Women's experience of the decision-making process for home-based postnatal midwifery care when discharged early from hospital: A Swedish interview study

Eur J Midwifery. 2022 Sep 9;6:60. doi: 10.18332/ejm/152547. eCollection 2022.

Abstract

Introduction: Women and their families are often excluded from reproductive decision-making processes in postnatal care, and do not know which choices they have. Shared decision-making is a critical but challenging component of maternity care quality. The aim was to explore women's experience of the decision-making process about early return from hospital with home-based postnatal midwifery care.

Methods: This is a descriptive qualitative study. In total, 24 women participated in a semi-structured telephone interview, averaging 58 minutes. Data were analyzed using thematic analysis according to Braun and Clarke.

Results: The main theme explored was 'The supremacy of giving new mothers autonomy to decide on the postnatal care model they would prefer'. Important aspects of the women's decision-making process were the time-point for receiving information about the home-based midwifery model of care, to receive sufficient time for consideration about the model, to have a rationale for choosing home-based care, and to comprehend the concept.

Conclusions: Women must be given sufficient time for consideration and necessary information about postnatal care models, which is essential for making an informed decision. Parents' readiness for discharge must be identified by midwives who need to facilitate shared decision-making by introducing early postnatal care model choices, describe these options, and support women to explore their preferences. Midwives must ensure parents' participation in decision-making for the time of discharge from hospital.

Keywords: decision-making; experiences; home-based care; midwifery care; mothers; postnatal care.