A qualitative study of the experiences and expectations of women receiving in-patient postnatal care in one English maternity unit

Abstract

BackgroundStudies consistently highlight in-patient postnatal care as the area of maternity care women are least satisfied with. As part of a quality improvement study to promote a continuum of care from the birthing room to discharge home from hospital, we explored women's expectations and experiences of current in-patient care.MethodsFor this part of the study, qualitative data from semi-structured interviews were transcribed and analysed using content analyses to identify issues and concepts. Women were recruited from two postnatal wards in one large maternity unit in the South of England, with around 6,000 births a year.ResultsTwenty women, who had a vaginal or caesarean birth, were interviewed on the postnatal ward. Identified themes included; the impact of the ward environment; the impact of the attitude of staff; quality and level of support for breastfeeding; unmet information needs; and women's low expectations of hospital based postnatal care. Findings informed revision to the content and planning of in-patient postnatal care, results of which will be reported elsewhere.ConclusionsWomen's responses highlighted several areas where changes could be implemented. Staff should be aware that how they inter-act with women could make a difference to care as a positive or negative experience. The lack of support and inconsistent advice on breastfeeding highlights that units need to consider how individual staff communicate information to women. Units need to address how and when information on practical aspects of infant care is provided if women and their partners are to feel confident on the woman's transfer home from hospital.

The perceptions of women on child birthing in a public-health facility in a peri-urban area in Kavango east region, Namibia

“…[17] In our study, it was also indicated that adequate care and a good relationship with care-givers during delivery motivated the regular users of public-health facilities to go to the maternity hospital. This was also found by Beake et al, [18] who studied women's experiences and expectations relating to their PNC in a maternity hospital in southern England. Women's satisfaction rating for the care they receive is based on the interaction with their caregiver.…”

Women’s Perception Concerning Health Care in the Post-Partum Period: A Meta-Synthesis

“…Four studies have notified how many researchers analyzed the data [11] [13]- [15], but all studies have informed the set of categories identified and the nature of deductive or inductive analysis and also have ceased to provide information on any criterion. We followed the guidance by Sandelowski & Barroso [16] and Campbell et al [17], about the necessity to evaluate by applying careful judgment in order to distinguish between superficial mistakes which make the findings invalid.…”

“…In eight studies the subjects were women and only in one puerperal and professionals [8]. An isolated [10]- [13] [15] or combined interview with focal group [9] and the observation [8] …”

Would a student midwife run postnatal clinic make a valuable addition to midwifery education in the UK? — A systematic review

“…Since then this traditional pattern of visits has been replaced by a service that emphasises the importance of "individualised care planning" ensuring the most efficient and effective care for women and babies (5). However, current postnatal care provision in some regions is not meeting the needs of the women who receive it (12) and despite high levels of dissatisfaction reported by women receiving postnatal care it remains the most neglected area of maternity services (12,18).…”