Identifying maternal needs following childbirth: comparison between pregnant women and recent mothers

Abstract

Background The postnatal period is associated with new needs for mothers. Four categories of needs were highlighted in our previous study: for information, for psychological support, for the sharing of experiences and for practical and material support. The aims of this study were as follows: (1) to validate these 4 needs by comparing recent mothers’ needs with the needs of pregnant women and (2) to compare these needs between primiparous and multiparous women. Methods The 4 needs previously identified were investigated by online self-report questionnaires completed by women in their last trimester of pregnancy and by mothers who had a child between 0 and 6 months of age. Results The 4 needs were largely present during the postpartum period. The need for information seemed to be more present during pregnancy (92.4%) than during the postpartum period (84.6%, p = 0.03), but women used the Internet significantly more often to search for information after childbirth (54.8%) than during pregnancy (41.2%, p < 0.0001). The needs for psychological support and to share experiences seemed to be closely linked. Even if the global satisfaction with psychological support was fairly high, it weakened after childbirth (p < 0.05). Feelings of loneliness (p < 0.0001) and depression scores (p = 0.01) were also higher during the postpartum period than during pregnancy. Not surprisingly, primiparous women felt less reassured in their roles as mothers and more stressed during the postpartum period than multiparous women (p < 0.0001). Finally, the need for practical support was also more pronounced during the postpartum period than during pregnancy (p = 0.01). Conclusion All mothers seem to meet the 4 identified needs during the postpartum period but at different levels of intensity. Trying to meet these needs could offer an opportunity to improve mothers’ quality of life.

Women's views on postnatal care from a midwife who has not provided their pregnancy and birth care: Implications for midwifery relationships

“…A number of studies and guidelines have attempted to address the aims of postnatal care and also the role of the midwife in postnatal care (NICE, 2021;NZCOM, 2015;Schmied et al, 2008). There is some suggestion that the role of the postnatal midwife is under-researched and too focused on physical factors within a biomedical model rather than the provision of psychological, emotional, and social support for new mothers (Waldenstrom et al, 2006) though it is generally acknowledged in the literature that the midwife's role in the postnatal period is to be available, supportive (both emotionally and practically), competent and knowledgeable (Hunter, 2004;McLeish et al, 2020McLeish et al, , 2021Persson & Dykes, 2002;Slomian et al, 2021). (NZCOM, 2015, p.2).…”

“…Postnatally, it would seem that the relationship between midwife and woman can be constructed with many supportive elements. The importance of nonjudgemental, reassuring guidance, positive affirmation and information sharing during the postnatal period is reflected in literature (McLeish et al, 2020;Slomian et al, 2021;Walker et al, 2019). Trust has been shown to be a central element within the midwife woman relationship and women are more likely to want midwives to guide their care if they know and trust them (Edwards, 2010;Huber & Sandall, 2009;Lewis et al, 2017;Wilkins, 2010).…”

“…None the less, many recent studies acknowledge the significant value that first time mothers from a range of demographics attach to effective postnatal social support from health professionals (McLeish et al, 2021;Slomian et al, 2021;Walker et al, 2019) though many studies report significant barriers and obstacles to midwives providing constructive and good quality postnatal care in hospitals (Beake et al, 2005;Bick et al, 2011;Fenwick et al, 2010;McLachlan et al, 2008, Schmied et al, 2008.…”

“…Postnatal care provision is often criticised for being inflexible, too standardised, and not tailored to the personal needs of women (Delaney et al, 2018;Lambermon et al, 2021). In a rapidly developing technological world, women seek and request postnatal digital information and welcome phone consultations in addition to home visits from midwives (Guerra-Reyes et al, 2017;Kurth et al, 2016;Letourneau et al, 2007;Sawyer et al, 2019;Slomian et al, 2021). They are keen to receive peer telephone support and use smart phone or computer apps to assist with breastfeeding (Danbjorg et al, 2014a;Forster et al, 2014Forster et al, , 2019Shorey et al, 2018) Finlayson et al, (2020 conducted a large qualitative review to examine what matters to women in the postnatal period.…”

“…Within the current climate of more complex postnatal needs as discussed earlier in this thesis, it is acknowledged and recommended that many postnatal women require care incorporating a multi-team approach to create a safety net around them Finlayson et al, 2020;Knight et al, 2021;Slomian et al, 2021, Walker et al, 2019. The emotional well-being of postnatal women is seen as a critical part of their care and emotional support can be facilitated by strengthening the woman's own ability to mobilise social support, develop selfefficacy and positive coping strategies (Fahey and Shenassa, 2013).…”