Women's views on postnatal care from a midwife who has not provided their pregnancy and birth care: Implications for midwifery relationships

Abstract

In Aotearoa New Zealand (from hereafter New Zealand), postnatal care is typically provided in hospital and at home by a known Lead Maternity Carer (LMC) midwife who has provided continuity of care and lead maternity care throughout the childbearing episode. While this model of maternity care is accepted as optimal, increasingly and for a myriad of reasons, postnatal care is being provided by a midwife or midwives previously unknown to the woman and her family. This study aimed to explore women’s experience of postnatal care when provided in this context, in order to understand the critical components for establishing a constructive and supportive postnatal care experience.

The study design was qualitative descriptive to enable a rich and data-close explication of the women’s experiences. Semi-structured interviews with eleven first-time mothers were analysed thematically to develop three main themes that captured the essence of their experiences. The findings confirmed that postnatal midwifery care is a highly valued and vital component of postnatal adjustment as a new parent. While continuity of care was desired by most women, they articulated a range of ways that midwives can build meaningful relationships when they meet women for the first time postnatally. Themes centred around how women navigated the postnatal period which was characterised as being challenging and how the midwife provided an anchoring presence as these new mothers grew in confidence as new mothers and when caring for their babies.

Sub-themes identified why the study participants were cared for postnatally by midwives who were previously unknown to them, examined their postnatal experiences in hospital prior to going home and describes their first meetings with their postnatal midwives and the key ingredients which enabled their alliances to work constructively.