ivery of infant massage
Empower the mother with education about healthy childhood development to nurture positive engagement, autonomy, and improve emotional wellbeing
MANAGEMENT OF PHYSICAL ISSUES:
Address chronic pain management and physical disorders (e.g., chronic low back pain, urinary incontinence, and pelvic organ prolapse), which affect daily function through remediation, compensation, or environmental modification.
Address the sequelae of physical issues such as accompanying stress, anxiety, depression, diminished sense of wellbeing and ability to care for the baby.
Provide adaptive strategies to address sleep deprivation being common and correlated to exacerbated experiences of physical issues and sequelae in the postpartum period.
Support psychological wellbeing by teaching new skills, assisting with the development of healthy habits and routines, and addressing life balance.
Support development of physical wellbeing through the development of appropriate pre- and/or post-natal exercise programs, addressing potential pelvic health issues, and establishing sleep and breastfeeding schedules and routines.
EDUCATE AND ADVOCATE:
Provide new mothers with empowering information and community resources
Provide access to resources for social supports within the community
Help identify atypical situations (e.g., pelvic floor problems or unmet infant milestones) and to determine the best course of action for next-steps
Refer to needed providers when beyond the scope of the OT domain and process
HOW OCCUPATIONS CAN INFLUENCE PPD
Meaningful activities have been repeatedly cited within the existing body of literature as being a priority for women identified with postpartum depression. Feeley et al. (2016) outlined four primary areas that were expressed by the findings of their qualitative study to be the most important aspects of care in the postpartum period: 1) comprehensive care; 2) support; 3) activities; and 4) professional help. Activities are explicitly valuable to the care of this population. One study indicated that women were most likely to advocate for nontraditional treatment interventions for their symptoms of depression, such as exercise and yoga (Shivakumar et al., 2014). Yoga is shown to have a significant positive impact on PPD in a random controlled trial (Buttner, Brock, O'Hara, & Stuart, 2015). Leisure-time physical activity was additionally found to have a significant impact on participating women with PPD’s perceptions of self-worth, empowerment, and an overall reduction in susceptibility to depressive symptoms (Lloyd, O’Brien, & Riot, 2016).
Engaging in social support related to a church or spiritual organization was highly valued and of positive impact on both women of color (Keefe, Brownstein-Evans, & Rouland Polmanteer, 2016) and Hispanics in rural settings (Kim & Dee, 2017). While one study found that an arts-based program for women with PPD lead to verbalized feelings of improved quality of life, perceptions of self-efficacy and gained satisfaction from informal social support in the 10-week course (Morton & Forsey, 2013). Selix and Goyal (2015) elaborate upon the importance of empowering women with adaptive strategies for returning to the workplace to resume professional occupations, as 80% of women who are employed during their pregnancy return to their professional roles within the first year of the newborn’s life.
Perhaps most importantly, the transition to the maternal role and the ability to engage in the occupation of maternal self-care while balancing the demands of child-rearing is the immediate focus of occupational intervention. This maternal skill set is referred to by Barkin and Wisner (2013) as maternal functioning, further articulating the seven functional domains of maternal self-care as “social support, self-care, psychological well-being, infant care, mother-child interaction, management and adjustment” (pg. 1051). Familiarization with this new occupational domain may require redefining the cumulative occupational profile that is known to the individual previously, prior to the 