Advertisement
JOGC

Voices of Postpartum Women: Exploring Canadian Women's Experiences of Inpatient Postpartum Care

      Abstract

      Objective

      To explore and understand postpartum inpatient experiences in a Canadian context.

      Methods

      Inpatients at BC Women's Hospital & Health Centre were invited to complete a questionnaire during their postpartum stay. Completed responses were obtained from 178 women, representing 44% of all postpartum inpatients during the survey period.

      Results

      Overall, women had positive experiences during their postpartum stay: 93% rated their experience as “excellent” or “very good”; 78% felt that nurses never seemed rushed or too busy to care for them; and 85% of women found the nurses to be very helpful with breastfeeding. Two-thirds of the women had concerns about going home that were related to infant feeding, feeling overwhelmed, and not knowing how to settle their baby. Other areas of improvement pertained to the hospital environment being less restful than desired. Certain groups needed additional support, such as primiparous women, women who had Caesarean deliveries, and women from certain ethnic groups.

      Conclusion

      This exploration of women's inpatient postpartum experiences in a Canadian hospital provides valuable information for improving service delivery, including assessing hospital routines, providing information/education, and improving discharge planning. Given that postpartum experiences are not uniform across demographic groups, an alternative or augmented approach to postpartum care may be warranted for some women.

      Résumé

      Objectif

      Explorer et comprendre les expériences postpartum à l’hôpital au Canada.

      Méthodologie

      On a invité des patientes hospitalisées au BC Women’s Hospital & Health Centre à répondre à un questionnaire durant leur séjour postpartum. En tout, 178 femmes ont répondu, soit 44 % de toutes les patientes sollicitées.

      Résultats

      Dans l’ensemble, les femmes avaient eu des expériences positives durant leur séjour postpartum : 93 % ont qualifié leur expérience d’« excellente » ou de « très bonne »; 78 % trouvaient que les infirmières ne semblaient jamais trop pressées ou trop occupées pour s’occuper d’elles; et 85 % trouvaient que les infirmières les avaient beaucoup aidées pour l’allaitement maternel. Les deux tiers des femmes avaient des inquiétudes pour le retour à la maison quant à l’alimentation du bébé, au sentiment d’être submergées et à la façon de calmer leur bébé. Les autres points à améliorer concernaient le fait que l’environnement hospitalier ne permettait pas le repos souhaité. Certains groupes avaient besoin de soutien supplémentaire, notamment les femmes primipares, les femmes qui avaient subi une césarienne et les femmes de certains groupes ethniques.

      Conclusion

      Cette exploration des expériences postpartum des femmes dans un hôpital canadien donne des renseignements précieux pour l’amélioration de la prestation des services, notamment en ce qui concerne l’évaluation des routines hospitalières, l’éducation et les renseignements fournis et la planification du congé. Comme les expériences postpartum ne sont pas uniformes d’un groupe démographique à l’autre, il peut être nécessaire d’offrir à certaines femmes une approche différente ou augmentée.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Obstetrics and Gynaecology Canada
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Wray J.
        Seeking to explore what matters to women about postnatal care.
        B J Midwifery. 2006; 14: 246-254
        • Ockleford E.M.
        • Berryman J.C.
        • Hsu R.
        Postnatal care: What new mothers say.
        B J Midwifery. 2004; 12: 166-171
        • Waldenström U.
        • Rudman A.
        • Hildingsson I.
        Intrapartum and postpartum care in Sweden: women's opinions and risk factors for not being satisfied.
        Acta Obstet Gynecol Scand. 2006; 85: 551-560
        • Hodnett E.D.
        Pain and women's satisfaction with the experience of childbirth: a systematic review.
        Am J Obstet Gynecol. 2002; 186: 160-172
        • Healthcare Commission
        Women's experiences of maternity care in the NHS in England.
        Healthcare Commission, London2007
        • Ellberg L.
        • Hogber U.
        • Lindh V.
        We feel like one, they see us as two: New parents' discontent with postnatal care.
        Midwifery. 2010; 26: 463-468
        • Hildingsson I.M.
        • Sandin-Bojo A.K.
        What is could indeed be better”—Swedish women's perceptions of early postnatal care.
        Midwifery. 2011; 27: 737-744
        • Beake S.
        • Rose V.
        • Bick D.
        • et al.
        A qualitative study of the experiences and expectations of women receiving in-patient postnatal care in one English maternity unit.
        BMC Pregnancy Childbirth. 2010; 10: 70
        • Hildingsson I.M.
        New parents' experiences of postnatal care in Sweden.
        Women Birth. 2007; 20: 105-113
        • Brown S.J.
        • Davey M.A.
        • Bruinsma F.J.
        Women's views and experiences of postnatal hospital care in the Victorian survey of recent mother 2000.
        Midwifery. 2005; 21: 109-126
        • Martin A.
        • Horowitz C.
        • Balbierz A.
        • et al.
        Views of women and clinicians on postpartum preparation and recovery.
        Matern Child Health. 2014; 18: 707-713
        • Declercq E.R.
        • Sakala C.
        • Corry M.P.
        • et al.
        Listening to Mothers SM III: Pregnancy and Birth.
        Childbirth Connection, New York2013
        • Chalmers B.
        • Dzakpasu S.
        • Heaman M.
        • et al.
        The Canadian Maternity Experiences Survey: an overview of findings.
        J Obstet Gynaecol Can. 2007; 30: 217-228
        • Kingston D.
        • Heaman M.
        • Chalmers B.
        • et al.
        Comparison of maternity experiences of Canadian-born and non-recent immigrant women: Findings from the Canadian Maternity Experiences Survey.
        J Obstet Gynaecol Can. 2011; 33: 1105-1115
        • Rudman A.
        • Waldenstrom U.
        Critical views on postpartum care expressed by new mothers.
        BMC Health Serv Res. 2007; 7: 178
        • Negron R.
        • Martin A.
        • Almog M.
        • et al.
        Social support during the postpartum period: Mothers' views on needs, expectations and mobilization of support.
        Matern Child Health. 2013; 17: 616-623
        • Bailey S.
        Postnatal care: exploring the views of first time mothers.
        Community Pract. 2010; 83: 26-29
        • Foster D.A.
        • McLachlan H.L.
        • Rayner J.
        • et al.
        The early postnatal period: Exploring women's views, expectations and experiences of care using focus groups in Victoria, Australia.
        BMC Pregnancy Childbirth. 2008; 827
        • Canadian Institute of Health Research (CIHI)
        Canadian Patient Experiences Survey – Inpatient Care Procedure Manual.
        (Available at)
        https://www.cihi.ca/en/cpes_ic_procedure_20140501_en.pdf
        Date: 2014
        Date accessed: February 7, 2018
        • Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)
        HCAHPS Hospital Survey.
        (Available at)
        http://www.hcahpsonline.org/en/survey-instruments/
        Date: 2017
        Date accessed: February 7, 2018
        • Schafter J.L.
        • Graham J.W.
        Missing data: Our view of the state of the art.
        Psychol Methods. 2002; 7: 147-177
        • Sterne J.A.
        • White I.R.
        • Carlin J.B.
        • et al.
        Multiple imputation for missing data in epidemiological and clinical research: Potential and pitfalls.
        BMJ. 2009; 29: 336
        • De Leeuw E.
        • Hox J.
        • Husiman M.
        Prevention and treatment of item nonresponse.
        J Off Stat. 2003; 19: 153-176
        • Provincial Health Services Authority
        Vancouver Community Health Profile.
        (Available at)
        • Guittier M.J.
        • Cedraschi C.
        • Jamei N.
        • et al.
        Impact of mode of delivery on the birth experience in first time mothers: a qualitative study.
        BMC Pregnancy Childbirth. 2014; 14: 254
        • Cooke M.
        Tomasina S. Differences in the evaluation of postnatal midwifery support by multiparous and primiparous women in the first two weeks after birth.
        Aust J Midwifery. 2003; 16: 18-24
        • Salonen A.H.
        • Oommen H.
        • Kaunonen M.
        Primiparous and multiparous mothers' perceptions of social support from nursing professionals in postnatal wards.
        Midwifery. 2013; 30: 476-485
        • Collins K.
        • O'Cathain A.
        The continuum of patient satisfaction – from satisfied to very satisfied.
        Soc Sci Med. 2003; 57: 2465-2470
        • Giordano L.A.
        • Elliot M.N.
        • Goldstein E.
        • et al.
        Development, Implementation, and Public Reporting of the HCAHPS Survey.
        Med Care Res. 2010; 67: 27-37
        • Thomas D.R.
        A general inductive approach to analyzing qualitative evaluation data.
        Am J Eval. 2006; 27: 237-246
        • Viera A.J.
        • Garrett J.M.
        Understanding interobserver agreement: The Kappa statistic.
        Fam Med. 2005; 37: 360-363
        • Bass G.I.
        • Japp J.
        • Wiegers T.A.
        • et al.
        Women's suggestions for improving midwifery care in the Netherlands.
        Birth. 2015; 42: 369-378
        • Hall W.A.
        • Hauck Y.
        Getting it right: Australian primiparas' views about breastfeeding: A quasi-experimental study.
        Int J Nurs Stud. 2007; 44: 786-795
        • Public Health Agency of Canada
        What Mothers Say: The Canadian Maternity Experiences Survey.
        (Available at)
        http://www.phac-aspc.gc.ca/rhs-ssg/pdf/survey-eng.pdf
        Date: 2009
        Date accessed: February 7, 2018
        • Wirihana L.A.
        • Barnard A.
        Women's perceptions of their healthcare experience when they choose not to breastfeed.
        Women Birth. 2012; 25: 135-141
        • Fahey J.O.
        • Shenassa E.
        Understanding and meeting the needs of women in the postpartum period: the Perinatal Maternal Health Promotion Model.
        J Midwifery Womens Health. 2013; 58: 613-621
        • Cheng C.Y.
        • Pickler R.H.
        Effects of stress and social support on postpartum health of Chinese mothers in United States.
        Res Nurs Health. 2009; 32: 582-591
        • Robertson E.
        • Grace S.
        • Wallington T.
        • et al.
        Antenatal risk factors for postpartum depression: a synthesis of recent literature.
        Gen Hosp Psychiatry. 2004; 26: 289-295
        • Kreps G.L.
        • Sparks L.
        Meeting the health literacy needs of immigrant populations.
        Patient Educ Couns. 2008; 71: 328-332