Effects of a maternal role adjustment program for first time mothers who use postpartum care centers (Sanhujoriwon) in South Korea: A quasi-experimental study

Abstract

Background: Many South Korean women stay in specialized postpartum care centers called Sanhujoriwon for 2 weeks after childbirth, a time which is widely recognized as a critical period for maternal role adjustment. Mothers' time within the postpartum care center offers a unique opportunity for nursing intervention to promote a successful transition to motherhood, especially for first time mothers. This study aimed to develop a maternal role adjustment program within the Sanhujoriwon based on the ecological model, and to evaluate its effects on maternal role confidence and breastfeeding success. Methods: A non-equivalent control group pretest-posttest design was used. Data were collected from 30 participants in the experimental group and 37 in the control group at four measurement times, i.e., admission day to Sanhujoriwon, discharge day from Sanhujoriwon, 4-6 weeks postpartum, and 12 weeks postpartum. The experimental group received the maternal role adjustment program, which included family education and counseling regarding breastfeeding and infant care, and encouraged rooming-in practices during their stay in the Sanhujoriwon. The data were analyzed using the IBM SPSS statistics 25.0 program using descriptive statistics, t-test, chi-square test, ANCOVA, and GEE. Results: There were significant interaction effects showing different patterns in maternal role confidence and breastfeeding success scores over the four time points. Maternal role confidence in the experimental group gradually increased over time. Maternal role confidence in the control group also increased from baseline to 4 to 6 week postpartum, but abruptly decreased at 12 week postpartum. At 12 weeks postpartum, maternal role confidence in the experimental group was significantly higher than that of the control group. In addition, breastfeeding success scores in the experimental group also gradually increased over the four time points, while those of the control group showed a gradual decline. Breastfeeding success scores were significantly higher than those of control group at both 4-6 weeks and 12 weeks postpartum. Conclusions: These results indicate that the maternal role adjustment program was effective in improving maternal role confidence and breastfeeding success among first time mothers in the postpartum care center.