E-health for pregnant women: a success story iStock

E-health for pregnant women: a success story

In Body
Written by  Femke Kools Friday, 26 February 2016 08:22

Pregnant women who drink alcohol, or who suffer from psychological and emotional symptoms, are more at risk for a wide range of problems. How do you support women who may not be feeling quite right, or who cannot give up alcohol for nine months? With an E-health program, according to research at Maastricht University. On Thursday, 3 March, two candidates will give back-to-back defences of their theses, both of which are on research into the use of e-health in the care of pregnant women. This is purely a coincidence, because they had never met before this interview.

Yvonne Fontein was originally a midwife and had her own practice until 2008. Today, she works as a lecturer and researcher with the Midwifery programme at Rotterdam University of Applied Sciences. Fontein is a PhD candidate within the Midwifery Science research group at Zuyd University of Applied Sciences. She examined the use of a tailor-made website with practical tips that pregnant women can use to determine whether they are feeling good psychologically and emotionally, what factors throw them off balance and how they can best manage it all (coping mechanisms). In addition, the participating midwives discussed the issue with even greater emphasis than they normally do with pregnant women. The intervention ‘WazzUp Mama’ appeared to have a significant positive effect on pregnant women: they felt better about themselves than women who received no special attention on the subject from their midwife. “One of the things that surprised me in the study, is that it is highly dependent on the affinity that a midwife has for the psychological aspects of a pregnancy, whether there’s focus on it in their practice. And that often has to do with work experience; how you see the total picture of the pregnancy and not just the medical or biological aspects.”

A glass per week
Nickie van der Wulp got into alcohol research through social psychology. Today, she is director of the Korsakov Knowledge Centre, which is committed to providing quality care to patients with Korsakoff’s syndrome. Her research was commissioned by the Dutch Institute for Alcohol Policy (STAP) to examine how you can help pregnant women who drink alcohol to stop drinking during their pregnancy. “The women who participated in the research drank on average one glass per week. There is no safe lower limit, because we don’t know what the effect is of a single sip or glass, so we’re committed to zero consumption.” The website negenmaandenniet.nl gave interactive feedback on the knowledge level of pregnant women about alcohol use during pregnancy and provided recommendations. “We saw that the group that received feedback via the website stopped drinking more often than those who received feedback from midwives and especially more often than those who received no special intervention. My theory is that pregnant women didn’t dare to be honest with the midwives. It was even difficult for midwives to discuss the topic again during the second and third measurements. Annoyed reactions like: ‘I've already said that I don’t drink anymore!’, make it difficult for them to proceed.”

The role of the partner
Both PhD candidates are very aware of the workload of midwives and the fact that their research questions came on top of an already heavy workload. Van der Wulp is still adamant: “They currently ask whether you smoke, drink alcohol or use drugs, but I think that’s too limited. You should also ask if someone drank before the pregnancy and how much. If they drank regularly, they’re more likely to drink during the pregnancy. And if the partner continues drinking and even says that it doesn’t matter if his pregnant wife drinks, the risk is also higher. I thought that was notable from my research: the role of the partner is very important.” Van der Wulp also noted that some midwives still underestimate the problem of alcohol use during pregnancy. Fontein: “And they often underestimate their own influence on pregnant women. While they’re often very willing to adapt their lifestyle if it’s in the interest of the baby.”
Every year in the Netherlands, six hundred babies are born with Foetal Alcohol Syndrome (FAS): they have distinctive facial features, are smaller, have brain damage and more. “For children with behavioural problems or ADHD, we don’t know to what extent this could be caused by alcohol. There are so many women who drink alcohol during pregnancy, which is so harmful to the development of the foetus; that was an incredible motivation for me.” Fontein: “My motivation was that a pregnancy is not all roses for everyone and I think that’s a pity, because most women don’t experience many. And I see enormous improvements that can be made in prenatal care, by better observing and listening to what the pregnant women need. With the best intentions, midwives tend to fill in the women’s experiences. But you have to be very focused on what the woman needs.” Van der Wulp: “I have a lot of respect for the profession, but the knowledge about alcohol could be much better. Especially highly educated pregnant women sometimes want to have a drink and with them in particular you have to use very good arguments to convince them that it’s harmful.”

No solid figures
The problem is, of course, that there are no rock solid figures on how much alcohol is harmful. This also applies to ‘maternal distress’ during pregnancy. What is known is that one in four or five women in the Netherlands suffer from it each year, which is approximately 35,000. Potential consequences of this are a greater fear of childbirth, postpartum depression or severe prolonged psychological complaints. The child can also suffer from it, in terms of birth weight and subsequent behavioural or developmental problems. Factors that make women the most out of balance during pregnancy, as is shown in Fontein’s research, have to do with purely the expectation of having a(nother) child. “That’s also related to the role of working mothers nowadays and everything they have on their plate. Even with a second child, it may increase the amount of stress in that area. Also if the woman had previously had psychological symptoms, there was more stress during pregnancy. One of the most important ‘coping mechanisms’ was talking about your worries or problems. And in that case more with loved ones than with the midwives. That was also then encouraged through the site.”

The site www.negenmaandenniet.nl was expanded using a ZonMW grant from a research version to a public version. “Every pregnant woman should visit the website," says Van der Wulp. The future of www.wazzupmama.nl is still being considered.

Yvonne Fontein is a lecturer and researcher with the Midwifery programme at Rotterdam University of Applied Sciences. On Thursday, 3 March at 16.00 at Maastricht University, she will defend her thesis entitled ‘Wazzup Mama! The development of an intervention to reduce preventable and maternal distress during pregnancy’.
Nickie van der Wulp is director of the Korsakov Knowledge Centre. On Thursday, 3 March at 14.00 at Maastricht University, she will defend her thesis entitled ‘Zero for nine: Reducing alcohol use during pregnancy through health counselling and Internet-based computer-tailored feedback’.

Rate this item
(0 votes)
Read 3082 times
You are here: Home Research Body E-health for pregnant women: a success story

Maastricht University Webmagazine

Marketing & Communications
Postbus 616, 6200 MD Maastricht
Minderbroedersberg 4-6, 6211 KL  Maastricht
Tel: +31 43 388 5222
This email address is being protected from spambots. You need JavaScript enabled to view it.

Download UM Magazine

Read a digital version of Maastricht University magazine,
or download the PDF.
UM Webmagazine June 2017

Connect with us