Postnatal debriefing practices and patient experiences following unexpected intrapartum interventions: A prospective...

To examine current practices in obstetric-led postnatal debriefing after unexpected intrapartum interventions, including the frequency, timing, and content of postnatal discussions, and to explore women's perspectives on the current standard of care.

A prospective survey was conducted at a Dublin maternity hospital between February and April 2024. Women who experienced unexpected intrapartum interventions, including emergency cesarean section, operative vaginal delivery, postpartum hemorrhage, obstetric anal sphincter injury, shoulder dystocia, or manual removal of placenta, were recruited prior to hospital discharge. Patient-reported experiences were collected via questionnaire and linked to clinician-documented debriefing data. Findings were compared with a similar cohort studied in 2019.

Of 366 women identified in 2024, 290 (79.2%) were included in the analysis. A total of 72.1% of these women had a documented debrief compared to 83.8% in 2019. Debriefing most commonly occurred on postnatal day 1 for both cohorts. Women reported high levels of understanding of their intervention (83.8% in 2024 vs. 89.8% in 2019), opportunity to ask questions (90.7% in 2024 vs. 88.6% in 2019), and satisfaction with explanations provided (91.7% in 2024). Provision of written information leaflets declined between cohorts, and counseling regarding future pregnancy implications, including trial of labor after cesarean, inter-pregnancy interval, and recurrence risks, was inconsistent.

Obstetric-led postnatal debriefing is common and valued following unexpected intrapartum interventions, when conducted early and by the clinician involved in the birth. While patient satisfaction is high, opportunities remain to improve documentation, patient education and future pregnancy planning.