Reconciling relationships with physical activity: a qualitative study of women's postnatal physical activity decision-making.

BACKGROUND: Challenges with engaging in postnatal physical activity can negatively affect the health of women and their families. This study investigated women's physical activity decision-making processes and strategies to support their physical activity as part of a healthy postpartum transition. METHODS: Thirty healthy women with infants aged 2.5-12 months completed 3-day activity diaries and an individual interview. Using Glaser and Charmaz's grounded theory methodology, the core category, reconciling relationships with physical activity, was constructed, which explained women's processes of postnatal physical activity decision-making. RESULTS: Through reconciling relationships with physical activity, women discerned the types of physical activity they were comfortable pursuing at various points in the postpartum transition. Based on the meaning physical activity held for participants and their views about risks, supports, and resources, women gauged their capacity and the workability of their physical activity desires. Most women were uncertain of their capacity (physical, emotional) to return to physical activity and viewed the achievement of several or all of their desired physical activities as unworkable. Only a small group of women fully pursued the desirable physical activities they viewed as important for their well-being. Women adjusted the strategies they used to achieve physical activity when their expectations of capacity and workability did not align with their experiences. Some women lacked access to resources or supportive messaging about postpartum physical activity and downgraded their physical activity pursuit after negative personal physical or childcare experiences. CONCLUSIONS: Women can benefit from discussions about physiological birth recovery and navigating community and peer resources to support physical activity access and the safe return to physical activity following birth.

Postpartum depression: the (in) experience of Brazilian primary healthcare professionals.

AIM: This article reports experiences of Brazilian physicians and nurses caring for women with postpartum depression in primary healthcare settings. BACKGROUND: Prevalence of postpartum depression in Brazil ranges from 12-37%, which fits with international claims about differences in the magnitude of the problem and consistency of screening. DESIGN: Qualitative descriptive. METHOD: This study was situated in health units of the Family Health Strategy in Campina Grande, Brazil. Data were collected from September 2010-January 2011 through open-ended interviews with ten nurses and seven physicians, observations, and field diary records. Inductive content analysis was used to develop categories. FINDINGS: Three categories: (1) Limited professional exposure to postpartum depression; (2) Postpartum depression as the domain of psychiatry; and (3) Challenges dealing with postpartum depression demonstrated that few professionals felt postpartum depression merited their attention. Women, with signs of postpartum depression, were usually identified by family members who noticed behaviours that seemed abnormal. Care providers indicated they had inadequate time and access to screening techniques to identify women with depression attending unit-based pregnancy and postpartum groups. When identified, women were referred directly to psychiatric care. CONCLUSION: Without consistent screening and diagnostic techniques, Brazilian health professionals are insecure about identifying and treating cases of postpartum depression. Referring women to psychiatric units entail more time for women to be diagnosed and treated and increased costs for health services. Primary healthcare professionals require training to screen, identify, and treat postpartum depression in primary healthcare settings.