Birthing parent postpartum acute care use: Multilevel opportunities for strengthening healthcare

IF 2.8 3区 医学 Q1 NURSING
Clara E. Busse PhD, MPH, Alison M. Stuebe MD, MSc, Katherine Tumlinson PhD, Christine Tucker PhD, Catherine J. Vladutiu PhD, Brian Pence PhD, Kristin P. Tully PhD
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Abstract

Background

Two-thirds of pregnancy-related deaths occur from 1 day to 1 year after birth, and medical complications frequently occur after birth. Postpartum health concerns are often urgent, requiring timely medical care, which may contribute to a reliance on acute care. One approach to improving postpartum health is to investigate birthing parents' accounts of acute care use in the months after birth, which is what we did in this study.

Methods

This mixed-methods study included questionnaire responses, semi-structured interviews, and chart review of 18 English-speaking individuals who used acute care in the 90 days after birth in the southeastern United States. Interviews were conducted remotely, recorded, and professionally transcribed. Qualitative data were inductively coded to iteratively develop categories and themes with respect to contributors and barriers to postpartum acute care use.

Results

Birthing parents engaged in complex decision-making processes to decide where and when to seek postpartum acute care in response to their urgent health concerns. Many described fear and uncertainty about their postpartum health. Most participants contacted a healthcare practitioner before using acute care, followed their guidance, and were treated or otherwise reassured at the acute care visit.

Discussion

These findings suggest multilevel opportunities for strengthening healthcare systems, including better-preparing individuals for the postpartum period and structuring care to accommodate birthing parents and include their support systems. The insights from this study can inform multilevel strategies for strengthening healthcare so that birthing parents are safe and well postpartum.

分娩父母产后急性护理的使用:加强医疗保健的多层次机遇。
背景:四分之三与妊娠有关的死亡发生在产后 1 天到 1 年之间,产后经常出现医疗并发症。产后健康问题往往很紧急,需要及时的医疗护理,这可能会导致对急症护理的依赖。改善产后健康的一种方法是调查分娩父母在产后数月内使用急症护理的情况,这也是我们在本研究中采用的方法:这项混合方法研究包括对美国东南部产后 90 天内使用急症护理的 18 位讲英语的人进行问卷调查、半结构化访谈和病历审查。访谈以远程方式进行,并进行录音和专业转录。我们对定性数据进行了归纳编码,从而就产后使用急症护理的促成因素和障碍反复发展出类别和主题:分娩父母在决定何时何地寻求产后急症护理以应对紧急健康问题时,都经历了复杂的决策过程。许多人描述了对产后健康的恐惧和不确定性。大多数参与者在使用急症护理前联系了医护人员,听从了他们的指导,并在急症护理就诊时得到了治疗或其他安抚:讨论:这些发现为加强医疗保健系统提供了多层次的机会,包括让个人为产后做好更充分的准备,调整护理结构以适应分娩父母的需要并纳入他们的支持系统。本研究的见解可为加强医疗保健的多层次战略提供参考,从而使分娩父母在产后获得安全和健康。
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来源期刊
Birth-Issues in Perinatal Care
Birth-Issues in Perinatal Care 医学-妇产科学
CiteScore
4.10
自引率
4.00%
发文量
90
审稿时长
>12 weeks
期刊介绍: Birth: Issues in Perinatal Care is a multidisciplinary, refereed journal devoted to issues and practices in the care of childbearing women, infants, and families. It is written by and for professionals in maternal and neonatal health, nurses, midwives, physicians, public health workers, doulas, social scientists, childbirth educators, lactation counselors, epidemiologists, and other health caregivers and policymakers in perinatal care.
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