Assessing mothers' concerns in the postpartum period: methodological issues

This paper reports a study evaluating the sensitivity of a semi-structured interview schedule and card sort methods in assessing postpartum concerns of women.

Several methods have been used to assess postpartum maternal concerns and the process of becoming a mother, but few studies have evaluated the methods with respect to their sensitivity for obtaining information.

A cohort of mothers was followed-up at one (n = 110) and 6 weeks (n = 83) after childbirth in Dar es Salaam, Tanzania. Women with a minimum of 7 years of primary education were interviewed and they also sorted cards. Those with less fewer than 7 years of primary education were interviewed only. The methods were used in alternate order to assess method interaction.

In the interviews at 1 week, mothers more often expressed worry and interest related to the baby or themselves when they had sorted cards first. The extent to which women expressed worry and interest about specific baby- and mother-related topics was generally higher for women who had sorted cards before the interview at both 1 and 6 weeks. Independent of whether they were interviewed only, interviewed after sorting cards or before, mothers more often expressed a higher degree of interest than of worry about the baby and self at both 1 and 6 weeks. The order of the data collection methods did not influence the way women sorted cards as being worries and interests.

Compared to interview using a semi-structured interview schedule, our findings suggest that the card sort is more sensitive in obtaining information about women's concerns. Although the interview method has the advantage of reaching less educated people, the card sort is a technique that is associated with fewer barriers and is a more participatory method for those who can use it.