Postnatal quality of life assessment: Introducing the Mother-Generated Index

Background: The extent of postnatal morbidity has become increasingly apparent over the last 15, years, but currently no tool is available that measures postnatal quality of life. This pilot study introduces a subjective tool, the Mother-Generated Index, which assesses the woman's quality of life and identifies those aspects that are of most concern to her. Methods: The Mother-Generated Index was administered by structured interview to 60 participants at 6 to 8 weeks and to 43 participants at 8 months postpartum. Validation was sought through concurrent use of the Edinburgh Postnatal Depression Scale, the SF12, and two indexes related to maternal and neonatal physical morbidity. The Mother-Generated Index gives a primary index (quality of life) score, which is reported here, and a secondary index, which identifies the areas considered most important by the mother. Results: The primary index was more sensitive at 8 months. The highest and lowest quartile scores were compared. Statistically significant differences in were found in the mothers' Edinburgh Postnatal Depression scores at 6 to 8 weeks, and in their Edinburgh Postnatal Depression and SF12 mental component scores and their physical morbidity index at 8 months. Although physical problems were only, a small feature at 8 months, social and psychological issues were,prominent in both groups. Age,parity, and mode of delivery had no significant effect on the women's scores or the areas they, identified as most important. Conclusion: Quality of life of is a complex and personal area, affected by many different aspects of health and well-being. From this pilot study the primary index appears to be a useful step in assessing a mother's quality of life. It identifies which areas of her life are most important to her, and allows her to indicate where she would like to see improvements.