Cultural differences in postnatal quality of life among German-speaking women – a prospective survey in two countries

Abstract

BackgroundAssessment of quality of life after childbirth is an important health-outcome measurement for new mothers and is of special interest in midwifery. The Mother-Generated Index (MGI) is a validated instrument to assess postnatal quality of life. The tool has not been applied for making a cross-cultural comparison before. This study investigated (a) responses to the MGI in German-speaking women in Germany and Switzerland; and (b) associations between MGI scores on the one hand and maternity and midwifery care on the other.MethodsA two-stage survey was conducted in two rural hospitals 10 km apart, on opposite sides of the German-Swiss border. The questionnaires included the MGI and questions on socio-demographics, physical and mental health and maternity care, and were distributed during the first days after birth and six weeks postpartum. Parametric and non-parametric tests were computed with the statistical programme SPSS.ResultsA total of 129 questionnaires were returned an average of three days after birth and 83 in the follow-up after seven weeks. There were no statistically significant differences in the MGI scores between the German and the Swiss women (p = 0.22). Significantly more favourable MGI scores were found associated with more adequate information during pregnancy (p = 0.02), a more satisfactory birth experience (p < 0.01), epidural anaesthesia (p < 0.01), more information (p = 0.01) and better support (p = 0.02) during the time in hospital and less disturbed sleep (p < 0.01). Significantly lower MGI scores were associated with the presence of a private doctor during birth (p = 0.01) and with exclusive breastfeeding during the first postnatal days (p = 0.04).ConclusionThe MGI scores of these German-speaking women were higher than those in other studies reported previously. Thus the tool may be able to detect differences in postnatal quality of life among women with substantially divergent cultural backgrounds. Shortcomings in maternity and midwifery care were detected, as for example the inadequate provision of information during pregnancy, a lack of individualised postpartum care during the hospital stay and insufficient support for exclusively breastfeeding mothers. The MGI is an appropriate instrument for maternity care outcome measurement in cross-cultural comparison research.

Does Breastfeeding or Not Affect a Better Maternal Quality of Life? : Literature Review

“…The delivery method was divided into vaginal birth and caesarean sections. There was no significant correlation between the delivery method and the quality of life of the mother (Grylka-Baeschlin, et al, 2014;Rezaei et al, 2016). It was due to differences concept in QoL instrument (Grylka-Baeschlin, van Teijlingen and Gross, 2014).…”

“…The analysis of correlation between breastfeeding practices and quality of life for mothers was obtained from nine literatures that were reviewed by researchers. Six literatures stated that breastfeeding practices are significantly related to the maternal quality of life (Aminova, et al, 2018;Chen et al, 2007;Grylka-Baeschlin et al, 2014;Kamalifard et al, 2018;Mortazavi, Mousavi, & Chaman, 2014;Zubaran & Foresti, 2011), while three other literatures stated that breastfeeding practices have no significant correlation to the maternal; quality of life (Rezaei et al, 2016;Triviño-Juárez et al, 2016;Martínez-Galiano et al, 2019).…”

Postnatal quality of life — A content analysis of qualitative results to the Mother-Generated Index

“…This paper presents the qualitative content analysis of the areas of life which were mentioned by German and Swiss mothers as being affected by having a baby by completing the MGI in a prospective, cross-cultural, longitudinal survey. Translation and validation of the MGI 23 and its use for cross-cultural comparison 11 have been published elsewhere.…”

“…However, XXX et al 11 observed higher postnatal QoL at a median of three days after birth compared to six and a half weeks postpartum. This might be due to the closeness of the assessment to the birth and the subsequent overwhelming feelings in the first days after birth.…”

“…[5][6][7] A systematic review identified 16 salutogenically-focused outcome categories including maternal satisfaction and breastfeeding as the most common ones as well as wellbeing and QoL. 6 However, only a few studies considered QoL as an outcome of childbirth and maternity care [8][9][10][11] although knowledge about factors which are associated with QoL and wellbeing of women after childbirth are essential for optimising maternity care. Emmanuel and Sun 12 observed changes in health-related QoL during the perinatal period with improvement after birth compared to pregnancy and further amelioration during the first weeks after birth.…”