Postpartum Care Services Research Articles

Domestic violence: A cross-sectional study among pregnant and postpartum women.

To assess the prevalence of domestic violence/intimate partner violence, aggressors, types of violence and associated factors in women who attend an antenatal and postnatal care service in a public hospital in Brazil. Cross-sectional study. We interviewed women attending antenatal and postpartum care services in a Brazilian public tertiary woman's hospital in Campinas, São Paulo, between July 2019 and September 2021. Data were collected through interviewer-administered questionnaires previously used in healthcare settings: Abuse Assessment Screen (AAS); Woman Abuse Screening Tool (WAST); Hurt, Insulted, Threatened with Harm and Screamed (HITS). We evaluated the relationship between the sociodemographic characteristics of women and domestic/intimate violence using bivariate and multivariable logistic regression analyses. Of the 600 pregnant and postpartum women interviewed, 138 (23%) had suffered any abuse. Some participants disclosed physical violence during pregnancy (2.3%) and during the last 12 months (5.3%). The partner was identified as the main aggressor in most of the cases (60%). When women had a partner, 3.5% reported domestic violence and 6.7% disclosed intimate partner violence during pregnancy or postpartum period. Women with non-white skin colour (OR=1.53; 95% CI 1.01-2.34; p=.048), gestational age ≤ 13 weeks (OR=3.41; 95% CI 1.03-11.25; p=.044) and in postpartum period (OR=2.81; 95% CI 1.32-5.99; p=.008) were more likely to experience domestic violence at some time in their lives. Women interviewed before the COVID-19 pandemic were more likely to disclose that they had suffered any abuse. Experience of violence during pregnancy and postpartum period was more frequent in women with non-white skin colour, in their first gestational trimester and in the postpartum period, and was more reported before the COVID-19 pandemic. Antenatal and postpartum care services could be safe places to support violence survivors. Pregnant and postpartum women are a vulnerable group to experiencing domestic violence/intimate partner violence. Violence can negatively affect women's and children's health and well-being. Antenatal and postpartum care should be considered as a moment to routinely inquiry women about past and current violence experiences. Regular contact among healthcare professionals and women during this period offers a window of opportunities for implementing psychosocial interventions among women at risk of violence. Healthcare providers (i.e., physicians, psychologists, social workers, nurses and midwives) have an important role in identifying survivors, offering support and providing quality information to women.

Latina Women’s Experiences With Health Facility Breastfeeding Care: Implications for Quality Improvement

ObjectivesLittle is known about how to promote high-quality, person-centered breastfeeding care for women of color. We sought to understand breastfeeding care experiences among Latina women to inform the co-design of quality improvement interventions.MethodsWe conducted in-depth interviews with 21 Latina women with low incomes in Connecticut about their breastfeeding care experiences during prenatal, birth, and postpartum visits and ways to improve care experiences. We conducted a thematic analysis and mapped results to the WHO quality of care framework for maternal and newborn health.ResultsMost women received little or no breastfeeding information during prenatal visits and reported that providers rushed visits. Yet, women wanted to learn about breastfeeding before birth and valued spending quality time with providers, particularly when they asked open-ended questions about breastfeeding that promoted discussion. Women emphasized that respectful breastfeeding care requires providers be attentive to their needs and preferences, especially during birth care. While most women appreciated birth care nurses who answered breastfeeding questions and responded to requests (e.g., for breast pumps), a few felt disrespected when nurses ignored requests for their infants to be brought to them and pressured women to formula feed against their wishes. Women reported that lactation consultants (LCs) offered encouragement, though LCs were often unavailable when needed. After discharge, some women felt discouraged because providers did not follow up to offer breastfeeding support. Among women who had negative experiences, many still strove to meet their breastfeeding goals; a few chose to not use postpartum and primary care services as result of negative experiences. At the provider level, women recommended that providers build relationships and trust with women by engaging in breastfeeding conversations. They also recommended systems level changes, including longer prenatal visits, continuity of breastfeeding care, culturally responsive providers who speak Spanish and look like them, provision of breastfeeding peer counselors, and timely access to LCs.ConclusionsMulti-level changes recommended by Latina women should be prioritized in efforts to improve breastfeeding care quality.Funding SourcesNIH/NHLBI K12HL138037; CDC U48DP006380-02-00.

The effect of postpartum sleep quality on mothers’ breastfeeding self-efficacy level

ABSTRACT This study was performed to investigate the effect of sleep quality of new mothers on their breastfeeding self-efficacy. The data of 52 mothers were analysed in the study. Data were collected by the midwife at the first, sixth and 12th weeks after the birth. In the analysis, the repeated measures ANOVA, independent samples t-test, chi-square test and correlation analysis were used. Sleep quality was poor in 38.5%, 17.3% and 15.4% of the participants in the first, the second and the third follow-ups respectively. Breastfeeding self-efficacy levels of the mothers whose sleep quality was good improved. In promoting breastfeeding, the sleep factor should be considered, and it should be included in social support and postpartum care services.

Assessment of Perinatal Depression Risk among internally displaced Yazidi Women in Iraq: a descriptive cross-sectional study

BackgroundYazidi survivors of a 2014 genocidal attack by the self-proclaimed Islamic State of Iraq and Syria (ISIS) have complex medical and mental health needs in the perinatal and postpartum period. Few studies have assessed perinatal mental health needs for this population of women who are living in camps for Internally Displaced Persons (IDP) in the Kurdistan Region of Iraq (KRI).MethodsThe specific aim of this formative cross-sectional study was to assess the prevalence of perinatal depressive symptoms, specifically the risk of perinatal depression symptoms, among a purposive sample of Yazidi women living in camps for internally displaced persons in the Kurdistan region of Iraq. One hundred twenty-two pregnant and recently postpartum (<1 year) Yazidi women completed a Kurdish-language version of the Edinburgh Postnatal Depression Scale (EPDS) questionnaire. Pregnant and postpartum participants’ responses were analyzed together, in order to assess an overall combined risk of perinatal mental health issues for the study population. Logistic regression analyses were used to measure the association of participant characteristics with an elevated risk of perinatal depressive symptoms.ResultsParticipants were 17-45 years of age (mean 32 years, SD 7.63) Among the 122 women, 67.2% (n=82) were pregnant and 32.8% (n=40) were <1 year postpartum. Overall, 78% (n=95) of participants were at an elevated risk of depression (EPDS >10), and 53% (n=65) of all participants were at risk of moderate to severe depression (EPDS >12). Thoughts of self-harm (EPDS item 10) were reported among 97% (n=118) of participants. Logistic regression analysis indicated that increased risk of perinatal depressive symptoms was significantly associated with reports of health problems during pregnancy (OR=3.22, 95% [CI]:1.08-9.61) and marital status (OR=16.00; 95% [CI]: 0.42-0.50). Age (OR= 0.84; 95% [CI]: 0.75–0.94) and level of education (OR=0.15; 95% [CI]: 0.42-0.50) had protective effects.ConclusionsRates of perinatal depressive symptoms risk among internally displaced Yazid pregnant and postpartum women are higher than the general Kurdish-speaking population in Iraq (28.4%). Culturally responsive trauma informed perinatal and postpartum care services, which include both community-based and clinical strategies for perinatal depressive symptoms and suicide prevention for this population, are critically needed.

Midwives' experiences of an organizational change in early postpartum care services in Norway: A qualitative study.

INTRODUCTIONThe length of postpartum hospital stays is decreasing internationally. The ongoing organizational change from hospital to home-based postpartum care implies the promotion of family-centered care for healthy women, their babies and families. The aim of the study was to explore midwives’ experiences of an organizational change in early postpartum care services from hospital to home-based care in Norway.METHODSTen midwives participated in two separate focus-group interviews. Systematic Text Condensation (STC) was the method used to analyze the data.RESULTSThe midwives in the current study described that the organizational change in early postpartum care services from hospital to home-based care was characterized by: 1) unclear leadership, 2) increased continuity of care and professional growth, and 3) the midwives being solution-oriented.CONCLUSIONSThe midwives had both positive and negative experiences of an organizational change in early postpartum care services from hospital to home-based care in Norway. The study indicates a need for increased resources, training in new tasks and employees being more included when changes in midwifery practice are planned and implemented. The current study contributes knowledge of relevance to those planning to start home-based postpartum care, which may contribute to improving quality of care, employees’ satisfaction and prevent burnout.

Choreograph postpartum care experiencescapes in a resort setting

PurposeThe purpose of this paper is to apply the concept of holistic wellness to a postpartum care resort experiencescape to enhance women’s health and well-being. Several relevant theories are highlighted to demonstrate how to design a soothing postpartum care experiencescape. This paper also discusses the notion of regenerative business practices to achieve a win-win-win (customer–resort–community) strategy composed of collaborative networks that serve people and the planet.Design/methodology/approachA multidisciplinary literature review discusses the lack of postpartum care in the USA and shows how resorts could help improve women’s health and well-being by offering postpartum care services. This is a theory synthesis paper that seeks to achieve conceptual integration across multiple frameworks.FindingsThis conceptual model displays the interconnected relationships of holistic wellbeing, postpartum care experiencescape design and regenerative practices.Research limitations/implicationsThe essence of this conceptual paper is to address postpartum care in the USA and to develop a conceptual model for designing postpartum care experiencescapes in a resort setting.Practical implicationsThe authors offer suggestions on how resorts and health-care services can co-design a postpartum care resort experiencescape to transform the mother’s postpartum period to the joy of parenthood.Social implicationsThis paper discusses how postpartum care experiencescapes in the resort context would contribute to solving some prevalent societal issues while advancing the future of hospitality research and businesses.Originality/valueNo research within the hospitality literature has yet discussed how the hospitality industry can collaborate with the health-care sector to establish postpartum care services to be at the forefront in leading the age of regeneration.

Influencing Pelvic Floor Changes on the Quality of Women’s Life During and Post Pregnancy

Introduction: Pelvic floor dysfunctions are widely acknowledged as one of the most serious public health issues, in terms of frequency, cost, and influence on quality of life of women. Over a third of females are believed to have pelvic floor diseases of varying severity at some point in their lives. Objective: To evaluate the influencing pelvic floor changes on the quality of women’s life during and post pregnancy. Methodology: This Multi-Centre cohort study was carried at the department of Urology &amp; Transplantation, Institute of Kidney Diseases Peshawar, and Department of Gynaecology Jamrud Hospital Peshawar .The study duration was one year from June 2020 to June 2021 after approval of synopsis. A total of 45 women fulfilling the inclusion criteria were enrolled in our study. All the collection of data was carried out through predesigned questionnaire. Vaginal examination, translabial 2D/3D ultrasonography and a POP-Q test was done in the 3rd trimester of gestation and Three months after birth. The statistical analyses were performed using SAS software version 9.4. Results: In the current study, weakness of connective tissues was observed in 23 (51.1%) and Gestational diabetes was observed in 6 (13%). Amongst 45 women, vaginal deliveries were observed in 17 (37.78%), caesarean section in 17 (37.78%) while vacuum extraction deliveries were observed in 11 (24.44%) females. Two subjects were found to have LAM avulsion three months after their VE deliveries. Conclusion: Pelvic floor dysfunction is associated with connective tissue weakening and a larger fetus weight at delivery. To minimize future Pelvic floor problems, more women should seek postpartum care services. Keywords: Pelvic floor changes; Quality of life; Post pregnancy

Mental Health and Postpartum Care in California: Implications from California's Provisional Postpartum Care Extension.

California's Provisional Postpartum Care Extension (PPCE) extended Medicaid eligibility through 1year postpartum for women enrolled in Medi-Cal with annual household incomes of 138%-322% of the federal poverty level and maternal mental health diagnoses. For this cross-sectional descriptive study, we used the 2017 Listening to Mothers in California survey of postpartum women to identify those potentially eligible for PPCE. We then sought to describe their demographic characteristics, self-reported mental health, and utilization of postpartum care and mental health services compared with those with Medi-Cal during pregnancy who did not meet PPCE eligibility criteria. Overall, potentially PPCE-eligible women comprised 6.8% of respondents. Among those who did not qualify for PPCE, the primary reason was the absence of self-reported maternal mental health symptoms. Potentially PPCE-eligible women were approximately two-thirds Hispanic/Latina and more than one-third were ages 25 to 29. The most common self-reported mental health symptom was anxiety during pregnancy (78.9%). Among potentially PPCE-eligible women, 8.4% were taking medicine for anxiety/depression postpartum and 16.0% were receiving postpartum counseling/treatment for emotional or mental well-being. Our analyses suggest that PPCE could have extended postpartum coverage eligibility for approximately 30,360 women statewide. However, our findings demonstrate how narrowly defined PPCE eligibility criteria likely excluded many postpartum women in Medi-Cal who would have been left with limited benefits or more cost-sharing under alternative coverage options. This research could inform state and federal policymakers considering other proposals to extend postpartum Medicaid eligibility.

Knowledge, attitude, and practice among primary health-care and obstetrics and gynecology physicians in postpartum care services in National Guard Hospital, Saudi Arabia.

The postpartum period, also known as the fourth trimester, is defined as the first 12 weeks postpartum. Primary health care (PHC) plays an important role in providing a comprehensive postpartum care to mothers. This study aimed to assess knowledge, attitude, and practice of postpartum care among PHC physicians and obstetrics and gynecology physicians. This is a cross-sectional study to assess the knowledge, attitude, and practice of PHC physicians and obstetrics and gynecology physicians in postpartum care services at Western Region, Saudi Arabia. A structured questionnaire was used for data collection. The Statistical Package for the Social Sciences (SPSS; version 27.0) was used for data analysis. Proportions and tables were used to summarize categorical data. A total of 159 responses were analyzed with 65.4% response rate. The median (interquartile range [IQR]) for knowledge score was 15 (13-17). The median (IQR) for attitude was 20 (18-22), while the median (IQR) for practice total scores was 3 (2-4). Knowledge and practice scores showed significant differences between all the groups. On the other hand, attitude only showed significant differences between males and females, favoring a better attitude among females (P = 0.014). There were good levels of KAP associated especially with female physicians and higher physician levels. Minor differences were noticed between different groups in our sample according to age, gender, specialty, and years of experience.

Knowledge, attitude, and practice regarding postpartum care among mothers attending an Egyptian family health unit

ObjectivesTo evaluate knowledge and attitude of mothers about postpartum care and to assess postpartum care that was provided for both mothers and newborns.BackgroundThe postnatal period is critical for the newborn and the mother. All of maternal and neonatal problems could be reduced if women receive appropriate postpartum care. Therefore, it is essential to provide education to mothers regarding appropriate postpartum care, as improved household practices and use of services, often at the community level, will increase newborn survival.Participants and methodsA cross-sectional study was conducted on a simple random sample of 321 mothers in the reproductive age. The mothers were selected randomly from the Elsafasef health care facility of Damanhur District of El-Behra Governorate, Egypt. A predesigned questionnaire was used to assess sociodemographic data, knowledge, and attitude of the participants regarding postpartum care, and a checklist was used to assess postpartum care services provided for both mothers and their neonates.ResultsGood knowledge was reported among 57% of the studied group, whereas 79.3% of them had a positive attitude, and approximately 51.2% and 64.8% of the studied group had good practice regarding postpartum care services that were provided for them and their neonates, respectively.ConclusionMore than half of mothers had good knowledge and satisfactory practice regarding postpartum care, and a majority of them had a positive attitude toward postpartum care.

IDENTIFYING FACTORS ASSOCIATED WITH THE USE OF A SCALED-UP POSTPARTUM FAMILY PLANNING PROJECT IMPLEMENTED IN PUNJAB, PAKISTAN

Pakistan has one of the highest unmet needs for family planning among low and middle-income countries. Postpartum family planning (PPFP) is considered to have the potential of significantly improving the contraceptive prevalence rate and reducing the unmet need for family planning. Jhpiego (John Hopkins Affiliate) implemented a PPFP pilot project in the district headquarter hospital of Mandi Bahauddin. The key interventions of the Jhpiego pilot were to improve services pertinent to PPFP. Based on the successes of the pilot, the interventions were scaled up to other health facilities. The present study aims to identify the factors associated with the utilization of the postpartum family planning health project implemented in the health facilities once the scale-up activities ended and comparing it with the pilot facility. A cross-sectional survey with a sample of 410 women using postpartum care services in the facilities was conducted using a structured questionnaire. The findings indicated that the complete set of interventions were not present in the facilities. Postpartum family planning method uptake was low (26%) along with the shortage of contraceptives supplies. Multivariate logistic regression was conducted to identify the predictors for the current use of postpartum family planning. The predictors identified that women with the age of 25 years and above with 3 or more children, who attended antenatal care visits and were counselled on PPFP were more likely to adopt/use PPFP in the postpartum period. The findings indicated scale-up was limited and the interventions were not sustained once the donor support ended.

The Review and Future Perspectives of the Postpartum Care Service System for the Improvement of the Private-Postpartum Care Center’s Publicity

The study aimed to review the current postpartum care service system and suggest measures of improvement for the public reinforcement of the private-postpartum care center (PCC). We conducted a review of literature, including an internet search, and we analyzed the in-depth interviews using questionnaires answered by workers from the 6 private-PCCs operated in Goyang city. Using these data, we derived possible measures which could improve the publicity of private-PCCs. It was found that the 11 nationwide public-PCCs had serious operating deficits, and its utilization by the vulnerable was insufficient. In areas where private-PCCs are concentrated, we can propose the following policies to strengthen publicity, rather than establishing another public-PCC. First, it is important to provide support for private-PCCs to apply cost reductions for vulnerable groups, similar to the maternal and newborn medical care of public-PCCs. Second, publicity would be strengthened by reorganizing the pregnancy and childbirth education program, while also offering additional services for mothers with stillbirths and abortions. For the integrated management of postpartum care services, this should be shifted towards reinforcing the publicity of private-PCCs, rather than operating a public-PCC in relatively concentrated private-PCC areas. Through these policies, it is expected that financial and administrative waste will be reduced, and an integrated management system for postpartum care services will be established.

Factors Associated with the Utilisation of Postnatal Care Services in a Rural Community in Abia State

Background: Postnatal period is as important as pregnancy and childbirth. Half of all postnatal deaths occur during the first week after birth. During postnatal period, the mother’s body undergoes major changes from pregnancy. Therefore, there is need for continuity of care after birth to prevent and manage complications that may arise during postnatal. This study was carried out to determine factors associated with the utilisation of postnatal care services in a rural community in Abia state. Methods: This was a descriptive cross-sectional study conducted from March 2019 to May 2019 among women living in Amuvi community in Arochukwu Local Government Area (LGA)of Abia state. The study participants were women of reproductive age group (15-49 years) who had at least been pregnant once, carried pregnancy to full maturity and delivered at term. Data was collected using pre-tested semi-structured interviewer-administered questionnaire. Results: Four hundred and sixty-seven (467) women participated in the study. Four hundred and forty-three (95.1%) women attended postnatal visits while 23 (4.7%) did not. Reasons given for attending postnatal care by respondents were; routine check-ups, counselling on family planning, appointment with health workers 54 (11.7%), same day appointment as child’s immunisation, child was sick. Respondents who were married were 2 times (AOR=2.587, 95% CI:-0.878-0.120) more likely to use postnatal care services than single mothers. Mothers who had an occupation were 2 times (AOR=2.897, 95% CI: 0.051-0.267) more likely to use postnatal care services than those who did not. Husband’s occupation was statistically significant with utilisation of postnatal services. Conclusion: Utilisation of postpartum care services was high among women in Amuvi community of Abia state. PNC services utilisation were associated with marital status, mother’s occupation and husband’s educational status.

Postpartum Care Utilization Among Women with Medicaid-Funded Live Births in Oregon.

Postpartum care is an important strategy for preventing and managing chronic disease in women with pregnancy complications (i.e., gestational diabetes (GDM) and hypertensive disorders of pregnancy (HDP)). Using a population-based, cohort study among Oregon women with Medicaid-financed deliveries (2009-2012), we examined Medicaid-financed postpartum care (postpartum visits, contraceptive services, and routine preventive health services) among women who retained Medicaid coverage for at least 90days after delivery (n = 74,933). We estimated postpartum care overall and among women with and without GDM and/or HDP using two different definitions: 1) excluding care provided on the day of delivery, and 2) including care on the day of delivery. Pearson chi-square tests were used to assess differential distributions in postpartum care by pregnancy complications (p < .05), and generalized estimating equations were used to calculate adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Of Oregon women who retained coverage through 90days after delivery, 56.6-78.1% (based on the two definitions) received any postpartum care, including postpartum visits (26.5%-71.8%), contraceptive services (30.7-35.6%), or other routine preventive health services (38.5-39.1%). Excluding day of delivery services, the odds of receiving any postpartum care (aOR 1.26, 95% CI 1.08-1.47) or routine preventive services (aOR 1.32, 95% CI 1.14-1.53) were meaningfully higher among women with GDM and HDP (reference = neither). Medicaid-financed postpartum care in Oregon was underutilized, it varied by pregnancy complications, and needs improvement. Postpartum care is important for all women and especially those with GDM or HDP, who may require chronic disease risk assessment, management, and referrals.

Socio demographic characteristics of women who leave their babies to social services after giving birth in Turkey

Context: It has been known that parents leave their newborn babies under government protection due to various social, cultural, and economic reasons, unwanted pregnancies being one of the most important reasons.Aims: The aim of the study was to examine the sociodemographic and life characteristics of mothers who had to leave their newborn babies to social services after giving birth.Settings and Design: Using a qualitative research approach, this research was conducted in the qualitative document analysis design.Materials and Methods: The data were obtained from the social review reports (electronic) of 66 mothers who gave birth and left their newborn babies to social services between 2010 and 2019 in a hospital in the city center of Izmir, Turkey.Statistical Analysis Used: The electronic data (number: 1–66) in these reports were analyzed by descriptive and content analysis methods.Results: Most of the mothers were had 2 years of education (n = 17), were not officially married (n = 31), and worked in an environment open to abuse (n = 6). Six themes were obtained from the data analysis including family status and living with the spouse/partner, pre- and post-pregnancy residence, the process of abandoning the infant, pregnancy process and health problems, sharing pregnancy news and safety, and the conception of pregnancy and the legal process.Conclusions: This study revealed that mothers who leave their infant to social services have several high-risk sociodemographic and life characteristics, predominantly related to lifestyle, residence, pregnancy experience, and sexual violence. Midwives and other healthcare professionals can help improve mother/infant health by considering these risk groups, while providing the prepregnancy, pregnancy, delivery, and postpartum care services and by providing support to mothers who want to leave their infant to social services.

Midwives' perceptions of the continued existence of postpartum care services in midwifery homes, and the importance of midwifery homes in the community

Midwives' perceptions of the continued existence of postpartum care services in midwifery homes, and the importance of midwifery homes in the community

Finding a Medical Home for Perinatal Depression: How Can We Bridge the Postpartum Gap?

Finding a Medical Home for Perinatal Depression: How Can We Bridge the Postpartum Gap?

Delayed Establishment of Gut Microbiota in Infants Delivered by Cesarean Section.

The maternal vaginal microbiome is an important source for infant gut microbiome development. However, infants delivered by Cesarean section (CS) do not contact the maternal vaginal microbiome and this delivery method may perturb the early establishment and development of the gut microbiome. The aim of this study was to investigate the early gut microbiota of Korean newborns receiving the same postpartum care services for two weeks after birth by delivery mode using fecal samples collected at days 3, 7, and 14. Early gut microbiota development patterns were examined using 16S rRNA gene-based sequencing from 132 infants either born vaginally (VD, n = 64) or via Cesarean section (CS, n = 68). VD-born neonates showed increased alpha diversity in infant fecal samples collated at days 7 and 14 compared to those from day 3, while those of CS infants did not differ (p < 0.015). Bacterial structures of infants from both groups separated at day 7 (p < 0.001) and day 14 (p < 0.01). The bacterial structure of VD infants gradually changed over time (day 3 vs. day 7, p < 0.012; day 3 vs. day 14, p < 0.001). Day 14 samples of CS infants differed from day 3 and 7 samples (day 3 vs. day 14, p < 0.001). VD infant relative abundance of Bifidobacterium (days 7, 14), Bacteroides (days 7, 14), and Lachnospiraceae (day 7) significantly increased compared to CS infants, with a lower abundance of Enterobacteriaceae (found in all periods of the CS group) (LDA > 3.0). Relative abundances of Bifidobacterium, Lactobacillus, and Staphylococcus were significantly increased in both VD and CS groups at day 14 (LDA > 3.0). Predicted functional analysis showed that VD infants had overrepresented starch/sucrose, amino acid and nucleotide metabolism in gut microbiota with depleted lipopolysaccharide biosynthesis until day 14 compared to CS infants. This study confirmed that delivery mode is the major determinant of neonatal intestinal microbiome establishment and provides a profile of microbiota perturbations in CS infants. Our findings provide preliminary insight for establishing recovery methods to supply the specific microbes missing in CS infants.

Client satisfaction with existing postnatal care and associated factors: A study among mothers in Awi Zone, Amhara region, Ethiopia.

Background:The majority of maternal and neonatal adverse events take place during the postnatal period. However, it is the most neglected period for the provision of quality care.Objective:The aim of this study among mothers in the Awi Zone, Amhara region, Ethiopia, was to assess client satisfaction with existing postnatal care and associated factors.Methods:An institution-based cross-sectional study was conducted in Awi Zone hospitals from 1 to 30 April 2018. A total of 422 post-partum mothers were selected by systematic sampling. The data were collected using a pre-tested structured questionnaire via a face-to-face interview. Data entry and analysis were completed using EpiData version 3.1 and SPSS version 22, respectively. The data were summarized with frequency and cross-tabulation. Both binary and multiple logistic regressions were used to identify predictor variables using odds ratios and 95% confidence intervals.Result:The prevalence of postnatal care satisfaction was 63%. Being from urban area (AOR = 2.1, 95% CI = (1.11–3.99)), having a history of antenatal care follow up (AOR = 1.62, 95% CI = (1.23–1.64)), spontaneous vaginal birth (AOR = 3.14, 95% CI = (1.77–3.28)), and those who did not face any complications during birth (AOR = 2.90, 95% CI = (1.47–1.69)) were some of the factors associated with client satisfaction.Conclusion:According to the results of this study, the majority of mothers were satisfied with post-partum care services. The study findings indicate that maternal satisfaction on post-partum care is mainly affected by residency, antenatal care follow up, mode of delivery, and complications during birth. Therefore, health care providers and other concerned bodies should give special attention to those mothers who are from rural areas, who face complications during birth or who have instrumental-assisted or cesarean section birth. Also, every pregnant mother should be supported to have at least four regular antenatal care visits.

The experiences of early postpartum Shenzhen mothers and their need for home visit services: a qualitative exploratory study

BackgroundThe early postpartum period is the most stressful period for a new mother, who is assuming new roles and responsibilities in life, and must deal with the demands from her newborn baby and her own care needs. Little is known about whether the current postnatal care services provided by hospitals and community centers meet the needs of women. The aim of this study was to identify the experiences of women in Shenzhen and the problems that they encountered during the first 6 weeks after giving birth; and to explore their expressed needs with regard to postnatal care services.MethodsThis is a qualitative exploratory study. Data were collected in November 2018 through in-depth, semi-structured, face-to-face interviews. A purposive sample was recruited from a tertiary maternal hospital in Shenzhen, China. The dataset was analyzed using content analysis.ResultsTwenty-two mothers were interviewed during their postpartum body check on the 30th or 42nd day after giving birth. Six themes were identified: “the self-care needs of women,” “proficiency in infant care,” “involvement of family in postpartum and infant care,” “family conflicts over postpartum and infant care,” “preparing for the transition to parenthood / grandparenthood,” and “the need for comprehensive postpartum home visit services.”ConclusionsThe concerns expressed by the women during the postpartum period were related to their need to recover physically and to their desire to be perceived as proficient in infant care. Support from husbands and grandmothers could facilitate or impede a woman’s transition to motherhood, and the family’s transition to parenthood / grandparenthood. There were disagreements arising from intergenerational beliefs about postpartum and child care. In providing postpartum care services to women in situations where the family is involved in their care, health professionals should consider the family as a whole.