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Birthing parent postpartum acute care use: Multilevel opportunities for strengthening healthcare
Clara E Busse1,2, Alison M Stuebe1,3, Katherine Tumlinson1,2
1Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Insights
Postpartum acute care use involves complex decisions influenced by fear and uncertainty. Healthcare systems can improve postpartum safety by better preparing individuals and structuring care to include support systems.
Area of Science:
- Perinatal Health
- Maternal Healthcare
- Postpartum Outcomes
Background:
- Two-thirds of pregnancy-related deaths occur postpartum.
- Postpartum medical complications frequently require urgent care.
- Understanding acute care utilization is key to improving postpartum health.
Purpose of the Study:
- To investigate birthing parents' experiences with acute care use in the postpartum period.
- To identify factors influencing decisions regarding postpartum acute care.
- To explore barriers and facilitators to accessing timely postpartum medical attention.
Main Methods:
- Mixed-methods study involving 18 participants in the southeastern US.
- Data collection via questionnaires, semi-structured interviews, and chart reviews.
- Qualitative data analyzed using inductive coding to identify themes.
Main Results:
- Birthing parents navigate complex decision-making for postpartum acute care.
- Fear and uncertainty surrounding postpartum health were common.
- Most participants consulted healthcare providers before seeking acute care and received reassurance.
Conclusions:
- Multilevel interventions can strengthen postpartum healthcare systems.
- Improved preparation for the postpartum period is needed.
- Care structures should accommodate birthing parents and their support networks for enhanced safety and well-being.
Background:
Two-thirds of pregnancy-related deaths occur from 1 day to 1 year after birth, and medical complications frequently occur after birth. Postpartum health concerns are often urgent, requiring timely medical care, which may contribute to a reliance on acute care. One approach to improving postpartum health is to investigate birthing parents' accounts of acute care use in the months after birth, which is what we did in this study.
Methods:
This mixed-methods study included questionnaire responses, semi-structured interviews, and chart review of 18 English-speaking individuals who used acute care in the 90 days after birth in the southeastern United States. Interviews were conducted remotely, recorded, and professionally transcribed. Qualitative data were inductively coded to iteratively develop categories and themes with respect to contributors and barriers to postpartum acute care use.
Results:
Birthing parents engaged in complex decision-making processes to decide where and when to seek postpartum acute care in response to their urgent health concerns. Many described fear and uncertainty about their postpartum health. Most participants contacted a healthcare practitioner before using acute care, followed their guidance, and were treated or otherwise reassured at the acute care visit.
Discussion:
These findings suggest multilevel opportunities for strengthening healthcare systems, including better-preparing individuals for the postpartum period and structuring care to accommodate birthing parents and include their support systems. The insights from this study can inform multilevel strategies for strengthening healthcare so that birthing parents are safe and well postpartum.
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