Women's experiences with enhanced recovery after elective caesarean section with next day discharge: A qualitative study.
Early discharge
Elective caesarean section
Enhanced recovery
Qualitative study
Women
Journal
Midwifery
ISSN: 1532-3099
Titre abrégé: Midwifery
Pays: Scotland
ID NLM: 8510930
Informations de publication
Date de publication:
Apr 2020
Apr 2020
Historique:
received:
30
08
2019
revised:
14
01
2020
accepted:
15
01
2020
pubmed:
28
1
2020
medline:
18
11
2020
entrez:
28
1
2020
Statut:
ppublish
Résumé
A maternity service in Australia recently implemented an 'Enhanced recovery after Elective Caesarean' pathway, which includes antenatal preparation and facilitates an active role in postnatal recovery such as encouraging mobility and early cessation of fasting. The pathway includes next day discharge for women and their babies after elective caesarean section and safely transitions maternity care from hospital to home with community midwifery care. While enhanced recovery has been implemented in a number of surgical procedures to reduce hospital stay and to improve patient outcomes it has only been considered for elective caesarean sections in more recent years. Given this, enhanced recovery is not well established or researched in obstetric contexts. Furthermore, women's experiences with reduced hospital stays post-caesarean, particularly next day discharge, is limited. A qualitative explorative descriptive study of women's experiences with the pathway and the associated early transition home will help to inform clinical practice and the research evidence base. Eleven interviews were conducted with women who had experienced the pathway and next day discharge. Thematic analysis was conducted. Three major themes and twelve sub-themes emerged from the data. Major themes identified were women's general experience of an enhanced recovery pathway, their experiences following arrival at home and support at home. All women interviewed were satisfied with the pathway and home recovery. However, there are a number of aspects of care that are essential to a positive experience. This includes excellent support from social networks, healthcare staff and home midwifery care; well managed pain relief; and adequate and timely information, including reassurance that they or their baby could remain in hospital if required. This study takes a woman-centred perspective adding to both literature and practice.
Sections du résumé
BACKGROUND
BACKGROUND
A maternity service in Australia recently implemented an 'Enhanced recovery after Elective Caesarean' pathway, which includes antenatal preparation and facilitates an active role in postnatal recovery such as encouraging mobility and early cessation of fasting. The pathway includes next day discharge for women and their babies after elective caesarean section and safely transitions maternity care from hospital to home with community midwifery care. While enhanced recovery has been implemented in a number of surgical procedures to reduce hospital stay and to improve patient outcomes it has only been considered for elective caesarean sections in more recent years. Given this, enhanced recovery is not well established or researched in obstetric contexts. Furthermore, women's experiences with reduced hospital stays post-caesarean, particularly next day discharge, is limited. A qualitative explorative descriptive study of women's experiences with the pathway and the associated early transition home will help to inform clinical practice and the research evidence base.
METHODS
METHODS
Eleven interviews were conducted with women who had experienced the pathway and next day discharge. Thematic analysis was conducted.
FINDINGS
RESULTS
Three major themes and twelve sub-themes emerged from the data. Major themes identified were women's general experience of an enhanced recovery pathway, their experiences following arrival at home and support at home. All women interviewed were satisfied with the pathway and home recovery. However, there are a number of aspects of care that are essential to a positive experience. This includes excellent support from social networks, healthcare staff and home midwifery care; well managed pain relief; and adequate and timely information, including reassurance that they or their baby could remain in hospital if required.
CONCLUSION
CONCLUSIONS
This study takes a woman-centred perspective adding to both literature and practice.
Identifiants
pubmed: 31986313
pii: S0266-6138(20)30006-1
doi: 10.1016/j.midw.2020.102632
pii:
doi:
Types de publication
Journal Article
Langues
eng
Pagination
102632Informations de copyright
Copyright © 2020 Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Conflict of interest None to declare.