Women's successful transition to motherhood during the early postnatal period: A qualitative systematic review of postnatal and midwifery home care literature.

Walker, Sandra Y.; Rossi, Dolene; Sander, Teresa

doi:10.1016/j.midw.2019.102552

Cited by 39 publications

(53 citation statements)

References 58 publications

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“…Pascoe argues that cognitive evaluation involves comparison against an individually identified standard, in this case the mother’s subjective perception of the extent to which care received was proportionate to her needs. In line with the findings reported in a recent review ( Walker et al, 2019 ), the key aspects of mothers’ evaluations were timely availability of access to appropriate support when needed and the quality of the interactions with the health professionals providing care. In particular, mothers experienced these interactions as positive when the support received from a professional was closely attuned to their individual needs at that time, a process described by Smythe et al (2014) as “tactful practice.” Some mothers said that ideally they would like continuity of care during the postnatal period, to build a relationship.…”

Section: Discussionsupporting

confidence: 75%

“…This study provides evidence in support of the contention that high-quality, needs-led professional support in the postnatal period plays a key role in enabling first-time mothers to make a confident transition to parenthood by providing positive feedback and direct support to master skills such as breastfeeding ( Forster et al, 2008 ; Leahy-Warren, 2005 ; Walker et al, 2019 ). Trajectory 2 shows how high support matched to high need can enable mothers to overcome the challenges they face, while Trajectory 3 shows that a lack of support, or high quantity of support contacts experienced by mothers as low quality , can undermine their ability to develop their parental confidence.…”

Section: Discussionsupporting

confidence: 60%

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First-Time Mothers’ Expectations and Experiences of Postnatal Care in England

et al. 2020

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Postnatal care is the aspect of maternity care with which women in England are least satisfied. Little is known about first-time mothers’ expectations of postnatal care, or how these expectations relate to their experiences and appraisal of care. Thirty-two first-time mothers took part in a longitudinal qualitative descriptive study, based on two semi-structured interviews—the first in pregnancy, and the second 2 to 3 months after birth. Trajectory analysis was used to identify the thematic patterns in the relationships between postnatal care expectations, needs, experiences, and confidence. Five trajectories were identified, showing that mothers’ satisfaction with postnatal care and confidence were primarily influenced not by the extent to which their expectations were met but the varied extent to which their individual postnatal needs were met. Rapid and responsive assessment of needs both antenatally and postnatally, and appropriate adjustment of care, is key in supporting women effectively at this time.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionsupporting

confidence: 60%

First-Time Mothers’ Expectations and Experiences of Postnatal Care in England

et al. 2020

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“…Similar problems have been reported internationally and about postnatal care in the community [ [25] , [26] , [27] , [28] , [29] , [30] , [31] ]. Walker et al [ 32 ] argue from the results of their qualitative systematic review that the key to supporting a successful transition to motherhood is the ability of women and midwives to connect, and that this can best be achieved through postnatal midwifery home care. This study deepens understanding of the ways in which the social support aspects of postnatal care in any setting can be an opportunity to enhance first time mothers’ confidence and skills, or alternatively can undermine mothers’ ability to cope and thrive in the transition to parenthood.…”

Section: Discussionmentioning

confidence: 99%

A qualitative study of first time mothers’ experiences of postnatal social support from health professionals in England

et al. 2021

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Problem Many women experience the transition to motherhood as stressful and find it challenging to cope, contributing to poor emotional wellbeing. Background Postnatal social support from health professionals can support new mothers in coping with this transition, but their social support role during the postnatal period is poorly defined. Aim To explore how first time mothers in England experienced social support from health professionals involved in their postnatal care. Methods A qualitative descriptive study, theoretically informed by phenomenological social psychology, based on semi-structured, in-depth interviews with 32 mothers from diverse backgrounds. These were analysed using inductive thematic analysis, with themes subsequently mapped on to the four dimensional model of social support (emotional, appraisal, informational, practical). Findings There were nine themes connected to social support, with the strongest mapping to appraisal and informational support: for appraisal support, ‘Praise and validation’, ‘Criticism and undermining’, and ‘Made to feel powerless’; for informational support, ‘Is this normal?’, ‘Need for proactive information’, and ‘Confusion about postnatal care’; for emotional support, ‘Treated as an individual and heard’ and ‘Impersonal care and being ignored’; for practical support, ‘Enabling partners to provide practical support’. Conclusions Health professionals can play an important role postnatally in helping first time mothers to cope, develop confidence and to thrive, by taking every opportunity to give appropriate and personalised appraisal, informational and emotional social support alongside clinical care. Training and professional leadership may help to ensure that all health professionals are able and expected to offer the positive social support already offered by some.

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“…Our provided conceptual framework regarding postpartum care utilisation is supported by the qualitative systematic review by Walker et al . 25 They determined necessities for a successful transition to motherhood in the early postpartum period, and identified four themes: connection between women and midwives, identification of women’s individual needs, family and cultural influences, and education and support. Our framework builds on this review by focussing on the practical part of the care that is necessary for this transition, and by indicating that this care may be provided by others than midwives.…”

Section: Discussionmentioning

confidence: 99%

Insight into the process of postpartum care utilisation and in-home support among vulnerable women in the Netherlands: an in-depth qualitative exploration

et al. 2021

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ObjectiveTo gain insight into the process of postpartum care utilisation and in-home support among vulnerable women.Design, method, participants and settingA qualitative interview study was conducted among 23 pregnant and postpartum vulnerable women in the Netherlands, following a grounded theory approach. Women were determined as vulnerable by their healthcare providers. Theoretical sampling of participants was applied and was alternated by data analysis to include information-rich cases until saturation was achieved.ResultsA conceptual framework of postpartum care utilisation was generated consisting of three phases: pregnancy, early postpartum period and late postpartum period. Within these phases, information provision, parenting self-efficacy and social network were identified as overarching themes. Perceived inadequate information on content of postpartum care posed a major barrier to forming realistic expectations during pregnancy and hindered its utilisation. Low self-efficacy facilitated postpartum care utilisation. All women experienced increased self-efficacy during and after postpartum care. Support from a social network influenced expectations regarding the added value of postpartum care during pregnancy, and lowered actual utilisation during the postpartum period. The costs of postpartum care and the role of the maternity care assistant acted as general barriers or facilitators influencing the three overarching themes and therefore postpartum care utilisation indirectly.ConclusionsOur findings suggest that postpartum care utilisation among vulnerable women may be improved by considering the particular phase and relevant themes applying to individual women, and adapt care accordingly. We recommend to provide comprehensive, understandable information and to emphasise the gains of postpartum care in improving self-efficacy for vulnerable women. Moreover, involving a woman’s social network in postpartum care may add value to this care for this population.

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Women's successful transition to motherhood during the early postnatal period: A qualitative systematic review of postnatal and midwifery home care literature.

Cited by 39 publications

References 58 publications

First-Time Mothers’ Expectations and Experiences of Postnatal Care in England

First-Time Mothers’ Expectations and Experiences of Postnatal Care in England

A qualitative study of first time mothers’ experiences of postnatal social support from health professionals in England

Insight into the process of postpartum care utilisation and in-home support among vulnerable women in the Netherlands: an in-depth qualitative exploration

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