Improving care for new mothers with postnatal morbidity in Ireland
Pathways to dedicated clinics for women in Ireland who experience morbidity during the antenatal, intrapartum or postnatal periods are lacking. In view of this, a postnatal morbidity clinic was set up and an evaluation was conducted with clinic attendees with the aim of improving the service by using the results to guide the expansion and improvements.
A survey was developed using two validated questionnaires of women who were discharged from the clinic over 6 months. Surveys were self-completed and returned by 92 women, then analysed using descriptive statistics for quantitative data and thematic analysis for qualitative data.
Several areas were highlighted for improvement, such as expanding debriefing services, making a more precise plan of action upon discharge and improving continuity of care.
Postnatal morbidities exert a considerable toll on new mothers. Listening to women's experiences of attending the clinic guided the successful expansion of advanced midwife practitioner-led supports and improved efficiencies within the clinic as well as highlighting the importance of such a service for all women.
Contrary to the perception that a woman will be healed both in body and mind during the postnatal period and reverting to their pre-pregnancy state (Way, 2012), few women come through birth completely unscathed. Some women's pregnancy and childbirth are associated with suffering and ill health (Singh and Newburn, 2000; World Health Organization (WHO), 2008; Halperin et al, 2015). For these women, life becomes a challenge, with their pregnancy and birthing experience having a profound negative effect on their physical and mental wellbeing (Singh and Newburn, 2000; WHO, 2008). Therefore, the importance of high-quality postnatal care cannot be underestimated, as it may have a lasting effect on a mother's short- and long-term health (Royal College of Midwives (RCM), 2014). Maternal morbidity is a wide-ranging concept that refers to any ‘physical or mental illness, or disability directly related to pregnancy and/or childbirth, resulting in acute or chronic ill health for women’ (Hardee et al, 2012). Morbidities need to be assessed, treated and managed effectively to significantly enhance the quality of women's lives (Webb et al, 2008; Prick et al, 2015). More specifically, in a recent National Institute for Health and Care Excellence (NICE, 2021) guideline on postnatal perineal pain, it was suggested ‘that poor perineal pain management can lead to long term physical, psychological, and psychosexual difficulties’. The review committee also acknowledged the important benefits of healthcare professionals with suitable expertise addressing perineum problems as early as possible with women, to give reassurance and effective healthcare.
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