challenges, and also they were able to cope well during the postpartum period. It may be assumed that in Indian settings the support system of the family members is relatively sound, thus indicating that majority of women are able to cope up with the postpartum challenges. Family members, especially the mothers and the grandmother of the postnatal woman, play a major role in bringing about a positive feeling toward motherhood.^5-8