Maternal and Child Health Journal

, Volume 18, Issue 3, pp 707–713 | Cite as

Views of Women and Clinicians on Postpartum Preparation and Recovery

  • Anika Martin
  • Carol Horowitz
  • Amy Balbierz
  • Elizabeth A. Howell


To explore important domains of women’s postpartum experiences as perceived by postpartum mothers and obstetricians/midwives, and to investigate how postpartum care could enhance patient preparation for the postpartum period. Qualitative research study was conducted to explore women’s and clinicians’ perceptions of the postpartum experience. Four focus groups of postpartum women (n = 45) and two focus groups of obstetric clinicians (n = 13) were held at a large urban teaching hospital in New York City. All focus groups were audio recorded, transcribed, and analyzed using grounded theory. Four main themes were identified: lack of women’s knowledge about postpartum health and lack of preparation for the postpartum experience, lack of continuity of care and absence of maternal care during the early postpartum period, disconnect between providers and postpartum mothers, and suggestions for improvement. Mothers did not expect many of the symptoms they experienced after childbirth and were disappointed with the lack of support by providers during this critical time in their recovery. Differences existed in the major postpartum concerns of mothers and clinicians. However, both mothers and clinicians agreed that preparation during the antepartum period could be beneficial for postpartum recovery. Results from this study indicate that many mothers do not feel prepared for the postpartum experience. Study findings raise the hypothesis that capturing patient-centered domains that define the postpartum experience and integrating these domains into patient care may enhance patient preparation for postpartum recovery and improve postpartum outcomes.


Focus groups Postpartum women Obstetric clinicians Preparation 



This study was supported by the Agency for Healthcare Research and Quality (R01 HS09698-03).


  1. 1.
    Kline, C. R., Martin, D. P., & Deyo, R. A. (1998). Health consequences of pregnancy and childbirth as perceived by women and clinicians. Obstetrics and Gynecology, 92, 842–848.CrossRefPubMedGoogle Scholar
  2. 2.
    Howell, E. A., Mora, P. A., Chassin, M. R., & Leventhal, H. (2010). Lack of preparation, physical health after childbirth, and early postpartum depressive symptoms. Journal of Women’s Health (Larchmt), 19, 703–708.CrossRefGoogle Scholar
  3. 3.
    Howell, E. A. (2010). Lack of patient preparation for the postpartum period and patients’ satisfaction with their obstetric clinicians. Obstetrics and Gynecology, 115, 284–289.CrossRefPubMedGoogle Scholar
  4. 4.
    Boyles, S. H., Li, H., Mori, T., Osterweil, P., & Guise, J. M. (2009). Effect of mode of delivery on the incidence of urinary incontinence in primiparous women. Obstetrics and Gynecology, 113, 134–141.CrossRefPubMedGoogle Scholar
  5. 5.
    Hermansen, I. L., O’Connell, B. O., & Gaskin, C. J. (2010). Women’s explanations for urinary incontinence, their management strategies, and their quality of life during the postpartum period. Journal of Wound Ostomy & Continence Nursing, 37, 187–192.CrossRefGoogle Scholar
  6. 6.
    Leeman, L. M., & Rogers, R. G. (2012). Sex after childbirth: Postpartum sexual function. Obstetrics and Gynecology, 119, 647–655.CrossRefPubMedGoogle Scholar
  7. 7.
    Rathfisch, G., Dikencik, B. K., Kizilkaya Beji, N., Comert, N., Tekirdag, A. I., & Kadioglu, A. (2010). Effects of perineal trauma on postpartum sexual function. Journal of Advanced Nursing, 66, 2640–2649.CrossRefPubMedGoogle Scholar
  8. 8.
    Lewis, A., Ilot, I., Lekka, C., & Oluboyede, Y. (2011). Improving the quality of perinatal mental health: A health visitor-led protocol. Community Practitioner, 84, 27–31.PubMedGoogle Scholar
  9. 9.
    Ogbuanu, C. A., Jones, C. A., McTigue, J. F., Baker, S. L., Heim, M., Baek, J., et al. (2009). A program evaluation of postpartum/newborn home visitation services in Aiken county, South Carolina. Public Health Nursing, 26, 39–47.CrossRefPubMedGoogle Scholar
  10. 10.
    Bonuck, K. A., Freeman, K., & Trombley, M. (2006). Randomized controlled trial of a prenatal and postnatal lactation consultant intervention on infant health care use. Archives of Pediatrics and Adolescent Medicine, 160, 953–960.PubMedGoogle Scholar
  11. 11.
    McComish, J. F., Groh, C. J., & Moldenhauer, J. A. (2013). Development of a doula intervention for postpartum depressive symptoms: Participants’ recommendations. Journal of Child and Adolescent Psychiatric Nursing, 26, 3–15.CrossRefPubMedGoogle Scholar
  12. 12.
    McAndrew, L. M., Musumeci-Szabo, T. J., Mora, P. A., Vileikyte, L., Burns, E., Halm, E. A., et al. (2008). Using the common sense model to design interventions for the prevention and management of chronic illness threats: From description to process. British Journal of Health Psychology, 13, 195–204.CrossRefPubMedGoogle Scholar
  13. 13.
    Shi, L. (2000). Type of health insurance and the quality of primary care experience. American Journal of Public Health, 90, 1848–1855.CrossRefPubMedCentralPubMedGoogle Scholar
  14. 14.
    Merton, R. K., Fiske, M., & Kendall, P. L. (1990). The focused interview: A manual of problems and procedures (2nd ed.). London: Collier McMillan.Google Scholar
  15. 15.
    Corbin, J., & Strauss, A. (2008). Basics of qualitative research: Techniques and procedures for developing grounded theory. Thousand Oaks: Sage Publications, Inc.Google Scholar
  16. 16.
    George, L. (2005). Lack of preparedness: Experiences of first-time mothers. American Journal of Maternal Child Nursing, 30, 251–255.CrossRefPubMedGoogle Scholar
  17. 17.
    Tulman, L., & Fawcett, J. (1991). Recovery from childbirth: Looking back 6 months after delivery. Health Care for Women International, 12, 341–350.CrossRefPubMedGoogle Scholar
  18. 18.
    Anderberg, E., Berntorp, K., & Crang-Svalenius, E. (2009). Diabetes and pregnancy: Women’s opinions about the care provided during the childbearing year. Scandinavian Journal of Caring Sciences, 23, 161–170.CrossRefPubMedGoogle Scholar
  19. 19.
    Mainous, A. G., 3rd, Baker, R., Love, M. M., Gray, D. P., & Gill, J. M. (2001). Continuity of care and trust in one’s physician: Evidence from primary care in the United States and the United Kingdom. Family Medicine, 33, 22–27.PubMedGoogle Scholar
  20. 20.
    Thom, D. H., Ribisl, K. M., Stewart, A. L., & Luke, D. A. (1999). Further validation and reliability testing of the Trust in Physician Scale. The Stanford Trust Study Physicians. Medical Care, 37, 510–517.CrossRefPubMedGoogle Scholar
  21. 21.
    Aune, I., Dahlberg Msc, U., & Ingebrigtsen, O. (2012). Parents’ experiences of midwifery students providing continuity of care. Midwifery, 28, 372–378.PubMedGoogle Scholar
  22. 22.
    Homer, C. S., Foureur, M. J., Allende, T., Pekin, F., Caplice, S., & Catling-Paull, C. (2012). ‘It’s more than just having a baby’ women’s experiences of a maternity service for Australian Aboriginal and Torres Strait Islander families. Midwifery, 28, E449–E455.CrossRefPubMedGoogle Scholar
  23. 23.
    Lomas, J., Pickard, L., & Mohide, A. (1987). Patient versus clinician item generation for quality-of-life measures. The case of language-disabled adults. Medical Care, 25, 764–769.CrossRefPubMedGoogle Scholar
  24. 24.
    Nisenzon, A. N., Robinson, M. E., Bowers, D., Banou, E., Malaty, I., & Okun, M. S. (2011). Measurement of patient-centered outcomes in Parkinson’s disease: What do patients really want from their treatment? Parkinsonism & Related Disorders, 17, 89–94.CrossRefGoogle Scholar
  25. 25.
    Newport, D. J., Brennan, P. A., Green, P., Ilardi, D., Whitfield, T. H., Morris, N., et al. (2008). Maternal depression and medication exposure during pregnancy: Comparison of maternal retrospective recall to prospective documentation. BJOG, 115, 681–688.CrossRefPubMedGoogle Scholar
  26. 26.
    Tomeo, C. A., Rich-Edwards, J. W., Michels, K. B., Berkey, C. S., Hunter, D. J., Frazier, A. L., et al. (1999). Reproducibility and validity of maternal recall of pregnancy-related events. Epidemiology, 10, 774–777.CrossRefPubMedGoogle Scholar
  27. 27.
    Sou, S. C., Chen, W. J., Hsieh, W. S., & Jeng, S. F. (2006). Severe obstetric complications and birth characteristics in preterm or term delivery were accurately recalled by mothers. Journal of Clinical Epidemiology, 59, 429–435.CrossRefPubMedGoogle Scholar
  28. 28.
    Quigley, M. A., Hockley, C., & Davidson, L. L. (2007). Agreement between hospital records and maternal recall of mode of delivery: Evidence from 12 391 deliveries in the UK Millennium Cohort Study. BJOG, 114, 195–200.CrossRefPubMedGoogle Scholar
  29. 29.
    Howell, E. A., Balbierz, A., Wang, J., Parides, M., Zlotnick, C., & Leventhal, H. (2012). Reducing postpartum depressive symptoms among black and Latina mothers: A randomized controlled trial. Obstetrics and Gynecology, 119, 942–949.CrossRefPubMedCentralPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Anika Martin
    • 1
  • Carol Horowitz
    • 1
    • 2
  • Amy Balbierz
    • 1
  • Elizabeth A. Howell
    • 1
    • 3
    • 4
  1. 1.Department of Health Evidence and PolicyIcahn School of Medicine at Mount SinaiNew YorkUSA
  2. 2.Department of MedicineIcahn School of Medicine at Mount SinaiNew YorkUSA
  3. 3.Department of Obstetrics, Gynecology, and Reproductive ScienceIcahn School of Medicine at Mount SinaiNew YorkUSA
  4. 4.Department of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkUSA

Personalised recommendations