Swedish womeńs suggestions for health care improvements during the first year after birth: A qualitative study of free-text answers given within a randomized controlled trial

Abstract

Objective

The time after birth is a crucial period for women, involving both physical recovery and emotional challenges. Previous research indicates that postnatal care is a neglected area of maternity care. The aim of this study was to explore women’s suggestions for health care improvements, based on their experiences during the first year after birth.

Methods

This study is based on data from a one-year follow-up questionnaire collected prospectively after randomization in a multicentre trial in Sweden. The questionnaire included an open-ended question: “Based on your experience during the first year after giving birth, do you have any suggestions of change in health care, which could have contributed to better health for you?” Thematic analysis inspired by Braun and Clark was conducted to analyse the answers.

Results

A total of 2516 women completed the questionnaire, with 719 (29 %) providing free text responses to the open-ended question. Women described the transition to motherhood as challenging and lonely, and offered numerous suggestions to improve care after birth. The results showed four themes: Provision of compassionate, tailored and respectful care after birth, Evidence-based breastfeeding support, Guidance regarding bodily changes and A need for extended follow-up.

Conclusion

Women suggested improvements and pointed out the importance of continuity of care after birth, a comprehensive and individualized postnatal care, accessible and extended throughout the first year. Future research must focus on how to establish a postnatal care program that extends further than the first six weeks, based on women’s experiences and suggestions to ensure an optimal start to motherhood.