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Psychosocial Considerations

Psychosocial issues are important determinants of health for pregnant women and their newborns and include the availability of social support, self-esteem and depression.[11] These concerns are not unique to low income women, but may affect these women disproportionately or in unique ways. The Antenatal Psychosocial Assessment (ALPHA) is a tool that was developed to evaluate these and other important factors in the lives of pregnant women. The factors  in the tool were chosen because they had demonstrated association with woman abuse, child abuse, postpartum depression, marital or couple dysfunction, and physical illness.[16] The tool is designed to identify issues in women’s lives and to open opportunities to work with women to decide if and how these issues should be addressed. Below are some examples of suggested questions that can be used to assess various elements in the ALPHA questionnaire.

To assess social support...

  • How does your partner and/or family feel about your pregnancy?

  • What support do you get from your family, friends, and partner?

  • Who will be helping you when you go home with the baby?

  • What family and/or friends do you have in town?

  • Who do you turn to when you have a problem or when you’ve had a bad day?

To assess a couple’s relationship...

  • How will your partner be involved in looking after the baby?

  • How do you share tasks at home? How do you feel about this?

  • Has your relationship changed since pregnancy? What will it be like after the baby?

  • Do you have any concerns about your relationship with your partner?

  • In your culture, what usually happens in a couple relationship once the baby is born?

The full questionnaire also includes screening questions for substance use and family violence. To see the complete tool, user guide and self-reporting form, visit the ALPHA website.

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11. Health Canada. Family centred maternity and newborn care, 4th Edition. Available at: http://www.phac-aspc.gc.ca/dca-dea/prenatal/fcmc1_e.html. Accessed August 2005.

16. Antenatal Psychosocial Health Assessment http://dfcm.utoronto.ca/research/alpha/ accessed March 19, 2006

All references for this section