Review
New parents’ experience of information and sense of security related to postnatal care: A systematic review

https://doi.org/10.1016/j.srhc.2018.06.001Get rights and content

Highlights

  • The first postnatal week, the emotions were characterized by anxiety and/or fear.

  • Family-centred care with individually adapted and consistent information appears to be important parts for parents' sense of security in postnatal care.

  • The continuity when midwives who attended the birth also took care of the family during the postnatal period created feelings of safety.

  • Parents expressed a desire to participate in decisions concerning the care of themselves and their new-born.

  • Partners of women who underwent Caesarean sections were dissatisfied with the information around the child and the woman's physical health.

  • During the first time at home with a new-born, parents needed to know who they could turn to if there was a problem about their own health or the well-being of the child.

Abstract

Background

Becoming a parent is often a tumultuous experience and a great challenge. The transition when a child is born is described affecting the parents and their relationship psychically, physically, mentally and emotionally. Information within care should be relevant and supportive. Furthermore information within the context of care should be relevant, supportive and helpful to parents in handling their new situation and increasing their self-reliance.

Aim

To provide a contextualised understanding of how parents experience postnatal care in relation to information and sense of security”.

Method

A systematic search was undertaken at PubMed and CINAHL database for literature published between January 2002 and August 2017. Inclusion criteria focused on postnatal care. Eight of the studies used qualitative methods and two of the studies used quantitative methods, as a result the findings could not be combined using meta-analysis or meta-synthesis, instead narrative synthesis of the findings were used.

Results

Ten studies were included. The analysis revealed three categories related to parent’s experience of information and sense of security during the postnatal period. These categories were; Expectations on the care; Own resources; and Confirmation. Support from staff and family is described as significant for the parents' sense of security. During the first postnatal week, the emotions were characterized by anxiety and/or fear. Parents prefer a “non-judgmental” attitude from the staff and to be met as an individual.

Conclusion

Family -centred care such as continuity, participation, individually adaptation, consistent, information and preparation for parenting appear to be important components for parents' sense of security in postnatal care.

Introduction

Becoming a parent is described as one of the most challenging transitions that human beings experience in life. Many couples are under great strain when a child enters the family. The transition is revolutionary mentally, physically and emotionally, and a natural consequence is relationship change. The partnership can change for the better however it can also lead to separation and divorce [1]. Swedish researchers have found that postnatal care does not always meet the parent’s need of information and support [2]. Care during childbirth involves major challenges. In many families there is no proximity to grandparents and close relatives who could be of support for new parents. Urbanization, where many young people move from their hometown, as well as migration from other cultures and displacement due to war, place additional demands on postnatal care, further increasing the need for individualized care, information and support [3]. Approximately 85% of all new-born children in Sweden receive their postnatal care at a hospital unit. The average hospital stay after birth is at the moment less than two days for a mother with a healthy baby [4].

The purpose of postnatal care according to the World Health Organisation (WHO) is to provide “the highest possible quality of care and medical treatment with the least possible intervention to optimize the health and well-being of the new family” [5]. The goal of care after normal childbirth with a healthy child is to give the parents of the new-born, support in their role, to introduce breastfeeding and to help first-time parents to interpret the child's signals [5]. Postnatal care should focus on the needs of the whole family, not just the new-born child and the mother [4].

In a study aimed to evaluate dimensions of parent’s sense of security the first week after childbirth, it was found that a sense of security among mothers’ was related to midwives/nurses empowering behaviour and a sense of general well-being. Among fathers a sense of personal well-being, a sense of mother’s well-being as well as midwives/nurses empowering behaviour was important [6].

It is well known that it is important to see parents and children as a whole unit and that both parents' ability to exercise parenthood is assured [7]. During the first period after birth, parents need information and counselling around breastfeeding and care of the new-born child, information on physical changes including signs of illness or health issues, self-care including hygiene and healing processes, sex life, contraception and nutrition [5].

In order to respond to the needs of parents and to ensure that parents feel secure in the parenting role, healthcare professionals need to understand factors leading to increased or decreased self-reliance and sense of security. There is also a need for more knowledge of how parents perception of the information given regarding the new-born child, so that healthcare professionals can gain a better understanding of the parents' experiences.

Our definition of sense of security includes confidence and adjustment, which is used by Persson et al in their studies [6]. Sense of security is found to be an internal sense – an intrinsic state based on faith and trust in oneself and others. External factors that strengthened Sense of security are to be part of a community, to recognize and be familiar with things and situations and to use various kinds of aids [8].

The aim of our study was to provide a contextualised understanding of how parents experience postnatal care in relation to information and sense of security”.

Section snippets

Literature search

A systematic search of PubMed and CINAHL database for literature published between January 2002 and August 2017 in English was conducted. We searched for original peer-reviewed quantitative, qualitative, and mixed methods studies of postnatal care and new parent’s experience of information and sense of security. The literature search began with the keywords; information, new parents; maternity hospital; early parenthood, sense of security; post-natal care (Mesh term); postpartum period (Mesh

Results

This review is based on studies utilizing both qualitative and quantitative design. After the initial review of 68 abstract and 28 papers, ten articles with suitable content remained for our study. Six of the ten included studies were conducted in Sweden; one in Norway, one in the UK and two in Australia. Eight articles were conducted with qualitative design and two with quantitative design. Participants in the included studies varied between 9 and 2699. The articles are presented in Table 1.

Discussion

Qualitative studies can provide a rich, contextualized understanding of some aspect of human experience in care. In healthcare where evidence for improving practice is very important, generalization in relation to knowledge claims careful attention by both qualitative and quantitative researchers. It is difficult to generalize qualitative studies, but insights from qualitative inquiry can be a very important source of evidence for practice [22]. Integration of qualitative and quantitative

Conclusion

Continuity of care, parent participation, individually adapted and consistent information, as well as preparation for parenting appear to be important factors related to parents' sense of security postnatal according to the studies included in our literature review. These factors are in line with the objectives of person-centered care which has revealed better outcomes for patients in various sectors in health care.

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