Postpartum Care Recommendations from Parents of Premature Infants Requiring Intensive Care.

Abstract

Objective: To describe postpartum care preferences and experiences among individuals who deliver a premature infant requiring neonatal intensive care.

Methods: In this qualitative description study, we recruited patients 2 to 8 weeks after delivery of a premature infant requiring neonatal intensive care to participate in semi-structured interviews. We asked participants to share their postpartum care experiences including their expectations and preferences regarding what is addressed during postpartum visits, their decision-making process in attending scheduled postpartum visits, and their suggestions for how to optimize postpartum care to serve their needs. We used thematic analysis to generate codes and identify themes.

Results: Of 26 participants, 8 (31%) had attended a postpartum visit, 4 (15%) had missed their appointment, and 14 (54%) had a visit scheduled to occur after the time of the study interview. We found that participants weigh the perceived benefits of attending a postpartum visit against barriers to care, such as insurance restrictions, competing responsibilities and priorities when deciding whether to attend their postpartum visit. At their postpartum visit, participants preferred when clinicians centered the visits around the participants' goals and tailored the encounter to their specific concerns. Lastly, participants recognize that screening for postpartum mood disorders is important; however, the current screening tools do not differentiate between mood disorders and expected responses to a stressful neonatal intensive care experience.

Conclusions for practice: Postpartum visits tailored to patient preferences for care in the early postpartum period are needed alongside system-level interventions to address barriers to accessing postpartum care for patients who deliver premature infants.