A new qualitative systematic review conducted to inform the scope of a new World Health Organization (WHO) post-birth (postnatal) guideline identifies four clear themes for a positive experience in mothers across 15 different countries and cultures, according to a study published April 22, 2020 in the open-access journal PLOS ONE by Kenneth Finlayson, research associate at the University of Central Lancashire (UCLan), UK, and colleagues.
The postnatal period is the phase of a mother's life immediately following childbirth--the specific duration varies across cultures, though the WHO defines the postnatal period as immediately after the baby is born up to six weeks (42 days) after birth. In this study, Finlayson and colleagues aimed to identify what matters to mothers in the postnatal period in order to understand how postnatal services can better meet their needs and those of their new babies.
To perform their systematic literature review, the authors searched several databases for studies reporting first-hand accounts of women who gave birth, published in any language after 2000. After rating each potential study and filtering out those studies with flaws or which didn't fall into the scope of the review, the authors were left with 36 papers from 15 countries published between 2003-2019 to include in their data analysis.
Based on themes recurring throughout these 36 articles, Finlayson and colleagues were able to define a positive postnatal period as one in which women adapt to their new identity and develop confidence as a mother, with emotional and psychological support from their community, and caregivers; adjust to changes in their close relationships; navigate ordinary physical and emotional challenges; and experience personal growth as they adjust to motherhood and parenting in their own cultural context. Based on these findings, family, community, and online sources should be educated and mobilised to provide appropriate reassurance and validation to new mothers.
The authors only found 3 relevant studies from low-income countries, which is a limitation here--the authors also note that most of the studies were conducted in an urban setting, so there may be important differences around birth and the postnatal period in rural settings. Regardless, this systematic review provides a foundation for future work on the postnatal experience for women, and suggests several areas where caregivers may wish to focus in order to help women achieve a positive sense of motherhood post-birth.
Kenny Finlayson, research associate at the University of Central Lancashire (UCLan) and lead author of the study, said: "Our study shows that support during the postnatal phase is an important factor that shapes the entire maternal experience, for both new mothers and their babies. With the right support in place from community, family and healthcare professionals during this crucial period, women around the world can feel more confident and adjust to the significant changes that come with motherhood."
Dr Mercedes Bonet Semenas, medical officer at the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization (WHO) Department of Sexual and Reproductive Health and Research, co-author, said: "Understanding what women want in the postnatal period will contribute significantly to ensuring that future WHO guidelines include both clinical and non-clinical recommendations to ensure a positive postnatal experience for both women and newborns."
Citation: Finlayson K, Crossland N, Bonet M, Downe S (2020) What matters to women in the postnatal period: A meta-synthesis of qualitative studies. PLoS ONE 15(4): e0231415. https:/
Funding: The work was commissioned to the University of Central Lancashire by the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), a cosponsored program executed by the World Health Organization (WHO). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing Interests: The authors have declared that no competing interests exist.
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