Effects of Hybrid Family Planning Counseling on Postpartum Maternal Health

Condition(s) studied

Investigational drug(s) / intervention(s)

Hybrid family planning counseling: The study will begin with the randomization of samples meeting the inclusion and exclusion criteria to assign them to the intervention and control groups. The first interview will be conducted in person at the hospital between weeks 34-38 of pregnancy. The second interview will be conducted online (Zoom or WhatsApp) within the first four weeks postpartum. Pre-test measurements will be taken. The third interview will be conducted online at week 6 postpartum. After the modules are completed, follow-ups will be conducted at 3, 6, and 12 months, and interim and post-test measurements will be taken. The purpose of the interim measurement is to evaluate the effect of the training more accurately, permanently, and reliably over time. The aim here is not just to use a pre-test-post-test approach, but to evaluate it in a more detailed and dynamic way. The researcher will share contact information with the participants, and women will be able to contact the researcher at any time. Data will be

Study summary

This research aims to examine the effects of hybrid family planning counseling on maternal health in the postpartum period. The study is unique and innovative in that it evaluates the effectiveness of hybrid counseling models, which are gaining importance in the literature but have been the subject of a limited number of studies, particularly in Turkey. The World Health Organization recommends a minimum interval of 24 months between births, and it is known that early postpartum pregnancies have negative effects on maternal and neonatal health. In this context, the hybrid family planning counseling model to be developed will contribute to reducing maternal mortality and morbidity by supporting women in making informed and correct contraceptive choices. Furthermore, it is predicted that the findings of the study will be directly related to the United Nations Sustainable Development Goals, namely gender equality, healthy living, and quality education. The research is planned as a randomized controlled longitudinal study. Data collection is planned for August 2026 at the Adana City Training and Research Hospital antenatal clinic. The sample will consist of a total of 96 pregnant women, 48 in the experimental group and 48 in the control group, determined by power analysis. A counseling module will be created by gathering expert opinions. The module will consist of 3 sessions. Each session will last 45 minutes, including 30 minutes of interactive presentation and 15 minutes of question and answer. The module sessions will have a dynamic structure that takes into account the needs of the mother during pregnancy and the postpartum period. The first meeting will be held face-to-face in the hospital at 34-38 weeks of pregnancy, the second meeting will be online within the first 4 weeks postpartum, and the third meeting will be online at 6 weeks postpartum. During the implementation phase, quantitative measurements of the research will be carried out using the "Antenatal Pregnancy Information Form", "Postnatal Mother Information Form", "Postpartum Family Planning Attitude Scale", "Edinburgh Postpartum Depression Scale" and "Sexual Life Quality Scale".

Research hypotheses:

H0: Longitudinal hybrid family planning counseling (antenatal-postpartum period) does not affect maternal health. H1: Longitudinal (antenatal-postpartum) hybrid family planning counseling affects maternal health.

Eligibility

Primary outcome measure(s)

• Antenatal Pregnancy Information Form — Baseline
  Prepared by researchers in line with the literature, this form consists of 15 questions about the socio-demographic characteristics, obstetric characteristics, and family planning of pregnant women.
• Postnatal Mother Information Form — Baseline
  Prepared in accordance with literature reviews, this form consists of 11 questions covering mothers' information regarding the postpartum period, family planning, and childbirth.
• Postpartum Family Planning Attitude Scale — 3, 6, and 12 months after the intervention
  Developed by Varol and Çiçeklioğlu (2023), this scale consists of 27 items. 16 of the items contain positive statements, and 11 contain negative statements. The scale items are rated using a Likert-type scoring system ranging from 1 to 5. The lowest possible score on the scale is 27, and the highest is 135. Items 1-3 represent "Perceived Risk"; items 4-6 represent "Perceived Seriousness"; Items 7-10 represent "Perceived Benefits", items 11-18 "Perceived Barriers", items 19-23 "Taking Action", and items 24-27 "Self-Efficacy". The highest possible score on the scale indicates a higher belief in health regarding perceived risk, perceived severity, perceived barriers, perceived benefits, taking action, and self-efficacy; therefore, a more positive attitude towards postpartum depression. In the development study, the Cronbach's alpha coefficient was found to be 0.878, and the scale was considered reliable.
• Edinburgh Postnatal Depression Scale — 3, 6, and 12 months after the intervention
  Developed by Cox et al. in 1987 to determine the risk of depression in women during the postpartum period. In Turkey, the validity and reliability study of the scale was conducted by Engindeniz et al., with a cutoff score of ≥13. The scale consists of 10 items, each arranged in a four-option Likert scale. Response options are scored between 0 and 3. Items 1, 2, and 4 are scored as 0-1-2-3; items 3, 5, 6, 7, 8, 9, and 10 are scored as 3-2-1-0. The total score obtainable from the scale ranges from 0 to 30. The total score obtained by summing the item scores indicates that individuals with a score of 13 or higher are considered to be in the risk group. The Cronbach's alpha value of the scale is 0.87.
• Sexual Life Quality Scale-Female — 3, 6, and 12 months after the intervention
  Developed by Symonds et al. in 2005 and adapted into Turkish by Tuğut and Gölbaşı, the scale consists of 18 items designed to assess problems related to sexual life over the past four weeks. The scale, answered using a six-point Likert scale, can be used with different scoring methods. In this study, a system where items are scored from 1 to 6 was preferred. The total score obtainable from the scale ranges from 18 to 108. A higher score indicates better sexual life quality. The Cronbach's alpha coefficient of the scale was determined to be 0.83.

Trial sites (1)

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