Changes in care in the fourth trimester in Ireland: 2010–2020.

MIDWIVES; MATERNAL health services; HEALTH services accessibility; FOCUS groups; DISCUSSION; ATTITUDES of medical personnel; ATTITUDE (Psychology); DURATION of pregnancy; MIDWIFERY; RESEARCH methodology; UNLICENSED medical personnel; MEDICAL personnel; INTERVIEWING; QUALITATIVE research; DESCRIPTIVE statistics; RESEARCH funding; POSTNATAL care; THEMATIC analysis; CESAREAN section; STATISTICAL sampling; DATA analysis software; COMORBIDITY

Background: There has been a shift in maternity care over the past decade. The changes encountered by postnatal ward staff and the impact of these changes on women postnatally requires exploration. This study aimed to ascertain midwives' and healthcare assistants' perspectives of the changes in postnatal care and challenges to providing care in the current context. Methods: This was a qualitative study involving two focus groups of 15 midwives and healthcare assistants from an Irish urban maternity hospital. The participants' responses were analysed thematically. Results: Changes in women's clinical characteristics, including increased comorbidities and caesarean section rates, were highlighted as creating additional care needs. Furthermore, additional midwifery tasks and clinical protocols as well as shorter hospital stays leave little time for high-quality, woman-centred care. Participants highlighted a negative impact on maternal health from limited follow-up midwifery care in the community. Conclusions: With additional midwifery duties and a reduction in time to complete them, additional community midwifery care is key to providing high-quality follow-on care after postnatal discharge from hospital. [ABSTRACT FROM AUTHOR]