Advertisement

The maternal health-related issues that matter most to women in Ireland as they transition to motherhood - A qualitative study

Published:February 10, 2021DOI:https://doi.org/10.1016/j.wombi.2021.01.013

      Abstract

      Background

      Many studies on women’s maternity care experiences reveal recurring issues that are poor or less than optimal. Women’s opinions on the maternal health-related issues that matter most to them are essential if care and services are to be improved.

      Aims

      To identify the maternal health-related issues that matter most to women in Ireland, based on their own experiences of maternity care, services and motherhood.

      Methods

      A qualitative exploratory study with 24 women. Following university ethical approval, audio-recorded one-to-one telephone interviews were conducted and thematically analysed.

      Findings

      We identified two themes, each with four subthemes, connected to a central concept of the invisible woman. Pendulum of care, and subthemes Inconsistent services, All about the baby, Induced anxiety and Information seesaw, illustrated the extremes of care and services that women experienced. Magnitude of motherhood, and subthemes Weight of responsibility, Real-time reassurance, Change of identity and Growth into advocacy, depicted the intensity of their new role while transitioning to motherhood.

      Discussion

      Findings articulate the issues that mattered most to women in Ireland as they transitioned to motherhood. Some women identified specific research topics/areas, but all of the issues identified can be translated into researchable topics that seek to improve local care and service provision.

      Conclusion

      Given the recurring nature of women’s less than satisfactory experiences of aspects of maternity care in many countries, it is likely that conducting research on issues that matters most to women will have the greatest impact on their health, wellbeing and lives as they transition to motherhood.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Women and Birth
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Jenkins M.G.
        • Ford J.B.
        • Morris J.M.
        • Roberts C.L.
        Women’s expectations and experiences of maternity care in NSW – what women highlight as most important.
        Women Birth. 2014; 27: 214-219https://doi.org/10.1016/j.wombi.2014.03.002
        • Larkin P.
        • Begley C.M.
        • Devane D.
        ‘Not enough people to look after you’: an exploration of women's experiences of childbirth in the Republic of Ireland.
        Midwifery. 2012; 28: 98-105https://doi.org/10.1016/j.midw.2010.11.007
        • Barimani M.
        • Oxelmark L.
        • Johansson S.-E.
        • Hylander I.
        Support and continuity during the first 2 weeks postpartum.
        Scand. J. Caring Sci. 2015; 29: 409-417https://doi.org/10.1111/scs.12144
        • Woodward B.M.
        • Zadoroznyj M.
        • Benoit C.
        Beyond birth: women’s concerns about post-birth care in an Australian urban community.
        Women Birth. 2016; 29: 153-159https://doi.org/10.1016/j.wombi.2015.09.006
        • Devane D.
        • Barrett N.
        • Gallen A.
        • O’Reilly M.F.
        • Nadin M.
        • Conway G.
        • Biesty L.
        • Smith V.
        Identifying and prioritising midwifery care process metrics and indicators: a Delphi survey and stakeholder consensus process.
        BMC Pregnancy Childbirth. 2019; 19: 198https://doi.org/10.1186/s12884-019-2346-z
        • Gagnon A.J.
        • DeBruyn R.
        • Essen B.
        • Gissler M.
        • Heaman M.
        • Jeambey Z.
        • Korfker D.
        • McCourt C.
        • Roth C.
        • Zeitlin J.
        • Small R.
        Development of the Migrant Friendly Maternity Care Questionnaire (MFMCQ) for migrants to Western societies: an international Delphi consensus process.
        BMC Pregnancy Childbirth. 2014; 14: 200https://doi.org/10.1186/1471-2393-14-200
        • Nieuwenhuijze M.J.
        • Korstjens I.
        • de Jonge A.
        • de Vries R.
        • Lagro-Janssen A.
        On speaking terms: a Delphi study on shared decision-making in maternity care.
        BMC Pregnancy Childbirth. 2014; 14: 223https://doi.org/10.1186/1471-2393-14-223
        • Devane D.
        • Begley C.M.
        • Clarke M.
        • Horey D.
        • OBoyle C.
        Evaluating maternity care: a core set of outcome measures.
        Birth. 2007; 34: 164-172https://doi.org/10.1111/j.1523-536X.2006.00145.x
        • Kennedy H.P.
        • Cheyney M.
        • Dahlen H.G.
        • Downe S.
        • Foureur M.J.
        • Homer C.S.E.
        • Jefford E.
        • McFadden A.
        • Michel-Schuldt M.
        • Sandall J.
        • Soltani H.
        • Speciale A.M.
        • Sevens J.
        • Vedam S.
        • Renfrew M.J.
        Asking different questions: a call to action for research to improve the quality of care for every woman, every child.
        Women Birth. 2018; 31: 242-243https://doi.org/10.1016/j.wombi.2018.06.011
        • UN/WHO
        The global strategy for women’s, children's and adolescents health (2016-2030).
        Survive. Thrive. Transform. 2016; (Available at:)
        • Kennedy H.P.
        • Yoshida S.
        • Costello A.
        • Declercq E.
        • Dias M.A.
        • Duff E.
        • Gherissi A.T.F.
        • Kaufman K.
        • McConville F.
        • McFadden A.
        • Michel-Schuldt M.
        • Moyo N.T.
        • Schuiling K.
        • Speciale A.M.
        • Renfrew M.J.
        Asking different questions: research priorities to improve the quality of care for every woman, every child.
        Lancet Glob. Health. 2016; 4: e777-e779https://doi.org/10.1016/S2214-109X(16)30183-8
        • Health Research Board (HRB)
        Research. Evidence. Action. HRB Strategy 2020.
        (Available at:) HRB, Dublin2016
        • Department of Health (DoH) Ireland
        Creating A Better Future Together National Maternity Strategy 2016-2026.
        (Available at:) Department of Health, Dublin2016
        • Health Service Executive (HSE)
        National Women and Infants Health Programme. National Maternity Strategy Implementation Plan.
        (Available at:) HSE, Dublin2018
        • Hesson A.
        • Fowler C.
        • Rossiter C.
        • Schmied V.
        ‘Lost and confused’: parent representative groups’ perspectives on child and family health services in Australia.
        Aust. J. Prim. Health. 2017; 23: 560-566https://doi.org/10.1071/PY17072
        • Schmied V.
        • Cooke M.
        • Gutwein R.
        • Steinlein E.
        • Homer C.
        Time to listen: strategies to improve hospital-based postnatal care.
        Women Birth. 2008; 21: 99-105https://doi.org/10.1016/j.wombi.2008.04.002
        • Martin A.
        • Horowitz C.
        • Balbierz A.
        • Howell E.A.
        Views of women and clinicians on postpartum preparation and recovery.
        Matern. Child Health J. 2014; 18: 707-713https://doi.org/10.1007/s10995-013-1297-7
        • Bick D.
        • Duff E.
        • Shakespeare J.
        Better births - but why not better postnatal care?.
        Midwifery. 2020; 80 (PMID 102574)https://doi.org/10.1016/j.midw.2019.102574
        • Anon
        Postnatal care: the Cinderella of the service?.
        Midwife Health Visit. Community Nurs. 1978; 14: 389
        • Bowen G.
        Naturalistic inquiry and the saturation concept: a research note.
        Qual. Res. 2008; 8: 137-152https://doi.org/10.1177/1468794107085301
        • Braun V.
        • Clarke V.
        Using thematic analysis in psychology.
        Qual. Res. Psychol. 2006; 3: 77-101https://doi.org/10.1191/1478088706qp063oa
        • Mandai M.
        • Kaso M.
        • Takahashi Y.
        • Nakayama T.
        Loneliness among mothers raising children under the age of 3 years and predictors with special reference to the use of SNS: a community-based cross-sectional study.
        BMC Womens Health. 2018; 18: 131https://doi.org/10.1186/s12905-018-0625-x
        • Miller Y.D.
        • Dane A.C.
        • Thompson R.
        A call for better care: the impact of postnatal contact services on women’s parenting confidence and experiences of postpartum care in Queensland, Australia.
        BMC Health Serv. Res. 2014; 14: 635https://doi.org/10.1186/s12913-014-0635-9
        • Malouf R.
        • Henderson J.
        • Alderdice F.
        Expectations and experiences of hospital postnatal care in the UK: a systematic review of quantitative and qualitative studies.
        BMJ Open. 2019; 9e022212https://doi.org/10.1136/bmjopen-2018-022212
        • Lewis L.
        • Hauck Y.L.
        • Ronchi F.
        • Crichton C.
        • Waller L.
        Gaining insight into how women conceptualize satisfaction: western Australian women’s perception of their maternity care experiences.
        BMC Pregnancy Childbirth. 2016; 16: 29https://doi.org/10.1186/s12884-015-0759-x
        • Higginbottom G.M.
        • Morgan M.
        • Alexandre M.
        • Chiu Y.
        • Forgeron J.
        • Kocay D.
        • Barolia R.
        Immigrant women’s experiences of maternity-care services in Canada: a systematic review using a narrative synthesis.
        Syst. Rev. 2015; 4: 13https://doi.org/10.1186/2046-4053-4-13
        • Ong S.F.
        • Chan W.C.
        • Shorey S.
        • Chong Y.S.
        • Klainin-Yobas P.
        • He H.G.
        Postnatal experiences and support needs of first-time mothers in Singapore: a descriptive qualitative study.
        Midwifery. 2014; 30: 772-778https://doi.org/10.1016/j.midw.2013.09.004
        • Kurth E.
        • Krähenbühl K.
        • Eicher M.
        • Rodmann S.
        • Fölmli L.
        • Conzelmann C.
        • Zemp E.
        Safe start at home: what parents of newborns need after early discharge from hospital – a focus group study.
        BMC Health Serv. Res. 2016; 16: 82https://doi.org/10.1186/s12913-016-1300-2
        • Fenwick J.
        • Butt J.
        • Dhaliwal S.
        • Hauck Y.
        • Schmied V.
        Western Australian women’s perceptions of the style and quality of midwifery postnatal care in hospital and at home.
        Women Birth. 2010; 23: 10-21https://doi.org/10.1016/j.wombi.2009.06.001
        • Dahlberg U.
        • Haugan G.
        • Aune I.
        Women’s experiences of home visits by midwives in the early postnatal period.
        Midwifery. 2016; 39: 57-62https://doi.org/10.1016/j.midw.2016.05.003
        • Brown S.J.
        • Davey M.A.
        • Bruinsma F.J.
        Women’s views and experiences of postnatal hospital care in the Victorian Survey of Recent Mothers 2000.
        Midwifery. 2005; 21: 109-126https://doi.org/10.1016/j.midw.2004.09.006
        • Cheyne H.
        • McCourt C.
        • Semple K.
        Mother knows best: developing a consumer led, evidence informed, research agenda for maternity care.
        Midwifery. 2013; 29: 705-712https://doi.org/10.1016/j.midw.2012.06.015
        • Tully K.P.
        • Stuebe A.M.
        • Verbiest S.B.
        The fourth trimester: a critical transition period with unmet maternal health needs.
        Am. J. Obstet. Gynecol. 2017; 217: 37-41https://doi.org/10.1016/j.ajog.2017.03.032
        • Baas C.I.
        • Erwich J.J.H.M.
        • Wiegers T.A.
        • de Cock T.P.
        • Hutton E.K.
        Women’s suggestions for improving midwifery care in the Netherlands.
        Birth. 2015; 42: 369-378https://doi.org/10.1111/birt.12185
        • Hall J.
        • Hundley V.
        • Collins B.
        • Ireland J.
        Dignity and respect during pregnancy and childbirth: a survey of the experience of disabled women.
        BMC Pregnancy Childbirth. 2018; 18: 328https://doi.org/10.1186/s12884-018-1950-7
        • Redshaw M.
        • Martin C.R.
        • Savage-McGlynn E.
        • Harrison S.
        Women’s experiences of maternity care in England: preliminary development of a standard measure.
        BMC Pregnancy Childbirth. 2019; 19: 167https://doi.org/10.1186/s12884-019-2284-9
        • Scottish Government
        The Best Start. A Five-Year Forward Plan for Maternity and Neonatal Care in Scotland. Edinburgh.
        (Available at:)2017
        • NHS England
        Maternity Transformation Programme.
        (Availavle at:)2020
        • Todd A.L.
        • Ampt A.J.
        • Roberts C.L.
        “Very Good” ratings in a survey of maternity care: kindness and understanding matter to Australian women.
        Birth. 2017; 44: 48-57https://doi.org/10.1111/birt.12264
        • Coultas C.
        • Kieslich K.
        • Littlejohns P.
        Patient and public involvement in priority-setting decisions in England’s transforming NHS: an interview study with clinical commissioning groups in South London sustainability transformation partnerships.
        Health Expect. 2019; 22: 1223-1230https://doi.org/10.1111/hex.12948