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Al Hadi A, Dawson J, Paliwoda M, Walker K, New K. Women utilisation, needs and satisfaction with postnatal follow-up care in Oman: A cross-sectional survey. Midwifery 2024; 135:104037. [PMID: 38833917 DOI: 10.1016/j.midw.2024.104037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 05/18/2024] [Accepted: 05/28/2024] [Indexed: 06/06/2024]
Abstract
BACKGROUND In Oman, there is a lack of data on utilisation, needs and women's satisfaction with care and information provided during postnatal follow-up period. AIM To investigate postnatal follow-up care utilisation and women's needs; level of postnatal information received and satisfaction with services. METHODS A purposive sample of women (n = 500), recruited in the immediate postnatal period at one metropolitan and one regional birthing hospital in Oman. An electronic survey link was sent to participants at 6-8 weeks postnatally. Quantitative variables were analysed as frequencies and chi-squared test. RESULTS A total of 328 completed surveys were received; a response rate of 66 %. Most respondents were located in the metropolitan area (n = 250) and between 20 and 39 years (n = 308). Utilisation was low as women reported no need or no benefit in attending. Women's information needs were not sufficiently met by HCPs, requiring women to seek information from family and the internet to meet their needs. Satisfaction with services was mostly neither satisfied nor dissatisfied (30 %) or satisfied (30 %). CONCLUSION Postnatal follow-up care utilisation in both metropolitan and regional areas is less than optimal and not utilised as there was no advice to attend or no appointment date/time given, no benefit experienced previously, no need and information needed sourced from family or the internet. The information provided by postnatal follow-up care consumers can be used to enhance service delivery, inform future updates to the national maternity care guidelines, and provides a baseline for future evaluation and research.
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Affiliation(s)
- Amal Al Hadi
- School of Nursing, Midwifery and Social Work, level 3, Chamberlain Building (#35), The University of Queensland, Brisbane, Queensland, St Lucia 4072, Australia.
| | - Jennifer Dawson
- Newborn Research Centre, The Royal Women's Hospital, Victoria, Melbourne, Parkville, Victoria 3052, Australia
| | - Michelle Paliwoda
- School of Nursing, Midwifery and Social Work, level 3, Chamberlain Building (#35), The University of Queensland, Brisbane, Queensland, St Lucia 4072, Australia
| | - Karen Walker
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales 2050, Australia
| | - Karen New
- School of Nursing, Midwifery and Social Work, level 3, Chamberlain Building (#35), The University of Queensland, Brisbane, Queensland, St Lucia 4072, Australia
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Laws RA, Zheng M, Brown V, Lymer S, Campbell KJ, Russell CG, Taki S, Litterbach E, Ong KL, Denney-Wilson E. The impacts of an mHealth intervention targeting parents on health service usage and out-of-pocket costs in the first 9 months of life: The Growing healthy app. MATERNAL & CHILD NUTRITION 2024:e13662. [PMID: 38804571 DOI: 10.1111/mcn.13662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 04/15/2024] [Accepted: 04/25/2024] [Indexed: 05/29/2024]
Abstract
Mobile health (mHealth) interventions provide a low-cost, scalable approach to supporting parents with infant feeding advice with the potential to reduce health care visits and associated costs for infant feeding support. This Australian study examined the impact of the Growing healthy (GH) app on health service utilisation and out-of-pocket costs for families in the first 9 months of their infants life. A quasi-experimental study with a comparison group was conducted in 2015-2016 with an mHealth intervention group (GH app, n = 301) and a nonrandomized usual care group (n = 344). The GH app aimed to support parents of young infants with healthy infant feeding behaviours from birth to 9 months of age. App-generated notifications directed parents to age-and feeding-specific content within the app. Both groups completed surveys at baseline when infants were less than 3 months old (T1), at 6 months (T2) and 9 months (T3) of age. At T3, participants reported health services used and any out-of-pocket costs for advice on infant feeding, growth or activity. App users had lower odds (odds ratio: 0.38 95% confidence interval: 0.25, 0.59) of using one or more services and had lower number of visits to a general practitioner (1.0 vs. 1.5 visits, p = 0.003) and paediatrician (0.3 vs. 0.4 visits, p = 0.049) compared to the usual care group. There was no difference in out-of-pocket costs between groups. Provision of an evidenced-based infant feeding app may provide substantial savings to the health system and potentially to parents through fewer primary health care and paediatrician visits.
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Affiliation(s)
- Rachel A Laws
- School of Exercise and Nutrition Science, Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Miaobing Zheng
- School of Exercise and Nutrition Science, Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Vicki Brown
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Sharyn Lymer
- Biostatistics Consultant, Sydney, NSW, Australia
| | - Karen J Campbell
- School of Exercise and Nutrition Science, Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Catherine G Russell
- School of Exercise and Nutrition Science, Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Sarah Taki
- Health Promotion Unit, Population Health Research & Evaluation Hub, Sydney Local Health District, Sydney, NSW, Australia
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Eloise Litterbach
- School of Exercise and Nutrition Science, Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
- Institute for Health Transformation, The Australian Centre for Behavioural Research in Diabetes, Deakin University, Geelong, VIC, Australia
| | - Kok-Leong Ong
- Department of Information Systems and Business Analytics, AISSC, RMIT University, Melbourne, VIC, Australia
| | - Elizabeth Denney-Wilson
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, NSW, Australia
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Singh R, Botfield JR. Postpartum contraception in Australia: opportunities for increasing access in the primary care setting. Aust J Prim Health 2024; 30:NULL. [PMID: 37879299 DOI: 10.1071/py23101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 10/10/2023] [Indexed: 10/27/2023]
Abstract
In Australia, 20% of pregnancies occur within the first year after birth and most are unintended. Both unintended pregnancies and short interpregnancy intervals (<12-18months) can have adverse effects on maternal, infant, and child health. Access to postpartum contraception reduces the risk of unintended pregnancies and short interpregnancy intervals, and supports women in pregnancy planning and birth spacing. In this forum article, we describe how postpartum contraception is currently provided in Australia and highlight opportunities for improving access in the primary care setting.
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Affiliation(s)
- Rhea Singh
- SPHERE NHMRC Centre of Research Excellence, Monash University, Melbourne, Vic., Australia; and
| | - Jessica R Botfield
- SPHERE NHMRC Centre of Research Excellence, Monash University, Melbourne, Vic., Australia; and
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Black KI, Dorney E, Hall JA, Pelosi M, Khan SA, Cheney K. Using a validated instrument to assess pregnancy planning and preconception care at antenatal booking visits: a retrospective cohort study. Med J Aust 2023; 219:366-370. [PMID: 37743071 DOI: 10.5694/mja2.52109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 07/20/2023] [Indexed: 09/26/2023]
Abstract
OBJECTIVE To determine the completion rate for the London Measure of Unplanned Pregnancy (LMUP), a psychometrically validated measure of a woman's intention with regard to a current or recent pregnancy, during booking visits at two metropolitan antenatal care clinics; to identify socio-demographic characteristics associated with unplanned pregnancy. DESIGN, SETTING, PARTICIPANTS Retrospective cohort study; analysis of LMUP data for women attending antenatal care booking consultations as public patients in the Sydney Local Health District, 31 December 2019 - 30 November 2020. MAIN OUTCOME MEASURES Proportions of women with LMUP scores indicating unplanned (0-9) or planned pregnancies (10-12); associations between planned pregnancy and socio-demographic characteristics, crude and adjusted for age, parity, and socio-economic status (Index of Relative Socioeconomic Disadvantage). RESULTS Of 4993 women with antenatal care bookings, the LMUP was completed by 2385 (47.8%; 1142 of 3564 women at the tertiary referral hospital [32.0%], 1118 of 1160 at the secondary hospital [96.3%]). Planned pregnancies were indicated by the total LMUP scores of 1684 women (70.6%); 1290 women (59.1%) reported no health actions in preparation for pregnancy. In multivariable analyses, planned pregnancies were more likely in all age groups than for women aged 24 years or younger (30-34 years: adjusted odds ratio [aOR], 2.54; 95% confidence interval [CI], 1.76-3.66; 35-39 years: aOR, 2.91; 95% CI, 1.95-4.33). The likelihood of planned pregnancy declined with increasing parity (v no previous births: three previous births: aOR, 0.25; 95% CI, 0.16-0.40; four or more previous births: aOR, 0.10; 95% CI, 0.05-0.19). CONCLUSION Seven in ten women who completed the LMUP had planned their pregnancies, but fewer than half had undertaken health-related actions prior to conceiving. Higher parity was associated with unplanned pregnancy, indicating the importance of postpartum contraception advice. Overcoming barriers to implementing the LMUP more widely would enhance preconception health monitoring.
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Affiliation(s)
- Kirsten I Black
- The University of Sydney, Sydney, NSW
- Royal Prince Alfred Hospital, Sydney, NSW
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Li CK, Botfield J, Amos N, Mazza D. Women's experiences of, and preferences for, postpartum contraception counselling. Aust J Prim Health 2023; 29:229-234. [PMID: 36265546 DOI: 10.1071/py22163] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 09/20/2022] [Indexed: 07/20/2023]
Abstract
BACKGROUND The lack of access to and uptake of postpartum contraception is a key contributor to an estimated 121million unintended pregnancies worldwide. Research on counselling and women's preferences for postpartum contraception is scarce in Australia. We therefore aimed to explore Australian women's experiences of, and preferences for, accessing postpartum contraceptive counselling. METHOD In this qualitative study, English-speaking women of reproductive age (18-40years) with at least one child under the age of 5years were recruited via social media to participate in a semi-structured telephone interview. Interviews focussed on women's experiences of, and preferences for, postpartum contraception. The interviews were audio-recorded, transcribed, coded and thematically analysed. RESULTS Twenty women participated. Most did not receive in-depth contraceptive counselling antenatally or postnatally, though had brief discussions with their GPs or obstetricians at the 6-week postnatal check. Participants felt some counselling throughout their antenatal and postnatal care would have been useful, particularly those who experienced medical complications perinatally. Most participants expressed a general preference for their GP or a midwife to provide such counselling, rather than an obstetrician or nurse, and they noted characteristics such as compassion, trust and care as being particularly important. CONCLUSION The provision of postpartum contraceptive counselling could be enhanced in Australia. Contraceptive uptake in the postpartum period may be promoted by ensuring consistent and routine provision of contraceptive counselling for women antenatally and postnatally by their maternity carers.
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Affiliation(s)
- Ching Kay Li
- Department of General Practice, School of Public Health and Preventative Medicine, Faculty of Medicine, Monash University, Notting Hill, Vic., Australia; and SPHERE Centre of Research Excellence, Monash University, Notting Hill, Vic., Australia
| | - Jessica Botfield
- Department of General Practice, School of Public Health and Preventative Medicine, Faculty of Medicine, Monash University, Notting Hill, Vic., Australia; and SPHERE Centre of Research Excellence, Monash University, Notting Hill, Vic., Australia
| | - Natalie Amos
- Department of General Practice, School of Public Health and Preventative Medicine, Faculty of Medicine, Monash University, Notting Hill, Vic., Australia; and SPHERE Centre of Research Excellence, Monash University, Notting Hill, Vic., Australia; and Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Vic., Australia
| | - Danielle Mazza
- Department of General Practice, School of Public Health and Preventative Medicine, Faculty of Medicine, Monash University, Notting Hill, Vic., Australia; and SPHERE Centre of Research Excellence, Monash University, Notting Hill, Vic., Australia
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Macdonald C, MacGregor B, Hillman S, MacArthur C, Bick D, Taylor B. Qualitative systematic review of general practitioners' (GPs') views and experiences of providing postnatal care. BMJ Open 2023; 13:e070005. [PMID: 37045584 PMCID: PMC10106050 DOI: 10.1136/bmjopen-2022-070005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
OBJECTIVES Develop an understanding of the views and experiences of general practitioners (GPs) about their role in postnatal care, including barriers and facilitators to good care, and timing and content of planned postnatal checks. DESIGN Qualitative systematic review. DATA SOURCES Electronic database searches of MEDLINE, EMBASE, CINAHL, PubMed, Web of Science, PsychINFO from January 1990 to September 2021. Grey literature and guideline references from National Institute of Health and Care Excellence, WHO, International Federation of Gynecology and Obstetrics, Royal College of General Practitioners, Royal College of Obstetrics and Gynaecology. INCLUSION CRITERIA Papers reporting qualitative data on views and experiences of GPs about postnatal care, including discrete clinical conditions in the postnatal period. Papers were screened independently by two reviewers and disputes resolved by a third reviewer. QUALITY APPRAISAL The Critical Appraisal Skills Programme checklist was used to appraise studies. DATA EXTRACTION AND SYNTHESIS Thematic synthesis involving line-by-line coding, generation of descriptive then analytical themes was conducted by the review team. The Capability, Opportunity, Motivation-Behaviour (COM-B) model was used to develop analytical themes. RESULTS 20 reports from 18 studies met inclusion criteria. Studies were published from 2008 to 2021, reporting on 469 GPs. 13 were from UK or Australia. Some also reported views of non-GP participants. The clinical focus of studies varied, for example: perinatal mental health, postnatal contraception. Five themes were generated, four mapped to COM-B: psychological capability, physical opportunity, social opportunity and motivation. One theme was separate from the COM-B model: content and timing of postnatal checks. Strong influences were in physical and social opportunity, with time and organisation of services being heavily represented. These factors sometimes influenced findings in the motivation theme. CONCLUSIONS GPs perceived their role in postnatal care as a positive opportunity for relationship building and health promotion. Addressing organisational barriers could impact positively on GPs' motivation to provide the best care. PROSPERO REGISTRATION NUMBER 268982.
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Affiliation(s)
- Clare Macdonald
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Becky MacGregor
- Unit of Academic Primary Care, University of Warwick, Coventry, UK
| | - Sarah Hillman
- Unit of Academic Primary Care, University of Warwick, Coventry, UK
| | - Christine MacArthur
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Debra Bick
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - Beck Taylor
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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Al Hadi A, Dawson J, Paliwoda M, Walker K, New K. Healthcare Providers' Views of Information, Support, and Services Offered to Women in the Postnatal Follow-up Care Period in Oman: A Qualitative Study. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2023; 11:2-13. [PMID: 36650845 PMCID: PMC9839975 DOI: 10.30476/ijcbnm.2022.96663.2140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 11/29/2022] [Accepted: 12/03/2022] [Indexed: 01/19/2023]
Abstract
Background Postnatal care is a component of the maternity care continuum, which is often under-valued and under-offered. The aim of this study was to explore healthcare providers' (HCPs) views about postnatal follow-up care (PNFC) offered to women in Oman. Methods This qualitative study was performed from May 2021 to January 2022; 29 individual participated in semi-structured telephone interviews with staff nurses (N=20), nurse/midwives (N=5), and doctors (N=4) from Khoula and Ibra hospitals and Al Amerat, Muttrah and Al Qabil health centers in Oman. Conventional content analysis was guided by Erlingsson and Brysiewicz. Results Seventeen sub-categories and four categories emerged from the data; they included communication and timing of PNFC, provision of PNFC with various components, challenges and needs for providing PNFC, and the impact of COVID-19 on PNFC. Conclusion Providing postnatal follow-up care in Oman is challenging for HCPs due to lack of clinics dedicated to postnatal care, no scheduled appointment times for women, very limited guidance within the National Maternity Care guideline, and some HCPs (i.e., nurses) with no formal education on the components of postnatal care. These hinder the ability to provide information, education, support, and services to women.
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Affiliation(s)
- Amal Al Hadi
- Health and Behavioural Sciences, School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Queensland, Australia
| | - Jennifer Dawson
- Newborn Research Centre, The Royal Women’s Hospital, Victoria, Melbourne, Australia
| | - Michelle Paliwoda
- Health and Behavioural Sciences, School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Queensland, Australia
| | - Karen Walker
- School of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Karen New
- Health and Behavioural Sciences, School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Queensland, Australia
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Botfield JR, Tulloch M, Contziu H, Bateson D, Phipps H, Wright SM, Mcgeechan K, Black KI. Who is responsible for postpartum contraception advice and provision? The perspective of hospital‐based maternity clinicians in New South Wales, Australia. Aust N Z J Obstet Gynaecol 2022. [DOI: 10.1111/ajo.13627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 10/16/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Jessica R. Botfield
- Family Planning NSW Newington New South Wales Australia
- SPHERE NHMRC Centre of Research Excellence Melbourne Victoria Australia
| | - Melanie Tulloch
- Canterbury Hospital Campsie New South Wales Australia
- Royal Prince Alfred Hospital Camperdown New South Wales Australia
| | - Hannah Contziu
- Royal Prince Alfred Hospital Camperdown New South Wales Australia
| | - Deborah Bateson
- Family Planning NSW Newington New South Wales Australia
- SPHERE NHMRC Centre of Research Excellence Melbourne Victoria Australia
- Faculty of Medicine and Health University of Sydney New South Wales Sydney Australia
| | - Hala Phipps
- Canterbury Hospital Campsie New South Wales Australia
- Royal Prince Alfred Hospital Camperdown New South Wales Australia
- Faculty of Medicine and Health University of Technology New South Wales Sydney Australia
| | | | - Kevin Mcgeechan
- Family Planning NSW Newington New South Wales Australia
- SPHERE NHMRC Centre of Research Excellence Melbourne Victoria Australia
- Faculty of Medicine and Health University of Sydney New South Wales Sydney Australia
| | - Kirsten I. Black
- SPHERE NHMRC Centre of Research Excellence Melbourne Victoria Australia
- Royal Prince Alfred Hospital Camperdown New South Wales Australia
- Faculty of Medicine and Health University of Sydney New South Wales Sydney Australia
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9
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Ahmadinezhad M, Vizeshfar F, Pakniat A. Mothers' Perceptions of the Quality of Postnatal Care Provided in Health Centers and the Associated Factors: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2022; 10:110-119. [PMID: 35372630 PMCID: PMC8957657 DOI: 10.30476/ijcbnm.2021.90057.1663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 12/08/2021] [Accepted: 12/12/2021] [Indexed: 11/29/2022]
Abstract
Background Postnatal care plays a great role in the health of mothers and their neonates. This study aimed to evaluate the mothers' perceptions of the provided postnatal care and the associated factors. Methods In this cross-sectional study, the health centers of Sirik city in Hormozgan province, Iran, were selected using convenience sampling. The study was conducted on 160 mothers who had referred to the selected centers for postnatal care from 7 August 2018 to 2 August 2020 and had given birth to live full-term neonates (>37 weeks of gestation) 40 days to 12 months before sampling. The Mothers' Perceptions of the Quality of Postnatal care questionnaire was designed by the research team; it included 18 questions about mothers' perception of care. The collected data were analyzed using the SPSS software, version 21. Results The mothers' mean score of perception was 69.84±16.04; most mothers rated the provided postnatal care and their relationship with the personnel as good or excellent. The mean total scores of the mothers' perceptions were not different based on their satisfaction with postnatal care (P=0.646) and time of the first referral after birth (P=0.251), but they were significantly different according to the number of referrals (P=0.023) and their satisfaction with the health personnel (P<0.001). Conclusion The study results revealed that mothers had a good perception about postnatal care provided by health center staff. Hence, it is necessary to educate all health staff in this regard to provide high-quality postnatal care to all mothers who refer to these centers.
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Affiliation(s)
- Maryam Ahmadinezhad
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Fatemeh Vizeshfar
- Community Based Psychiatric Care Research Center, Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azadeh Pakniat
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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Feasibility, acceptability and sustainability of postpartum contraceptive implant provision by midwives in NSW public hospitals. Women Birth 2021; 35:e439-e445. [PMID: 34836756 DOI: 10.1016/j.wombi.2021.11.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 11/13/2021] [Accepted: 11/16/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Repeat pregnancy in the first year after a birth is common. Many of these conceptions are unintended and may be prevented by providing access to contraception in the immediate postpartum period. Midwives in the hospital setting could potentially play a greater role in improving postnatal contraception information and provision. AIM We sought to implement and examine the success of a program training hospital-based midwives in immediate postpartum implant insertion. METHODS This mixed methods study in two hospitals in New South Wales sought to explore the feasibility, acceptability and sustainability of a program that provided competency-based implant insertion training for midwives. The study documented training completion, implant insertion numbers and experience, and conducted end of study interviews with midwives and stakeholders. FINDINGS Twenty-seven midwives undertook training and inserted 265 implants during the study period. Interviews with 13 midwives and 11 stakeholders concluded the program to be feasible and acceptable with midwives reporting high satisfaction from their involvement. All interviewees felt that midwives were well placed to insert implants, and reported that challenges around workload and opportunities for practice were generally manageable. It was recognised that sustainability of the program would require supportive policy and regular insertion opportunities. CONCLUSIONS Midwives successfully upskilled in implant insertions and there was widespread support for the program with expectations it would be sustained. Provision of contraceptive information and implant insertion by midwives in the immediate postpartum period is likely to increase contraceptive choice and access for women and contribute to reducing rapid repeat pregnancies.
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11
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Pollock D, Cooper M, McArthur A, Barker T, Munn Z. Women's experiences of their interactions with health care providers during the postnatal period in Australia: a qualitative systematic review protocol. JBI Evid Synth 2021; 19:622-628. [PMID: 33074985 DOI: 10.11124/jbies-20-00182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of the review is to explore and evaluate women's experiences of interactions with health care providers during their postnatal period. INTRODUCTION The postnatal period is a transformative time for women. Women experience significant change and adaptation, which could impact upon parenting confidence, health, and psychological outcomes during this time. The interaction women have with their health care providers during the postnatal period plays an integral role in improving these health outcomes. INCLUSION CRITERIA This qualitative review will explore the experiences of primiparous and multiparous women during the postnatal period with a key focus on evaluating the interactions they have with health care providers. It will include all studies that utilize qualitative methods (such as interviews and focus groups). Articles that explore the postnatal care experiences of women who have endured a pregnancy loss, given birth to a baby with complex needs, or those that solely focus on describing the neonatal and intensive care experiences, will not be included. METHODS PubMed, CINAHL, Embase, Emcare, and PsycINFO will be searched. Studies published from 2000 onwards and written in English will be assessed for inclusion. Studies that are selected initially will be assessed for methodological quality by two independent reviewers utilizing the JBI critical appraisal instrument for qualitative research. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42020186384.
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Affiliation(s)
- Danielle Pollock
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Megan Cooper
- Australian College of Midwives, Adelaide, SA, Australia.,UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Alexa McArthur
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Timothy Barker
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Zachary Munn
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
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Schlaff RA, Baruth M, LaFramboise FC. Preparing for postpartum: health care provider discussions and predictors of patient satisfaction. Women Health 2021; 61:345-354. [PMID: 33648432 DOI: 10.1080/03630242.2021.1892902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Women's health care providers are trusted sources of patient education during pregnancy and postpartum; however, little is known about discussion prevalence or patient satisfaction. The purposes of this study were to describe patient-provider discussion prevalence and identify demographic and pregnancy-related factors associated with discussion occurrence and satisfaction. An electronic survey was completed by 319 postpartum women who received prenatal care for a singleton pregnancy within the last 12 months in the United States. Participants reported demographic and pregnancy-related information, and occurrence and satisfaction with information shared during prenatal and postpartum health care. Descriptive statistics and odds ratios were calculated. During pregnancy and postpartum, college graduates were more likely to report any discussion (pregnancy: OR = 1.70, 95% C.I. 1.01, 2.86; postpartum: OR = 1.94, 95% C.I. 1.16, 3.25). Participants with gestational diabetes were less likely to report any discussion during pregnancy (OR = 0.43, 95% C.I. 0.20, 0.92). Obese participants were less likely to report any postpartum discussion compared to underweight/normal weight participants (OR = 0.51, 95% C.I. 0.29, 0.89). Within postpartum health care, college graduates (p = .01) and those with a cesarean section (p = .01) reported lower satisfaction; multiparous women reported higher satisfaction (p = .03). Findings highlight potential inequities in clinical practice and risk factors for postpartum anticipatory care satisfaction.
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Affiliation(s)
- Rebecca A Schlaff
- Department of Health Science, Saginaw Valley State University, University Center, Michigan, USA
| | - Meghan Baruth
- Department of Health Science, Saginaw Valley State University, University Center, Michigan, USA
| | - Faith C LaFramboise
- Department of Kinesiology, Saginaw Valley State University, University Center, Michigan, USA
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13
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Vanguri S, Rogers-McQuade H, Sriraman NK. ABM Clinical Protocol #14: Breastfeeding-Friendly Physician's Office-Optimizing Care for Infants and Children. Breastfeed Med 2021; 16:175-184. [PMID: 33599542 DOI: 10.1089/bfm.2021.29175.sjv] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A central goal of the Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient.
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Affiliation(s)
- Swathi Vanguri
- Department of Obstetrics and Gynecology, Crozer-Keystone Health System, Upland, Pennsylvania, USA
| | | | - Natasha K Sriraman
- Department of Pediatrics, Eastern Virginia Medical School, Norfolk, Virginia, USA.,Division of General Academic Pediatrics, Children's Hospital of the King's Daughters, Norfolk, Virginia, USA.,Division of Community Health & Research, Eastern Virginia Medical School, Norfolk, Virginia, USA
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Botfield JR, Tulloch M, Contziu H, Phipps H, Bateson D, Wright SM, McGeechan K, Black KI. Contraception provision in the postpartum period: Knowledge, views and practices of midwives. Women Birth 2020; 34:e1-e6. [PMID: 32912738 DOI: 10.1016/j.wombi.2020.07.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 06/23/2020] [Accepted: 07/23/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Women are susceptible to unintended pregnancies in the first year after giving birth, particularly as consideration of contraception may be a low priority during this time. Discussing and providing contraception before women leave hospital after giving birth may prevent rapid repeat pregnancy and its associated risks. Midwives are well placed to assist with contraceptive decision-making and provision; however, this is not routinely undertaken by midwives in the Australian hospital setting and little is known regarding their views and experiences in relation to contraception. METHODS An anonymous survey was conducted with midwives at two urban hospitals in New South Wales to better understand their contraceptive knowledge, views and practices regarding midwifery-led contraception provision in the postpartum period. FINDINGS The survey was completed by 128 midwives. Most agreed that information about contraception provided in the postpartum period is valuable to women, although their knowledge about different methods was variable. The majority (88%) believed that midwives have a role in providing contraceptive information, and 79% reported currently providing contraceptive counselling. However, only 14% had received formal training in this area. CONCLUSION Findings demonstrate that most midwives provide some contraception information and believe this is an important part of a midwife's role. Yet most have not undertaken formal training in contraception. Additional research is needed to explore the content and quality of midwives' contraception discussions with women. Training midwives in contraceptive counselling would ensure women receive accurate information about available options. Upskilling midwives in contraception provision may increase postpartum uptake and reduce rapid repeat pregnancies.
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Affiliation(s)
| | | | | | | | - Deborah Bateson
- Family Planning NSW, Ashfield, Australia; University of Sydney, Australia
| | | | - Kevin McGeechan
- Family Planning NSW, Ashfield, Australia; University of Sydney, Australia
| | - Kirsten I Black
- Royal Prince Alfred Hospital, SLHD, Australia; University of Sydney, Australia
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15
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Rouhi M, Stirling CM, Crisp EP. Mothers' views of health problems in the 12 months after childbirth: A concept mapping study. J Adv Nurs 2019; 75:3702-3714. [PMID: 31452233 DOI: 10.1111/jan.14187] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 07/22/2019] [Accepted: 08/10/2019] [Indexed: 01/03/2023]
Abstract
AIMS To identify the health problems that women feel require help and subsequent help-seeking behaviour during the 12 months period after childbirth. BACKGROUND Many women experience physical and mental health problems after childbirth, but there is a gap in understanding how they perceive their health after childbirth. Studies suggested they are inhibited in expressing their needs and so seek informal rather than professional help for their health problems. DESIGN A mixed method concept mapping study. METHOD Two groups of Australian women were recruited by an online platform and purposive sampling (N = 81) in 2017-2018, based on an established concept mapping methodology. A first group created 83 brainstorm statements about post-childbirth health problems and help-seeking and a second group sorted and rated the statements based on their perception of the prevalence of the issues and the help-seeking advice they would offer to others. Bradshaw`s Taxonomy of Needs was used to theoretically underpins the explanation of the results of women's felt need after childbirth. RESULTS Multidimensional scaling resulted in six clusters of issues which were categorized into three domains: 'health issues and care', 'support' and 'fitness'. Despite being directly asked, about two-thirds of the women did not report experiencing any health problems. CONCLUSION Our findings showed women had a broader perception of healthcare needs which included support and fitness. There is a potential gap in services for women who do not have good social support. IMPACT Family and friends were a key source of help-seeking. Post-childbirth routine care was focused on infant care and limited to the first 6 weeks after childbirth. The content of current post-childbirth care must be reviewed.
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Affiliation(s)
- Maryam Rouhi
- School of Nursing, College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Christine M Stirling
- School of Nursing, College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Elaine P Crisp
- School of Nursing, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
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16
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Baratieri T, Natal S. Ações do programa de puerpério na atenção primária: uma revisão integrativa. CIENCIA & SAUDE COLETIVA 2019; 24:4227-4238. [DOI: 10.1590/1413-812320182411.28112017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 04/11/2018] [Indexed: 11/22/2022] Open
Abstract
Resumo O puerpério trata-se de um período de significativa morbimortalidade para as mulheres, e a Atenção Primária à saúde (APS) é importante no desenvolvimento de ações para atender as necessidades de saúde das mulheres. Objetivou-se sistematizar o conhecimento produzido sobre as ações de programas de atenção pós-parto no âmbito da APS, tanto em nível nacional, como internacional. Utilizou-se revisão integrativa de literatura de artigos junto às bases Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde), BDENF (Base de dados em Enfermagem), SciELO (Scientific Electronic Library Online) e PubMed (Biblioteca Nacional de Medicina dos Estados Unidos). A busca ocorreu de abril a maio de 2017. Atenderam aos critérios de seleção 43 artigos. Os resultados apontam que: a APS possui estrutura física para atenção à puérpera, porém com déficit em recursos humanos e materiais; há baixa cobertura de consulta pós-parto e visita domiciliar; boa avaliação do incentivo ao aleitamento materno, porém com foco na criança; rastreamento da Depressão Pós-Parto internacionalmente por meio da “Edimburgh Post-Natal Depression Scale”, e déficit na atenção a esse agravo no Brasil. A atenção pós-parto ainda tem como foco o cuidado ao recém-nascido e são restritos, em sua maioria, ao puerpério imediato e tardio.
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Affiliation(s)
| | - Sonia Natal
- Universidade Federal de Santa Catarina, Brazil
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17
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Hill S, Tapley A, van Driel ML, Holliday EG, Ball J, Davey A, Patsan I, Spike N, Fitzgerald K, Morgan S, Magin P. Australian general practice registrars and their experience with postpartum consultations: A cross-sectional analysis of prevalence and associations. Aust N Z J Obstet Gynaecol 2019; 60:196-203. [PMID: 31281967 DOI: 10.1111/ajo.13034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 04/29/2019] [Accepted: 06/06/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND In Australia, general practitioners (GPs) are recognised as an essential source of postpartum care. However, there remains a paucity of research pertaining to this, and in particular, to that of GP trainees (in Australia, termed 'registrars'). Previous post-graduate experience in obstetrics and gynaecology (O&G) is not a prerequisite for GP training, and thus, it is imperative that vocational training provides adequate exposure to postpartum consultations. AIM To investigate the prevalence and associations of Australian GP registrars' (trainees') experience in postpartum care. MATERIALS AND METHODS A cross-sectional study employing data from the Registrar Clinical Encounters in Training (ReCEnT) project. ReCEnT is an ongoing cohort study where GP registrars record 60 consecutive consultations mid-way through each training term. The outcome variable was postpartum problem/diagnosis (compared to all other problems/diagnoses). The independent variables included registrar, practice, patient, consultation, clinical and educational factors. Analyses employed univariate and multivariable regression. RESULTS Analysis included 2234 registrars (response rate 96.1%), 289 594 consultations, and 453 786 problems/diagnoses. Postpartum care (897) comprised 0.2% (95% CI: 0.19-0.21) of all problems/diagnoses in 0.3% (95% CI: 0.27-0.31) of all consultations. Significant multivariable associations included registrar's gender (female) and obtainment of post-graduate O&G qualifications. Postpartum consultations were longer and resulted in more learning goals being generated. DISCUSSION An overall low prevalence was established. Both male registrars, and those without pre-existing O&G qualifications, may have particularly limited experience. These findings should inform educational policy and practice regarding postpartum care experience in general practice training.
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Affiliation(s)
- Sophia Hill
- Hunter New England Local Health District, Newcastle, New South Wales, Australia
| | - Amanda Tapley
- NSW & ACT Research and Evaluation Unit, GP Synergy, Newcastle, New South Wales, Australia.,School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Mieke L van Driel
- Primary Care Clinical Unit, Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Elizabeth G Holliday
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Jean Ball
- Clinical Research Design, Information Technology and Statistical Support (CReDITSS) Unit, Newcastle, New South Wales, Australia
| | - Andrew Davey
- NSW & ACT Research and Evaluation Unit, GP Synergy, Newcastle, New South Wales, Australia.,School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Irena Patsan
- NSW & ACT Research and Evaluation Unit, GP Synergy, Newcastle, New South Wales, Australia.,School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Neil Spike
- Eastern Victoria GP Training (EVGPT), Melbourne, Victoria, Australia.,Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Simon Morgan
- GP Synergy, Newcastle, New South Wales, Australia
| | - Parker Magin
- NSW & ACT Research and Evaluation Unit, GP Synergy, Newcastle, New South Wales, Australia.,School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
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19
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The fourth trimester: a critical transition period with unmet maternal health needs. Am J Obstet Gynecol 2017; 217:37-41. [PMID: 28390671 DOI: 10.1016/j.ajog.2017.03.032] [Citation(s) in RCA: 186] [Impact Index Per Article: 26.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 02/15/2017] [Accepted: 03/29/2017] [Indexed: 11/23/2022]
Abstract
After childbirth, most American women are not scheduled for follow-up care for 6 weeks, and this visit is poorly attended. Many new mothers feel unprepared for the common health issues they encounter and are uncertain of whom to contact. To improve care, the 4th Trimester Project is bringing together mothers, health care providers, and other stakeholders to explore what families need most from birth to 12 weeks postpartum. Eighty-seven individuals convened in March 2016 in Chapel Hill, NC. Four major topic areas emerged: (1) the intense focus on women's health prenatally is unbalanced by infrequent and late postpartum care; (2) medical practice guidelines often do not align with women's experiences and constraints; (3) validation of women as experts of their infants and elevating their strengths as mothers is necessary to achieve health goals; and (4) mothers need comprehensive care, which is difficult to provide because of numerous system constraints. Considerations for improving postpartum services include enabling more convenient care for families that is holistic, culturally appropriate, conversation based, and equitable. Maternal health issues in the fourth trimester intersect and can compound one another. Enhanced collaboration among health care providers may improve the focus of clinical interactions to address the interrelated health issues most important to women.
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20
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Brodribb WE, Mitchell BL, Van Driel ML. Postpartum consultations in Australian general practice. Aust J Prim Health 2017; 22:128-132. [PMID: 25586677 DOI: 10.1071/py14082] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 10/25/2014] [Indexed: 11/23/2022]
Abstract
Many GPs undertake postpartum care for women and their infants. GP follow-up enables early identification and management of problems, education and support for parenting, and reconnection with general practice following the birth. However, there is little information about GPs' understanding of their role in postpartum care and how it is undertaken. This cross-sectional survey of GPs in Southern Queensland, conducted between February and July 2013, describes the involvement of GPs in postpartum care. GPs were posted a 52-item questionnaire adapted from a previous Victorian GP study and were telephoned 2 weeks later. GPs completed the survey on paper or online. The response rate was 17.4% (163 GPs). Approximately 39% were uncertain whether women were happy with the GP-provided postpartum care. GPs' recommendations for the timing of postpartum reviews were inconsistent within and across birthing sectors and consultations took longer than anticipated. Developing guidelines around the timing and appropriate length of postpartum consultations could assist GPs in providing appropriate care for mothers and infants.
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Affiliation(s)
- Wendy E Brodribb
- Discipline of General Practice, The University of Queensland, Level 8, Health Sciences Building, Royal Brisbane and Women's Hospital, Herston, Brisbane, Qld 4029, Australia
| | - Benjamin L Mitchell
- Discipline of General Practice, The University of Queensland, Level 8, Health Sciences Building, Royal Brisbane and Women's Hospital, Herston, Brisbane, Qld 4029, Australia
| | - Mieke L Van Driel
- Discipline of General Practice, The University of Queensland, Level 8, Health Sciences Building, Royal Brisbane and Women's Hospital, Herston, Brisbane, Qld 4029, Australia
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21
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Brodribb WE, Mitchell BL, van Driel ML. Practice related factors that may impact on postpartum care for mothers and infants in Australian general practice: a cross-sectional survey. BMC Health Serv Res 2016; 16:244. [PMID: 27400740 PMCID: PMC4940844 DOI: 10.1186/s12913-016-1508-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 07/05/2016] [Indexed: 11/23/2022] Open
Abstract
Background While there is a significant focus on the health and well-being of women during pregnancy, labour and birth, much less emphasis is placed on the care of postpartum women and their infants in primary care following the birth. Some studies have investigated the role of GPs in postpartum care, and others examined facilitators and barriers to mothers accessing care. However there is little information available to investigate the effect of practice related factors on access to care of mothers and infants at this time. Methods A 20-item questionnaire for completion by the practice managers was mailed to 497 general practices in Southern Queensland, Australia between February and July 2013. Questionnaire items included practice demographics, practice procedures and personnel including appointment scheduling, billing, practice nurse function and qualifications and a free-text option for comments. Descriptive statistics are presented as numbers and percentages. Chi Squared test compared practice location with methods of identification of postpartum women, practice size with other Queensland data and ANOVA compared practice size with the number of postpartum appointments. Logistic regression was used to predict variables that were related to booked appointment times. Free text responses were grouped in common themes. Results The response rate was 27.4 %. At 67.2 % of the practices, mothers had to self-identify as needing a postpartum consultation and most consultations were allocated 15 minutes or less. Only 20 % of practices accepted the government insurance payment (bulk-billing) for all maternal and infant services, with more practices bulk-billing children only. Out-of-pocket expenses ranged from $10-$60. Nearly 80 % of practice nurses saw postpartum mothers or infants ‘nearly always’ or ‘sometimes’. Approximately 30 % had midwifery or child health training. There were higher odds of longer booked appointment times for solo practitioner practices (unadj OR 3.30 95%CI 1.03-10.57), but no other variables predicted booked appointment times Conclusions This study identified a number of practice related factors that, if addressed, could positively impact on postpartum care. These include ensuring ongoing practice relationships to assist with booking appropriate consultation times and guaranteeing that there are no financial impediments to women accessing care. Some factors can easily be adapted within practices. Others would require changes of policy at a local or national level. Electronic supplementary material The online version of this article (doi:10.1186/s12913-016-1508-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Wendy E Brodribb
- Discipline of General Practice, The University of Queensland, Health Sciences Building, Herston, Queensland, 4029, Australia.
| | - Benjamin L Mitchell
- Discipline of General Practice, The University of Queensland, Health Sciences Building, Herston, Queensland, 4029, Australia
| | - Mieke L van Driel
- Discipline of General Practice, The University of Queensland, Health Sciences Building, Herston, Queensland, 4029, Australia
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23
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Brodribb WE, Mitchell BL, Van Driel ML. Continuity of care in the post partum period: general practitioner experiences with communication. AUST HEALTH REV 2016; 40:484-489. [DOI: 10.1071/ah15144] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 11/06/2015] [Indexed: 11/23/2022]
Abstract
Objectives Informational and management continuity of care assists in providing a seamless transition for women and infants from tertiary or secondary to primary care during the post partum period. Few studies have evaluated the interaction between different aspects of the health system following a woman’s discharge from hospital after the birth of her infant. The present study describes how general practitioners (GPs) experience communications with hospitals and other post partum care providers relevant to continuity of care. Methods In the present cross-sectional study, a 52-item questionnaire adapted from a previously used survey was mailed to 932 GPs in southern Queensland, Australia, between February and July 2013. Questionnaire items included participant demographics, the timeliness and usability of discharge summaries, communication with other post partum care providers and consultation practices. Results The response rate was 17.4%. Nearly one-quarter of participants never or rarely received a hospital discharge summary in a timely manner and most considered the summaries somewhat useful. Few GPs (14.3%) had contact with or received information from domiciliary midwives who conducted post partum home visits. A higher proportion (38%) had some communication with a Child and Family Health nurse in the month before the survey. Conclusions Information flow from hospital to general practice and between other post partum care providers is less than ideal and may affect ongoing care for mothers and infants, especially those at risk. Knowledge exchange between healthcare services and initiatives to improve information sharing needs to be developed and implemented. What is already known on this topic? Transitions from tertiary or secondary care to primary care and between primary care providers are often times of vulnerability for patients, including women and infants in the post partum period. There is little information documenting communications between different maternity services and GPs that facilitate ongoing care. What does this paper add? There are significant gaps in the exchange of information about post partum women and infants from hospitals to GPs and a lack of communication between GPs and other post partum care providers, such as domiciliary midwives and Child and Family Health nurses. What are the implications for practitioners? Improvements in the timeliness, presentation and content of hospital discharge summaries, as well as enhancing channels of communication, collaboration, cooperation and information sharing between providers of community post partum care, are necessary if mothers are to receive the best care possible.
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Woodward BM, Zadoroznyj M, Benoit C. Beyond birth: Women's concerns about post-birth care in an Australian urban community. Women Birth 2015; 29:153-9. [PMID: 26522960 DOI: 10.1016/j.wombi.2015.09.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 09/01/2015] [Accepted: 09/30/2015] [Indexed: 01/01/2023]
Abstract
BACKGROUND The provision of post-birth care in the community is changing substantially in many parts of Australia including Queensland, where there has been a burgeoning of clinics in private retail outlets such as pharmacies. Little is known about women's experiences of post-birth care in community pharmacies, nor of how their experiences compare with those in publicly-funded Child and Family Health Clinics (CFHC). AIM To provide qualitative insights into women's experiences of the different forms of post-birth care in the community, and identify where improvements could be made to service provision. METHODS A purposive sample of mothers of infants aged under 12 months was recruited to maximise variation in the use of private and public postnatal care services. Semi structured interviews were conducted with fifteen mothers whose antenatal, birthing and post-birth experiences varied across public and private sectors and birthing providers. RESULTS Concerns about lack of information and psychosocial support following discharge from hospital were widely reported, particularly by women who had given birth in a private facility under the care of a private obstetrician. Women used both pharmacy nurses and CFHCs. Pharmacy nurses were generally preferred for their accessibility, psychosocial support for mother, and continuity of care. However, these services are unregulated and without quality assurance mechanisms. Mothers found CFHCs regimented, focused on infant surveillance rather than support for mothers, and difficult to access. CONCLUSION There is a clear need for community post-birth care that will provide mothers with the information and psychosocial support they need. Currently, private, home-birth midwives and pharmacy nurses are providing women-centred care more effectively than nurses in publicly funded CFHC or GPs. This seems to be linked to continuity of carer, and to service priorities, resulting in inequities and systematic variations in the quality of post-birth care. Further research on this important health care issue is recommended.
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Affiliation(s)
- Brianna M Woodward
- School of Social Science, The University of Queensland, St Lucia, Queensland, Australia
| | - Maria Zadoroznyj
- School of Social Science, The University of Queensland, St Lucia, Queensland, Australia.
| | - Cecilia Benoit
- Centre for Addictions Research of BC, University of Victoria, Canada
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Marsh W, Colbourne DM, Way S, Hundley VA. Would a student midwife run postnatal clinic make a valuable addition to midwifery education in the UK?--a systematic review. NURSE EDUCATION TODAY 2015; 35:480-486. [PMID: 25497039 DOI: 10.1016/j.nedt.2014.11.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 11/19/2014] [Accepted: 11/25/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND There is growing evidence in the UK that some National Health Service improvements, particularly in the postnatal period, are having an impact on the quality and variety of student midwives' clinical experiences, making it challenging for them to meet the standards set by the regulatory body for midwives and receive a licence to practice. A possible solution to this may be the introduction of a Student Midwife integrated Learning Environment (SMiLE) focusing upon the delivery of postnatal care (PN) through a student run clinic. OBJECTIVE To identify the current state of knowledge, regarding the educational outcomes of students who engage with student run clinics (SRC) and the satisfaction of clients who attend them. Search strategy--BNI, CINAHL, EMBASE, and MEDLINE were searched for articles published until April 2014. SELECTION CRITERIA Studies, nationally and internationally, were carried out on healthcare students running their own clinics. Outcome measures were the evaluation of educational outcomes of students and client satisfaction were included. DATA COLLECTION AND ANALYSIS Data were extracted, analysed and synthesised to produce a summary of knowledge, regarding the effectiveness of SRCs. MAIN RESULTS 6 studies were selected for this review. AUTHORS' CONCLUSIONS The findings that SRC can offer advantages in improving educational outcomes of students and provide an effective service to clients are encouraging. However, given the limited number of high-quality studies included in this review, further research is required to investigate the effectiveness of SRC.
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Affiliation(s)
- Wendy Marsh
- Bournemouth University, Faculty of Health and Social Sciences, Midwifery Education, 4th floor St Mary's Community Health Campus, Milton Road, Portsmouth PO3 6AD, UK.
| | - Dana M Colbourne
- Bournemouth University, Faculty of Health and Social Sciences, Midwifery Education, 4th floor St Mary's Community Health Campus, Milton Road, Portsmouth PO3 6AD, UK
| | - Susan Way
- Bournemouth University, Faculty of Health and Social Sciences, Royal London House, Christchurch Road, Bournemouth BU1 3LT, UK
| | - Vanora A Hundley
- Bournemouth University, Faculty of Health and Social Sciences, Royal London House, Christchurch Road, Bournemouth BU1 3LT, UK; NMAHP Research Unit, University of Stirling, Stirling, FK9 4LA Scotland, UK
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Brodribb W, Zadoroznyj M, Nesic M, Kruske S, Miller YD. Beyond the hospital door: a retrospective, cohort study of associations between birthing in the public or private sector and women's postpartum care. BMC Health Serv Res 2015; 15:14. [PMID: 25608861 PMCID: PMC4310139 DOI: 10.1186/s12913-015-0689-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Accepted: 01/09/2015] [Indexed: 11/20/2022] Open
Abstract
Background In Australia, maternity care is available through universal coverage and a parallel, competitive private health insurance system. Differences between sectors in antenatal and intrapartum care and associated outcomes are well documented but few studies have investigated differences in postpartum care following hospital discharge and their impact on maternal satisfaction and confidence. Methods Women who birthed in Queensland, Australia from February to May 2010 were mailed a self-report survey 4 months postpartum. Regression analysis was used to determine associations between sector of birth and postpartum care, and whether postpartum care experiences explained sector differences in postpartum well-being (satisfaction, parenting confidence and feeling depressed). Results Women who birthed in the public sector had higher odds of health professional contact in the first 10 days post-discharge and satisfaction with the amount of postpartum care. After adjusting for demographic and postpartum contact variables, sector of birth no longer had an impact on satisfaction (AOR 0.95, 99% CI 0.78-1.31), but any form of health professional contact did. Women who had a care provider’s 24 hour contact details had higher odds of being satisfied (AOR 3.64, 95% CI 3.00-4.42) and confident (AOR 1.34, 95% CI 1.08- 1.65). Conclusion Women who birthed in the public sector appeared more satisfied because they had higher odds of receiving contact from a health professional within 10 days post-discharge. All women should have an opportunity to speak to and/or see a doctor, midwife or nurse in the first 10 days at home, and the details of a person they can contact 24 hours a day.
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Affiliation(s)
- Wendy Brodribb
- Discipline of General Practice, School of Medicine, The University of Queensland, Royal Brisbane and Women's Hospital, Level 8, Health Sciences Building, Herston, QLD, 4029, Australia.
| | - Maria Zadoroznyj
- Institute for Social Science Research, School of Social Science, The University of Queensland, 4th floor, GPN3 (Building 39A), St Lucia, QLD, 4072, Australia.
| | - Michelle Nesic
- Queensland Centre for Mothers & Babies, School of Psychology, The University of Queensland, Hood St, St Lucia, QLD, 4072, Australia.
| | - Sue Kruske
- School of Nursing and Midwifery, The University of Queensland, Level 2, Edith Cavell Building, UQ Herston Campus, Herston, QLD, 4029, Australia.
| | - Yvette D Miller
- School of Public Health and Social Work, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, QLD, 4059, Australia.
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