Objective: To describe policies, practices, and associated rationales of hospital obstetric units regarding mothers' support person options during childbirth and to explore practices concerning support of breastfeeding initiation after cesarean delivery.

Design: Descriptive telephone survey.

Setting: Hospitals in the southeastern region of the United States.

Participants: Convenience sample of 154 obstetric nurse manager and nurse representatives employed by the participating hospitals.

Main Outcome Measures: Types of policies regarding mothers' support person options during childbirth and immediate postpartum stage, initiation of breastfeeding after cesarean birth, and attitudes about policies.

Results: All hospitals allowed two or more support persons during vaginal births, 89% permitted only one support person during nonemergent cesareans, and 58.0% of the nurse representatives believed that mothers should be allowed a second support person. Less than one third (31.2%) of the hospitals considered a mother's request to breastfeed in the operating room, and most (78.6%) allowed mothers to breastfeed in the recovery room.

Conclusions: Overall, maternal support policies, practices, and nurse representatives' attitudes were mother and family friendly, particularly related to vaginal births. Though breastfeeding initiation after cesarean birth was encouraging, support person options during nonemergent cesarean births and related rationales warrant further examination. JOGNN, 35, 634-643; 2006. DOI: 10.1111/J.1552-6909.2006.00078.x

Aims. This paper reports a study whose purpose was to revalidate the Hung Postpartum Stress Scale by expanding and revising its contexts to reflect the social changes that have occurred in Taiwan over the last two decades.

Background. Existing measures of general stress, which have also been used to assess postpartum stress, fail to measure women's specific childbearing stressors during the postpartum period. The Hung Postpartum Stress Scale was initially developed 11 years ago by Hung and associates to measure stress in the early postpartum period as it occurred in the Taiwanese social milieu of the time. However, revalidation was needed because of rapid changes in the Taiwanese social system.

Methods. Employing a non-experimental, quantitative research design and a proportional stratified quota sampling of hospitals by birth rate, the revised instrument was completed by 861 postpartum women selected from clinics and hospitals in Taiwan.

Results. An exploratory common factor analysis indicated the structure validity of three dimensions of postpartum stress: concerns about maternity role attainment, concerns about negative body changes, and concerns about lack of social support. With regard to generalizability of the factors across delivery type, education level, and income status subgroups within the population, high coefficients of congruence were shown. Moreover, the internal consistency reliabilities for the total Hung Postpartum Stress Scale and its three dimensions across the full sample and within pertinent sub-samples showed that it is a reliable tool for measuring postpartum stress.

Conclusions. A series of analyses supported the validity and reliability of the revised Hung Postpartum Stress Scale. Additional research is recommended using confirmatory factor analysis to determine the stability of the factor structure identified in the present study.