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Postpartum midwifery care and familial psychosocial risk factors in Switzerland: A secondary data analysis / Hebammenbetreuung im Wochenbett und familiäre psychosoziale Risikofaktoren in der Schweiz: eine Sekundäranalyse

Rebekka Erdin
Rebekka Erdin
, 
Irina Iljuschin
Irina Iljuschin
 et 
Jessica Pehlke-Milde
Jessica Pehlke-Milde
   | 30 juin 2017
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Publié en ligne: 30 juin 2017
Pages: 1 - 13
Reçu: 26 avr. 2016
Accepté: 20 août 2016
DOI: https://doi.org/10.1515/ijhp-2017-0002
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© 2017 Rebekka Erdin, Irina Iljuschin, Jessica Pehlke-Milde, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Figure 1

Geographical distribution of the proportion of families with more than one representable risk factor on the level of the swiss cantons
Geographical distribution of the proportion of families with more than one representable risk factor on the level of the swiss cantons

Figure 2

Loading of representable risk factors grouped by the nationality of the mother. A list of countries in each category is provided in the appendix. (The black lines at the top of each bar denote the 95 % confidence interval of each proportion.)
Loading of representable risk factors grouped by the nationality of the mother. A list of countries in each category is provided in the appendix. (The black lines at the top of each bar denote the 95 % confidence interval of each proportion.)

Figure 3

Referral to other disciplines by the independent midwife, grouped by risk factor loading. (The black lines at the top of each bar denote the 95 % confidence interval of each proportion.)
Referral to other disciplines by the independent midwife, grouped by risk factor loading. (The black lines at the top of each bar denote the 95 % confidence interval of each proportion.)

Characteristics of postpartum midwifery care grouped for risk factor loading: means and frequencies with corresponding 95% confidence intervals

No risk factorOne risk factorSeveral risk factors
Number (n)42 10910 5213622
Total number of consultations: mean5.35 [5.33, 5.38]5.57 [5.51, 5.63]6.09 [5.98, 6.19]
Consultations until 10 days pp
  Mean4.08 [4.06, 4.10]3.71 [3.67, 3.75]3.48 [3.41, 3.54]
  frequency96.8% [96.7%, 97.0]92.7% [92.2%, 93.2%]88.8% [87.7%, 89.8%]
  Cons. 1st day pp: frequency5.58% [5.37%, 5.80%]2.17% [1.91%, 2.46%]2.04% [1.63%, 2.56%]
  Cons. 2nd-4th day pp: frequency40.8% [40.3%, 41.3%]36.1% [35.2%, 37.0%]29.7% [28.2%, 31.2%]
  Cons. 5th - 10th day pp: frequency94.3% [94.0%, 94.5%]90.7% [90.2%, 91.3%]87.1% [86.0%, 88.2%]
Second visits on same day during first 10 days pp
  mean0.275 [0.266, 0.284]0.247 [0.231, 0.263]0.264 [0.236, 0.292]
  frequency11.8% [11.5%, 12.1%]12.0% [11.4%, 12.7%]13.0% [11.9%, 14.1%]
  AND visits during first 4 days: frequency6.48% [6.25%, 6.72%]5.09% [4.69%, 5.53%]4.64% [4.00%, 5.37%]
  AND no visits during first 4 days: frequency5.28% [5.07%, 5.50%]6.94% [6.47%, 7.44%]8.37% [7.51%, 9.31%]
Medically prescribed consultations after 10 days pp
  mean0.460 [0.447, 0.472]1.04 [1.00, 1.08]1.76 [1.67, 1.84]
  frequency15.6% [15.2%, 15.9%]28.4% [27.5%, 29.3%]42.0% [40.4%. 43.6%]
  AND no consultations during first 10 days: frequency1.10% [1.00%, 1.20%]5.07% [4.66%, 5.50%]9.25% [8.35%, 10.2%]
Breast Feeding
  B.f. advice after 10 days pp: mean0.487 [0.479, 0.495]0.545 [0.527, 0.563]0.556 [0.524, 0.588]
  B.f. advice after 10 days pp: frequency29.6% [29.2%, 30.0%]31.3% [30.4%, 32.2%]29.7% [28.3%, 31.2%]
  B.f. problems, at least once: frequency46.5% [46.0%, 47.0%]55.0% [54.1%, 56.0%]63.9% [62.3%, 65.4%]
Referral to other disciplines
  frequency12.2% [11.9%, 12.6%]12.9% [12.3%, 13.6%]19.5% [18.2%, 20.8%]

List of countries in Figure 2

Category of NationalityCountries
Eastern Europe (incl. Russia)Kosovo, Albania, Serbia, Macedonia, Bosnia-Herzegowina, Russia, Croatia, Poland, Romania, Slovakia, Ukraine, Hungary, Czech Republic, Bulgaria, Slovenia, Latvia, Lithuania, Moldova, Estonia, Belarus, Montenegro
Northern Central and Western EuropeGermany, France, Great Britain, Austria, Principality of Liechtenstein, Netherlands, Sweden, Belgium, Finland, Denmark, Ireland, Norway, Island, Luxembourg
Southern EuropePortugal, Italy, Spain, Greece, Andorra, Cyprus, Malta
AsiaTurkey, Sri Lanka, China, India, Thailand, Syria, Japan, Iraq, Vietnam, Philippines, Afghanistan, Iran, Lebanon, Pakistan, Israel, Bangladesh, Mongolia, Indonesia, Armenia, Nepal, Kazakhstan, Taiwan, Cambodia, North Korea, United Arab Emirates, Azerbaijan, Bhutan, Myanmar, Georgian Republic, Jordan, Kyrgyzstan, Kuwait, Laos, Malaysia, Oman, South Korea, Palestine, Saudi Arabia, Singapore, Tadzhikistan, Turkmenistan, Uzbekistan, Yemen
AfricaEritrea, Morocco, Tunisia, Somalia, Democratic Republic of the Congo, Cameroon, Angola, Algeria, Ethiopia, South Africa, Cote d’Ivoire, Kenya, Senegal, Nigeria, Republic of the Congo, Cape Verde, Egypt, Madagascar, Togo, Ghana, Guinea, Burundi, Benin, Burkina Faso, Botswana, Central African Republic, Djibouti, Gabun, Gambia, Guinea-Bissau, Equatorial Guinea, Liberia, Libya, Mali, Mozambique, Mauretania, Mauritius, Niger, Rwanda, Sudan, Sierra Leone, Swaziland, Seychelles, Chad, Tanzania, Uganda, Zambia, Namibia, Zimbabwe
Latin America and CaribbeanBrazil, Colombia, Argentina, Mexico, Dominican Republic, Peru, Bolivia, Ecuador, Chile, Venezuela, Cuba, Dominica, Antigua and Barbuda, Costa Rica, Guatemala, Guyana, Honduras, Haiti, Jamaica, Nicaragua, Panama, Paraguay, El Salvador, Trinidad and Tobago, Uruguay
Northern AmericaUnited States of America, Canada
Australia and OceaniaAustralia, New Zealand, Tonga

List of familial psychosocial risk factors derived from existing screening instruments, classified according to their representability in the data of the survey: description of their representation in the data, citation of reference data and frequencies of the risk factors in the survey data and the reference data

Risk factorRepresented in the data asFreq. dataReference dataFreq. Ref. data
well representableYoung mother< 18y or < 20y and > 1 children0.197 %EURO-PERISTAT 2010 < 20y1.1 %
Single mother2.00 %BFS, population census 20005.6 %
Low education motherNo vocational training13.7 %BFS, women’s education 201413.8 %
Unemployment mother4.44 %BFS, unemployment rate 20145.3 %
Preterm birth< 37 weeks of gestation7.35 %EURO-PERISTAT 20107.4 %
Multiple birth2.00 %BFS, live births 20141.8 %
vaguely representableSocial/linguistic isolationPI

PI: Statement in the category ‘psychosocial indication’ for problems during the postpartum period or as indication for medically prescribed visits after ten days postpartum

: ‘migration’		2.64 %
Financial distressPI

PI: Statement in the category ‘psychosocial indication’ for problems during the postpartum period or as indication for medically prescribed visits after ten days postpartum

: ‘poverty’		0.637 %BFS, income poverty 20127.7 %
Alcohol/drugs motherPI

PI: Statement in the category ‘psychosocial indication’ for problems during the postpartum period or as indication for medically prescribed visits after ten days postpartum

: ‘drug abuse’		0.150 %
Maternal medical conditions‘postpartum depression’, ‘depression’2.57 %O’Hara and Swain (1996): postpartum depression rate13 %
Family violencePI

PI: Statement in the category ‘psychosocial indication’ for problems during the postpartum period or as indication for medically prescribed visits after ten days postpartum

: ‘domestic violence’ and ‘suspected child abuse’		0.321 %
Infant medical conditions‘malformation’ and ‘heart defect’1.30 %
not representableCharacteristics fatherMother raised in children’s home
NicotineLack of personal hygiene
Unwanted pregnancy / no rejoice in pregnancyLack of self-organisation and planning
Short birth spacingProblems to accept / care for the child
Pregnancy complicationsChild adopted or in foster home
Crowded housingFamily known at youth welfare service
Massive couple conflictsRegulation disorder of the child
History of abuse

Total number of representable risk factors per family (n = 60 090)

Number of risk factors01234567
Number of families45 16111 1732 7627411935271
Frequency of families75.2 %18.6 %4.60 %1.23 %0.321 %0.087 %0.012 %0.002 %
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