Occupational Therapy’s Role in the Physical and Psychological

Rehabilitation of Mothers in the Perinatal Period

Ashley Heine OTS
Department of Occupational Therapy
Faculty Mentor: Ranelle Nissen, PhD, OTR/L
University of South Dakota
Site Mentor: Melissa Lee, OTR/L, BCB-PMD

INTRODUCTION METHODS IMPLICATIONS

Background
Various physical, mental, and emotional hardships often parallel the
triumphs of the perinatal period for mothers. Musculoskeletal dysfunctions,
poor sleep, and general exhaustion are common (Buurman & Lagro-Janssen, 2013;
Fernandes, 2018; Slootjes, McKinstry, & Kenny, 2016). Additionally, while apprehension
regarding new roles is typical, some mothers experience an uncontrollable
amount of mental distress that affects their participation in daily activities
(Barba-Müller, Craddock, Carmona, & Hoekzema, 2018). Occupational performance deficits
may be evident within the childcare, personal hygiene, toileting and toilet
hygiene, sexual activity, sleep, meal preparation, work performance, social
participation, financial management, and home management occupations
(Slootjes et al., 2016).
Objective
The purpose of the capstone experience was to determine the role of
occupational therapy (OT) in the physical and psychological rehabilitation
of mothers in the perinatal period. Secondarily, validation of the
effectiveness of MOHO as a guiding framework for OTs serving pregnant
and postpartum women was investigated.
THEORETICAL FRAMEWORK
The Model of Human Occupation (MOHO) was proposed by Gary
Kielhofner to focus the profession on a paradigm of human occupation.
Using MOHO, OT practitioners can assist mothers in establishing healthier
habits to mold into their routines (Kielhofner, 2008).
Mothers’ motivation, habits, routines, and occupational performance are
impacted by input from the environment. OT practitioners use client-
Figure 1. The Sectors of the Capstone
Experience
OUTCOMES
Business Management & Marketing
Activities included developing marketing content, patient interaction,
and collaboration with experts in the field. Business concepts were
introduced, and the MOHO was viewed in a new way to aid
understanding of patient activation.
Clinical Practice
Enhanced understanding of the contextual factors affecting mothers in
the perinatal period was accomplished though immersion in OT in a
pelvic rehabilitation clinic. The intricacies of volition, habituation, and
performance became less theoretical, such that a conceptualized idea of
barriers and successes of this population was identified.
Research
Limited data supports hypothesis regarding inadequate postpartum care
in the Southwest. No data saturation or clinical significance achieved.
Buurman, M., & Lagro, J. (2013). Women’s perception of postpartum pelvic floor dysfunction and their help-seeking
OT Practice and Education
It is the duty of the profession of OT to advocate for
consultation between OTs and women in the perinatal period.
An enhanced awareness by constituents of the profession
regarding the gap in services for pregnant and postpartum
women and the role of OT in fulfilling this gap is necessary.
This process begins within OT training programs. While the
broad scope of the profession poses barriers to implementing
highly specific education related to pregnancy and childbirth,
measures can be taken to increase awareness of OT’s role in
preventing and treating such conditions.
Research
• More information on the direction for OT education related
to perinatal care
• Further research on the effectiveness of integrated physical
and psychological rehabilitation of perinatal women by
OTs
• Additional collaboration regarding theoretical frameworks
used by OTs in the specialty area of perinatal health
• OTs interested in maternal care will need guidance in
identifying appropriate methods for increasing OT referrals
• Continued advocacy for the role of OT in in primary care
Conclusion
The capstone experience has set a precedent for the
significance of theory in OT practice for women in the
perinatal period. The MOHO has been utilized for careful
consideration of the dynamic interplay amongst psychosocial
contexts affecting mothers. By broadening the view of a
problem or dysfunction to include the person, his or her
occupational performance deficits, and the role of the
environmental context, occupational therapy brings to light its
originality – the fusion of science and creativity for optimal
engagement in daily life.
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