Abstract
BackgroundIn England, 27.8% of all pregnant women undergo caesarean sections (CS) to deliver their babies. Women undergoing CS are at risk of developing sepsis and post-natal infections, which not only contribute significantly to maternal mortality and morbidity, but also negatively impact upon post-natal recovery and wellbeing. This study explores patients’ priorities in relation to CS recovery, focusing on their knowledge and experiences of infection prevention. The study formed part of the PREPS (Vaginal Preparation at caesarean section to Reduce Endometritis and Prevent Sepsis – a feasibility study of chlorhexidine) Trial; patients’ views on the PREPS Trial were also sought.MethodsUsing qualitative methodology, two focus groups and six telephone interviews were carried out between September and October 2017 with a total of 21 women who had undergone a CS within the preceding six months. Focus groups and individual telephone interviews were audio-recorded and transcribed verbatim; a thematic analysis was conducted using NVivo 11.ResultsWomen’s priorities around CS recovery centred on pain (or the lack thereof), mobility and the ability to resume everyday activities, including caregiving. Those undergoing a CS for the first time reported not feeling confident in their ability to identify signs of infection and sought visiting health professionals’ expertise and reassurance. Women were unable to recall whether they had received information regarding infection prevention and felt that they had not received sufficient advice. Some reported receiving general information regarding CS recovery, which ranged in quality. Prevention of womb infection is a major goal of the PREPS trial, however, the majority of women were not aware that womb (as opposed to wound) infection was a post CS risk.ConclusionsWomen undergoing a CS want more information on what constitutes a ‘normal’ post-operative recovery and specifically would welcome written information and infection prevention advice. This should be a key element of improving post-CS maternal experiences and potentially reducing sepsis and infection rates. CS stigma negatively impacts women’s recovery experiences and possibly information provision.The PREPS team incorporated findings regarding consent pathways for recruiting women into intrapartum research and developed two patient reported outcomes to collect in the main trial.Trial registrationThe PREPS trial has been registered with ISRCTN on the 10th July 2017 (ISRCTN33435996).
Highlights
In England, 27.8% of all pregnant women undergo caesarean sections (CS) to deliver their babies
Participants ranged in age; for over half (n = 12), this was their first CS, with the other 9 participants having 1 to 3 CSs previously
This study found that the ability to resume ‘normal life’ and every day activities to be a priority of women in CS recovery
Summary
In England, 27.8% of all pregnant women undergo caesarean sections (CS) to deliver their babies. Women undergoing CS are at risk of developing sepsis and post-natal infections, which contribute significantly to maternal mortality and morbidity, and negatively impact upon post-natal recovery and wellbeing. Women undergoing CS are at risk of developing sepsis and postnatal infection [4], which are significant contributors to maternal morbidity and mortality and barriers to postnatal recovery and maternal wellbeing. SSIs reduction and reducing antibiotic use have been identified as national [11,12,13] and international [14,15,16] priorities Reduction in these complications will improve maternal health and potentially neonatal wellbeing through the facilitation of ongoing breastfeeding and the reduction of interference with the attachment processes
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
