Experiences of primary care physicians managing postpartum care: a qualitative research study

Abstract

Abstract Background The postpartum period is redefined as 12 weeks following childbirth. Primary care physicians (PCP) often manage postpartum women in the community after uneventful childbirths. Postpartum care significantly impacts on the maternal and neonatal physical and mental health. However, evidence has revealed unmet needs in postpartum maternal care. Aim The study aimed to explore the experiences of PCPs in managing postpartum mothers. Methods Four focus group discussions and eleven in-depth interviews with twenty-nine PCPs were conducted in this qualitative research study in urban Singapore. PCPs of both gender and variable postgraduate training background were purposively enrolled. Audited transcripts were independently coded by two investigators. Thematic content analysis was performed using the codes to identify issues in the “clinician”, “mother”, “postpartum care” and “healthcare system & policy” domains stipulated in “The Generalists’ Wheel of Knowledge, Understanding and Inquiry” framework. Findings PCPs’ personal attributes such as gender and knowledge influenced their postpartum care delivery. Prior training, child caring experience and access to resource materials contributed to their information mastery of postpartum care. Their professional relationship with local multi-ethic and multi-lingual Asian mothers was impacted by their mutual communication, language compatibility and understanding of local confinement practices. Consultation time constraint, awareness of community postnatal services and inadequate handover of care from the specialists hindered PCPs in the healthcare system. Discussion Personal, maternal and healthcare system barriers currently prevent PCPs from delivering optimal postpartum care. Conclusion Interventions to overcome the barriers to improve postpartum care will likely be multi-faceted across domains discussed.