Maria Zadoroznyj1, Wendy E Brodribb2, Kate Young3, Sue Kruske4, Yvette D Miller5. 1. Institute for Social Science Research & School of Social Science, The University of Queensland, 4th floor, GPN3, St Lucia 4072, Qld, Australia. Electronic address: m.zadoroznyj@uq.edu.au. 2. Discipline of General Practice, School of Medicine, The University of Queensland, Royal Brisbane and Women's Hospital, Level 8, Health Sciences Building, Herston 4029, Qld, Australia. 3. Queensland Centre for Mothers & Babies, School of Psychology, The University of Queensland, Hood Street, St Lucia 4072, Qld, Australia. 4. School of Nursing and Midwifery, The University of Queensland, Level 2, Edith Cavell Building, UQ Herston Campus, Herston 4029, Qld, Australia. 5. Queensland Centre for Mothers & Babies, School of Psychology, The University of Queensland, Hood Street, St Lucia 4072, Qld, Australia; Public Health and Social Work, Queensland University of Technology, Victoria Park Road, Kelvin Grove 4059, Qld, Australia.
Abstract
BACKGROUND: Australian mothers consistently rate postnatal care as the poorest aspect of their maternity care, and researchers and policymakers have widely acknowledged the need for improvement in how postnatal care is provided. AIM: To identify and analyse mothers' comments about postnatal care in their free text responses to an open ended question in the Having a Baby in Queensland Survey, 2010, and reflect on their implications for midwifery practice and maternity service policies. METHODS: The survey assessed mothers' experiences of maternity care four months after birth. We analysed free-text data from an open-ended question inviting respondents to write 'anything else you would like to tell us'. Of the final survey sample (N=7193), 60% (N=4310) provided comments, 26% (N=1100) of which pertained to postnatal care. Analysis included the coding and enumeration of issues to identify the most common problems commented on by mothers. Comments were categorised according to whether they related to in-hospital or post-discharge care, and whether they were reported by women birthing in public or private birthing facilities. RESULTS: The analysis revealed important differences in maternal experiences according to birthing sector: mothers birthing in public facilities were more likely to raise concerns about the quality and/or duration of their in-hospital stay than those in private facilities. Conversely, mothers who gave birth in private facilities were more likely to raise concerns about inadequate post-discharge care. Regardless of birthing sector, however, a substantial proportion of all mothers spontaneously raised concerns about their experiences of inadequate and/or inconsistent breastfeeding support. CONCLUSION: Women who birth in private facilities were more likely to spontaneously report concerns about their level of post-discharge care than women from public facilities in Queensland, and publically provided community based care is not sufficient to meet women's needs. Inadequate or inconsistent professional breastfeeding support remains a major issue for early parenting women regardless of birthing sector.
BACKGROUND: Australian mothers consistently rate postnatal care as the poorest aspect of their maternity care, and researchers and policymakers have widely acknowledged the need for improvement in how postnatal care is provided. AIM: To identify and analyse mothers' comments about postnatal care in their free text responses to an open ended question in the Having a Baby in Queensland Survey, 2010, and reflect on their implications for midwifery practice and maternity service policies. METHODS: The survey assessed mothers' experiences of maternity care four months after birth. We analysed free-text data from an open-ended question inviting respondents to write 'anything else you would like to tell us'. Of the final survey sample (N=7193), 60% (N=4310) provided comments, 26% (N=1100) of which pertained to postnatal care. Analysis included the coding and enumeration of issues to identify the most common problems commented on by mothers. Comments were categorised according to whether they related to in-hospital or post-discharge care, and whether they were reported by women birthing in public or private birthing facilities. RESULTS: The analysis revealed important differences in maternal experiences according to birthing sector: mothers birthing in public facilities were more likely to raise concerns about the quality and/or duration of their in-hospital stay than those in private facilities. Conversely, mothers who gave birth in private facilities were more likely to raise concerns about inadequate post-discharge care. Regardless of birthing sector, however, a substantial proportion of all mothers spontaneously raised concerns about their experiences of inadequate and/or inconsistent breastfeeding support. CONCLUSION:Women who birth in private facilities were more likely to spontaneously report concerns about their level of post-discharge care than women from public facilities in Queensland, and publically provided community based care is not sufficient to meet women's needs. Inadequate or inconsistent professional breastfeeding support remains a major issue for early parenting women regardless of birthing sector.