Early hospital discharge following childbirth: Mothers' experiences during the first week of the postpartum period at home in Mzuzu City, Malawi
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Date
2011-03-01
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Abstract
There has been a dramatic decrease in the length of time mothers remain in hospital following childbirth, which may affect the health outcome of the mother and neonate in the immediate postpartum period. This is because mothers may have health needs and concerns during the immediate postpartum period related to physical recovery from childbirth, neonatal care, and family relations that may need the midwife’s attention. Hence, a descriptive phenomenological qualitative study was conducted to explore mothers’ experiences during the first week of the postpartum period following early hospital discharge after childbirth in Mzuzu City, Malawi. In-depth interviews were conducted with 26 participants. All participants had given birth within six weeks prior to interviews and were discharged from the hospital within 24 hours after delivery. Data was tape-recorded and field notes were taken to complement the recorded data. Narratives were analysed following Collaizz’s technique. The results indicated that the majority of participants and their neonates experienced health problems during the first week of the postpartum period. Maternal problems included abdominal pains, excessive bleeding, breast problems and general medical health problems. Neonates experienced neonatal infections such as eye, skin, gastro-intestinal, and general health problems. Very few participants in this study sought medical care for the health problems they or their neonates experienced. However, almost all the participants attended the one-week scheduled postpartum check-up visit. Furthermore, the study revealed that the majority of participants received support from family members, specifically from their mothers, mothers-in-law, husbands, and neighbours during the first week of the postpartum period. The study further revealed that mothers were either satisfied or dissatisfied with early hospital discharge depending upon the extent of family support they received, the hospital environment, the amount of information they received and health assessment that was conducted in preparation for early hospital discharge, and their personal health status. The results further indicated suggestions for improving the practice of early hospital discharge. Suggestions included follow-up through home visits, telephone calls, scheduled postpartum check-up visits at the hospital and self-report to the hospital if any problem arises. The study adds insights into health problems that mothers experience during the first week of the postpartum period following early hospital discharge. Therefore, preparation for early hospital discharge should include a thorough health assessment of both mother and neonate to ensure that they are healthy before discharge. Midwives should also educate mothers on normal physiological changes during the postpartum period and that certain signs and symptoms indicate serious health problems. This information will help them to differentiate normal experiences from abnormal ones. There is a need for further research to explore the prevalence and types of maternal and neonatal health problems following early postpartum hospital discharge. Furthermore, exploration of the factors that contribute to postpartum health problems in the home during the early postpartum period is necessary. This knowledge will assist in guiding the care and education of mothers following childbirth.