April 7-9, 2022 • Hyatt Regency • Lexington, KY
Communication Strategies to Promote Comprehensive Well-being
Communication Strategies to Promote Comprehensive Well-being
Abstract: Do Women Desire More from Postnatal Communication? Voice, Partnership, and Opportunities for Accountability in Patient-Provider Communication
Many women experience gaps in understanding about what happened during birth, (Baxter, 2007; Lavender & Walkinshaw, 1998; Mercer et al., 2012), and desire explanation and understanding of their labor and delivery experiences (Carlgren & Berg, 2008; Thompson & Downe, 2016). In addition, women are not typically asked postnatally how they felt about their births (Creedy et al., 2000), highlighting a missed opportunity to identify women’s unresolved emotional and communication needs. A deeper sense of connection to their own particular birth events can be facilitated by offering woman-centered patient-provider discussion appointments early in the postpartum period. When given the opportunity to meet with and talk through their birth experiences with a provider, women outside the U.S. report on these experiences positively (Freyer & Weaver, 2014); however, these meetings are not part of standard practice in the United States, nor are they explicitly recommended as part of postpartum care (ACOG, 2018). Therefore, the current study sought to understand U.S. women’s perceptions of the value, utility, and necessity of such discussion (or “debriefing”) sessions as an additional part of standard maternity care. In the current study, Qualtrics Panels was used to recruit and survey a demographically representative sample of U.S. women who had given birth in the past year. After removing cases of missing data, there were n = 394 responses. Women were given survey questions asking both open-ended and close-ended questions designed to measure and understand their interest and desire for postnatal discussion sessions. When asked “If given the opportunity, I would sit down with my healthcare provider(s) to talk about how I experienced my most recent labor and delivery, how I feel about my labor and delivery, and ask questions about my labor and delivery,” 45.2% (n = 178) indicated yes, 37.6% (n = 148) responded maybe, and 17.3% (n = 68) responded no. Thematic analyses (Braun & Clark, 2012) were conducted on the open-ended explanations within each of the yes, maybe, and no response categories. Those who responded yes to the idea of postnatal discussions cited the opportunity to voice gratitude or grievance, the desire to rewind and replay their births, and the need for explanation and accountability from providers. Those who responded maybe largely felt that their questions were inconsequential, or that having “just one question” or pure curiosity was not enough to warrant a full discussion session. Finally, those who responded no cited satisfaction with their birth experiences, an inability to change what happened, being knowledgeable about labor and delivery processes already, and trusting that their provider(s) made good decisions on their behalf. Overall, this information underscores the need to incorporate meaning-making and dialogue into the immediate postnatal period. Postpartum women can be supported in their curiosity, desire for understanding, and need to emotionally process this pivotal life event. Providers, too, can benefit from the opportunity to clarify events and decisions and work through their own emotions tied to the delivery.