Abstract
BackgroundThe postpartum period is redefined as 12 weeks following childbirth. Primary care physicians (PCP) often manage postpartum women in the community after uneventful childbirths. Postpartum care significantly impacts on the maternal and neonatal physical and mental health. However, evidence has revealed unmet needs in postpartum maternal care.AimThe study aimed to explore the experiences of PCPs in managing postpartum mothers.MethodsFour focus group discussions and eleven in-depth interviews with twenty-nine PCPs were conducted in this qualitative research study in urban Singapore. PCPs of both gender and variable postgraduate training background were purposively enrolled. Audited transcripts were independently coded by two investigators. Thematic content analysis was performed using the codes to identify issues in the “clinician”, “mother”, “postpartum care” and “healthcare system & policy” domains stipulated in “The Generalists’ Wheel of Knowledge, Understanding and Inquiry” framework.FindingsPCPs’ personal attributes such as gender and knowledge influenced their postpartum care delivery. Prior training, child caring experience and access to resource materials contributed to their information mastery of postpartum care. Their professional relationship with local multi-ethic and multi-lingual Asian mothers was impacted by their mutual communication, language compatibility and understanding of local confinement practices. Consultation time constraint, awareness of community postnatal services and inadequate handover of care from the specialists hindered PCPs in the healthcare system.DiscussionPersonal, maternal and healthcare system barriers currently prevent PCPs from delivering optimal postpartum care.ConclusionInterventions to overcome the barriers to improve postpartum care will likely be multi-faceted across domains discussed.
Highlights
Postpartum period for a mother has been re-defined from a time frame of 6 weeks after the birth of her child to a postnatal period of 12 weeks [1]
42% of them reported that key health topics such as birth control methods, postpartum depression, healthy eating, appropriate types of exercise, changes in sexual responses and feelings were discussed with their primary care physicians (PCPs) during only 48–60% of their consultations [7]
The framework underpins the generation of new knowledge for Family Medicine via research, which is apt for this study, as it seeks to inquire and understand the practice of PCPs in postpartum care
Summary
Postpartum period for a mother has been re-defined from a time frame of 6 weeks after the birth of her child to a postnatal period of 12 weeks [1]. Postpartum period is a critical time to support these mothers and their new-born child as they often encounter major unmet needs [3]. In the early postpartum period, especially for mothers with early hospital discharges, they are unsure of the healthcare services to address their breastfeeding difficulties [4]. They perceive lack of mental health screening and support [3] during this period, which is a stark contrast to the care they receive during the antenatal period [5]. Primary care physicians (PCP) often manage postpartum women in the community after uneventful childbirths. Evidence has revealed unmet needs in postpartum maternal care
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