Maternal General Health Issue

Maternal general health issue has always been a subject of interest in health and field of psychology which encompasses the health care dimensions of family planning, pre-conception, prenatal and postnatal care. Nigeria is one of the countries that have the highest maternal death rate during and after delivery (Global one, 2015). The effects of mother's deaths and even depressive symptoms results in vulnerable families, and their infants, if they survive childbirth, they are more likely to die before reaching their second birthday or suffer psychological disorders later in life (WHO maternal health, 2015).

Given the prevalence of maternal morbidity, the repercussion it has for the health and wellbeing of nursing mothers calls for concerns, hence, the need to investigate the psychological, social, and medical factors that account for their psychological wellbeing. Psychological wellbeing is described as the quality of a life of a person and it includes what a lay people call "happiness", "peace", "fulfillment" and "life satisfaction". Huppert 2009, opines that psychological wellbeing is about life going well.

It is the combination of feeling good and functioning effectively. Sustainable wellbeing does not require individuals to feel good all the time; the experience of painful emotions (For example, disappointment, failure, grief) is a normal part of life, and being able to manage these negative or painful emotions are essential for long-term wellbeing. Psychological wellbeing is however, compromised when negative emotions are extreme or last very long and interferes with a person's ability to function in his or her daily life (Huppert, 2009).

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The concept of feeling good incorporates not only the positive emotions of happiness and contentment but also such emotions as interest, engagement, confidence and affection. Functioning well (in a psychological sense) involves the development of one's potential, having some control over one's life, having a sense of purpose and experiencing positive relationships. Correspondingly, Ryff (1991) states that convergence of similar features of positive psychological functioning, constitutes the core dimensions of psychological wellbeing. Kumar (2006) observes that conceptions of wellbeing are integrally related to how one values the nature of man and what perspective is valued. In alignment with Kumar's opinion, psychological wellbeing is a broad term that encompasses different psychological functioning such as general health, life satisfaction, attitudes, just to mention a few.

As a consequence, 'psychological wellbeing' is defined as the general health of a person specifically as it relates to nursing mothers. According to World Health Organization, (2003), Health is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity. This implies that a person may be physically healthy and not psychologically healthy.

According to Saurel-Cubizolles, Romito, Lelong, Ancel, (2000), physical and psychological problems after childbirth are common, and may have a significant negative and possibly long-term impact on women's well-being and daily functioning. Among the physical and psychological problems is that manifested in the experience of childbirth. According to Ingrid and Maggie (2012), the experience of childbirth can be complex due to a range of individual, medical and social factors that can interact to influence women's experiences and outcomes.

Therefore, this research examined the influence of certain psychological constructs like social support, personality type and mode of delivery as they affect general health wellbeing of nursing mothers which has not been specifically explored.

Based on this position, one factor that has been consistently identified as influencing the duration and severity of women's physical and psychological wellbeing following childbirth is the mode of delivery (Ingrid J. Rowlands& Maggie Redshaw, 2012; Soderquist, Wijma, Wijma, 2002; Creedy, Shochet, May, 2000). Modes of delivery are various methods through which a woman can give birth to her child; these are unassisted vaginal birth (is a normal delivery though which a mother gives birth to her baby); assisted vaginal birth (this is through use of instruments like forceps, induced labor, or when the hole of the vagina had to be torn to allow the baby come out.

This is typically done during a contraction while the mother pushes.); and caesarean section (it is a surgical procedure in which one or more incisions are made through mother's abdomen and uterus to deliver the baby). As proposed by Guittier, Cedraschi, Jamei, Boulvain, and Guillemin, (2014), a positive delivery experience can result in a sense of accomplishment and feelings of self-worth and self-confidence. However a negative delivery experience can result in detrimental consequences ranging from feelings of maternal distress to postpartum depression and even post traumatic disorder.

Social support no doubt has been extensively explored in researches. It has been explored in terms of psychological problems among the students, (Md-Aris; Mariam, 2010). It has also been specifically looked into in relation to psychological well-being (Mohamed, Deviga, Mohd, Aqeel, Roslee, 2014; Christine, Marci, and Susan, 1993). Research has shown link between social support with depression, coping styles and stress, (Ren, Jiang, Yao, Li, Liu, Pang, 2015; Keshia, 2014).

Social support combined with confidence in infant care has also been linked through research among first-time mothers. In the same vein, mode of delivery has been examined based on birth experience in the first timer mothers, (Guittier, Cedraschi, Jamei, Boulvain, and Guillemin, 2014). It has also been looked into with specifics to psychological, postpartum emotional distress, and physical wellbeing in the postnatal period, (Ingrid ;Maggie, 2012; Adams, Eberhard-Gran, Sandvik, Eskild, 2012).

Also, personality traits are observed to influence the psychological wellbeing of nursing mothers. Researchers have established a link between personality traits and other psychological disorders such as postpartum depression (NHMRC, 2000). Owing to this, personality traits will most likely influence psychological wellbeing of individuals. Though there is limited evidence to show the relationship between personality traits and psychological wellbeing, researchers have found strong relationship between personality and postpartum depression. Among these researchers is Saudina Udovicic (2014) who investigated the roles of big five personality traits and social support as predictors of postpartum depression. He found a significant correlation between neuroticism and postpartum depressive symptoms. Also, conscientiousness and openness to experience were found to be significant predictors of postpartum depression. This is consistent with other researches: (O'Hara & Swain, 1996); (Dudley, Roy, Kelk and Bernard, 2001). Therefore personality and psychological wellbeing may be associated due to its link with depressive symptoms.

Apart from personality traits, social support can be viewed to play a role in the general heath of nursing mothers. Definitions of social support emphasize the perception or provision of resources available to an individual from those within his or her social network (Dunkel, Schetter& Brooks 2009; Gottlieb & Bergen 2009; Thoits 2011). In addition to this, social support can be described as the emotional, instrumental or tangible aid exchanged between members of the networks. Social relationships play a central role in shaping the quality of people's lives.

Researchers have shown great interest in the phenomena of social support, particularly in the context of health. Particularly, Mohammed, Mustaffa, Deviga and Aqeel, 2014, conducted a quantitative study with survey method on fifty pre-natal mothers and fifty post-natal mothers in Malaysia to investigate the influence of social support on maternal depression and mental wellbeing. They found that a negative correlation existed between social support and maternal depression and positive correlation existed between social support and maternal wellbeing. In seeking to know the role of social support, it is important to explore its role on the psychological wellbeing of nursing mothers.

Personality traits have also been examined alongside social support as predictors of postpartum depression, (Saudina, 2014), while it has also been examined alongside passion, and self-esteem, (Lars, 2011).Psychological well-being have been looked into as a criterion in relation to the effect of family structure, family process (Christina, 1997). Also its combined outcome with physical activity of obese pregnant women have been studied (Ing-Marie, Sofia, Gunilla, and Ann, 2013), and also paired with marriage with respect to the mediating influence of social support, (Laura, Kate, 2015). Researchers have even further research on psychological wellbeing to the interest of the HIV/AIDS patients, (Oppong, 2012).

But worthy of note in the literature is the fact that mode of delivery, personality traits, and social support has never been elucidated in the research with respect to their combined influence and relationship with psychological well-being of nursing mothers both in the local and foreign literature. Therefore, this study investigated the combined influence of personality traits, social supports, modes of delivery on psychological wellbeing of nursing mothers (that is, women in their postpartum period). This study seeks to answer the following research questions:

Can the social support received by nursing mothers improve their psychological wellbeing? Is psychological wellbeing influenced by the personality traits of the nursing mothers? Can mode of delivery influence the general health outcomes of the nursing mothers?

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