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Mespreuve AS, Apers L, Moller AB, Galle A. Postnatal quality of care measures for mothers and newborns at home: A scoping review. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003498. [PMID: 39163315 PMCID: PMC11335102 DOI: 10.1371/journal.pgph.0003498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 06/30/2024] [Indexed: 08/22/2024]
Abstract
The postnatal period is one of the most critical periods in the lives of mothers and newborns. Yet, the postnatal period remains the most neglected period along the maternal health care continuum. Globally, measures assessing quality of postnatal care (PNC) often focus on care at health facility level, the provision of home-based PNC and associated quality of care measures seem largely overlooked. This scoping review aims to give an overview of the literature on measures assessing quality of PNC for mothers and newborns in a home-based setting. This review was conducted according to the Arksey and O'Malley's methodology for scoping reviews. Three electronic bibliographic databases were searched together with a grey literature search. Two reviewers independently screened the identified articles. All data on home-based PNC measures were extracted and mapped according to the 2022 World Health Organization PNC Guideline recommendations in three categories: i) maternal care, ii) newborn care, iii) health system and health promotion interventions. Several additional quality of care domains, characterizing home-based PNC, were identified: i) social and emotional empowerment, ii) assessment of the home setting, iii) early breastfeeding, iv) health education and counseling, v) personal hygiene and prevention of infections, vi) referral to health facility when necessary, vii) thermal care, viii) parent-child relationship and ix) promote economic self-sufficiency. This review illustrates that home-based PNC has a very broad spectrum of care and plays a vital role in improving maternal and newborn health and well-being. In addition, there is a clear need for more research on the optimal timing and content of home-based care in the postnatal period for maximizing its potential.
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Affiliation(s)
- Ann-Sofie Mespreuve
- Department of Public Health and Primary Care, International Centre for Reproductive Health, Ghent University, Ghent, Belgium
| | - Lise Apers
- Department of Public Health and Primary Care, International Centre for Reproductive Health, Ghent University, Ghent, Belgium
| | - Ann-Beth Moller
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Galle
- Department of Public Health and Primary Care, International Centre for Reproductive Health, Ghent University, Ghent, Belgium
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Groening P, Silver EJ, Nemerofsky SL. Decreasing the Newborn Birth Hospitalization Length of Stay. Am J Perinatol 2024; 41:e1362-e1367. [PMID: 36724873 DOI: 10.1055/a-2024-1145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES This study aimed to determine our ability to shorten birth hospitalization length of stay (LOS) in which patient characteristics were associated with early discharge and had effects on early newborn readmission rate. STUDY DESIGN Retrospective chart review of births from April 1, 2020 to December 31, 2020, was considered for this study. Delivery mode and maternal and newborn characteristics were evaluated for effect on discharge timing. Hospital readmissions within 7 days of discharge were reviewed. RESULTS In total, 845 out of 1,077 total live births were included in the study population. Five hundred and eighty-nine (69.7%) newborns were discharged early (<48 hours after vaginal delivery [VD] and <72 hours after cesarean delivery [CS]). Factors associated with early discharge included 79.8% CS (p < 0.001), 84% birth after 2 p.m. (p < 0.001), 71.2% no diagnosis of maternal diabetes (p = 0.02), and 70.6% negative maternal coronavirus disease 2019 (p = 0.01). The overall 7-day readmission rate was 1.2 and 0.5% for newborns discharged early after VD. CONCLUSION Most newborns can be discharged early without increasing newborn readmission. KEY POINTS · Most patients were discharged <72 hours after CS.. · Most patients were discharged <48 hours after VD.. · Early discharge does not affect newborn readmissions..
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Affiliation(s)
- Portia Groening
- Albert Einstein College of Medicine, Bronx, New York
- Division of Neonatology, Department of Pediatrics, Children's Hospital at Montefiore, Bronx, New York
| | | | - Sheri L Nemerofsky
- Albert Einstein College of Medicine, Bronx, New York
- Division of Neonatology, Department of Pediatrics, Children's Hospital at Montefiore, Bronx, New York
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Larsson B, Rubertsson C, Hildingsson I. Previous negative experiences of healthcare reported by Swedish pregnant women with fear of birth - A mixed method study. SEXUAL & REPRODUCTIVE HEALTHCARE 2023; 36:100859. [PMID: 37210773 DOI: 10.1016/j.srhc.2023.100859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 05/11/2023] [Accepted: 05/15/2023] [Indexed: 05/23/2023]
Abstract
BACKGROUND Negative encounters in healthcare might affect women's health. During their reproductive life span, women are exposed to various health examinations, and have reported disrespectful care and obstetric violence. Such experiences might be a basis for fear of birth. AIM to explore and describe the prevalence, associated factors and experiences of previous negative healthcare encounters in women with fear of birth. METHODS A cross-sectional mixed-method study of 335 pregnant women with fear of birth. Data were collected by a questionnaire in mid-pregnancy, which included socio-demographic and obstetric background data as well as a question about the occurrence of previous negative experiences in healthcare. RESULT A previous negative experience of healthcare was found in 189 women (56.6%). The analysis of the women's comments regarding what caused their negative experiences generated three themes: disrespectful treatment and no one listened; painful, inadequate, or improper care; and impact of other people's stories. CONCLUSION This study showed that previous negative experiences in healthcare were common in women with fear of birth and the content of the encounters could be summarised as disrespectful care and obstetric violence. Women's previous encounters in healthcare might be an underlying reason for fear of birth and should be investigated. It is, therefore, of utmost importance to listen to women and their narratives in order to establish a trustful relationship and promote evidence-based, women-centred, respectful care, which is urgently needed.
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Affiliation(s)
- Birgitta Larsson
- Department of Health Promoting Science, Sophiahemmet University College, Stockholm, Sweden; Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Christine Rubertsson
- Department of Health Science, Medical Faculty, Lund University, Lund, Sweden; Department of Obstetrics and Gynecology, Skane University Hospital, Sweden
| | - Ingegerd Hildingsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
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Mahmood A, Eusaph AZ, Javed A, Muzaffar A. Exploring areas of improvement in postnatal care services in a tertiary care hospital in Lahore. Pak J Med Sci 2023; 39:732-736. [PMID: 37250562 PMCID: PMC10214816 DOI: 10.12669/pjms.39.3.6780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 01/23/2023] [Accepted: 01/28/2023] [Indexed: 11/02/2023] Open
Abstract
Background and Objective Poor postnatal care can increase morbidity and mortality. This study assessed the current deficiencies in quality of postnatal care provided to mothers in Lady Aitchison hospital, Lahore when compared to WHO standards and identifies the areas for quality improvement. Methods It is a descriptive cross-sectional study which employs quantitative method to collect and analyze the data. It was conducted to include ninety-six maternities attending the wards of Lady Aitchison Hospital, Lahore during January 2022 to February 2022. Consenting post-partum mothers were selected by random sampling and interviewed by using a structured proforma. Results Among 96 mothers, 56% were below 25 years of age, 39% had secondary education, with more than one child (71%) and 57% visited for the first time. Majority of mothers, were given medicine timely (82%) and found the attitude (85%) and information (83%) provided by the healthcare workers helpful. Their subjective satisfaction rate with staff was 90%. The main areas of concern were lack of proper examination guidelines and facilities, limited information to mothers regarding neonatal care and substandard interior of hospitals. The statistics on the detailed maternal and neonatal examination showed that it was left out in 30% to 50% patients. Information regarding the danger signs of mothers and neonates was not given in 69% and information on family planning was provided to only 28%. Contentment with the infrastructure of the hospital was subpar and it was suggested that the sanitary conditions of washrooms and the paraphernalia of the wards i.e., ACs and beds needed improvement. Conclusions This study suggests that in developing countries like Pakistan, majority of the patients were satisfied by the services of healthcare workers. The prime improvement area is the infra-structure of the hospital which can be upgraded to provide better quality facilities in terms of air-conditioning, washrooms and well-designed areas for extensive examination of breast, pelvis, abdomen and neonates. There is also need for introduction of standard guidelines for postnatal care.
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Affiliation(s)
- Atiya Mahmood
- Dr. Atiya Mahmood, MBBS. Medical Officer, Government Samanabad Hospital, Lahore, Pakistan
| | - Amna Zia Eusaph
- Prof. Dr. Amna Zia Eusaph, MBBS, FCPS. Lady Aitchison Unit 5, Lahore, Pakistan
| | - Ayesha Javed
- Dr. Ayesha Javed, MBBS. Post Graduate Trainee, Mayo Hospital, Lahore, Pakistan
| | - Arooj Muzaffar
- Dr. Arooj Muzaffar, MBBS. Post Graduate Trainee, Mayo Hospital, Lahore, Pakistan
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Galle A, Moran AC, Bonet M, Graham K, Muzigaba M, Portela A, Day LT, Tuabu GK, Silva BDSÉ, Moller AB. Measures to assess quality of postnatal care: A scoping review. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001384. [PMID: 36963034 PMCID: PMC10021656 DOI: 10.1371/journal.pgph.0001384] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/27/2023] [Indexed: 02/19/2023]
Abstract
High quality postnatal care is key for the health and wellbeing of women after childbirth and their newborns. In 2022, the World Health Organization (WHO) published global recommendations on maternal and newborn care for a positive postnatal care experience in a new WHO PNC guideline. Evidence regarding appropriate measures to monitor implementation of postnatal care (PNC) according to the WHO PNC guideline is lacking. This scoping review aims to document the measures used to assess the quality of postnatal care and their validity. The review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Five electronic bibliographic databases were searched together with a grey literature search. Two reviewers independently screened and appraised identified articles. All data on PNC measures were extracted and mapped to the 2022 WHO PNC recommendations according to three categories: i) maternal care, ii) newborn care, iii) health system and health promotion interventions. We identified 62 studies providing measures aligning with the WHO PNC recommendations. For most PNC recommendations there were measures available and the highest number of recommendations were found for breastfeeding and the assessment of the newborn. No measures were found for recommendations related to sedentary behavior, criteria to be assessed before discharge, retention of staff in rural areas and use of digital communication. Measure validity assessment was described in 24 studies (39%), but methods were not standardized. Our review highlights a gap in existing PNC measures for several recommendations in the WHO PNC guideline. Assessment of the validity of PNC measures was limited. Consensus on how the quality of PNC should be measured is needed, involving a selection of priority measures and the development of new measures as appropriate.
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Affiliation(s)
- Anna Galle
- Department of Public Health and Primary Care, WHO Collaborating Centre on Primary Care and Family Medicine, University Centre for Nursing and Midwifery, Ghent University, Belgium
| | - Allisyn C Moran
- World Health Organization Department of Maternal, Newborn, Child and Adolescent Health and Ageing, Geneva, Switzerland
| | - Mercedes Bonet
- World Health Organization Department of Sexual and Reproductive Health and Research, Development and Research Training in Human Reproduction (HRP), UNDP/UNFPA/ UNICEF/WHO/World Bank Special Programme of Research, Geneva, Switzerland
| | - Katriona Graham
- Department of Public Health and Primary Care, WHO Collaborating Centre on Primary Care and Family Medicine, Ghent University, Belgium
| | - Moise Muzigaba
- World Health Organization Department of Maternal, Newborn, Child and Adolescent Health and Ageing, Geneva, Switzerland
| | - Anayda Portela
- World Health Organization Department of Maternal, Newborn, Child and Adolescent Health and Ageing, Geneva, Switzerland
| | - Louise Tina Day
- Department of Infectious Disease Epidemiology, Maternal Newborn Health Group, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Godwin Kwaku Tuabu
- Department of Public Health and Primary Care, WHO Collaborating Centre on Primary Care and Family Medicine, Ghent University, Belgium
| | - Bianca De Sá É Silva
- Department of Public Health and Primary Care, WHO Collaborating Centre on Primary Care and Family Medicine, Ghent University, Belgium
| | - Ann-Beth Moller
- World Health Organization Department of Sexual and Reproductive Health and Research, Development and Research Training in Human Reproduction (HRP), UNDP/UNFPA/ UNICEF/WHO/World Bank Special Programme of Research, Geneva, Switzerland
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Women's perceptions of counselling on pain assessment and management during labour in Finland: A cross-sectional survey. Midwifery 2022; 114:103471. [DOI: 10.1016/j.midw.2022.103471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 08/12/2022] [Accepted: 08/26/2022] [Indexed: 11/19/2022]
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Larsson B, Elfving M, Vesterlund E, Karlström A, Hildingsson I. Fulfilment of expectations on birth and the postpartum period - A Swedish cohort study. SEXUAL & REPRODUCTIVE HEALTHCARE 2022; 33:100748. [PMID: 35728347 DOI: 10.1016/j.srhc.2022.100748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 04/27/2022] [Accepted: 06/01/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND The fulfilment of birth expectations is important to women and strongly related to birth satisfaction. OBJECTIVE The aim of this study was to investigate women's expectations and experiences of birth and the postnatal period and associated factors. An additional aim was to explore if women's expectations were fulfilled. METHODS A longitudinal cohort study of 280 women where 226 were followed up two months after birth. Data were collected using questionnaires. Odds ratios with a 95% confidence interval were calculated between the explanatory background variables and expectations/experiences. RESULTS The majority (79%) rated continuity as important, but few (32%) actually had a known midwife assisting during birth. Positive birth expectations were found in 37% and a positive birth experience in 66%. Many women (56%) preferred a short postnatal stay, and 63% went home within 24 h. Thirty-six percent preferred postnatal home visits, but only eight women (3.5%) received this. Breastfeeding expectations were high with 86% rating it as important but after birth 63% reported exclusively breastfeeding. Only a few background factors were associated with women's expectations and experiences. Most likely to be fulfilled were women's expectations for a vaginal birth (83%), a positive birth experience (71%) and short length of postnatal stay (67%). Postnatal home visits (96%) and continuity of care (73%) were not fulfilled. CONCLUSIONS Pregnant women's expectations about continuity are fulfilled only to a minor degree. The fulfilment of postnatal expectations varied and the preference for a short postnatal stay was fulfilled whereas home visits were not.
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Affiliation(s)
- Birgitta Larsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Department of Nursing, Mid Sweden University, Sundsvall, Sweden
| | | | - Elin Vesterlund
- Department of Nursing, Mid Sweden University, Sundsvall, Sweden
| | | | - Ingegerd Hildingsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Department of Nursing, Mid Sweden University, Sundsvall, Sweden.
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