Evaluation of satisfaction on additional postpartum care - a comparative, multicentre study.

BACKGROUND

A growing body of knowledge is questioning the timing of postpartum care (PPC) and suggesting a structural change. The primary aim was to evaluate individuals' satisfaction with additional PPC, and the secondary aim was to identify different needs postpartum.

METHODS

This comparative study was conducted in six maternity clinics in Gothenburg, Sweden 2019-2020. A total of 1159 eligible individuals were enrolled. An intervention model of care was evaluated, where the intervention group received two postpartum care compared to standard care, one visit (seven weeks postpartum) to their midwives. The participants answered questionnaires in connection to all postpartum care visits and at one-year postpartum a follow-up questionnaire was sent out.

RESULTS

The data from a total of 958 of 1159 participants (82.7%) were analysed: 447 of 554 (80.7%) in the intervention group vs 511 of 605 (84.4%) in the standard group. The participants in the intervention group reported satisfaction with the early, additional visit 413/444 (93%); where primiparous individuals reported a higher appreciation compared to parous individuals; 223/233 (95.7%) vs 190/211 (90.0%), P = 0.051. The three-weeks postpartum visit was perceived as timely, 434/441 (98.4%). Participants attending the clinic situated in a low socioeconomic status area were less likely to report a preference for additional visits. Nearly half of the participants in the standard group 201/466 (43%) expressed a preference towards an additional and early visit and this was more common among primiparous, 127/254 (50%) vs parous 74/212 (34.9%) P = 0.001. Those in the standard group who expressed a need for earlier support reported a wish for discussing abdominal/vaginal problems and experience of giving birth. Primiparous 73/127 (57.7%) were more likely than parous individuals 28/74 (37.8%) P = 0.011 to express a need for additional support with breastfeeding.

CONCLUSIONS

The results demonstrate an increased need for early and additional visits among primiparous, and important topics were abdominal/vaginal problems, experience of giving birth and breastfeeding. Information for individuals in low socioeconomic status areas needs to be expanded.