First-Time Mothers’ Expectations and Experiences of Postnatal Care in England

Jenny Mcleish,Maggie Redshaw,Merryl Harvey,Reem Malouf,Fiona Alderdice,Jane Henderson

doi:10.1177/1049732320944141

Jenny Mcleish, Maggie Redshaw + Show 4 more

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https://doi.org/10.1177/1049732320944141

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Abstract

Postnatal care is the aspect of maternity care with which women in England are least satisfied. Little is known about first-time mothers’ expectations of postnatal care, or how these expectations relate to their experiences and appraisal of care. Thirty-two first-time mothers took part in a longitudinal qualitative descriptive study, based on two semi-structured interviews—the first in pregnancy, and the second 2 to 3 months after birth. Trajectory analysis was used to identify the thematic patterns in the relationships between postnatal care expectations, needs, experiences, and confidence. Five trajectories were identified, showing that mothers’ satisfaction with postnatal care and confidence were primarily influenced not by the extent to which their expectations were met but the varied extent to which their individual postnatal needs were met. Rapid and responsive assessment of needs both antenatally and postnatally, and appropriate adjustment of care, is key in supporting women effectively at this time.

Highlights

Postnatal care has an important role in enabling a safe and successful transition to parenthood (Demott et al, 2006), but is the aspect of maternity care with which women in England are least satisfied (Redshaw & Henderson, 2015)
The consequences of poor postnatal care may be especially problematic for first-time mothers, who need to develop parental confidence and skills (Barclay et al, 1997; Leahy-Warren & McCarthy, 2011), and this may be challenging for mothers who are young, socioeconomically disadvantaged, or lack social support at home (Kurtz Landy et al, 2008)
Support from professionals offered as part of postnatal care can help new mothers to develop this confidence (Leahy-Warren, 2005; Wiegers, 2006), which is inversely associated with stress, anxiety, and postnatal depression (Leahy-Warren & McCarthy, 2011)

Summary

Introduction

Postnatal care has an important role in enabling a safe and successful transition to parenthood (Demott et al, 2006), but is the aspect of maternity care with which women in England are least satisfied (Redshaw & Henderson, 2015). The consequences of poor postnatal care may be especially problematic for first-time mothers, who need to develop parental confidence and skills (Barclay et al, 1997; Leahy-Warren & McCarthy, 2011), and this may be challenging for mothers who are young, socioeconomically disadvantaged, or lack social support at home (Kurtz Landy et al, 2008). It has been suggested that some of the dissatisfaction women express in relation to their postnatal care may be attributable to a mismatch between their expectations and their experiences, and that this may be acute for women from Black, Asian, and other ethnic minority communities (Beake et al, 2010; Jomeen & Redshaw, 2013; Puthussery et al, 2010). The role played by expectations in patient satisfaction has been much debated, with some models proposing that expectations are an important component in satisfaction (Jackson et al, 2001; Linder-Pelz, 1982), while others argue that the significance of met or unmet expectations is eclipsed by factors such as appraisal of actual experiences (Pascoe, 1983; Thompson & Suñol, 1995)

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