kjwhn Korean Journal of Women Health Nursing Korean J Women Health Nurs 2287-1640 2093-7695 Korean Society of Women Health Nursing 10.4069/kjwhn.2015.21.4.332 kjwhn-21-332 Original Article Advanced Aged Women's Needs for Pregnancy and Childbirth Care MinHye Young 1 JeongGeum Hee 2 Department of Nursing, Dongyang University, Yeongju, Korea Division of Nursing, Hallym University, Chuncheon, Korea Corresponding author: Jeong, Geum Hee Division of Nursing, Hallym University, 1 Hallymdaehak-gil, Chuncheon 200-702, Korea. Tel: +82-33-248-2713, Fax: +82-33-248-2734, E-mail: ghjeong@hallym.ac.kr 122015 17122015 214 332341 03122015 11122015 11122015 Copyright © 2015 Korean Society of Women Health Nursing 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Purpose

Advanced aged pregnancy may be related with health problems so that more aggressive health care is necessary forthesewomen. This studyaimedtoprovidethebasic datafordevelopingnursinginterventionprograms to enhancethehealth of pregnant womenandtheirnew-bornbabiesandbyidentifyingthe advancedagedwomen's need forpregnancy andchildbirth.

 Methods

It is thecross-sectional descriptivestudyto identify the advancedaged women's need on pregnancy and childbirth. Subjects were pregnant women 35 years or older and postpartum women. Total number of subjects was 95. Measurement tool is self-reportingsurveythat consistedof 67items with four-point Likert scale, which was completed duringOctober to November 2014.

 Results

Average score was 3.44 out of maximum4onthe careneed onpregnancyand childbirth. Averagescores accordingto categorywereas follows: babyrearingandparental role, 3.55; preconception care, 3.49; deliverycare, 3.47; postpartum care3.42; and prenatal pregnancy, 3.39. Thedegreeof needsonpregnancyandchildbirthwasdifferent accordingtodeliveryexperi-ence (t=-2.49, p=.014).

 Conclusion

Prenatal and postpartum nursing interventions were completed regardless of pregnant women's ageuntil now; however, new nursinginterventionprograms arenecessaryto prevent the risk of advanced aged pregnancy, to provide the preconception care, and to increase the infant care and family support.

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DemographicandObstetricCharacteristicsof Participants (N=95)

Characteristics Categories n (%) or M±SD
Age (year)   36.72±1.62
  35~39 88 (92.6)
  40 ≥ 7 (7.4)
Education level High school 27 (28.4)
  College 58 (61.1)
  Postgraduate 10 (10.5)
Monthly income 299 ≤ 38 (40.0)
(10,000 won) 300~449 32 (33.7)
  450 ≥ 25 (26.3)
Occupation Yes 49 (51.6)
  No 46 (48.4)
Length of marriage 2 ＜ 78 (82.1)
(year) 2 ≥ 17 (17.9)
Pregnant and 1st trimester (13) ≤ 15 (15.8)
postpartum status 2nd trimester (14~28) 22 (23.2)
(week) 3th trimester (29~40) 38 (40.0)
  Postpartum (6) ≤ 20 (21.0)
Experience of Have 52 (54.7)
childbirth None 43 (45.3)
Planned pregnancy Yes 56 (58.9)
  No l39 (41.1)
Future plan on Yes 19 (20.0)
pregnancy No 46 (48.4)
  Don't know 30 (31.6)
First medical screening 4 ≤ 32 (33.7)
gestational age 5~7 51 (53.7)
(week) 8 ≥ 12 (12.6)
Regular prenatal care Yes 78 (82.1)
  No 17 (17.9)
Infertility treatment None 79 (83.2)
  Have 16 (16.8)
Spontaneous abortion None 70 (73.7)
  Have 25 (26.3)
Elective abortion None 78 (82.1)
  Have 17 (17.9)
Disease of None 84 (88.4)
prepregnancy Have 11 (11.6)
Complication of None 76 (80.0)
Pregnancy Have 19 (20.0)
The most helpful Husband and family 46 (48.4)
person Friends and neighbors 28 (29.5)
  Health care providers 21 (22.1)
Source of information Internet information 48 (30.0)
related with Health care providers 30 (18.8)
pregnancy and childbirth† Educational booklets Friends and neighbors 25(15.6)
25(15.6)
  Husband and family 19 (11.8)
  Mass media 10 (6.3)
Preferred instructional Lecture 25 (26.3)
method Internet information 18 (18.9)
  Educational booklet 18 (18.9)
  Personal counseling 14 (14.7)
  Smartphone application 13 (13.7)
  Telephone counseling 7 (7.4)

Multiple response.

Health Care Needs for Pregnancy and Childbirth of Participants (N=95)

Subcategory (number of items) Abbreviated description of items M±SD Rank
Preconception care (5) Nutrition management for pregnancy 3.41±0.57 4
  Taking folic acid supplements 3.55±0.61 2
  Checking health examination before pregnancy 3.45±0.52 3
  Avoiding risk-factors related to pregnancy 3.69±0.55 1
  (alcohol, cigarette, caffeine, medicine etc)    
  Information about infertility 3.35±0.52 5
  Subtotal 3.49±0.39 2
Prenatal care (27) Release of fatigue during pregnancy 3.33±0.51 20
  Nutrition during pregnancy 3.52±0.54 8
  Anemia control during pregnancy 3.54±0.56 7
  Materials that should be avoided during pregnancy 3.63±0.60 3
  (alcohol, cigarette, caffeine, medicine etc)    
  Constipation control during pregnancy 3 24±0 61 23
  Control of frequent voiding during pregnancy 3.19±0.57 26
  Exercise and activities during pregnancy 3.34±0.58 17
  Sleeping and rest during pregnancy 3.39±0.57 13
  Comfortable position during pregnancy 3.42±0.52 12
  Reason why pregnant women should not lift up the heavy load 3.34±0.58 17
  Cleansing during pregnancy 3.25±0.55 22
  Sex during pregnancy 2 72±0 72 27
  Relief method of back pain during pregnancy 3.37±0.58 14
  Control of gut trouble during pregnancy 3.34±0.65 17
  Care of swelling during pregnancy 3.33±0.53 20
  Information on dangerous symptoms during pregnancy 3.52±0.52 8
  How to detect pregnancy at first 3.23±0.64 24
  Fetal development process 3.57±0.50 6
  Counting fetal movement 3.48±0.52 10
  Screening for Congenital abnormal 3.65±0.50 1
  Prevention and care of abortion 3.61±0.49 4
  Prevention and care of premature birth 3.65±0.48 1
  Complication of pregnancy (diabetes mellitus, hypertension etc) 3.59±0.57 5
  Breast care during pregnancy 3.35±0.58 15
  Skin care during pregnancy 3.22±0.62 25
  Body weight change during pregnancy 3.35±0.54 15
  Routine check and health care during pregnancy 3.48±0.52 10
  Subtotal 3.39±0.39 5
Intrapartum care (7) Information on onset symptoms of labour 3.55±0.50 3
  Labour process 3.47±0.52 4
  Means of controlling labour pain 3.56±0.52 2
  Explanation on the test and treatment 3.47±0.52 4
  Preparation of spontaneous delivery 3.59±0.52 1
  Information on cesarean delivery 3.29±0.60 7
  Husband's participation during delivery 3.37±0.65 6
  Subtotal 3.47±0.42 3
Postpartum care (16) Postpartum vaginal bleeding 3.47±0.50 5
  Postpartum nutrition 3.48±0.52 3
  Avoidable medicine during breast feeding 3.61 ±0.51 2
  Postpartum constipation control 3.34±0.61 12
  Postpartum comfortable position 3.32±0.61 13
  Postpartum exercise 3.29±0.58 15
  Postpartum vaginal discharge (lochia) 3.46±0.50 7
  Postpartum Cleansing (bath, shower) 3.38±0.59 11
  Sexual life after labour 3.07±0.66 16
  Promoting safety after delivery 3.46±0.54 7
  Postpartum depression control 3.64±0.52 1
  Contraception after a birth 3.31±0.55 14
  Breast massage and hygiene after birth 3.48±0.52 3
  Staying physically fit after birth 3.46±0.58 7
  Support of recovering to routine work 3.39±0.61 10
  Recommendation of service centers for postpartum care 3.47±0.52 5
  Subtotal 3.41±0.39 4
Care for baby rearing and parental role (12) Breast feeding method 3.65±0.48 4
  Formula feeding method 3.44±0.61 9
  Normal growth and development of child 3.67±0.47 2
  Vaccinations time and methods 3.67±0.51 2
  Preparation for layette 3.23±0.66 12
  Baby care 3.60±0.49 6
  Dealing with baby's emergency 3.81±0.39 1
  Preparation for parental role 3.57±0.52 7
  Support of husband and family for child foster 3.63±0.51 5
  Detailed explanation by medical persons on the questions 3.51±0.54 8
  Information of pregnancy and childbirth education 3.39±0.61 11
  Childbirth education class for parents 3.40±0.66 10
  Subtotal 3.55±0.35 1
Total 3.44±0.38

Differences in Health Care Needs according to Participants' Characteristics (N=95)

Characteristics Categories M±SD t or F p
Age (year) 35~39 3.45±0.29 1.04 .300
  40 ≥ 3.32±0.43    
Education level High school 3.51±0.32 1.95 .148
  College 3.43±0.30    
  Postgraduate 3.29±0.27    
Monthly income (10,000 won) 299 ≤ 3.46±0.32 0.19 .826
  300~449 3.42±0.34    
  450 ≥ 3.42±0.26    
Occupation Yes 3.39±0.30 1.57 .118
  No 3.49±0.30    
Pregnant and postpartum 1st trimester (13) ≤ 3.53±0.32 0.74 .526
status (week) 2nd trimester (14~28) 3.37±0.32    
  3th trimester (29~40) 3.44±0.28    
  Postpartum(6) ≤ 3.45±0.32    
Experience of childbirth Have 3.37±0.27 -2.49 .014
  None 3.52±0.33    
Planned pregnancy Yes 3.45±0.32 0.39 .697
  No 3.43±0.29    
Future plan on pregnancy Yes 3.42±0.30 1.10 .336
  No 3.40±0.31    
  Don't know 3.51±0.30    
First medical screening 4 ≤ 3.44±0.30 0.01 .985
gestational age (week) 5~7 3.44±0.31    
  8 ≥ 3.45±0.31    
Regular antepartum care Yes 3.44±0.31 -0.11 .908
  No 3.45±0.27    
Infertility treatment Have 3.48±0.31 0.63 .528
  None 3.43±0.31    
Spontaneous abortion Have 3.37±0.29 -1.41 .160
  None 3.47±0.31    
Elective abortion Have 3.43±0.26 -0.19 .845
  None 3.44±0.32    
Disease of prepregnancy Have 3.56±0.25 1.38 .170
  None 3.42±0.31    
Complication of pregnancy Have 3.44±0.25 -0.06 .950
  None 3.44±0.32