Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Birth. 2024 Dec;51(4):843-854. doi: 10.1111/birt.12860. Epub 2024 Aug 30.
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.
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.
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.
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.
三分之二的与妊娠相关的死亡发生在分娩后 1 天至 1 年内，并且分娩后经常出现医疗并发症。产后健康问题通常很紧急，需要及时的医疗护理，这可能导致对急性护理的依赖。改善产后健康的一种方法是调查分娩父母在分娩后几个月内使用急性护理的情况，这就是我们在这项研究中所做的。
这项混合方法研究包括问卷调查、半结构化访谈和对 18 名在美国东南部分娩后 90 天内使用急性护理的英语使用者的图表回顾。访谈是远程进行的，记录并由专业人员转录。定性数据采用归纳法进行编码，以针对产后急性护理使用的促成因素和障碍迭代开发类别和主题。
分娩父母在复杂的决策过程中决定在何处以及何时寻求产后急性护理，以应对他们的紧急健康问题。许多人描述了对产后健康的恐惧和不确定性。大多数参与者在使用急性护理之前联系了医疗保健从业者，遵循他们的指导，并在急性护理就诊时得到治疗或其他安抚。
这些发现表明，有机会加强医疗保健系统，包括更好地为个人准备产后阶段，并构建护理模式以适应分娩父母及其支持系统。这项研究的结果可以为加强医疗保健的多层次战略提供信息，以确保分娩父母产后安全和健康。
