Women’s perspectives on caesarean section recovery, infection and the PREPS trial: a qualitative pilot study

Weckesser, Annalise and Farmer, Nicola and Dam, Rinita and Wilson, Amie and Hodgetts Morton, Victoria and Morris, Katie (2019) Women’s perspectives on caesarean section recovery, infection and the PREPS trial: a qualitative pilot study. BMC Pregnancy and Childbirth, 19. ISSN 1471-2393

Text 10.1186/s12884-019-2402-8 - Published Version Download (251kB)

Abstract

Background
In England, 27.8% of all pregnant women undergo caesarean sections (CS) to deliver their babies. Women undergoing CS are at risk of developing sepsis and post-natal infections, which not only contribute significantly to maternal mortality and morbidity, but also negatively impact upon post-natal recovery and wellbeing. This study explores patients’ priorities in relation to CS recovery, focusing on their knowledge and experiences of infection prevention. The study formed part of the PREPS (Vaginal Preparation at caesarean section to Reduce Endometritis and Prevent Sepsis – a feasibility study of chlorhexidine) Trial; patients’ views on the PREPS Trial were also sought.

Methods
Using qualitative methodology, two focus groups and six telephone interviews were carried out between September and October 2017 with a total of 21 women who had undergone a CS within the preceding six months. Focus groups and individual telephone interviews were audio-recorded and transcribed verbatim; a thematic analysis was conducted using NVivo 11.

Results
Women’s priorities around CS recovery centred on pain (or the lack thereof), mobility and the ability to resume everyday activities, including caregiving. Those undergoing a CS for the first time reported not feeling confident in their ability to identify signs of infection and sought visiting health professionals’ expertise and reassurance. Women were unable to recall whether they had received information regarding infection prevention and felt that they had not received sufficient advice. Some reported receiving general information regarding CS recovery, which ranged in quality. Prevention of womb infection is a major goal of the PREPS trial, however, the majority of women were not aware that womb (as opposed to wound) infection was a post CS risk.

Conclusions
Women undergoing a CS want more information on what constitutes a ‘normal’ post-operative recovery and specifically would welcome written information and infection prevention advice. This should be a key element of improving post-CS maternal experiences and potentially reducing sepsis and infection rates. CS stigma negatively impacts women’s recovery experiences and possibly information provision.

The PREPS team incorporated findings regarding consent pathways for recruiting women into intrapartum research and developed two patient reported outcomes to collect in the main trial.

Item Type:	Article
Identification Number:	https://doi.org/10.1186/s12884-019-2402-8
Dates:	Date Event 5 July 2019 Accepted 15 July 2019 Published Online
Uncontrolled Keywords:	Caesarean section Postnatal infection, Caesarean section recovery, Patient experience, Qualitative research
Subjects:	CAH01 - medicine and dentistry > CAH01-01 - medicine and dentistry > CAH01-01-01 - medical sciences (non-specific) CAH15 - social sciences > CAH15-01 - sociology, social policy and anthropology > CAH15-01-02 - sociology
Divisions:	Faculty of Health, Education and Life Sciences > Centre for Social Care, Health and Related Research (C-SHARR)
Depositing User:	Annalise Weckesser
Date Deposited:	22 Jul 2019 08:51
Last Modified:	03 Mar 2022 17:15
URI:	https://www.open-access.bcu.ac.uk/id/eprint/7739

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