'It's much easier to get help for the baby': women, postpartum health and maternal and child health care groups.(Case study)

ABSTRACT

There is a substantial amount of investigation of women's experience of giving birth in Australia, and a developing understanding of women's experiences of their own health in the postpartum period and use of health services. This article reports on a preliminary study investigating women's post-birth health experiences. The study involved focus groups with thirty-two women involved in maternal and child health care groups. We found that all women reported minor health complications, but these were often not addressed due to the pressures of new motherhood. Women indicated that maternal and child health nurses and other women were important sources of information and assistance in the management of these health problems.

KEY WORDS

women's health; sociology; birth; postpartum; maternal and child health care

Introduction

The period after the birth of a baby is recognised as a period of social and physical adjustment. In the study reported here, entitled 'Bodies after Birth', we were interested in the primary and secondary health issues women described in the first twelve months following the birth of their first child. We were also interested in the services and information sources they accessed for these health issues. Studies carried out in contemporary Western societies have identified physical and emotional after-effects of birth, including breastfeeding and urinary problems, various forms of postpartum morbidity, sexual health issues, and a relatively widespread tendency for postpartum women to struggle with timely health-seeking behaviour (Barrett et al 1999; Glazener et al 1995; McQueen and Mander 2003; Symon et al 1999). Kearns et al (1997) suggest that some groups of women may feel inhibited in expressing their postpartum health needs. Gennaro and Fedher (2000) argue that it is important for health care providers to understand why women may have difficulties in prioritising their own health.

In Australia, Cooke and Barclay (1999) suggest that there has not been enough qualitative evaluation of postnatal services for effectiveness and adequacy despite changes to service delivery. The work on postpartum health conducted by Zadoroznyj (1996) found that evaluation of medical care for postpartum health issues was quite high, but issues of communication were less satisfactory to women in the post-birth period. Brown and Lumley (1998) suggest there is significant under-reporting of postpartum health issues and women may need encouragement to communicate about their health. New models focused on continuity of care across the prenatal and antenatal period need further investigation (Keleher et al 2002). Lloyd and Hawe (2003) suggest that there needs to be a broader examination of how postnatal health problems are framed in order to maximise assistance for women in the transition to motherhood (see also Gonda 1998). It is significant that the majority of these studies are closely focused on the immediate period post-birth; while this small-scale, exploratory, qualitative study was designed to gather data on the health issues of first time mothers in the initial months of mothering. It has been argued that little or no attention is given to the postnatal period (Symon et al 2003).