Study On The Effects Of Individual Nursing Intervention On The Postpartum Women's Reproductive Health

Background The increasing incidence of women's sexual problems after childbirth not only influence the sexual health and the quality of life after delivery, but also make against the harmonious development of family. However, little attention is paid on the postnatal sexual health in health care service and less study related to it was done. Moreover, most of the women after delivery go into the period of birth control. The emphasis of reproductive health during this period includes not only safe and healthy sexual life but also the choice of safe and effective contraception and the reduction of unintended pregnancy. Despite all kinds of contraceptive methods are made more widespread constantly, the incidence rate of abortion caused by unintended pregnancy has the tendency to increase. The present study maked individual nursing intervention in order to help each postpartum woman enjoy healthy and safe sexual life and use the appropriate contraceptive methods. Thus, the incidence of unintended pregnancy will be reduced and the postpartum women's reproductive health will be promoted.Aims To evaluate the effects of individual nursing intervention on postpartum women's reproductive health.Methods 248 primiparas were randomly divided into intervention group and control group with 124 primiparas in each group. There were no statistic differences in age, education, job, salary, mode of delivery, mode of feed and cut conditions (P>0.05) . Those in the intervention group received individual nursing intervention and follow-up in addition to routine care, while the control group received routinely nursing and follow-up only. The intervention consist of individual sexual health education, pelvic floor muscle exercise, contraception consultation and guide, provide"postpartum reproductive health manual". Questionnaires on Primiparas' basic information,Quality of sexual life, Knowledge of contraception and Postpartum reproductive status. Both groups followed up at 3, 6 and 12 months after delivery by email or telephone in order to assess the effects of the intervention by T-test, repeated-measure ANOVA and MANOVA.Results The consequence related reproductive health before pregnancy:the mean score of contraception knowledge of primiparas was 53.94±14.53. The rate of disqualification is 66.9%. Among all the contraception methods, the acknowledge rate of condom was highest and that of the hypodermatic implantation was lowest. The contraceptive ring and oral contraceptive pill were known partially. The status of sexual life one year before pregnancy were better. The results of intervention:②Analysis of variance of repeated measure and multivariate analysis of varianceshowed that the score of knowledge of contraception including total score,the scoreof contraceptive ring, condom, oral contraceptive pill and external ejaculation in theintervention group significantly increased compared with the control group (P<0.05).②Analysis of Chi-Square test showed that the contraception rate of the first sex afterchildbirth after intervention was higher in intervention group than in control group(P<0.05) .③Analysis of Chi-Square test showed that there was statisticallysignificant difference in the selection of future contraceptive methods between theintervention group and the control group (P<0.05) . Compared with the controlgroup , the primiparas in the intervention group would rather choose long-term, safeand effective contraceptive methods such as contraceptive ring and oralcontraceptive pill besides condom.④Analysis of variance of repeated measure andmultivariate analysis of variance showed that the score of quality of sexual lifeincluding total score, the score of sexual desire, vaginal lubrication and orgasmdisorder in the intervention group significantly higher than that of the control group(P<0.05) .⑤Analysis of Chi-Square test showed that there was no statisticallysignificant difference on the rate of unintended pregnancy between the interventiongroup and the control group (P>0.05) .⑥Analysis of Mann-Whitney test showedthat The primiparas with vagina delivery in the intervention group had better pelvicfloor muscle than those in the control group. There was statistically significantdifference on the status of the pelvic floor muscle between these groups (P<0.01) .Conclusion Sexual problems are very common after childbirth. Moreover, lackof the knowledge of contraception and serious contraceptive conditions directly orindirectly influence the postpartum reproductive health. The present studyimplemented individual nursing intervention not only decreased the incidence ofsexual problems after delivery effectively, but also increased the rate and effective rateof contraception, reduced the incidence of the unintended pregnancy and promote thepostpartum women's reproductive health.