Reviewing birth experience following a high-risk pregnancy: A feasibility study

Abstract

BackgroundComplications during pregnancy and birth are known risk factors for negative birth experience. Women value the opportunity to review their birth experiences, but limited knowledge exists about appropriate interventions and the feasibility of providing this care for women following high-risk pregnancies. ObjectiveTo describe the construction and evaluate the feasibility and acceptability of a postpartum midwifery counselling intervention for women following high-risk pregnancies. DesignA mixed-method study. SettingA high-risk antenatal outpatient clinic at Landspítali University Hospital in Reykjavík, Iceland. Sample, recruitment and data collectionThirty women who experienced high-risk pregnancies were invited to write about and review their birth experience with a known midwife 4–6 weeks postpartum. Eight midwives working in a high-risk antenatal clinic provided the intervention after a special training. Data including birth outcomes, birth experience and experience of the intervention were collected by questionnaires from women at two time points before and after the counselling intervention. Midwives providing the intervention completed diaries and participated in focus group interview to explore their experiences of the process. Data analysisDescriptive and content analysis. FindingsWomen and midwives perceived the intervention positively and feasible in this context. Midwives evaluated the pre-training program as helpful. Most women would like to review their birth experience with a midwife they know, 4-6 weeks postpartum. Almost half of the women wrote about their birth experiences. Key conclusionsThe findings indicate that women experiencing high-risk pregnancies might benefit from a follow up by a midwife they know. Women and midwives perceived the counselling intervention as an acceptable and feasible option in maternity care. The training program sufficiently prepared the midwives to provide the counselling intervention. Implications for practiceThe findings provide an opportunity to offer the intervention on a larger scale to explore the effects further and subsequently implement into routine care after birth for high-risk women.