The Space in the Middle: Attitudes of Women's Health and Neonatal Nurses in the United States about Abortion.

INTRODUCTION: Despite playing an integral part in sexual and reproductive health care, including abortion care, nurses are rarely the focus of research regarding their attitudes about abortion. METHODS: A sample of 1,820 nurse members of the Association of Women's Health, Obstetric and Neonatal Nurses were surveyed about their demographic and professional backgrounds, religious beliefs, and abortion attitudes. Scores on the Abortion Attitudes Scale were analyzed categorically and trichotomized in multinomial regression analyses. RESULTS: Almost one-third of the sample (32%) had moderately proabortion attitudes, 29% were unsure, 16% had strongly proabortion attitudes, 13% had strongly antiabortion attitudes, and 11% had moderately antiabortion attitudes. Using trichotomized Abortion Attitudes Scale scores (proabortion, unsure, antiabortion), adjusted regression models showed that the following characteristics were associated with proabortion attitudes: being non-Christian, residence in the North or West, having no children, and having had an abortion. CONCLUSIONS: Understanding nurses' attitudes toward abortion, and what characteristics may influence their attitudes, is critical to sustaining nursing care for patients considering and seeking abortion. Additionally, because personal characteristics were associated with antiabortion attitudes, it is likely that personal experiences may influence attitudes toward abortion. A large percentage of nurses held attitudes that placed them in the "unsure" category. Given the current ubiquitous polarization of abortion discourse, this finding indicates that the binary narrative of this topic is less pervasive than expected, which lends itself to an emphasis on empathetic and compassionate nursing care.

Creating and sustaining a military women's Health Research Interest Group.

In 2008, four doctorate military nurse scientists representing the triservices (Army, Navy, and Air Force) identified a common interest in the health and care of all women in the armed forces. For 7 years, the team's shared vision to improve servicewomen's health inspired them to commit to a rigorous schedule of planning, developing, and implementing an innovative program that has the capability of advancing scientific knowledge and influencing health policy and practice through research. The ultimate goal of the Military Women's Health Research Interest Group (MWHRIG) is to support military clinicians and leaders in making evidence-based practice and policy decisions. They developed a 4-pronged approach to cultivate the science of military women's healthcare: evaluate the existing evidence, develop a research agenda that addresses gaps in knowledge, facilitate the collaboration of multidisciplinary research, and build the bench of future researchers. The MWHRIG has been a resource to key leaders; its value has been validated by multiservice and multidisciplinary consultations. However, the journey to goal attainment has only been achieved by the enduring commitment of these MWHRIG leaders and their passion to ensure the health and wellbeing of the many women who serve in the United States military. This article describes their journey of dedication.

Dr. Ruth lubic, a timeliness and tireless visionary for childbearing families.

The author describes her interview with Dr. Ruth Lubic, a visionary in the field of maternal-child nursing and discusses an early publication of Dr. Lubic's in the Journal of Obstetrics, Gynecology, & Neonatal Nursing. Dr. Lubic's many accomplishments are highlighted.

A selective review of maternal sleep characteristics in the postpartum period.

OBJECTIVE: To determine the current knowledge of postpartum women's sleep patterns, sleep disturbances, consequences of sleep disturbances, and known strategies for prevention in order to provide best practice recommendations for health care providers. DATA SOURCES: A literature search from 1969 through February 2008 was conducted using the CINHL, Index of Allied Health Literature, Ovid, PsycINFO, and PubMed electronic databases in addition to reference lists from selected articles and other key references. Search terms included sleep, postpartum, sleep deprivation, and sleep disturbance. STUDY SELECTION: A critical review of all relevant articles from the data sources was conducted with attention to the needs of postpartum women's sleep and implications for health care providers. DATA EXTRACTION: Literature was reviewed and organized into groups with similar characteristics. DATA SYNTHESIS: An integrative review of the literature summarized the current state of research related to sleep alterations in postpartum women. CONCLUSIONS: Postpartum women experience altered sleep patterns that may lead to sleep disturbances. The most common reasons for sleep disturbances are related to newborn sleep and feeding patterns. Although present, the relationships among sleep disturbance, fatigue, and depression in postpartum women lack clarity due to their ambiguous definitions and the variety of the studies conducted. Providers should encourage prenatal education that assists the couple in developing strategies for decreasing postpartum sleep deprivation. Alterations of in-hospital care and home care should be incorporated to improve the new family's sleep patterns.

The relationship between sleep characteristics and fatigue in healthy postpartum women.

BACKGROUND: Postpartum sleep is a difficult and complicated concept to measure owing to the intrusive nature of research at a sensitive and private time for new families. Nurses often find themselves advising mothers on ways to improve sleep and reduce fatigue based on teachings that are not evidence based. The purpose of this secondary analysis of a larger study of postpartum fatigue patterns was to examine the relationship between sleep characteristics and postpartum fatigue during the first 6 weeks after delivery. METHODS: A prospective, longitudinal, descriptive study was conducted of 109 postpartum women. Sleep and fatigue were measured using a 16-item subjective sleep characteristics scale and a 30-statement subjective fatigue instrument. Three measurement points were used: 1) 1-2 days after delivery (before hospital discharge); 2) 2 weeks postpartum; and 3) 6 weeks postpartum. RESULTS: Fatigue had a positive correlation with sleep disturbance at all three measurement points, indicating that higher levels of fatigue are associated with more disturbed sleep. No association was found between levels of fatigue and sleep supplementation. Levels of fatigue had a negative correlation with sleep effectiveness at all measurement points, indicating that the women were more fatigued if they perceived their sleep quality and adequacy to be poor or if they perceived the time spent sleeping to be short. CONCLUSIONS: To reduce fatigue, nurses should focus on exploring ways to reduce maternal sleep disturbance and improve maternal sleep effectiveness. It is unclear whether the age-old advice to "nap when your baby naps" is effective in reducing postpartum fatigue.

Postpartum fatigue in the active-duty military woman.

OBJECTIVE: (a) To describe fatigue levels in military active-duty women, (b) to describe the relationship among selected predictor variables of fatigue, and (c) to examine the relationship between predictor variables, fatigue levels, and performance (as measured by functional status) after childbirth. DESIGN: Based on the Theory of Unpleasant Symptoms, a longitudinal, prospective design. SETTING: A large military medical facility in the southwest United States. PATIENTS/PARTICIPANTS: A convenience sample of 109 military active-duty women. MAIN OUTCOME MEASURE: Postpartum fatigue. RESULTS: Women were found to be moderately fatigued across time, with no change in fatigue levels from 2 to 6 weeks after delivery. All variables correlated with fatigue during hospitalization and at 2 weeks after delivery, and depression, anxiety, maternal sleep, and functional status correlated with fatigue at 6 weeks after delivery. Regression analyses indicated that maternal anxiety predicted fatigue at 6 weeks after delivery. Over half the women had not regained full functional status when they returned to work, and 40% still displayed symptoms of postpartum depression and anxiety. CONCLUSIONS: Military women continue to experiencing postpartum fatigue when they return to the workplace. Future research is needed to examine issues surrounding fatigue and its associated variables during the first year after delivery.

Screening for postpartum depression in military women with the Postpartum Depression Screening Scale.

Each year, approximately 16,000 women on active duty in the U.S. military experience the birth of a child. A descriptive, longitudinal, prospective design was used to gather data with the Postpartum Depression Screening Scale. Depression was measured after delivery but before hospital discharge (time 1), 2 weeks after delivery (time 2), and 6 to 8 weeks after delivery (time 3). Mothers were found to be experiencing the greatest severity of symptoms in the category of sleeping and eating disturbances. Almost one-half of the mothers in this study scored either significant postpartum depressive symptoms or positive screening for postpartum depression after delivery. This number remained virtually unchanged at time 2. By time 3, 40% of women still reported depressive symptoms. At 2 weeks and 6 weeks after delivery, 13% and 11% of mothers, respectively, had positive screening for postpartum depression, consistent with the national average of 10 to 15%. Future research is needed to examine issues surrounding postpartum depression of military women.