Birthing parent postpartum acute care use: Multilevel opportunities for strengthening healthcare

Author:

Busse Clara E.12ORCID,Stuebe Alison M.13,Tumlinson Katherine12,Tucker Christine1,Vladutiu Catherine J.3,Pence Brian4,Tully Kristin P.3

Affiliation:

1. Department of Maternal and Child Health, Gillings School of Global Public Health University of North Carolina at Chapel Hill Chapel Hill North Carolina USA

2. Carolina Population Center University of North Carolina at Chapel Hill Chapel Hill North Carolina USA

3. Department of Obstetrics and Gynecology University of North Carolina School of Medicine Chapel Hill North Carolina USA

4. Department of Epidemiology, Gillings School of Global Public Health University of North Carolina at Chapel Hill Chapel Hill North Carolina USA

Abstract

AbstractBackgroundThree‐quarters 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.MethodsThis 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.ResultsBirthing 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.DiscussionThese 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.

Funder

Agency for Healthcare Research and Quality

Eunice Kennedy Shriver National Institute of Child Health and Human Development

Publisher

Wiley

Reference45 articles.

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3. Pregnancy‐related deaths: data from Maternal Mortality Review Committees in 36 US States, 2017–2019;Trost SL;Education,2022

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