Elsevier

Midwifery

Volume 22, Issue 4, December 2006, Pages 356-364
Midwifery

Insights from Australian parents into educational experiences in the early postnatal period

https://doi.org/10.1016/j.midw.2005.09.004Get rights and content

Summary

Objective

to investigate the provision of parent education during the early postnatal period in order to gain insight that, through stakeholder collaboration, will contribute to the development of innovative strategies to enhance the provision of postnatal education in a contemporary health-care environment.

Design

the study comprises the first stage of an action-research project. The first stage of research sought to explore the experiences of mothers and fathers in the early postnatal period by conducting a questionnaire within 4 weeks of the birth of their baby. The data obtained from the questionnaire is to inform an action-research group for stage two of the project.

Setting

The Children, Youth and Women's Health Service, a large city maternity hospital in South Australia, covering a range of socio-economic strata.

Participants

85 parents completed and returned the questionnaire, comprising 52 mothers and 33 fathers.

Measurement

an anonymous self-report questionnaire was purpose designed to provide each parent with an opportunity to reflect on their own experience, with particular emphasis given to the provision of education and support during the early postnatal period.

Findings

a number of themes emerged, including a window of opportunity during the postnatal hospital stay to provide education and support, despite the reduction in the length of stay; the need for a family-centred approach to maternity services; and the significance of self and social network in the early transition to parenthood.

Conclusions

The findings from this stage of the research, combined with a review of the literature, provide insight that will contribute to stage two of the study. At this stage, an action-research group will continue planning to develop specific actions to enhance the provision of education to parents in the early postnatal period. These actions will subsequently be implemented and assessed.

Introduction

It has been asserted that ‘parenting is the most important public health issue facing many Western societies’ (Hanna et al., 2002, p. 209). In particular, the transition to parenthood is identified as a major life event, and may be one of the most acute changes experienced during a person's life (Terry, 1991; Hanna et al., 2002). This study provides insight into the experiences and needs of parents, with the intention of enhancing the education and support provided for them during the early transitional period after the birth of a baby.

The transitional period after the birth of a baby can be a time of great stress and even crisis for many couples (Aston, 2002; Draper, 2003). Although a limited number of researchers indicate that the transition to parenthood is not necessarily a traumatic experience, it is agreed that, in the context of contemporary family life, the birth of a baby involves significant psychological and psychosocial adjustments for parents (Shields and Reid, 1997; Olsson et al., 1998; White et al., 1999; Matthey et al., 2002).

A study undertaken in Sweden concluded that negotiating a healthy transition to parenthood was a primary concern for new parents (White et al., 1999). It has been found that a positive experience throughout the period of transition to parenthood contributes to the parent's ability to master new roles, and ultimately may influence the parents’ relationship with their children over time (Hudson et al., 2001; Fagerskiold et al., 2001).

Nevertheless, many parents do not feel prepared for parenthood, and continue to describe this transitional period as stressful and challenging (Sandford and Lamb, 1997; Cooke and Barclay, 1999; Matthey and Barnett, 1999; Early, 2001; McKellar et al., 2002). Numerous issues contribute to these findings, most notably the reduction of hospital admission time experienced by women after the birth of their baby (Cooke and Barclay, 1999). Over recent decades, the average length of stay after a normal birth in Australia has been reduced from 5 to 3 days (Cooke and Barclay, 1999). The most recent Cochrane review of early postnatal discharge from hospital of healthy mothers and term babies concluded that the risks and benefits associated with early discharge were uncertain (Brown et al., 2002). Although no evidence of adverse outcomes was reported, the methodological limitations of the research included in the review meant that the possibility of adverse outcomes could not be excluded. In surveys conducted by the Victorian Department of Human Services in 1994 and 2000, women rated their experience of postnatal hospital care poorly compared with their experiences of antenatal and intrapartum care (Brown et al., 2004). Mothers commented on how rushed staff appeared and on the lack of support and reassurance. Undoubtedly, shorter hospital stays present a number of challenges to the way in which care is provided by midwives during this time, with the provision of postnatal education and support acknowledged as an area considerably affected by this change in practice (Singh, 2000; Brown et al., 2004).

Further, changes in cultural and social practices within contemporary Western families have influenced the image of the 21st century father (Early, 2001; Draper, 2003). Since the 1970s, men have been encouraged to be active participants in the childbirth experience, and expectations are increasing that fathers will be more involved in the physical and emotional care of their children (White et al., 1999; Greenhalgh et al., 2000; Early, 2001; Persson and Dykes, 2002). Historically, maternity services and parent education have been directed primarily at mothers (Early, 2001; Draper, 2003). The increase in men's participation in childbirth and parenting raises many implications for future directions in the preparation of both men and women for parenthood.

This study commenced with the notion that the current provision of postnatal education is not sufficiently meeting the needs of parents during the early postnatal period, and sought to explore the following research questions: (1) are current strategies used to provide education sufficiently meeting the needs of parents during the early postnatal period?; (2) what do stakeholders believe contributes to the provision of effective education in the early postnatal period?; and (3) will the development and implementation of specific strategies in midwifery practice benefit parents in gaining knowledge and embracing the transition to parenthood?

It is proposed that collaboration with stakeholders, through action research, may enable identification and investigation of specific problem areas in the provision of postnatal education, and may be used to initiate innovative strategies to enhance postnatal education in the Australian health-care environment. The first aspect of this collaboration was the collection of data from parents who, as end-users of postnatal education services, provided valuable reflective insight into the status-quo of these services at a major Australian maternity hospital. This paper documents and explores the insights provided by these parents.

Section snippets

Method

In this study, the researchers have used an action-research methodology, which follows the action research cycle of planning, action, observation and reflection (Kemmis and McTaggart, 1982). Action research is chosen as an appropriate approach for this research because its fundamental aim is to improve practice and involve the people that modified practice will affect (Kemmiss and McTaggart, 1982). Consistent with the process of action research is the idea of a democratic collaboration between

Demographics

The participants consisted of 52 (61.2%) mothers and 33 (38.8%) fathers. Of the 52 mothers who responded, 25 (48.1%) were first-time mothers and 27 (51.9%) were mothers again. Of the 33 fathers who responded, 19 (57.6%) were first-time fathers and 14 (42.4%) were fathers again. The participants came from a diverse catchment area representing various socioeconomic groups; further details of the sample, such as age, ethnic background and type of health cover are included in Table 1.

Forty (76.9%)

Discussion

The authors acknowledge limitations to this study, particularly due to the small sample size and the difficulty this creates in drawing conclusions and generalising from the findings. Furthermore, because of limitations in resources, we were only able to include participants who were literate in English. Nevertheless, the study provides qualitative insights from parents that will contribute to further discussion and may be useful in developing strategies to provide enhanced education and

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