Maternal health education and social support needs across the perinatal continuum of care in India: A thematic analysis

Abstract

AbstractBackgroundSocial support and maternal education throughout the antenatal, delivery, and postpartum phases contribute to the optimization of health and well-being of mothers and infants. Understanding deficits among support and educational resources can contribute to improved public health decision-making and maternal and child healthcare and wellbeing.MethodsWe conducted a qualitative study among 20 postpartum North Indian women to better understand current resources and identify gaps in support across the perinatal continuum of care. Data was analyzed thematically.ResultsParticipants in this study have considerably low maternal knowledge surrounding delivery, in addition to low levels of maternal knowledge and social support around postpartum care and practices. Participants received the most social and educational support during the antenatal phase of pregnancy, which is consistent with the implementation of government and community program goals to increase antenatal care among pregnant women. Notable issues among women during these phases involved consent, and satisfaction and comfort with childbirth care. Participant narratives described the important role of both formal and informal support structures in addressing maternal health needs. Formal structures of support include health systems at the community and facility levels whereas informal structures include family, friends, and the community. Participants also relied heavily on advice from formal modes of support including community health workers (ASHAs), midwives, and doctors. While many participants’ support needs were met by their support networks, our study identified certain areas where support needs remained unmet such as post cesarean section diet and care, institutional delivery, support of ASHA etc., in addition to areas of discrepancy between the advice provided compared to evidence-based practices.ConclusionThis study identified a major lack of informational support during the delivery and postpartum phases of pregnancy, which may lead to complications for pregnant women. Programs targeting improved maternal health and wellbeing throughout the continuum of care need to educate pregnant women more about the institutional delivery process. Additionally, programs need to further supply women with support and education with regard to the postpartum phase, which remains neglected.Trial registration:This research is part of the formative phase of a larger intervention trial prospectively registered with Clinical trial registry of India. (CTRI/2020/12/029800 [Registered on: 15/12/2020] and clinicaltrials.gov (phase 1: NCT04636398, phase 2: NCT04693585)