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Article

Family and Spousal Support Are Associated with Higher Levels of Maternal Functioning in a Study of Iranian Postpartum Women

by
Parivash Ahmadpour
1,
Carolann Curry
2,
Shayesteh Jahanfar
3,
Rogaiyeh Nikanfar
1 and
Mojgan Mirghafourvand
4,*
1
Student Research Committee, Tabriz University of Medical Sciences, Tabriz 5165687386, Iran
2
Department of Community Medicine, Mercer University School of Medicine, Macon, GA 31207, USA
3
MPH Program, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA 02111, USA
4
Social Determinants of Health Research Center, Department of Midwifery, Tabriz University of Medical Sciences, Tabriz 5165687386, Iran
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2023, 12(7), 2718; https://doi.org/10.3390/jcm12072718
Submission received: 10 February 2023 / Revised: 31 March 2023 / Accepted: 3 April 2023 / Published: 5 April 2023
(This article belongs to the Special Issue The Maladies of New Motherhood: Negative Mood Symptoms, Postpartum Functioning, Current Interventions, and Protective Factors)
Versions Notes

Abstract

:
Postpartum maternal functioning is a multidimensional concept defined as how a woman manages her daily activities and emotional health after giving birth. This study aimed to determine the predictors of postpartum maternal functioning. This cross-sectional study was conducted on 564 women within one to four months after giving birth (with registered medical records in health centers of Tabriz, Iran) from 2020–2021. The participants were selected based on the cluster sampling method, and data were collected using a standard questionnaire inclusive of sociodemographic and obstetric characteristics, obstetric history, and Barkin Index of Maternal Functioning (BIMF). The adjusted general linear model was employed to estimate the effect of each independent variable (sociodemographic and obstetric characteristics) on the dependent variable (maternal functioning). The mean total score of maternal functioning was 93.1 (±SD = 14.8) out of 120. Based on the adjusted generalized linear model (GLM), “spouse support” and “family support” were strong predictors of maternal functioning. The total score of maternal functioning in women with moderate (B: −4.44; 95% CI: −7.71 to −1.17; p < 0.001) and low (B: −4.77; 95% CI: −8.90 to −1.47; p < 0.001) spousal support was significantly lower compared to women who received a high level of spousal support. Additionally, this score in women with moderate (B: −5.22; 95% CI: −8.56 to −1.87; p < 0.001) and low (B: −3.90; 95% CI: −7.31 to −0.48; p < 0.001) family support was significantly lower compared to women who received a high level of family support. Study results suggest that receiving support from both a spouse and family members can improve maternal functioning.

1. Introduction

Motherhood is one of the most important roles a woman plays throughout her life [1]. Pregnancy, childbirth, and motherhood can be challenging processes for a woman and her family, both psychologically and socially [2]. As a difficult and potentially traumatic event in life, childbirth may affect a woman’s perception of herself, her ability to accomplish daily activities, and her future opportunities in life [3]. Postpartum recovery is often defined as the recovery of the reproductive organs, but the full recovery of functional abilities is less considered in this regard [4]. Postpartum maternal functioning is a multidimensional concept [5]; Barkin et al. determined that the main domains of maternal functioning during the postpartum period are personal care, infant care, mother–child interaction, maternal psychological well-being, social support, management, and adjustment [6,7]. In general, postpartum maternal functioning gradually improves over time as a woman adjusts to the role [5].
In recent years, the health of mothers and infants after childbirth has received significant attention from researchers [8]. This is due to the fact that postpartum struggles can significantly affect maternal and infant health, infant development, social roles and related coping, personal relationships, and mental disorders. Some of the individual and environmental factors that can affect maternal functioning are the number of previous deliveries the mother has had, quality and adequacy of social and family support, the method of delivery, and complications of pregnancy and delivery [9,10]. Mothers are found to function well during the postpartum period when they receive enough support, balance self care with infant care, and adapt to their various responsibilities [11].
Social support has a positive influence on health during the childbearing period and enables a smooth transition to parenthood. Social support is defined as ‘any informational, tangible, and/or comparison, emotional, a social resource provided to and perceived as effective by the recipient’ [12]. High levels of social capital, especially in low-income communities with poor structural facilities are associated with positive health effects. In different settings, social support during the postpartum period has a positive influence on breastfeeding practices and mothers’ depressive symptoms [13].
Mothers need emotional support after childbirth because it can improve maternal health and promote greater daily functioning [14]. The financial and educational supports provided by spouses, relatives, and health staff can increase self-confidence in new mothers [15]. Webster et al. and Aktan reported a significant relationship between support for mothers and maternal functioning [5,16].
The ability to function well in new motherhood is an important skill and should be assessed in addition to depression/anxiety evaluation. In many settings, primary care services rarely screen for mental health problems during pregnancy or the puerperium. Data from studies in this area indicate the need for further research to explore the effectiveness of efforts to sensitize community health teams to the mental health and maternal functioning challenges women face [17,18]. In this study, factors associated with maternal functioning are explored with an eye towards prevention and maternal/child quality of life.

2. Materials and Methods

2.1. Study Design and Participants

A descriptive-analytical cross-sectional study was conducted on 564 women visiting health centers of Tabriz, Iran, from 2020–2021. The inclusion criteria were defined as giving birth to only one child within the 1–4 months, following being registered at a maternal clinic. Exclusion criteria were twofold: having a self-reported history of mental illness and failure to complete more than 20% of the questionnaire items.

2.2. Sampling

Subsequent to approval from the Ethics Committee of Tabriz University of Medical Sciences, (Ethics code: (Ethics code: IR.TBZMED.REC.1399.246), 564 women who met the inclusion criteria were selected from the health centers of Tabriz based on the cluster sampling method. There are 84 health centers in Tabriz. We first randomly selected a quarter of the health centers (n = 21) using www.random.org (accessed on 1 April 2021). Then, researchers provided a list of women who had given birth to a child within the previous one to four months from the established centers. The number of selected samples from each center was determined proportionally based on the number of women referring to each center. Finally, women were randomly selected from the prepared list using www.random.org (accessed on 1 April 2021). The selected women were contacted by telephone and invited to participate in the study. Participants were first briefed on the study objectives and procedure. When the women visited the health center at the specified time, they were again briefed on the study objectives and procedure and asked to sign a written consent form. Women were assured that their information would be kept confidential and the results would be reported anonymously. At that point, participants were provided with questionnaires soliciting information on their sociodemographic and obstetric characteristics. Finally, researchers completed the Barkin Index of Maternal Functioning (BIMF) [19] through interviews with participants.

2.3. Data Collection Tool

Sociodemographic and obstetrical characteristics were collected via self-report questionnaire. The Barkin Index of Maternal Functioning [20,21] was administered to capture postpartum maternal functioning.

2.3.1. Sociodemographic and Obstetric Charactristics Questionnaire

This questionnaire consisted of items on age of participants, age of spouse, age at marriage, housing status, educational attainment, spouse’s educational attainment, occupation, spouse’s occupation, body mass index (BMI), spousal support level, family support level, gestational age, parity, history of attending pregnancy classes, and delivery type. This questionnaire was developed by the research team and face/content validity was established.

2.3.2. Barkin Index of Maternal Functioning (BIMF)

We used the BIMF to evaluate the postpartum maternal functioning of study participants. The tool was developed by Barkin et al. in 2007 (Pittsburgh, PA, USA) and consists of 20 items and 7 domains: self-care, infant care, mother-child interaction, psychological well-being, social support, management and adjustment [6,22]. Each item in the BIMF is scored based on a 6-point scale (from 0 to 6), with the total score on this scale ranging between 0 and 120; higher scores indicate better maternal functioning. This index is a patient-centered scale covering all areas of postpartum maternal functioning and can be administered in both clinical and research settings [23]. The psychometric properties of this index have been previously confirmed in Iran [17]. The Iranian version consists of 20 items in 5 subscales: satisfaction with maternal competence, self-care, infant care, social support, and psychological well-being. The Cronbach’s alpha for this study was 0.876 and in line with estimates from various other studies.

2.4. Sample Size

The sample size was calculated at 347 with considering the mean score of maternal functioning equal with 97.4 (SD: 13) based on the results of Havizari et al.’s study [24] and α = 0.05, d (precision) = 0.02 around the mean and a test power of 90%. Then assuming a design effect of 1.5 due to the cluster sampling and a possible attrition rate, the final sample size was estimated to be 564.

2.5. Data Analysis

Data analysis was performed using SPSS 25 (IBM Inc., Armonk, NY, USA). Participants’ socio-demographic and obstetric characteristics were analyzed using descriptive statistics, including: frequency, percentage, mean, and standard deviation. The results of the Kolmogorov–Smirnov test showed that the quantitative data were following a normal distribution pattern. The relationship of postpartum maternal functioning with sociodemographic and obstetric characteristics was examined using one-way analysis of variance (ANOVA) and the independent t-test. Finally, the adjusted general linear model (GLM) was employed to estimate the effect of each of the independent variables (sociodemographic and obstetric characteristics) on the dependent variable (maternal functioning). The results were reported as B coefficient (95% confidence interval). p < 0.05 was considered significant.

3. Results

The mean age of participants was 29.5 (SD: 6.4) years. More than half (58.1%) had a high school degree or higher and most of them (80.1%) were housewives. The mean age of participant spouses was 33.8 (SD: 6.1) years, more than half of spouses (67%) had a high school degree or higher, and approximately half of them (45.4%) were self-employed. About one-third of participants stated that they were receiving a high level of support from their spouses (39.5%) and family members (32.8%) (Table 1).
The mean total BIMF score of participants was 93.1 (SD: 14.8) (total obtainable range of 0 to 120). The mean score of the BIMF and its subscales is presented in Table 2.
The results of bivariate tests (one-way ANOVA and independent t-test) showed that the total score of the BIMF had a significant relationship with housing status (p = 0.002), spouse’s occupation (p = 0.014), sufficiency of household income (p = 0.019), spouse support (p < 0.001) and family support (p < 0.001), and infant admission to the neonatal intensive care unit (p = 0.008). The results of adjusted GLM also indicated that the variables of spouse support, family support, and sufficiency of income for expenses were among the predictors of maternal functioning as the total score of maternal functioning in women with moderate (B: −4.44; 95% CI: −7.71 to −1.17; p < 0.001) and low (B: −4.77; 95% CI: −8.90 to −1.47; p < 0.001) spouse’s support was significantly lower compared to women who received high level of spouse’s support. Additionally, the score in women with moderate (B: −5.22; 95% CI: −8.56 to −1.87; p < 0.001) and low (B: −3.90; 95% CI: −7.31 to −0.48; p < 0.001) family support was significantly lower compared to women who received a high level of family support. In addition, the total BIMF score in women with completely sufficient income (B: 4.33; 95% CI: 0.45 to 8.22; p < 0.001) was significantly higher compared to women with insufficient income (Table 3).

4. Discussion

The results of our study demonstrated that the mean total BIMF score was relatively high in the participants. The results of adjusted GLM also indicated that there was a statistically significant relationship between spouse and family support level and sufficiency of income for expenses and maternal functioning. Notably, the overall BIMF score was higher in participants receiving a high level of support from their spouses and family members, compared to those receiving moderate or low levels of support, as well as in women with completely sufficient income compared to women with insufficient income.
The study results also indicated that the mean maternal functioning score of the participants was 93.1. The mean BIMF score was equal to 97.4 in a study conducted in Iran on 530 primiparous women [24], 96.1 in a study by Williams et al on 46 mothers of neonates admitted to the NICU (Level III) in the Midwestern US [25], and 104 in a study by Barkin et al. on 128 women under obstetric and postnatal care in Georgia [26]. In other researchers by Karami Chamgurdani et al. [17] and Barkin et al. [27] on depressed mothers, the mean BIMF score was low (63.4 in the Karami Chamgurdani et al.’s study and 80.0 in the Barkin et al.’s study). The results indicate that the depressed mothers had the lowest maternal functioning scores. Therefore, health care providers should look for the best solutions to improve maternal functioning of depressed women since it is of great importance for mothers who have recently given birth to a child to optimally play their motherhood role.
In this study, the highest and lowest scores among the subscales of maternal functioning were related to “satisfaction with maternal competence” and “psychological well-being”, respectively. In a study of 305 Iranian primiparous women, the highest and lowest scores among the subscales of maternal functioning within 4 months after delivery were related to “infant care” and “social activities”, respectively [28]. In another study conducted by Mirghafourvand et al. on 165 women, the highest score belonged to “infant care” and “self-care” and the lowest score was related to “social activities” [29]. The above-mentioned two studies employed the Inventory Functional Status after Childbirth (IFSAC) whose subscales are different from those of BIMF. Nevertheless, since the participants in this study gained the lowest score on “psychological well-being”, it is necessary to pay special attention to the mental health of mothers in the postpartum period [30].
The study results suggested that support from both family members and spouses can improve maternal functioning, as family and spouse support is a strong predictor of postpartum maternal health and functioning [31]. In similiar studies, mothers stated that their partners, friends, or even family members can provide key support in infant care, self-care, socialization, and leisure activities [9]. In a study conducted by McVeigh et al. (1995) in Australia, the results indicated that satisfaction with support from family members and friends in infant care positively affected maternal functioning [32]. According to the mothers who participated in a study by Jirapaet et al. (2001) in Thailand, social support had positive effects on maternal functioning [33]. Additionally, a study by Herba et al. (2016) in low- and middle-income countries found that the mental health of mothers and children depends on receiving support [31]. Because of physical changes and fatigue, women need to receive support when they begin taking on maternal responsibilities. Moreover, mothers should be supported both physiologically and psychologically during the postpartum period. Since social support is a strong predictor of maternal functioning, maternal care programs during the pregnancy and postpartum periods should include social support interventions [34].
The results of this study indicated that sufficient income for expenses can lead to enhanced maternal functioning. Receiving social/financial support is a powerful predictor of maternal health and performance after childbirth. In a study conducted by Aktan et al. (2010) in the United States, receiving support was directly related to self-care and social activities under the realm of performance status [5].
Our large sample size (n = 564) and the use of a standard, well-validated tool for measuring maternal functioning were two significant strengths of this study. Due to the cross-sectional nature of this study, the relationship shown between spouse and family support and maternal functioning does not necessarily indicate a causal relationship. Therefore, longitudinal and prospective research is needed to establish causality. Another potential limitation of this study is that the level of family and spouse support was measured merely based on one self-report item; future studies are recommended to employ a standard tool for measuring this variable. Ultimately, the findings of this study can help policy makers and providers to develop support programs (emotional, instrumental, and informational) for women during pregnancy and the postpartum period.

5. Conclusions

Our study findings suggested a significant relationship between spouse and family support and maternal functioning. The family and spouse support measurement is recommended to be part of pregnancy and postpartum care programs for women in order to identify the those who are receiving low levels of support. Once identified, women receiving low levels of support should receiving training and family counseling sessions with the aim of optimizing maternal functioning.

Author Contributions

Methodology, P.A., C.C., S.J., R.N. and M.M.; Software, M.M.; Validation, M.M.; Formal analysis, M.M.; Investigation, P.A., S.J., R.N. and M.M.; Data curation, P.A.; Writing—original draft, P.A. and R.N.; Writing—review & editing, C.C., S.J. and M.M.; Supervision, M.M.; Funding acquisition, M.M. All authors have read and agreed to the published version of the manuscript.

Funding

This study was funded by Tabriz University of Medical Sciences (Grant Number: 65346).

Institutional Review Board Statement

This study has been approved by the Ethics Committee of the Tabriz University of Medical Sciences, Tabriz, Iran (code number: IR.TBZMED.REC.1399.1109, 2021-02-22).

Informed Consent Statement

Written informed consent will be obtained from each participant.

Data Availability Statement

If required, our data can be submitted.

Acknowledgments

This Research protocol was approved and supported by Student Research Committee, Tabriz University of Medical Sciences.

Conflicts of Interest

The authors declare no conflict of interest.

References

  1. Norhayati, M.N.; Hazlina, N.H.N.; Aniza, A.A. Functional status of women with and without severe maternal morbidity: A prospective cohort study. Women Birth 2016, 29, 443–449. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  2. Molgora, S.; Fenaroli, V.; Acquati, C.; De Donno, A.; Baldini, M.P.; Saita, E. Examining the role of dyadic coping on the marital adjustment of couples undergoing assisted reproductive technology (ART). Front. Psychol. 2019, 8, 415. [Google Scholar] [CrossRef] [PubMed]
  3. Salmela-Aro, K.; Read, S.; Rouhe, H.; Halmesmäki, E.; Toivanen, R.M.; Tokola, M.I.; Saisto, T. Promoting positive motherhood among nulliparous pregnant women with an intense fear of childbirth: RCT intervention. J. Health Psychol. 2012, 17, 520–534. [Google Scholar] [CrossRef] [PubMed]
  4. Aktan, N.M. Functional status after childbirth: A review of the literature. Clin. Nurs. Res. 2007, 16, 195–211. [Google Scholar] [CrossRef] [PubMed]
  5. Aktan, N.M. Functional status after childbirth and related concepts. Clin. Nurs. Res. 2010, 19, 165–180. [Google Scholar] [CrossRef]
  6. Barkin, J.L.; Wisner, K.L.; Bromberger, J.T.; Beach, S.R.; Terry, M.A.; Wisniewski, S.R. Development of the Barkin index of maternal functioning. J. Womens Health 2010, 19, 2239–2246. [Google Scholar] [CrossRef] [Green Version]
  7. Ansariniaki, M.; Lamyian, M.; Ahmadi, F.; Rahimi Foroushani, A.; Curry, C.L.; Barkin, J.L. Persian version of the Barkin Index of Maternal Functioning (BIMF): A cross-cultural adaptation and psychometric evaluation. BMC Pregnancy Childbirth 2021, 21, 83. [Google Scholar] [CrossRef]
  8. Cheng, C.Y.; Fowles, E.R.; Walker, L.O. Continuing education module: Postpartum maternal health care in the United States: A critical review. J. Perinat. Educ. 2006, 15, 34–42. [Google Scholar] [CrossRef] [Green Version]
  9. Rychnovsky, J.D. Postpartum fatigue in the active-duty military woman. J. Obstet. Gynecol. Neonatal Nurs. 2007, 36, 38–46. [Google Scholar] [CrossRef]
  10. Barkin, J.L.; Bloch, J.R.; Hawkins, K.C.; Thomas, T.S. Barriers to optimal social support in the postpartum period. J. Obstet. Gynecol. Neonatal Nurs. 2014, 43, 445–454. [Google Scholar] [CrossRef]
  11. Barkin, J.L.; Wisner, K.L.; Bromberger, J.T.; Beach, S.R.; Wisniewski, S.R. Assessment of functioning in new mothers. J. Womens Health 2010, 19, 1493–1499. [Google Scholar] [CrossRef]
  12. Mbekenga, C.K.; Pembe, A.B.; Christensson, K.; Darj, E.; Olsson, P. Informal support to first-parents after childbirth: A qualitative study in low-income suburbs of Dar es Salaam, Tanzania. BMC Pregnancy Childbirth 2011, 11, 98. [Google Scholar] [CrossRef] [Green Version]
  13. Frumence, G.; Killewo, J.; Kwesigabo, G.; Nystrom, L.; Eriksson, M.; Emmelin, M. Social capital and the decline in HIV transmission-A case study in three villages in the Kagera region of Tanzania. SAHARA J. 2010, 7, 9–20. [Google Scholar] [CrossRef]
  14. Palancı AY, Ö.; Aktaş, S. The effect of maternal functional and postpartum depression status on breastfeeding self-efficacy of the mothers: A cross-sectional study. Health Care Women Int. 2021, 1–15. [Google Scholar] [CrossRef]
  15. Mercer, R.T. Becoming a mother versus maternal role attainment. J. Nurs. Scholarsh. 2004, 36, 226–232. [Google Scholar] [CrossRef]
  16. Webster, J.; Linnane, J.W.; Dibley, L.M.; Hinson, J.K.; Starrenburg, S.E.; Roberts, J.A. Measuring social support in pregnancy: Can it be simple and meaningful? Birth 2000, 27, 97–101. [Google Scholar] [CrossRef]
  17. Karami Chamgurdani, F.; Barkin, J.L.; Curry, C.L.; Mirghafourvand, M. Comparison of maternal functioning between Iranian mothers with and without depressive symptoms: A case-control study. Int. J. Environ. Res. Public Health 2020, 17, 3350. [Google Scholar] [CrossRef]
  18. James, K.F.; Aycock, D.M.; Fouquier, K.; Hires, K.A.; Barkin, J.L. Racial identity clusters and their relation to postpartum maternal functioning in black women. Matern. Child Health J. 2022, 26, 788–795. [Google Scholar] [CrossRef]
  19. Mirghafourvand, M.; Barkin, J.L.; Jafarabadi, M.A.; Karami, F.; Ghanbari-Homayi, S. The psychometric properties of the Barkin index of maternal functioning (BIMF) for the Iranian population. BMC Women’s Health 2019, 19, 166. [Google Scholar] [CrossRef]
  20. Barkin, J.L.; Wisner, K.L.; Wisniewski, S.R. The psychometric properties of the Barkin index of maternal functioning. J. Obstet. Gynecol. Neonatal Nurs. 2014, 43, 792–802. [Google Scholar] [CrossRef]
  21. Chamgurdani, F.K.; Barkin, J.L.; Esmaeilpour, K.; Malakouti, J.; Buoli, M.; Mirghafourvand, M. The effect of counseling with a skills training approach on maternal functioning: A randomized controlled clinical trial. BMC Women’s Health 2020, 20, 51. [Google Scholar] [CrossRef] [PubMed]
  22. Barkin, J.L.; Willis, G.B.; Hawkins, K.C.; Stanfill-Thomas, T.; Beals, L.; Bloch, J.R. Semantic Assessment of the B arkin I ndex of M aternal F unctioning in a Medically Underserved Obstetric Population. Perspect. Psychiatr. Care 2017, 53, 95–103. [Google Scholar] [CrossRef] [PubMed]
  23. Gebeyehu, S.; Gizachew, Y.; Chisa, Y.; Tekabe, B.; Trevethan, R. Psychometric properties of the Barkin Index of Maternal Functioning with Ethiopian mothers. MedRxiv 2021, 2021-12. [Google Scholar]
  24. Havizari, S.; Ghanbari-Homaie, S.; Eyvazzadeh, O.; Mirghafourvand, M. Childbirth experience, maternal functioning and mental health: How are they related? J. Reprod. Infant Psychol. 2021, 40, 399–411. [Google Scholar] [CrossRef] [PubMed]
  25. Williams, K.G.; Patel, K.T.; Stausmire, J.M.; Bridges, C.; Mathis, M.W.; Barkin, J.L. The neonatal intensive care unit: Environmental stressors and supports. Int. J. Environ. Res. Public Health 2018, 15, 60. [Google Scholar] [CrossRef] [Green Version]
  26. Barkin, J.L.; McKeever, A.; Lian, B.; Wisniewski, S.R. Correlates of postpartum maternal functioning in a low-income obstetric population. J. Am. Psychiatr. Nurses Assoc. 2017, 23, 149–158. [Google Scholar] [CrossRef]
  27. Barkin, J.L.; Wisner, K.L.; Bromberger, J.T.; Beach, S.R.; Wisniewski, S.R. Factors associated with postpartum maternal functioning in women with positive screens for depression. J. Women’s Health 2016, 25, 707–713. [Google Scholar] [CrossRef] [Green Version]
  28. Mirghafourvand, M.; Bagherinia, M. Relationship between maternal self-efficacy and functional status four months after delivery in Iranian primiparous women. J. Psychosom. Obstet. Gynecol. 2018, 39, 321–328. [Google Scholar] [CrossRef]
  29. Mirghafourvand, M.; Mohammad-Alizadeh-Charandabi, S.; Jafarabadi, M.A.; Soltanpour, S.; Aghamiri, V.; Bagherinia, M. Physical activity during pregnancy and its relationship with the functional status of primiparous women six weeks after childbirth: A cohort study. JCDR 2018, 12, 20. [Google Scholar] [CrossRef]
  30. Barkin, J.L. Perinatal mood symptoms and postpartum maternal functioning: Describing the evidence related to effective and ineffective interventions. Front. Psychiatry 2022, 13, 975078. [Google Scholar] [CrossRef]
  31. Herba, C.M.; Glover, V.; Ramchandani, P.G.; Rondon, M.B. Maternal depression and mental health in early childhood: An examination of underlying mechanisms in low-income and middle-income countries. Lancet Psychiatry 2016, 3, 983–992. [Google Scholar] [CrossRef]
  32. McVeigh, C. An investigation into the relationship between functional status after childbirth, self esteem, social support and anxiety. Ph.D. Thesis, University of Wollongong, Wollongong, Australia, 1995. [Google Scholar]
  33. Jirapaet, V. Factors affecting maternal role attainment among low-income, Thai, HIV-positive mothers. J. Transcult. Nurs. 2001, 12, 25–33. [Google Scholar] [CrossRef]
  34. Gholizadeh Shamasbi, S.; Barkin, J.L.; Ghanbari-Homayi, S.; Eyvazzadeh, O.; Mirghafourvand, M. The relationship between maternal functioning and mental health after childbirth in Iranian women. Int. J. Environ. Res. Public Health 2020, 17, 1558. [Google Scholar] [CrossRef] [Green Version]
Table
Table 1. Sociodemographic and obstetric characteristics of the participants (n = 564).
Table 1. Sociodemographic and obstetric characteristics of the participants (n = 564).
Characteristics Relationship with Maternal Functioning
Number (Percent)Mean (SD)p-Value
Age (Year)29.5 (6.4) *−0.058 ¥0.736 §
Body mass index (kg/m2)27.5 (3.2) *0.068 ¥0.149 §
Sufficiency of income for expenses 0.019 †
Completely sufficient104 (18.4)75.0 (16.0)
Somewhat sufficient326 (57.8)76.5 (14.5)
Insufficient134 (23.8)81.4 (15.5)
Home status <0.002 †
Private house328 (58.2)75.5 (14.9)
corporate home203 (36.0)80.8 (14.8)
Living in a relatives’ house33 (5.9)75.3 (16.4)
Education 0.467 †
Primary school29 (5.2)79.5 (18.2)
Secondary school96 (17.0)78.5 (14.8)
High school111 (19.7)81.2 (10.6)
Diploma158 (28.0)77.4 (14.1)
University170 (30.1)73.9 (17.5)
Spouse education 0.170 †
Illiterate10 (1.8)84.9 (13.3)
Primary school36 (6.4)80.5 (17.3)
Secondary school66 (11.7)76.8 (14.3)
High school74 (13.1)80.1 (11.2)
Diploma193 (34.2)78.6 (13.7)
University185 (32.8)74.3 (17.4)
Job 0.052 †
Housewife456 (80.9)78.2 (14.6)
Working at home56 (17.0)74.0 (17.8)
Working abroad12 (2.1)74.5 (10.1)
Spouse employment 0.014 †
Unemployed6 (1.1)86.6 (12.2)
Government employee119 (21.1)73.4 (17.9)
Manual worker183 (32.4)80.2 (14.6)
Self-employment256 (45.4)77.0 (13.7)
Spouse support <0.000 †
Low156 (27.7)90.0 (14.3)
Moderate185 (32.8)90.4 (14.7)
High223 (39.5)97.5 (14.3)
Family support <0.000 †
Low168 (29.8)91.1 (15.0)
Moderate211 (37.4)90.5 (14.3)
High185 (32.8)97.8 (14.2)
Gestational age37.5 (2.8) 0.534 ‡
≤37 (week)124 (22.0)77.2 (12.9)
≥38 (week)440 (78.0)77.5 (15.7)
Para 0.110 †
1318 (56.4)93.0 (14.8)
2196 (34.8)94.2 (14.9)
≥350 (8.9)89.3 (14.3)
Admission of newborn in NICU 0.008 ‡
No461 (81.7)92.9 (15.4)
Yes103 (18.3)94.1 (12.2)
Mode of Delivery 0.253 †
Normal vaginal delivery (NVD)165 (29.2)84.6 (10.4)
Elective cesarean section178 (31.6)76.9 (17.0)
Emergency cesarean section221 (39.2)76.7 (13.2)
* The numbers show mean (standard deviation); † One-way ANOVA; ‡ Independent t-test; § Pearson Correlation test; ¥ Correlation coefficient.
Table
Table 2. The status of maternal functioning and subdomains (n = 564).
Table 2. The status of maternal functioning and subdomains (n = 564).
VariableMean (SD) *Obtained Score RangeObtainable Score Range
Maternal functioning93.1 (14.8)33 to 1200 to 120
Satisfaction with Maternal Competence38.6 (6.7)15 to 480 to 54
Self-care18.4 (3.4)5 to 240 to 24
Infant care9.9 (1.9)2 to 120 to 12
Social Support14.3 (3.3)1 to 180 to 18
Psychological Well-being4.5 (3.3)0 to 120 to 12
* Mean (standard deviation).
Table
Table 3. Predictors of maternal function based on general linear model (n = 564).
Table 3. Predictors of maternal function based on general linear model (n = 564).
VariableB (CI 95% *)p-Value
Spouse support (Reference: High)
Moderate−4.77 (−7.58 to −1.08)0.005
Low−4.44 (−6.80 to 0.07)0.008
Family support (Reference: High)
Moderate−3.90 (−7.31 to −0.48)0.025
Low−5.22 (−8.58 to −1.87)0.002
Spouse employment (Reference: Self-employment)
Unemployed−5.10 (−16.79 to 6.68)0.398
Employee1.37 (−1.81 to 4.56)0.397
Manual worker−1.45 (−4.20 to 1.30)0.299
Home status (Reference: Living in a relatives’ house)
Private house4.06 (−1.24 to 9.37)0.133
corporate home1.08 (−4.36 to 6.53)0.695
Sufficiency of income for expenses (Reference: Insufficient)
Completely sufficient4.33 (0.45 to 8.22)0.029
Somewhat sufficient2.26 (−0.78 to 5.30)0.146
Admission of newborn in NICU (Reference: Yes)
No−1.61 (−1.00 to 1.61)0.318
* Confidence Interval 95%.
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MDPI and ACS Style

Ahmadpour, P.; Curry, C.; Jahanfar, S.; Nikanfar, R.; Mirghafourvand, M. Family and Spousal Support Are Associated with Higher Levels of Maternal Functioning in a Study of Iranian Postpartum Women. J. Clin. Med. 2023, 12, 2718. https://doi.org/10.3390/jcm12072718

AMA Style

Ahmadpour P, Curry C, Jahanfar S, Nikanfar R, Mirghafourvand M. Family and Spousal Support Are Associated with Higher Levels of Maternal Functioning in a Study of Iranian Postpartum Women. Journal of Clinical Medicine. 2023; 12(7):2718. https://doi.org/10.3390/jcm12072718

Chicago/Turabian Style

Ahmadpour, Parivash, Carolann Curry, Shayesteh Jahanfar, Rogaiyeh Nikanfar, and Mojgan Mirghafourvand. 2023. "Family and Spousal Support Are Associated with Higher Levels of Maternal Functioning in a Study of Iranian Postpartum Women" Journal of Clinical Medicine 12, no. 7: 2718. https://doi.org/10.3390/jcm12072718

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