Assessment of Self – Care Practices during Prenatal Period among Mothers in Babylon City

Objective:The study aims to assess the self-care practices of the antenatal mother, and to Identify the demographic characteristics of pregnant mother (Age, Level of education, occupation ..............etc. ). Methodology: A descriptive analytical design study was conducted on non-Probability (convenient sample), Startingfrom the period December1 st 2014 to August the 3 rd 2015.which consists of (150) pregnant women. Were selected from (4) health centers 2 from each sector in the Hilla city as randomly selected from the general population. The researcher used rated on (3level type Likert scale), by (Lindgren 2005) which is on the other hand the (Health practice questionnaire II (HPQ-II ). The questionnaire was consisted of (67) items developed and adopted to measure the self-care practices of pregnant women. The current items which were grouped into comprised of two parts which includes the following: Part. I A. Socio-demographic characteristics of mothers, B. Reproductive Information. Part II. Items of pregnant mother practices. A pilot study has been carried out to test the reliability of the questionnaire and content validity has been carried out through the (22) experts in the different fields. The reliability Coefficient through of the calculated (alpha Cronbach's) was (α= 0.827). The researcher gathered the subjects responses through the questionnaire & face-to face interview as one of the methods of data collection. Statistical analysis was conducted to determine a frequency distribution of responses for each item as reported for the entire sample. Results:"overall"Results shows of the study showed that the final evaluation of the practice of self-care during the period of prenatal he was a good 50%.The present study demonstrated no statistically significant relationship between the demographic variables and practices of the selfcare. Conclusions: The results achieved from all studied self-care practices among mothers during pregnancy (nutritional, physical activity, personal hygiene, rest and sleep, other practices),it was of a good level of the assessment. Recommendations : The present study recommends the continuation of ministry of health and public mass media which have a great role to play in creating awareness about prenatal care among pregnant women as well as among deprived populations in the other places. Encouraging the pregnant mothers to commitment through dietary programs toward vegetable based diets rich in a variety of vegetables, fruits and pulses minimally cereals, nuts, fat diets and sweets.


Instrument tf the Study:
After reviewing the literature and previous studies.This questionnaire was developed and adopted to measure the self-care practices of pregnant women, it has been modified as it is used by (Lindgren 2005) which is on the other hand the [Health practice questionnaire-II (HPQ-II .(] Part.I: A. Socio-demographic characteristics of mothers: It is comprised of (8) items which are concerned with the socio demographic characteristics of the subjects, include (Age, Level of education, Occupation, Place of residence, Marital status, Type of family, Household size, Economic status. Part I: B. Reproductive Information: It comprised of (7) items include Gestational Age, Gravida, Para, Abortion, Number of dead births, Routine visits and Source of benefit from health outreach services during pregnancy.
Part II: Items of pregnant mother practices:It consists of (67) items classified into (6) sections: Section I: (Nutritional Practices): comprises of (23) nutritional items which were concerned with types of nutritional classes, such as protein intake, vitamin & minerals and other nutritional habits.
Section II: (Physical Activity & Sports Practices) : Is concerned with physical activity and exercise and consists of (13).Section.IV: (Follow-up the PHC services): It concerned with education sessions, Follow-up weight, Follow-up blood pressure, Follow-up urine and blood tests, Follow-up the case of teeth and oral health, visit the health center, Ultrasound during pregnancy, Taking tetanus vaccine, Vaccination against pandemic flu, Other vaccinations and represented into (9) items.

Section. III: (Personal
Section.V: Other Practices: It comprises of (8) items which were related to clothing, Avoid exposure to x-rays, Avoid exposure to high temperature, a void using shaving machine and keep the cleanliness of utensils and cutting boards.
The questionnaire was determined through a panel of (22) expert in the different fields, to examine the questionnaire format for content relevancy and adequacy.
All the data was statistically analyzed using Statistical Package for the Social Sciences (SPSS) statistical software package (SPSS Inc., Chicago, IL, version 18.0 for Windows).Table (1):Shows the overall assessment of the self-care practices during prenatal period responses are good at the nutritional practices, burden of work, rest and sleep and follow-up of primary health care services.Fair at the Physical activity and sports practices and poor at the personal hygiene, other practices.Furthermore, the overall assessment of the self-care practices during prenatal period is good.Table (2):displays the obstetrical history of the mothers of the study sample were (68.7%) from the gestational age at age of the second trimester (4-6) months, (86.7%) was from gravida of pregnancy represent the age group (2-4) year of experiences,of the pregnancy (88.0%) of the para of the women, (75.3%) of them do not have abortion (absent),( 96.0% ) was the absent of number of dead, (68.7%) of them committed to routine visits, according to the private health care table on pregnant women finally, for the exposure to mass media the height percentage was (64.0%) of them from the health professional.

Figure (1) Overall assessment of the self-care practices during prenatal period
Table (1):reveals that most of the self-care practices 75 (50% ) had good assessment, 50 (33.3%)had fair assessment of the self-care, and 25 (16.7%) of them had poor assessment, up to 30 general questioner regarding meaning, nutritional, physical activity, Personal hygiene, burden of work, rest and sleep,follow-up of primary health care services, and others of the Self-Care Practices during prenatal period (show figure 1).

DISCUSSION
The overall assessment of the self-care practices during prenatal period responses are good at the nutritional practices, burden of work, rest and sleep and follow-up of primary health care services.Fair at the Physical activity and sports practices and poor at the personal hygiene, other practices.Furthermore, the history of the mother with self-care practices during perinatal period is high significant with Gestional age, Abortion &exposure to mass media(Show Figure 1).
It has been found from different studies that the Socio-demographic characteristics and data play a great role to be as reason of practicing the healthy behavior among pregnant women that as result affecting their health either positively or negatively (9) .
The demonstrated that highest percentage represented was (68.7%) was women in their second trimester (4)(5)(6)  (Yu-Hua Lin, 2009) a cross-sectional research design selected a convenience sampling of (172) pregnant women, he found that highest represents (44.19%) were in the third trimester (10).
The results of the same table show the number of previous pregnancies of the subject, it reveals that highest percentage represents (86.7%) of the sample were mothers had got pregnancy (2)(3)(4) times.This study disagree with results of (Gomora, A. 2015), the study conducted on (80) young women.The number of pregnancies of the participants had revealed that the majority (71.2%) had (two) pregnancies (11) .
The current study results show that the highest percentage of the sample (88.0%) has history of number of alive children (1)(2)(3).This study agree with (Amit, & et al, 2014), who were surveyed (400) subjects to asses women knowledge and attitudes and practices toward oral and dental health during pregnancy, researchers found that major sample registered (32.5%) (12) .This study shows that the highest percentage of women represented (75.3%). of the study sample did not have history of (abortion).This is agree with a study conducted in China by (He,&et al .,2009), to evaluate personal design history, knowledge and needs among low income urban females on sample number (1642), results indicated that approximately half of the women had had at minimum one abortion (13) .
In relation to number of dead birth the present study reveals that the highest percentages of mothers signified (96.0 %) study sample did not have history of (dead birth).The current study agree with the results of (Avelyn,G.2012), who had done a study to identify a self-care practices regarding prenatal care found that from a study sample of (N=80) (96.25%) delivered live births (14) .
From the study it can be seen that the highest percentage of womenrepresented (68.7%), study sample on regular routine visits which is very vital to the mother.The current study agree with (Rahman, & et al.2010), who includes regular monitoring of the mother and her baby throughout pregnancy by a variety of routine regular examinations and tests the women had only one ANC visit, The study sample collected was (N = 700) respondents, results show that odds are higher for the mothers who go to hospitals and clinics for antenatal medical checkups (15) .
In regard to exposure to mass media the present study results show that highest percentage of the sample had exposure to mass media during their prenatal period.This study agree with results of a study conducted by (Rahman,& et al.2010),The study sample was ( N = 700) respondents were selected from 8 different slums of 3 wards (15) .
Mass media is shown to play a strong role by creating awareness about pregnancy related complications and negative effect on the future health of mothers and their newborn babies (the results show that the mothers who are exposed to mass media are (2.253) times more likely to go for medical checkup than those not exposed.
Hygiene):It comprises of (8) items related to the daily hygiene.Section.IV: (Burden of workload, Rest &Sleep (: It comprises of (6) items related to the rest, sleep, work environment, Passive smoking in the home and work.