Observational Video Study of Maternal Sleep During the 24 Hours Before Hospital Discharge After Childbirth

To quantify maternal sleep during the 24 hours before hospital discharge after childbirth and to identify and describe the antecedents and contexts of waking.

Secondary analysis of data from an observational video study.

Academic medical center in the southeastern United States.

Fourteen women who gave birth.

We conducted a secondary analysis of video and audio recordings of inpatient postpartum care from a mixed-methods study conducted in 2020 by the Postnatal Patient Safety Learning Lab. We used a behavioral taxonomy to code 316.5 hours of sleep in 5-minute increments and waking context in the 24 hours before hospital discharge after childbirth. We developed case descriptions and visual case summaries to identify and describe the antecedents and contexts of waking.

We found a median of 2.8 hours of total sleep (range, 50 minutes to 5.6 hours) per participant during the 24-hour observation period. Antecedents to waking included sounds from the newborn, companion, health care team member(s), or environment. Difficulty getting to sleep due to physical and emotional discomfort was common in the case studies.

Total sleep and the antecedents and contexts of waking varied among participants. The low amount and fragmented nature of maternal sleep before hospital discharge highlights multiple opportunities to protect and promote sleep during inpatient care after childbirth. The hours leading up to hospital discharge are important for newborn feeding, recovery, and education about health warning signs.