Mentors Offering Maternal Support Reduces Prenatal, Pregnancy-Specific Anxiety in a Sample of Military Women

Authors
Weis, K. L. Lederman, R. P. Walker, K. C. Chan, W.
Publication year
2017
Citation Title
Mentors offering maternal support reduces prenatal, pregnancy-specific anxiety in a sample of military women.
Journal Name
Journal of Obstetric, Gynecologic, & Neonatal Nursing
Journal Volume
46
Page Numbers
669–685
DOI
10.1016/j.jogn.2017.07.003
Summary
Prenatal intervention programs may decrease civilian women's anxiety and depression levels during pregnancy; however, less is known about how prenatal interventions impact women affiliated with the military. This study randomly assigned 246 pregnant Active Duty Service members or wives of Service members to the Mentors Offering Maternal Support program (the intervention group) or a control group. Results indicated that compared to the control group, women in the intervention group had decreased anxiety levels.
Key Findings
Compared to women in the control group, women in the intervention group experienced a more significant decrease in anxiety related to preparation for labor and identification with the motherhood role; no significant group difference was found in depression, resilience, and self-esteem.
Women with no previous children were five times more likely to experience preparation for labor anxiety than women who gave birth before.
Single women's anxiety related to well-being of self and baby in labor doubled during the course of pregnancy. In addition, compared to women whose husband was not deployed, women with a deployed husband experienced more anxiety related to identification with the motherhood role.
Implications for Program Leaders
Develop workshops for pregnant Service members and military spouses on how to have a healthy pregnancy and ways to cope with military-related stressors
Offer support groups for pregnant Service members and military spouses to promote healthy pregnancy
Provide education to military couples on how to cope with military-related stress when expecting a child
Implications for Policy Makers
Encourage the development and continuation of prenatal intervention programs that aim to reduce pregnant Service members and military spouses' anxiety and depression levels
Recommend professional development for professionals working with pregnant Service member and military spouses to better understand the unique stressors these women may encounter
Continue to encourage peer support groups for Service members and military spouses who are pregnant
Methods
Participants were recruited via study brochures in the prenatal welcome package in obstetric clinics. Women had to be in the first trimester of pregnancy and be an Active Duty Service member or married to a Service member to be eligible for the study.
Participants were randomly assigned to the intervention group (n = 187) or the control group (n = 180); the intervention included eight one-hour sessions offered every other week in the first two trimesters, whereas the control group received normal prenatal care.
All participants were measured at the first, second, and third trimesters, which included assessments of pregnancy-specific anxiety, self-esteem, depression, and resilience.
Data were analyzed to compare the intervention and control group, and also to examine the change of scores across the three trimesters.
Participants
Participants were 246 pregnant Active Duty Service members (n = 97) and wives of Service members (n = 149).
The mean age of participants was 28.72 years (SD = 5.00), and most of them were White (60%), followed by Black (12%), Latino (22%), and other (6%).
The military branches that the participants (or their husbands) served in were: Air Force (64%), Army (24%), Navy (9%), and other (3%).
Limitations
The sample was primarily affiliated with the Air Force, so caution must be taken to apply the findings to other military branches.
The study was based on self-report data, so the results may be subject to memory bias and social-desirability bias.
The last assessment was at approximately 30 weeks gestation, so women's experiences of the last 10 weeks of pregnancy was unknown.
Avenues for Future Research
Conduct longitudinal studies to examine the effect of intervention on both women and their children
Obtain data from the obstetrician-gynecologists to get a more objective measure of women's mental health
Recruit larger number of participants from all military branches of various military bases so that the findings can be better generalized
Design Rating
2 Stars - There are some flaws in the study design or research sample, but those flaws do not significantly threaten the ability to make conclusions based on the data.
Methods Rating
2 Stars - There are no significant biases or deficits in the way the variables in the study are defined or measures and conclusions are appropriately drawn from the analyses performed.
Limitations Rating
2 Stars - There are a few factors that limit the ability to extend the results to an entire population, but the results can be extended to most of the population.
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
Objective: To determine the efficacy of the Mentors Offering Maternal Support (MOMS) program to reduce pregnancy-specific anxiety and depression and build self-esteem and resilience in military women.
Design: Randomized controlled trial with repeated measures.
Setting: Large military community in Texas.
Participants: Pregnant women (N ¼ 246) in a military sample defined as active duty or spouse of military personnel.
Methods: Participants were randomized in the first trimester to the MOMS program or normal prenatal care. Participants attended eight 1-hour sessions every other week during the first, second, and third trimesters of pregnancy. Pregnancy-specific anxiety, depression, self-esteem, and resilience were measured in each trimester. Linear mixed models were used to compare the two-group difference in slope for prenatal anxiety, depression, self-esteem, and resilience.
Results: The Prenatal Self-Evaluation Questionnaire was used to measure perinatal anxiety. Rates of prenatal anxiety on the Identification With a Motherhood Role (p ¼ .049) scale and the Preparation for Labor (p ¼ .017) scale were significantly reduced for participants in MOMS. Nulliparous participants showed significantly lower anxiety on the Acceptance of Pregnancy scale and significantly greater anxiety on the Preparation for Labor scale. Single participants had significantly greater anxiety on the Well-Being of Self and Baby in Labor scale, and participants with deployed husbands had significantly greater anxiety on the Identification With a Motherhood Role scale.
Conclusion: Participation in the MOMS program reduced pregnancy-specific prenatal anxiety for the dimensions of Identification With a Motherhood Role and Preparation for Labor. Both dimensions of anxiety were previously found to be significantly associated with preterm birth and low birth weight. Military leaders have recognized the urgent need to support military families.
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