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A. Nakibuule1, M. Nakaziba1, S. Nanyondo1, L. Mukyala1, D. Niyonsenga1
1Mbarara University of Science and Technology, Department of Physiotherapy, Mbarara, Uganda
Background: Postpartum rehabilitation is the process of restoring a mother to a pre-pregnant state through training and therapy immediately after birth of a child to six months. It is recommended to all mothers after delivery to reduce diastasis as well as prevent and/or manage post-delivery complications. However, it is not practiced in some settings due to numerous reasons.
Purpose: To understand the barriers to participation in postpartum rehabilitation alongside beliefs and practices of mothers to improve their postpartum health in Mbarara, Southwestern Uganda.
Methods: All 608 mothers who had delivered at least once and were present at the Maternal and Child Health clinic of Mbarara Regional Referral Hospital (MRRH) for any service during data collection time (January to March 2019) were recruited. This was a cross-sectional study and a researcher administered questionnaire designed in English and also translated to the local language was used to collect data. Data was entered into and analysed using Stata 13 version. Ethical approval was obtained from the Faculty Research Committee (FREC) and MRRH administration. Voluntary participation as well as anonymity and confidentiality were ensured. Feedback was given to all concerned parties at the end of this study.
Results: The response rate was 81.1%. Women who did not participate in post-partum rehabilitation cited the following reasons: lack of knowledge about postpartum rehabilitation (73.68%), postpartum pain (5.92%), being busy (4.28%), fatigue (1.81%) and lack of support from their husbands (0.33%). Mothers also had a strong attachment to their cultural practices (82%) which they believed would restore them to their pre-pregnant state and manage any post-delivery complications and thus judged it unnecessary to go back to hospital for a postpartum rehabilitation programme. Some of the identified practices used in place of formal rehabilitation were tying the stomach/tummy to reduce its size and manage back pain (42.9%), pressing the body to remove blood clots, get energy and get the pelvic bones back together (39.0%), drinking hot or cold fluids for energy production and specifically drinking herbs for pain management (30.9%) as well as feeding on special diets to get energy and prevent bowel problems (20.8%).
Conclusion(s): There appears to be a need for appropriate health education to address unhealthy practices and advocate the benefits of a timely postpartum rehabilitation programme.
Implications: Health literacy of new mothers in Mbarara, Southwestern Uganda relating to recovery after childbirth is low. This study has identified key beliefs and practices that could be addressed in post-partum education programs. A formal implementation study of the efficacy of including such session in routine care is warranted.
Funding, acknowledgements: This research was unfunded
Keywords: postpartum rehabilitation, barriers, beliefs and practices
Topic: Pelvic, sexual and reproductive health
Did this work require ethics approval? Yes
Institution: Mbarara University of Science and Technology
Committee: Faculty Research Committee (FREC) and MRRH Administration
Ethics number: N/A (No approval number provided for undergraduate research)
All authors, affiliations and abstracts have been published as submitted.
