Views of Women and Clinicians on Postpartum Preparation and Recovery


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.

This is a preview of subscription content, access via your institution.


  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.

    CAS  Article  PubMed  Google 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.

    Article  Google 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.

    Article  PubMed  Google 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.

    Article  PubMed  Google 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.

    Article  Google Scholar 

  6. 6.

    Leeman, L. M., & Rogers, R. G. (2012). Sex after childbirth: Postpartum sexual function. Obstetrics and Gynecology, 119, 647–655.

    Article  PubMed  Google 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.

    Article  PubMed  Google 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.

    PubMed  Google 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.

    Article  PubMed  Google 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.

    PubMed  Google 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.

    Article  PubMed  Google 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.

    Article  PubMed  Google 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.

    CAS  Article  PubMed Central  PubMed  Google 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.

    Article  PubMed  Google 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.

    CAS  Article  PubMed  Google 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.

    Article  PubMed  Google 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.

    PubMed  Google 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.

    CAS  Article  PubMed  Google Scholar 

  21. 21.

    Aune, I., Dahlberg Msc, U., & Ingebrigtsen, O. (2012). Parents’ experiences of midwifery students providing continuity of care. Midwifery, 28, 372–378.

    PubMed  Google 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.

    Article  PubMed  Google 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.

    CAS  Article  PubMed  Google 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.

    Article  Google 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.

    CAS  Article  PubMed  Google 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.

    CAS  Article  PubMed  Google 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.

    Article  PubMed  Google 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.

    CAS  Article  PubMed  Google 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.

    Article  PubMed Central  PubMed  Google Scholar 

Download references


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

Author information



Corresponding author

Correspondence to Amy Balbierz.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Martin, A., Horowitz, C., Balbierz, A. et al. Views of Women and Clinicians on Postpartum Preparation and Recovery. Matern Child Health J 18, 707–713 (2014).

Download citation


  • Focus groups
  • Postpartum women
  • Obstetric clinicians
  • Preparation