ABSTRACT
BACKGROUND: There is a tiered healthcare system in Australia to support maternal and child health, including, non-psychiatric day stay and residential parenting services (RPS) such as Tresillian and Karitane (in New South Wales [NSW]). RPS are unique to Australia, and currently there is limited information regarding the healthcare trajectory of women accessing RPS and if they are more likely to have admissions to other health facilities within the first-year post-birth. This study aimed to examine differences in hospital co-admissions for women and babies admitted to RPS in NSW in the year following birth compared to non-RPS admitted women. METHODS: A linked population data study of all women giving birth in NSW 2000-2012. Statistical differences were calculated using chi-square and student t-tests. RESULTS: Over the 12-year timeframe, 32,071 women and 33,035 babies were admitted to RPS, with 5191 of these women also having one or more hospital admissions (7607 admissions). The comparator group comprised of 99,242 women not admitted to RPS but having hospital admissions over the same timeframe (136,771 admissions). Statistically significant differences between cohorts were observed for the following parameters (p ≤ .001). Based upon calculated percentages, women who were admitted to RPS were more often older, Australian born, socially advantaged, private patients, and having their first baby. RPS admitted women also had more multiple births and labour and birth interventions (induction, instrumental birth, caesarean section, epidural, episiotomy). Their infants were also more often male and admitted to Special Care Nursery/Neonatal Intensive Care. Additionally, RPS admitted women had more admissions for mental health and behavioural disorders, which appeared to increase over time. There was no statistical difference between cohorts regarding the number of women admitted to a psychiatric facility; however, women attending RPS were more likely to have mood affective, or behavioural and personality disorder diagnoses. CONCLUSION: Women accessing RPS in the year post-birth were more socially advantaged, had higher birth intervention and more co-admissions and treatment for mental health disorders than those not accessing RPS. More research is needed into the impact of birth intervention and mental health issues on subsequent parenting difficulties.
Subject(s)
Mothers , Parenting , Australia/epidemiology , Cesarean Section , Child , Female , Humans , Infant , Infant, Newborn , Male , New South Wales/epidemiology , Parenting/psychology , PregnancyABSTRACT
The unprecedented COVID-19 pandemic has impacted families' mental health around the globe. In June 2020, 1163 parents of high (43%), middle (47%), and low socioeconomic status (SES) (10%) participated in an online survey developed to explore how daily life changes and restrictions that came with COVID-19 affected the experiences of pregnancy and/or parenting children under the age of 5 in Chile. The survey's design had an exploratory and descriptive scope, with a mix of qualitative and quantitative questions. With the aim of exploring differences before and after COVID-19, two time periods were established, and the 47-item questionnaire covered participants' sociodemographic information, support networks, health concerns, mood changes, self-regulation, adult and children's perceived well-being, parental competencies and parents' perceptions of the unborn baby and/or their children's needs. The results relative to retrospective reporting of pre-pandemic levels, showed an increase in children's crying and tantrums as well as in parental irritability and sadness. Additionally, decreases in the ability to calm down and sleep quality in both parents and children were identified. Finally, at a qualitative level, COVID-19 stands out both as an opportunity to get to know their children better and as a stressor related to parental burn-out and discomfort.
La sin precedentes pandemia del COVID-19 ha tenido un impacto en la salud mental de las familias alrededor del mundo. En junio de 2020, 1,163 progenitores de condiciones socioeconómicas (SES) altas (43%), medias (47%) y bajas (10%) participaron en una encuesta por computadora desarrollada para explorar cómo los cambios en la vida diaria y las restricciones que surgieron con el COVID-19 afectaron las experiencias de embarazo y/o crianza de niños bajo la edad de 5 años en Chile. El diseño de la encuesta tenía un alcance exploratorio y descriptivo, con una mezcla de preguntas cualitativas y cuantitativas. Con el propósito de explorar las diferencias antes y después del COVID-19, se establecieron dos períodos de tiempo, y el cuestionario de 47 puntos cubría la información sociodemográfica de los participantes, las redes de apoyo, las preocupaciones relacionadas con la salud, los cambios en el estado de ánimo, la autorregulación, la percepción del bienestar de adultos y niños, las competencias de los padres y las percepciones de los padres acerca del bebé no nacido y/o las necesidades de sus niños. Los resultados relativos al reporte retrospectivo de niveles previos a la pandemia mostraron un incremento en el llanto y las rabietas de los niños como también en la irritabilidad y estado de tristeza de los padres. Adicionalmente, se identificó una disminución en la habilidad de calmar y la calidad del sueño tanto en padres como en niños. Finalmente, al nivel cualitativo, el COVID-19 se presenta tanto como una oportunidad de llegar a conocer mejor a sus niños y como un factor de estrés relacionado con la fatiga y la incomodidad de los padres.
La pandémie sans précédent du COVID-19 a impacté la santé mentale des familles dans le monde entier. En juin 2020 1163 parents issus d'un milieu socioéconomique élevé (43%), moyen (47%) et peu élevé (10%) ont participé à un questionnaire en ligne afin d'explorer comment les changements de la vie de tous les jours et les restrictions qui ont accompagné le COVID-19 ont affecté les expériences de grossesse et/ou le parentage d'enfants sous l'âge de 5 ans au Chili. La conception de l'enquête avait une portée exploratoire et descriptive, avec un mélange de questions qualitatives et quantitatives. Avec le but d'explorer les différences entre l'avant et l'après COVID-19, deux périodes de temps ont été établies, et le questionnaire de 47 éléments a couvert les renseignements sociodémographiques des participants, leurs réseaux de soutien, leurs inquiétudes relatives à la santé, les changements d'humeurs, l'auto-régulation, le bien-être perçu des adultes et des enfants, les compétences parentales et les perceptions des parents du bébé à naître et/ou des besoins de leurs enfants. Les résultats relatifs aux états de fait rétrospectifs de niveaux pré pandémiques ont montré une augmentation des pleurs des enfants et des crises des enfants ainsi qu'une augmentation de l'irritabilité et de la tristesse parentale. De plus des baisses dans la capacité à se calmer t dans la qualité de sommeil des deux parents et des enfants ont été identifiées. Finalement, au niveau qualitatif, le COVID-19 se distingue à la fois en tant qu'une chance de mieux connaître leurs enfants et en tant que facteur de stress lié au burn-out et au malaise parental.