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Abstract

Occupational therapy practitioners’ (OTP’s) perceptions of their role in working on the acute postpartum hospital unit are unknown. The objective of this research was to determine the perspectives of OTP’s enrolled in a continuing education course to gain competency in providing services to acute postpartum patients. Investigators engaged in a phenomenology consisting of semi-structured interviews with six OTP’s working in acute care hospitals preparing to work on the postpartum unit. Three themes emerged from transcripts: (a) Its’ Not THAT Different; (b) Willing To Try; and (c) Shifting Focus To Mom. OTPs working in hospitals identified existing skills applicable to working with acute postpartum patients, a need for additional learning to enhance competence, and a desire to focus support for the birthing person to improve maternal outcomes. Hospital onboarding and/or entry-level OTP programs should consider including education on the postpartum population. Future research should focus on program implementation on acute postpartum hospital units.

Plain Language Summary

Occupational Therapy Practitioners Perceptions of Providing Services for the Acute Postpartum Population

Gaps and deficiencies in maternal health are prevalent in the United States. Occupational therapy practitioners (OTPs) may be well-poised to improve postpartum outcomes within the -are setting. This research seeks to understand the perceptions and beliefs of acute hospital OTPs preparing to work in the acute postpartum hospital unit. Semi-structured interviews were conducted with OTPs registered to take a continuing education course to gain competency in working with postpartum patients in the acute care setting. Interviews revealed three themes representing the perceptions of the OTP’s: (a) Its’ Not THAT Different; (b) Willing To Try; and (c) Shifting Focus To Mom. OTP’s identified existing skills applicable to the postpartum population while seeking out additional competency, and emphasizing the importance of the birthing person. Considerations for OTP education and hospital onboarding practices are discussed.

Keywords

phenomenology women evidence-based practice

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References

American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process—Fourth edition. The American Journal of Occupational Therapy, 74(Suppl._2), 7412410010p1–7412410010p87. https://doi.org/10.5014/ajot.2020.74S2001

American Occupational Therapy Association. (n.d.). Fact sheet: Occupational therapy’s role with acute care. https://www.aota.org/~/media/Corporate/Files/AboutOT/Professionals/WhatIsOT/RDP/Facts/Acute-Care.pdf

Aziz

Gyamfi-Bannerman

Siddiq

Wright

J. D.

Goffman

Sheen

J.-J.

D’alton

M. E.

Friedman

A. M.

(2019). Maternal outcomes by race during postpartum readmissions. American Journal of Obstetrics & Gynecology, 220(5), 484.e1–484.e10. https://doi.org/10.1016/j.ajog.2019.02.016

Barbic

S. P.

MacKirdy

Weiss

Barrie

Kitchin

Lepin

(2021). Scoping review of the role of occupational therapy in the treatment of women with postpartum depression. Annals of International Occupational Therapy, 4(4), e249–e259. https://doi.org/10.3928/24761222-20210921-02

Bozkurt

Yumru

A. E.

Şahin

(2014). Pelvic floor dysfunction, and effects of pregnancy and mode of delivery on pelvic floor. Taiwanese Journal of Obstetrics & Gynecology, 53(4), 452–458. https://doi.org/10.1016/j.tjog.2014.08.001

Britton

Rosenwax

McNamara

(2015). Occupational therapy practice in acute physical hospital settings: Evidence from a scoping review. Australian Occupational Therapy Journal, 62(6), 370–377. https://doi.org/10.1111/1440-1630.12227

Bruce

K. H. M.

Anderson

M. M.

Stark

J. D. M.

(2021). Factors associated with postpartum readmission for hypertensive disorders of pregnancy. American Journal of Obstetrics & Gynecology MFM, 3(5), Article 100397. https://doi.org/10.1016/j.ajogmf.2021.100397

Burkhart

Couchman

Crowell

Jeffries

Monvillers

Vilensky

(2021). Pelvic floor dysfunction after childbirth: Occupational impact and awareness of available treatment. OTJR: Occupation, Participation and Health, 41(2), 108–115. https://doi.org/10.1177/1539449220970881

Creswell

J. W. P. N

. (2017). Qualitative inquiry and research design: Choosing among five approaches (4th ed.). Sage.

10.

Enhanced Recovery After Delivery. (n.d.). Home—Enhanced Recovery After Delivery. https://enhancedrecoveryafterdelivery.com/

11.

Escobar

M. F.

Echavarría

M. P.

Zambrano

M. A.

Ramos

Kusanovic

J. P.

(2020). Maternal sepsis. American Journal of Obstetrics & Gynecology MFM, 2(3), Article 100149. https://doi.org/10.1016/j.ajogmf.2020.100149

12.

Fernandes

J. G.

(2018). Occupational therapists’ role in perinatal care: A health promotion approach. The American Journal of Occupational Therapy, 72(5), 7205347010p1–7205347010p4. https://doi.org/10.5014/ajot.2018.028126

13.

Frohlich

Kettle

(2015). Perineal care. BMJ Clinical Evidence, 2015, Article 1401. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356152/

14.

Glesne

(2016). Becoming qualitative researchers: An introduction. Pearson.

15.

Hamilton

Stevens

Lillis

Adams

(2018). The fourth trimester: Toward improved postpartum health and healthcare of mothers and their families in the United States. Journal of Behavioral Medicine, 41(5), 571–576. https://doi.org/10.1007/s10865-018-9969-9

16.

Handley

S. C.

Gallagher

Lindgren

J. Y.

Burris

H. H.

Dysart

K. C.

Greenspan

Culhane

J. F.

Son

(2022). Postpartum length of stay and hospital readmission before and during the coronavirus disease 2019 (COVID-19) pandemic. Obstetrics & Gynecology, 139(3), Article 381. https://doi.org/10.1097/AOG.0000000000004687

17.

Hoyert

D. L.

(2022). Maternal mortality rates in the United States, 2020. NCHS Health E-Stats. https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2020/maternal-mortality-rates-2020.htm

18.

Lillibridge

Park

MacDermott

(2021). Exploring occupational therapy’s role in supporting health and wellness in the transition to motherhood [Paper presentation]. Fall 2021 Virtual OTD Capstone Symposium. https://soar.usa.edu/otdcapstonesfall2021/11

19.

Mannion

C. A.

Vinturache

A. E.

McDonald

S. W.

Tough

S. C.

(2015). The influence of back pain and urinary incontinence on daily tasks of mothers at 12 months postpartum. PLOS ONE, 10(6), Article e0129615. https://doi.org/10.1371/journal.pone.0129615

20.

Mauney

Barth

W. H.

Clapp

M. A.

(2022). Association between peripartum hysterectomy and venous thromboembolism. American Journal of Obstetrics & Gynecology, 226(1), 119.e1–119.e11. https://doi.org/10.1016/j.ajog.2021.06.091

21.

Ngene

N. C.

Moodley

(2020). Postpartum blood pressure patterns in severe preeclampsia and normotensive pregnant women following abdominal deliveries: A cohort study. The Journal of Maternal-Fetal & Neonatal Medicine, 33(18), 3152–3162. https://doi.org/10.1080/14767058.2019.1569621

22.

Pitonyak

J. S.

(2014). Occupational therapy and breastfeeding Promotion: Our role in societal health. The American Journal of Occupational Therapy, 68(3), e90–e96. https://doi.org/10.5014/ajot.2014.009746

23.

Pollari

E. H.

Bhatt

Baffes

Walraven

Raye

Hussain

Greenlee

Somerville

(2022). Distinguishing OT’s tole in the transition to motherhood. The American Journal of Occupational Therapy, 76(Suppl._1), 7610510163p1. https://doi.org/10.5014/ajot.2022.76S1-PO163

24.

Provalis Research. (2016). QDA Miner Lite. http://provalisresearch.com/products/qualitative-data-analysis-software/

25.

Qiu

Cai

Sun

Zuegel

Steinacker

J. M.

Schumann

(2017). Heart rate recovery and risk of cardiovascular events and all-cause mortality: A meta-analysis of prospective cohort studies. Journal of the American Heart Association, 6(5), Article e005505. https://doi.org/10.1161/JAHA.117.005505

26.

Rani

Habiba

U. E.

Qazi

W. A.

Tassadaq

(2019). Association of breast feeding positioning with musculoskeletal pain in postpartum mothers of Rawalpindi and Islamabad. Journal of the Pakistan Medical Association, 69(4), 564–566.

27.

Rogers

A. T.

Bai

Lavin

R. A.

Anderson

G. F.

(2017). Higher hospital spending on occupational therapy Is associated with lower readmission rates. Medical Care Research and Review, 74(6), 668–686. https://doi.org/10.1177/1077558716666981

28.

Romano

Cacciatore

Giordano

La Rosa

(2010). Postpartum period: Three distinct but continuous phases. Journal of Prenatal Medicine, 4(2), 22–25. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3279173/

29.

Romeikienė

K. E.

Bartkevičienė

(2021). Pelvic floor dysfunction prevention in prepartum and postpartum periods. Medicina, 57(4), 387. https://doi.org/10.3390/medicina57040387

30.

Segraves

R. L.

Croghan

Coreas

Locati

Finley

R. N.

(2023). Initiating occupational and physical therapy in the hospital after birth: Access, reimbursement, and outcomes. Journal of Women’s Health Physical Therapy, 47(1), 26–35. https://doi.org/10.1097/JWH.0000000000000262

31.

Sepulveda

(Apple). (2019). A call to action: Addressing maternal mental health in pediatric occupational therapy practice. Annals of International Occupational Therapy, 2(4), 195–200. https://doi.org/10.3928/24761222-20190813-02

32.

Slootjes

H. L.

(2021). The role of occupational therapists in Perinatal Health [La Trobe University]. https://web.archive.org/web/20220525024055id_/https://ltu-figshare-repo.s3.aarnet.edu.au/ltu-figshare-repo/35247694/Thesis.pdf?AWSAccessKeyId=RADjuIEnIStOwNiA&Expires=1653446463&Signature=rukowkf45vHFCWA8Rjr1gNm2nuY%3D

33.

Sponseller

Silverman

Roberts

(2021). Exploring the role of occupational therapy with mothers who breastfeed. The American Journal of Occupational Therapy, 75(5), Article 7505205110. https://doi.org/10.5014/ajot.2021.041269

34.

Turawa

E. B.

Musekiwa

Rohwer

A. C.

(2020). Interventions for preventing postpartum constipation. The Cochrane Database of Systematic Reviews, 2020(8), Article CD011625. https://doi.org/10.1002/14651858.CD011625.pub3

35.

Wagner

(2019). Upper extremity pain in breastfeeding mothers: A narrative review of the literature. Journal of Hand Therapy, 32(4), 560–561. https://doi.org/10.1016/j.jht.2019.09.022

36.

Wieser

Gourounti

Sarantaki

(2021). Modes of birth and their impact on the psychological and physical health of women. Journal of Mind and Medical Sciences, 8(1), 1–4. https://doi.org/10.22543/7674.81.P14

37.

Park

Gulati

(2021). The fourth trimester: Pregnancy as a predictor of cardiovascular disease. European Cardiology Review, 16, Article e31. https://doi.org/10.15420/ecr.2021.18

38.

Yim

I. S.

Tanner Stapleton

L. R.

Guardino

C. M.

Hahn-Holbrook

Dunkel Schetter

(2015). Biological and psychosocial predictors of postpartum depression: Systematic review and call for integration. Annual Review of Clinical Psychology, 11, 99–137. https://doi.org/10.1146/annurev-clinpsy-101414-020426

39.

Yin

Zhang

Qian

(2023). Association of delivery mode and number of pregnancies with anorectal manometry data in patients with postpartum constipation. BMC Pregnancy and Childbirth, 23(1), Article 160. https://doi.org/10.1186/s12884-023-05480-1

40.

Yulizawati

Maputra

Enosentris

(2021). Transition of roles: Change of motherhood in women. Journal of Midwifery, 6, Article 74. https://doi.org/10.25077/jom.6.1.74-83.2021

41.

Zambrano

M. D.

Miller

E. C.

(2019). Maternal stroke: An update. Current Atherosclerosis Reports, 21(9), Article 33. https://doi.org/10.1007/s11883-019-0798-2

42.

Zoom Communications. (2023). https://zoom.us