What Do Women Want? Looking Beyond Patient Satisfaction

Abstract

Objective: To hear the voices of women, their partners, and nurses about expectations and priorities during the postpartum hospitalization.

Design: Focus groups using semistructured interview questions.

Setting: A 12-bed labor-delivery-recovery-postpartum unit at a small urban hospital in the U.S. Northeast.

Participants: Women who planned to or had given birth, their partners, and the maternity nurses who cared for them.

Measurements: Qualitative thematic analysis of focus group transcripts.

Results: Thematic analysis produced the following themes for women's priorities: Need for individualized attention to maternal physical and emotional care; Fear of providing inadequate care for the newborn, including establishing infant feeding; and Transitioning to parenting as a new mother versus as an experienced mother. Themes for nurses' priorities included Safety issues around sleep and breastfeeding, Transitioning to parenting with an emphasis on maternal self-care, and Addressing barriers to effective discharge education. Response comparisons between the women/partners and nurses suggest that there is a disconnection between women's and nurses' priorities and expectations for care during the postpartum period.

Conclusion: Women and nurses identified unmet needs in the postpartum period, consistent with the current literature. Providing standardized education during the transitional period around discharge from the hospital to home may not be optimal and may even detract from meeting the needs for rest and connection with family and the health care team. Nursing care that extends beyond the maternity hospitalization may be needed to individualize care and meet previously unmet needs.

Keywords: discharge teaching; fourth trimester; health education; maternal satisfaction; patient satisfaction; postpartum.