Baby Boot Camp: Facilitating Maternal Role Adaptation Among Military Wives
Abstract: Background: Current research suggests that women married to military service members may experience difficulty during the transition to motherhood attributable to the additional stressors of military life and inability to access traditional support systems. Objective: To test the effects of a nursing intervention on prenatal and postpartum maternal role adaptation among military wives. Methods: Primigravid military wives were assigned randomly to either a traditional childbirth education program (n = 47) or Baby Boot Camp (n = 44). The Baby Boot Camp is a 4-week childbirth-parenting preparation program based on a resilience paradigm. The strategies of Baby Boot Camp include identification of nontraditional external resources and development of internal resources to facilitate maternal role adaptation. The Prenatal Self-Evaluation Questionnaire, Personal Resource Questionnaire, and Resilience Scale were administered at baseline (32 to 37 weeks gestation), immediately after the intervention, and at 6 weeks postpartum. Results: The outcomes suggest that Baby Boot Camp strategies to enhance external and internal resources may have been successful in facilitating maternal role adaptation. An independent t-test showed that, as compared with the military wives who attended traditional childbirth education courses, the Baby Boot Camp participants experienced significantly greater prenatal and postpartum adaptation. As demonstrated by repeated measure analysis of variance, the Baby Boot Camp participants experienced an increase in external and internal resources immediately after the intervention. However, these differences in resources were not sustained at 6 weeks postpartum. Conclusions: The findings may lead to wider development and use of childbirth-parenting programs designed to meet the unique strengths and needs of the childbearing military wife.
Abstract: Introduction: Persistent inequities exist in obstetric and neonatal outcomes in military families despite universal health care coverage. Though the exact underlying cause has not been identified, social determinants of health may uniquely impact military families. The purpose of this study was to qualitatively investigate the potential impact of social determinants of health and the lived experiences of military individuals seeking maternity care in the Military Health System. Materials and methods: This was an Institutional Review Board-approved protocol. Nine providers conducted 31 semi-structured interviews with individuals who delivered within the last 5 years in the direct or purchased care market. Participants were recruited through social media blasts and clinic flyers with both maximum variation and homogenous sampling to ensure participation of diverse individuals. Data were coded and themes were identified using inductive qualitative research methods. Results: Three main themes were identified: Requirements of Military Life (with subthemes of pregnancy notification and privacy during care, role of pregnancy instructions and policies, and role of command support), Sociocultural Aspects of the Military Experience (with subthemes of pregnancy as a burden on colleagues and a career detractor, postpartum adjustment, balancing personal and professional requirements, pregnancy timing and parenting challenges, and importance of friendship and camaraderie in pregnancy), and Navigating the Healthcare Experience (including subthemes of transfer between military and civilian care and TRICARE challenges, perception of military care as inferior to civilian, and remote duty stations and international care). Conclusions: The unique stressors of military life act synergistically with the existing health care challenges, presenting opportunities for improvements in care. Such opportunities may include increased consistency of policies across services and commands. Increased access to group prenatal care and support groups, and increased assistance with navigating the health care system to improve care transitions were frequently requested changes by participants.