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Sjetne IS, Iversen HH. Women report better experiences from maternity care after postnatal consultations: A cross sectional study. PATIENT EDUCATION AND COUNSELING 2023; 111:107690. [PMID: 36893560 DOI: 10.1016/j.pec.2023.107690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 01/28/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE To determine if the patient reported experiences (PREMs) of women in maternity care differ by whether or not they had a postnatal consultation before leaving the birth institution. METHODS Secondary analysis of cross-sectional data to compare PREMs of women who had received an individual consultation (86 %), a group consultation (3 %), and women who had received no consultation (11 %). PREMs were collected using a self-administered questionnaire. Eight summated scales were constructed from 29 single items, pertaining to different parts of the received care. Scores ranged between 0 and 100, with high scores representing positive experiences. RESULTS Among the 8156 sampled women, 3387 (42 %) responded. There were statistically significant (p ≤ 0.002) differences (from 3.7 to 16.3 points) on all eight scales. The scores from women who had an individual postnatal consultation were consistently higher than the scores from the other groups. The largest difference was in the scale with the worst score: information about women's health during the postnatal stay. CONCLUSION Women who participated in individual postnatal consultations reported more positive experiences compared to those who did not. PRACTICE IMPLICATION The consistent differences found in this study provide support for administering individual postnatal consultations.
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Sjögren Forss K, Mangrio E, Hellström L. Interprofessional Teamwork to Promote Health: First-Time Parents' Experiences of a Combined Home Visit by Midwife and Child Health Care Nurse. Front Pediatr 2022; 10:717916. [PMID: 35311059 PMCID: PMC8927075 DOI: 10.3389/fped.2022.717916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 02/07/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND To achieve the requisites for a child's healthy development and to reduce health inequalities, it is important to promote health initiatives at an early stage in a child's life and to include the parents. Home visits by healthcare professionals have been found to have positive health effects for both the baby and the parents. From an extended home visit programme in Sweden, our aim was to illuminate first-time parents' experience of a home visit conducted by a midwife and a child health care nurse 1-2 weeks postnatal. METHODS Data was collected by interviews (n = 13) with first-time parents. The transcribed texts were analyzed using inductive content analysis. RESULTS The participants' experiences could be understood from the two themes, A trust in the professionals and Feeling safe as a new parent. The participants experienced that the midwives and the child health care nurses complemented each other and appreciated to get knowledge and information from both professions. In their own home, they felt secured and relaxed, and the professionals could help them provide a safe home environment for the child. CONCLUSION By meeting both professionals at the same time and in their own home, the participants experienced that the needs of the baby and their needs and concerns as new parents were included and supported.
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Affiliation(s)
- Katarina Sjögren Forss
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Elisabeth Mangrio
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Lisa Hellström
- Department of School Development and Leadership, Faculty of Education and Society, Malmö University, Malmö, Sweden
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Aune I, Voldhagen H, Welve I, Dahlberg U. Early discharge from hospital after birth:How Norwegian parents experience postnatal home visits by midwives - A qualitative study. SEXUAL & REPRODUCTIVE HEALTHCARE 2021; 30:100672. [PMID: 34741842 DOI: 10.1016/j.srhc.2021.100672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 10/06/2021] [Accepted: 10/18/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND According to the WHO, the quality of care is not conditioned by the length of stay at the postnatal ward. As long as the postnatal care provided is of high quality, it could be better for the family to stay in their home. AIM Firstly, to examine parents' experiences of early discharge and home visits by the postnatal ward midwife, in cases where the mother and baby have been discharged within 24 h after birth. Secondly, to examine participants' motivation for opting for early discharge from the hospital. METHODS 10 individual interviews were conducted, including five where both parents were present. The interviews were carried out 4-12 weeks after birth. The data were analysed using systematic text condensation. RESULTS The choice of early discharge was influenced by external factors like a wish to be together as a family while receiving sufficient support from both family and midwife. Internal factors, like previous experience, were also significant. The presence and attitude of the midwife, both in professional and practical terms, affected how the parents perceived postnatal care. Home visits from the midwife also affected the parents' feeling of security. CONCLUSION An offer of home visits from the midwife of the postnatal ward enables parents who wish to leave the hospital shortly after birth to receive the necessary care and support in the early postnatal period. This offer is suitable for healthy women who have given birth to a healthy baby and wish to return home not long after birth.
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Affiliation(s)
- Ingvild Aune
- Midwifery Education, Faculty of Medicine and Health Sciences, Department of Clinical and Molecular Medicine, NTNU - Norwegian University of Science and Technology, Olav Kyrres Gate 11, 7006 Trondheim, Norway.
| | - Heidi Voldhagen
- St. Olavs University Hospital, Department of Women's Health, Olav Kyrres Gt. 11, 7006 Trondheim, Norway
| | - Ina Welve
- St. Olavs University Hospital, Department of Women's Health, Olav Kyrres Gt. 11, 7006 Trondheim, Norway
| | - Unn Dahlberg
- St. Olavs University Hospital, Department of Women's Health, Olav Kyrres Gt. 11, 7006 Trondheim, Norway
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Høgh S, Navne LE, Johansen M, Svendsen MN, Sorensen JL. Postnatal consultations with an obstetrician after critical perinatal events: a qualitative study of what women and their partners experience. BMJ Open 2020; 10:e037933. [PMID: 32948568 PMCID: PMC7500287 DOI: 10.1136/bmjopen-2020-037933] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE The objective of this study was to explore women's and their partners' experiences with attending postnatal consultations with an obstetrician after critical perinatal events. DESIGN Qualitative interview study. We did semi-structured individual narrative interviews exploring the lived experiences. Interviews were analysed using a phenomenological approach and the thematic analysis was validated by a transdisciplinary group of anthropologists, obstetricians and a midwife. SETTING Department of obstetrics at a large hospital in Denmark. PARTICIPANTS We did a qualitative study with 17 participants (10 women and 7 partners) who had experienced critical perinatal events. RESULTS Five major themes were identified: (1) a need to gain understanding and make sense of the critical perinatal events, (2) a need for relational continuity, (3) the importance of discussing emotional effects as well as physical aspects of occurred events, (4) preparing for future pregnancies and (5) closure of the story.Most of the participants emphasised the importance of knowing the obstetrician undertaking the postnatal consultation. The majority of the participants described a need to discuss the emotional effects of the experience as well as the physical aspects of occurred events. The postnatal consultation served as an approach to obtain a positive closure of their birth story and to feel confident about potential future pregnancies. CONCLUSIONS This interview-based study suggests that postnatal consultation with an obstetrician might be an important tool for women and their partners in understanding the course of events during the critical birth experience and in processing it and preparing for future pregnancies. It appears to be important to assign an obstetrician whom they already know and to encourage them to discuss not only physical aspects of what happened but also the emotional effects of the experience.
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Affiliation(s)
- Stinne Høgh
- Department of Obstetrics, Rigshospitalet, Copenhagen, Denmark
| | - Laura Emdal Navne
- The Danish Centre for Social Science Research, VIVE, Copenhagen, Denmark
- Public Health, Faculty of Health Sciences, University of Copenhagen, Kobenhavn, Denmark
| | | | | | - Jette Led Sorensen
- Juliane Marie Centre for Children, Women and Reproduction Section 4074, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Women's experiences of home visits by midwives in the early postnatal period. Midwifery 2016; 39:57-62. [PMID: 27321721 DOI: 10.1016/j.midw.2016.05.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 05/04/2016] [Accepted: 05/07/2016] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The aim of the present study is to gain a deeper understanding of women's experiences of midwifery care in connection with home visits during the early postnatal period. RESEARCH DESIGN/SETTING A qualitative approach was chosen for data collection, and the data presented are based on six focus group interviews (n: 24). The women were both primiparous and multiparous, aged 22-37, and lived with their partners. All participants had given birth at a maternity unit responsible for about 4000 births a year. The transcribed interviews were analysed through systematic text condensation. FINDINGS The findings are reflected in three main themes: 'The importance of relational continuity', 'The importance of a postpartum talk' and 'Vulnerability in the early postnatal period'. When the woman had a personal relationship with the midwife responsible for the home visit she experienced predictability, availability and confidence. The women wanted recognition and time to talk about their birth experience. They also felt vulnerable in their maternal role in the early postnatal period and the start of the breast-feeding process. CONCLUSIONS It is important to promote relational continuity models of midwifery care to address the emotional aspects of the postnatal period. Women generally wish to discuss their birth experience, preferably with the midwife who was present during the birth. Due to the short duration of postnatal care in hospitals, the visit from the midwife a few days after childbirth becomes all the more important.
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Blanco MN, Taquette SR, Monteiro DLM, Miranda FRD. Postnatal and postabortion care during adolescence in the National Health System in Rio de Janeiro, Brazil. Int J Gynaecol Obstet 2014; 126:126-9. [PMID: 24825499 DOI: 10.1016/j.ijgo.2014.02.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 02/15/2014] [Accepted: 04/08/2014] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To study postnatal and postabortion outpatient care for adolescents in relation to the guidelines of the Brazilian Ministry of Health. METHODS The present cross-sectional study was conducted between 2011 and 2012 via interviews with coordinators from 147 of 148 (99.3%) National Health System facilities providing sexual and reproductive healthcare for adolescents in the city of Rio de Janeiro, Brazil. The χ(2) test or Fisher exact test was used to compare ratios, and t test to compare means, with a significance level of 5% (P<0.05). RESULTS Postnatal care was provided by 141 (95.9%) facilities; however, only 95 (67.4%) facilities complied with the guidelines of the Ministry of Health by providing two consultations: one in the first week and one between the 30th and 42nd day postpartum. In 32 (22.7%) facilities, a consultation was not scheduled in the first week; and in 25 (17.7%), a consultation between the 30th and 42nd day postpartum was not scheduled. Furthermore, only 11 (7.8%) facilities provided care in the age bracket recommended by WHO and the Brazilian Ministry of Health. CONCLUSION The provision of puerperal care in the Brazilian National Health System is currently far from the recommendations in government guidelines.
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Affiliation(s)
- Mariangela N Blanco
- Children's and Women's Health, Fernandes Figueira Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil; Medical Sciences Graduate Program (PGCM), College of Medical Sciences (FCM), State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil; Perinatal Center, Pedro Ernesto University Hospital (HUPE), State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil; Department of Gynecology and Obstetrics, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, Brazil.
| | - Stella R Taquette
- Medical Sciences Graduate Program (PGCM), College of Medical Sciences (FCM), State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil; Department of Internal Medicine, College of Medical Sciences (FCM), State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Denise L M Monteiro
- Children's and Women's Health, Fernandes Figueira Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil; Department of Gynecology and Obstetrics, College of Medical Sciences (FCM), State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil; Serra dos Órgãos University Center (UNIFESO), Rio de Janeiro, Brazil
| | - Fátima R D Miranda
- Perinatal Center, Pedro Ernesto University Hospital (HUPE), State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil; Department of Gynecology and Obstetrics, College of Medical Sciences (FCM), State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
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Fryer J, Weaver JJ. Should a postnatal birth discussion be part of routine midwifery care? ACTA ACUST UNITED AC 2014. [DOI: 10.12968/bjom.2014.22.2.118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Aune I, Dahlberg Msc U, Ingebrigtsen O. Parents' experiences of midwifery students providing continuity of care. Midwifery 2011; 28:372-8. [PMID: 21764190 DOI: 10.1016/j.midw.2011.06.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Revised: 05/31/2011] [Accepted: 06/13/2011] [Indexed: 10/17/2022]
Abstract
OBJECTIVE the aim of this study was to gain knowledge and a deeper understanding of the value attached by parents to relational continuity provided by midwifery students to the woman and her partner during the childbearing process. The focus of the study was on the childbirth and the postnatal home visit. DESIGN/SETTING in this pilot project by researchers at Sør-Trøndelag University College, Norway, six midwifery students provided continuity of care to 58 women throughout their pregnancy, birth and the postnatal period. One group interview of eight women and two group interviews of five men, based on the focus group technique, were conducted at the end of the project. Qualitative data were analysed through systematic text condensation. FINDINGS the findings included two main themes: 'trusting relationship' and 'being empowered'. The sub-themes of a 'trusting relationship' were 'relational continuity' and 'presence'. For the women, relational continuity was important throughout the childbearing process, but the men valued the continuous presence during birth most highly. 'Being empowered' had two sub-themes: 'individual care' and 'coping'. For the women, individual care and coping with birth were important factors for being empowered. The fathers highlighted the individual care as necessary to feel empowered for early parenting. The home visit of the student was highly appreciated. The relationship with the midwifery student could be concluded, and they had the opportunity to review the progression of the birth with the student who had been present during the birth. During the home visit, the focus was more on the experiences of pregnancy and birth than on what lay ahead. KEY CONCLUSIONS when midwifery students provided continuous care during pregnancy, birth and the postnatal period, both women and men experienced a trusting relationship. Relational continuity was important for women in the entire process, but for the men this was mostly important during childbirth. Individual care and coping with birth and early parenting enhanced empowerment. The limited sample size in this study means that it cannot be generalised without caution, and further research is needed.
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Affiliation(s)
- Ingvild Aune
- Faculty of Nursing, Midwifery Education, Sør-Trøndelag University College, Mauritz Hansens Gate 2, 7004 Trondheim, Norway.
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Tham V, Ryding EL, Christensson K. Experience of support among mothers with and without post-traumatic stress symptoms following emergency caesarean section. SEXUAL & REPRODUCTIVE HEALTHCARE 2010; 1:175-80. [DOI: 10.1016/j.srhc.2010.06.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2009] [Revised: 04/16/2010] [Accepted: 06/19/2010] [Indexed: 11/28/2022]
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Kvist LJ, Persson EK. Evaluation of changes in postnatal care using the "Parents' Postnatal Sense of Security" instrument and an assessment of the instrument's reliability and validity. BMC Pregnancy Childbirth 2009; 9:35. [PMID: 19674443 PMCID: PMC2738653 DOI: 10.1186/1471-2393-9-35] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2009] [Accepted: 08/12/2009] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND A sense of security is important for experiences of parenthood in the early postpartum period. The objectives of this study were to evaluate two models of postnatal care using a questionnaire incorporating the Parents' Postpartum Sense of Security (PPSS) instrument and to test the validity of the PPSS instrument. METHODS Postal surveys were sent to 234 mothers who had experienced two different forms of postnatal care (study group and control group) and returned by 86.8%. These two groups of mothers were compared for total scores on the PPSS instrument. Demographic variables and mothers' opinions about care interventions were also compared and these variables were tested for correlations with the total PPSS score. A regression analysis was carried out to assess areas of midwifery care which might affect a sense of security. The internal consistency and concurrent validity of the instrument were tested for the total population. RESULTS there were no significant differences between the groups for scores on the PPSS instrument. A total of three variables predicted 26% of the variability on the PPSS scores for the study group and five variables predicted 37% of the variability in the control group. One variable was common to both: "The midwives on the postnatal ward paid attention to the mother as an individual". There were significant correlations between the total PPSS scores and scores for postpartum talks and visits to the breastfeeding clinic. There was also a significant correlation between the single question: "I felt secure during the first postpartum week" and the total PPSS score. Tests for internal consistency and concurrent validity were satisfactory. CONCLUSION The proposed new model of care neither improved nor impaired mothers' feelings of security the week following birth. Being seen as an individual by the midwife who provides postnatal care may be an important variable for mothers' sense of postnatal security. It is possible that postpartum talks may encourage the processing of childbirth experiences in a positive direction. Availability of breastfeeding support may also add to a sense of security postpartum. The PPSS instrument has shown acceptable reliability and validity.
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Affiliation(s)
- Linda J Kvist
- Department of Obstetrics & Gynaecology, Helsingborg Hospital, Helsingborg, Sweden
- Division of Nursing, Department of Health Sciences, Lund University, Lund, Sweden
| | - Eva K Persson
- Division of Nursing, Department of Health Sciences, Lund University, Lund, Sweden
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