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Length of Postpartum Hospital Stays During COVID-19: Findings From a Convergent Parallel Mixed-Methods Study
Rebecca H Correia1, Devon Greyson2, Andrea Carruthers3
1Health Research Methodology Graduate Program, McMaster University, Hamilton, ON.
Insights
Postpartum hospital stays shortened during COVID-19, impacting patient experiences and highlighting unmet postpartum care needs. This study analyzed hospital stay length and patient experiences during the pandemic.
Area of Science:
- Maternal Health
- Public Health
- Health Services Research
Background:
- The COVID-19 pandemic significantly altered healthcare delivery, including maternity care.
- Understanding the impact of the pandemic on postpartum hospitalization is crucial for maternal health outcomes.
Purpose of the Study:
- To examine the length of postpartum hospitalization for live births during the COVID-19 pandemic.
- To explore how pandemic circumstances influenced postpartum hospital experiences.
Main Methods:
- A cross-provincial, convergent parallel mixed-methods study in Ontario and British Columbia, Canada.
- Quantitative analysis of health administrative data (2019, 2021, 2022) linked at ICES.
- Qualitative semi-structured interviews with birthing persons (BPs) to understand postpartum hospitalization experiences.
Main Results:
- Postpartum hospital stays significantly decreased during the COVID-19 pandemic compared to 2019.
- Factors associated with shortened stays included giving birth during COVID-19, social deprivation, midwifery care, multiparity, and lower newborn birth weight.
- Patient experiences were influenced by COVID-19 risk perception, clinical care, hospital services, visitor policies, and stay duration.
Conclusions:
- Postpartum hospital stays were shorter during the COVID-19 pandemic, with qualitative data revealing unmet postpartum service needs.
- Integrated administrative and interview data provided a comprehensive understanding of observed differences in postpartum care.
- Further research is needed to investigate the effects of shortened postpartum stays on health service outcomes and personal experiences.
Objectives:
We examined the length of postpartum hospitalization for live births during the COVID-19 pandemic and explored how pandemic circumstances influenced postpartum hospital experiences.
Methods:
We conducted a cross-provincial, convergent parallel mixed-methods study in Ontario (ON) and British Columbia (BC), Canada. We included birthing persons (BPs) with an in-hospital birth in ON from 1 January to 31 March 2019, 2021, and 2022 (quantitative), and BPs (≥18 years) in ON or BC from 1 May 2020 to 1 December 2021 (qualitative). We linked multiple health administrative datasets at ICES and developed multivariable linear regression models to examine the length of hospital stay (quantitative). We conducted semi-structured interviews using qualitative descriptive to understand experiences of postpartum hospitalization (qualitative). Data integration occurred during design and interpretation.
Results:
Relative to 2019, postpartum hospital stays decreased significantly by 3.29 hours (95% CI -3.58 to -2.99; 9.2% reduction) in 2021 and 3.89 hours (95% CI -4.17 to -3.60; 9.0% reduction) in 2022. After adjustment, factors associated with shortened stays included: giving birth during COVID-19, social deprivation (more ethnocultural diversity), midwifery care, multiparity, and lower newborn birth weight. Postpartum hospital experiences were impacted by risk perception of COVID-19 infection, clinical care and hospital services/amenities, visitor policies, and duration of stay.
Conclusions:
Length of postpartum hospital stays decreased during COVID-19, and qualitative findings described unmet needs for postpartum services. The integration of large administrative and interview data expanded our understanding of observed differences. Future research should investigate the impacts of shortened stays on health service outcomes and personal experiences.
