Maternal health education and social support needs across the perinatal continuum of care: a thematic analysis of interviews with postpartum women in Punjab, India.

Abstract

Background: Perinatal social support and maternal education throughout the antenatal, childbirth, and postpartum phases contribute to the optimization of health and well-being of mothers and infants. Understanding deficits among support and educational resources can contribute to improved public health decision-making and maternal and child healthcare and wellbeing. This study aimed to explore health and social experiences and resources to characterize and unmet needs across the perinatal period.

Methods: We conducted a qualitative study among 20 primiparous postpartum women from Punjab state, North India. Potential participants were identified from antenatal care registers maintained at healthcare sub-centers and were interviewed at their homes. Data were analyzed thematically, examining social support resources and needs across perinatal phases by social support domain: emotional, tangible, and informational.

Results: Study participants received the most social and educational support antenatally. We identified considerably low knowledge surrounding childbirth and low maternal knowledge and social support around postpartum care and practices. Notable issues reported involved lack of consent, and satisfaction and comfort with childbirth care. Participant narratives highlighted the crucial role of both formal and informal support structures, with a heavy reliance on advice from community health workers (ASHAs), midwives, and doctors. Unmet needs were identified in areas such as post-cesarean section diet and care, institutional childbirth, and ASHA support, along with discrepancies between the advice given and evidence-based practices. While many participants' support needs were met by their networks, these gaps highlight critical areas for systems improvement.

Conclusion: This study-identified gaps in maternal knowledge and support, particularly in the post-cesarean and institutional childbirth contexts, are underexplored in existing research. Findings suggest critical areas for improvement in maternal healthcare support, particularly regarding the alignment of advice with evidence-based practices. Programs should focus on educating women about the institutional childbirth process and providing better postpartum care education, especially regarding post-cesarean care and infant care. Strengthening the role of community health workers (ASHAs) with evidence-based training can improve support. Additionally, programs should enhance the integration of both formal (doctors, midwives) and informal support networks to create a more comprehensive care system.

Trial registration: This research is part of the formative phase of a larger intervention trial. Trial was prospectively registered with Clinical trial registry of India. (CTRI/2020/12/029800 [Registered on: 15/12/2020].