Il ruolo dell'ostetrica in gravidanza nell'attivazione delle risorse materne in puerperio : studio osservazionale prospettico

Introduction Puerperium is a period full of great physical changes and intense emotions, even unexpected. Woman acquires her new role of mother and unavoidable transformations occur in the relation with her partner. This process starts from pregnancy, when a mother has to create a space for the new presence of the baby. it’s not only about a physical area, but also a psychological and affective space. The woman becomes extremely receptive to the infant’s needs and she is ready to think over her ways of life and to change them. That’s why pregnancy is the best time for families and women’s safety promotion. Aim of the study The aim of this study is to understand what a midwife can do during pregnancy to turn on women’s endogenous skills and to help them to satisfy their needs during puerperium. To achieve this goal it’s essential to know and to understand women’s primary needs during the weeks following the childbirth. In this way the midwife will figure out which interventions will be helpful and advantageous for the new mothers. Material and methods The employed necessary data have been collected in two stages: at first by means of a questionnaire and subsequently, 30 days after the birth, through a telephonic interview. During the first phase 69 nulliparous women in the final stages of pregnancy have been chosen, who during July and August 2018 has gone to the pregnancy ward of L. Mangiagalli Clinic in Milano. During the second stage the cross-section will be reduced to 35 women. Results The mother’s needs after the childbirth have been classified in five main categories: breastfeeding needs, needs of the newborn well-being, need of professional support, need of practical support and difficulties in conciliate the condition of the self with the newborn needs. Two other uncommon categories will emerge: the need of reassurance and confirmation, and the need of receiving home help. Facing these necessities, the majority of the puerperae interviewed has highlighted that the information received during pregnancy has been fundamental, confirming the utility of the meetings of childbirth accompanying (which the majority of the women has attended – in responding to the thirst for information. More often, professionals providing assistance during pregnancy do not give any information about it and, as a consequence, women that aren’t attending those meetings are less or not at all informed about the period after birth. In addition to the importance of being informed, puerperae recognize the relevance of a professional support after the childbirth. During pregnancy the 23% of the women haven’t no contact to address to and the remaining 77% has contact with just one professional figure, not always able to answer to the mother’s needs: the result is a lack of assistance due to the lack of information. Puerperae are uninformed about some of the chances of puerperium support, above all about the home help of the freelance midwife and of the other professional figures (IBCLC) or voluntary workers helping with breastfeeding. On the contrary the counselling and the puerperium of the Hospital L. Mangiagalli in Milan are a well known entity. Conclusion and practical relevance During pregnancy every woman has to be informed about puerperium, breastfeeding and all the professional figures or voluntary workers that can give assistance and support. Doing that during pregnancy give to the future mothers a long time lapse to know and eventually receive explanation about the services present locally. So that, from the earliest days at home after birth, they’ll know to who will be better to address in case of necessity. Being able to contact several services allow every woman to chose the best figure depending on her necessities. In light of these considerations, during pregnancy the midwife is able to get women skills started by informing them about puerperium, breastfeeding and all the different possibilities of support present locally.