References

Baxter J. Postnatal debriefing: women's need to talk after birth. Br J Midwifery. 2019; 27:(9)563-571 https://doi.org/10.12968/bjom.2019.27.9.563

Bick D, Duff E, Shakespeare J. Better Births – But why not better postnatal care?. Midwifery. 2020; https://doi.org/10.1016/j.midw.2019.102574

Department of Health. National Maternity Strategy 2016-2026. 2016. https://bit.ly/3BL2x8G (accessed 2 February 2022)

Doherty J, Brosnan M, Sheehy L. Changes in care in the fourth trimester in Ireland: 2010–2020. Br J Midwifery. 2021; 29:(0)2-8 https://doi.org/10.12968/bjom.2021.29.12.683

Halperin O, Sarid O, Cwikel J. The influence of childbirth experiences on women's postpartum traumatic stress symptoms: A comparison between Israeli Jewish and Arab women. Midwifery. 2015; 31:(6)625-632 https://doi.org/10.1016/j.midw.2015.02.011

Hardee K, Gay J, Blanc AK. Maternal morbidity: neglected dimension of safe motherhood in the developing world. Glob Public Health. 2012; 7:(6)603-617 https://doi.org/10.1080/17441692.2012.668919

A Guide to Hospital Outpatient Satisfaction Surveys. 2003. https://bit.ly/3HaIB0h (accessed 2 February 2022)

Manzoor F, Wei L, Hussain A, Asif M, Shah SIA. Patient Satisfaction with Health Care Services; An Application of Physician's Behavior as a Moderator. Int J Environ Res Public Health. 2019; 16:(18) https://doi.org/10.3390/ijerph16183318

Menage D, Bailey E, Lees S, Coad J. Women's lived experience of compassionate midwifery: Human and professional. Midwifery. 2020; 85 https://doi.org/10.1016/j.midw.2020.102662

Mercer SW, Maxwell M, Heaney D, Watt GC. The consultation and relational empathy (CARE) measure: development and preliminary validation and reliability of an empathy-based consultation process measure. Fam Pract. 2004; 21:(6)699-705 https://doi.org/10.1093/fampra/cmh621

Munch S, McCoyd JLM, Curran L, Harmon C. Medically high-risk pregnancy: Women's perceptions of their relationships with health care providers. Soc Work Health Care. 2020; 59:(1)20-45 https://doi.org/10.1080/00981389.2019.1683786

Clinical Report, 2018.Dublin: National Maternity Hospital; 2019

Clinical Report, 2019.Dublin: National Maternity Hospital; 2020

Newman E. Humanisation of childbirth. Pract Midwife. 2019; 22:(9)15-19

National Institute for Health and Care Excellence. Postnatal care. 2013. https://bit.ly/3hcXd4D (accessed 21 February 2022)

National Institute for Health and Care Excellence. Postnatal care. 2021. https://bit.ly/3Hda5Ch (accessed 21 February 2022)

O'Brien D, Casey M, Butler MM. Women's experiences of exercising informed choices as expressed through their sense of self and relationships with others in Ireland: A participatory action research study. Midwifery. 2018; 65:58-66 https://doi.org/10.1016/j.midw.2018.07.006

Ockleford E, Berryman J, Hsu R. Postnatal care: what new mothers say. Br J Midwifery. 2004; 12:(3)166-170 https://doi.org/10.12968/bjom.2004.12.3.15363

Prick BW, Bijlenga D, Jansen AJG Determinants of health-related quality of life in the post-partum period after obstetric complications. Eur J Obstet Gynecol Reprod Biol. 2015; 185:88-95 https://doi.org/10.1016/j.ejogrb.2014.11.038

Royal College of Midwives. Postnatal Care Planning. 2014. https://bit.ly/3LX9nwF (accessed 2 February 2022)

Selkirk R, McLaren S, Ollerenshaw A, McLachlan AJ, Moten J. The longitudinal effects of mid-wife-led postnatal debriefing on the psychological health of mothers. J Reprod Infant Psychol. 2006; 24:(2)133-147 https://doi.org/10.1080/02646830600643916

Women's experiences of postnatal care. 2000. https://bit.ly/3HaITEp (accessed 6 April 2020)

Skibniewski-Woods D. A review of postnatal debriefing of mothers following traumatic delivery. Community Pract J Community Pract Health Visit Assoc. 2011; 84:(12)29-32

Way S. A qualitative study exploring women's personal experiences of their perineum after childbirth: Expectations, reality and returning to normality. Midwifery. 2012; 28:(5)e712-e719 https://doi.org/10.1016/j.midw.2011.08.011

Webb DA, Bloch JR, Coyne JC, Chung EK, Bennett IM, Culhane JF. Postpartum physical symp-toms in new mothers: their relationship to functional limitations and emotional well-being. Birth Berkeley Calif. 2008; 35:(3)179-187 https://doi.org/10.1111/j.1523-536X.2008.00238.x

Closing the gap in a generation: health equity through action on the social determinants of health: Commission on Social Determinants of Health final report.Geneva, Switzerland: World Health Organization; 2008

Bouncing back? - women's experiences of their own recovery after childbirth. 2012. https://bit.ly/35lxaWc (accessed 16 April 2020)

Yoshida Y, Sandall J. Occupational burnout and work factors in community and hospital mid-wives: A survey analysis. Midwifery. 2013; 29:(8)921-926 https://doi.org/10.1016/j.midw.2012.11.002

Improving care for new mothers with postnatal morbidity in Ireland

02 March 2022
Volume 30 · Issue 3

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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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