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“We don’t really address the trauma”: Patients’ Perspectives on Postpartum Care Needs after Severe Maternal Morbidities

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Abstract

Objectives

This qualitative study explored experiences of 15 women in New York City who suffered physical, emotional, and socioeconomic consequences of severe maternal morbidity (SMM). This study aimed to increase our understanding of additional burdens these mothers faced during the postpartum period.

Methods

Qualitative analysis of in-depth interviews (n = 15) with women who had given birth in NYC hospitals and experienced SMM. We focused on how experiences of SMM impacted postpartum recoveries. Grounded theory methodology informed analysis of participants’ one-on-one interviews. To understand the comprehensive experience of postpartum recovery after SMM, we drew on theories about social stigma, reproductive equity, and quality of care to shape constant-comparative analysis and data interpretation.

Findings

Three themes were generated from data analysis: ‘Caring for my body’ defined by challenges during physical recuperation, ‘caring for my emotions’ which highlighted navigation of mental health recovery, and ‘caring for others’ defined by care work of infants and other children. Most participants identified as Black, Latinx and/or people of color, and reported the immense impacts of SMM across aspects of their lives while receiving limited access to resources and insufficient support from family and/or healthcare providers in addressing postpartum challenges.

Conclusions for Practice

Findings confirm the importance of developing a comprehensive trauma-informed approaches to postpartum care as a means of addressing SMM consequences.

Significance

AbstractSection What is Already Known on this Subject?

For every maternal death, approximately 100 women suffer from life-threatening complications—referred to as severe maternal morbidity (SMM). SMM affects 2,500 to 3,000 women annually. Health impacts can be acute or chronic, including mental health conditions and physical disabilities.

AbstractSection What this Study Adds?

The postpartum recovery period is a time for acute vulnerability for people recovering from an SMM event. Women reported navigating an array of physical, social, and emotional traumas and challenges for which they had limited support. This study confirms the need for directive and strategic investment in the postpartum recovery of survivors of SMM to ensure optimum health outcomes.

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Data Availability

Data not available to privacy restrictions.

References

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Acknowledgements

We are humbled by the childbearing people who shared their experiences in hopes of improving outcomes for future parents. We also acknowledge our interviewers Maritza Franqui, Oriana Sanchez and Nicole JeanBaptiste who were instrumental to the interviews and data collection process.

Funding

This study was supported by funding from Merck, through their Merck for Mothers.

Author information

Authors and Affiliations

Authors

Contributions

A.N. and C.M. designed the study. P.N., A.N., F.E. and C.M. contributed to the design and implementation of the research. P.N., A.N., and C.M. analyzed and interpreted the results. F.E. computed the qualitative findings. P.N., A.N. and C.M wrote the manuscript. All authors discussed the results and commented on the manuscript.

Corresponding author

Correspondence to P. Mimi Niles.

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Conflict of interest

The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethical Approval

Institutional Review Board approval of the study protocol was obtained from the NYC Health Department (IRB 18–100) and each participating hospital. Informed consent forms were tailored to each recruitment strategy, and all participants gave oral and written consent before participating in the study.

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Niles, P.M., Nack, A., Eniola, F. et al. “We don’t really address the trauma”: Patients’ Perspectives on Postpartum Care Needs after Severe Maternal Morbidities. Matern Child Health J (2024). https://doi.org/10.1007/s10995-024-03927-1

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  • DOI: https://doi.org/10.1007/s10995-024-03927-1

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