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Timing Postpartum Education to Create the Best Outcomes: Advice from New Parents

#1 · July 20, 2023, 10:18 am

Quote from Jessa VonFeldt on July 20, 2023, 10:18 am
Written by Debbie Young, MSL, ICCE, LCCE, CLC 

As part of InJoy’s research into creating an effective postpartum teaching solution, we assembled several small focus groups of new parents with babies or children under the age of two in different parts of the country. Our goal? To find out what was working, and what wasn’t, when it came to their postpartum education. From these participants, we gleaned some important information about the timing and content parents need for a more informed (and possibly easier) time in the postpartum period. Perhaps the families you serve have had some of the same experiences!

During the focus groups, we asked them to recall their postpartum experiences. Almost all the participants agreed that their prominent feelings in the hospital after the baby was born included being overwhelmed, tired, ready to go home, and some were in pain. Possibly because of these feelings, most didn’t even realize that there were education requirements they had to meet before leaving the hospital or that they were being provided with education at all.

HOW NEW PARENTS PREFER TO LEARN

The parents said they would prefer learning about important things one-on-one from the nurse and particularly liked the bathing and diapers demonstrations. Other options they liked and used were apps or videos on their phone.

Some of the participants said that they did not fully engage in the educational materials offered during their stay or at home due to feeling tired or overwhelmed, but mostly because they weren’t pointed out by their nurse. Those who engaged with discharge books and other print materials in the hospital and later at home mentioned that they were specifically told to do so, and they did refer to them and find them helpful once they were made aware of them.

They also appreciated the nurse hotlines provided after birth and being informed of local community resources, though some got lost in a sea of paperwork in their discharge folder.

Most importantly, however, they said that they would have preferred learning crucial information about the postpartum period BEFORE the baby was born, when they were more clear-minded and less overwhelmed.

WHAT ARE THE GAPS?

In a discussion of what might have motivated them to engage in the educational materials during their stay, most said that timing and emphasis on what was important to learn would have made a difference. Some were frustrated about being offered education when it was not convenient for them, like when they were tired, sleeping, or trying to shower. A few said that if the nurse caught them at a good time, they did listen to what was said, and they engaged more in the learning materials. Some were offered videos on their television, but they weren’t always easy to hear or to focus on and this left them feeling more stressed.

They were also concerned about contradictory information given by different hospital staff. Some needed more information on breastfeeding and sleep. Others mentioned that the nurses focused a lot on breastfeeding and newborn care but offered very little education on maternal care and postpartum health, as far as they could remember. This made them feel like their own health was less important than their baby’s. It also drew focus on the importance of including partners or support people in education when possible (because provided education isn’t always retained!). Most were left feeling like they did not get enough information for a smooth transition home and that they were not aware enough of the signs of postpartum preeclampsia, hemorrhage, infection, or PMAD.

WHY IS THIS IMPORTANT?

The Joint Commission and other national health organizations speak to the need to bring awareness around critical postpartum issues, and the lack of education these participants found could have led to difficulties or tragedy. Learning warning signs and safety information regarding the postpartum period is of utmost importance. According to the CDC, in 2021, 1,205 women died of maternal causes in the US and that was up from 861 in 2020 and even less in 2019. For additional perspectives on this, in 2021 there were 32.9 deaths per 100,000 live births but in 2020, the rate was 23.8. You may have heard that over 80% of those deaths are preventable. Non-Hispanic Black people have more than double the chance of dying in the postpartum as Non-Hispanic White people.

CLOSING THE GAPS

We know that not all pregnant people take a childbirth or other class that would touch on postpartum topics. In the group we worked with 62% took some type of prenatal class, mostly childbirth education or breastfeeding basics. Some were unable to get to class due to COVID, and others took an online or virtual class during that time. For those that did not take a class, their main learning came from books that the pregnant mother read alone or with her partner.

What can we do better?

Educate prenatally about postpartum---design specific classes and provide essential information online during pregnancy that reaches all patients, whether or not they take a traditional class

Prioritize discharge teaching to the most important topics and send patients home with additional information they can access when it becomes relevant to them

Have nurses point out the educational materials available and refer to them (or better yet, teach from them!) in the hospital

Follow up with patients in the weeks after birth or provide a hotline and links to community resources (via paper and digitally where they are easy to find!)

Use educational materials that help you standardize messaging and provide continuity of care

Involve partners and support people in education sessions

If videos are played at the bedside, be sure parents can hear them clearly and can stop and start them as needed (also consider videos they can watch on their own phone)

Perhaps you are already doing some or all the above, or perhaps you could use a little help. In addition to speaking with parents, InJoy interviewed a group of nurses and managers to develop our Complete Postpartum Teaching Solution, which provides solutions to many of challenges of providing postpartum education. Helping all pregnant parents learn what to expect in the hospital, when they bring the baby home, and important warning signs may help reduce the morbidity and mortality rates in the US and ultimately help parents have a better experience. One participant summed it up well with, “You don’t know what you don’t know until you realize you need to know it.”

Related InJoy Products:

Preparing for Your Hospital Stay & Recovery: Express Online Module

Understanding Postpartum Health & Baby Care Book + Guided Learning Web App

Understanding Postpartum Health & Baby Care Video Program

Free Webinar: Exploring the Unmet Needs of Postpartum Women

Debbie Young, MSL, ICCE, LCCE, CLC, ICBD, is the Customer Relations Manager at InJoy. Working with families as an educator and doula since 1987 and after using InJoy products in her work since 1994, Debbie joined the InJoy team in 2013. She continues to be involved with families as a doula and a childbirth educator on a part-time basis. She teaches, writes and speaks on various birth, postpartum and building family subjects. Debbie is a past president of DONA International and was the Managing Editor for the International Doula for eight years. She is the current President Elect for ICEA.

She has a BA in Health Promotion: Women’s Health and a Master’s in Leadership through Grand Canyon University. Debbie has interviewed many leading professionals in the Maternal/Child field.

Written by Debbie Young, MSL, ICCE, LCCE, CLC 

As part of InJoy’s research into creating an effective postpartum teaching solution, we assembled several small focus groups of new parents with babies or children under the age of two in different parts of the country. Our goal? To find out what was working, and what wasn’t, when it came to their postpartum education. From these participants, we gleaned some important information about the timing and content parents need for a more informed (and possibly easier) time in the postpartum period. Perhaps the families you serve have had some of the same experiences!

During the focus groups, we asked them to recall their postpartum experiences. Almost all the participants agreed that their prominent feelings in the hospital after the baby was born included being overwhelmed, tired, ready to go home, and some were in pain. Possibly because of these feelings, most didn’t even realize that there were education requirements they had to meet before leaving the hospital or that they were being provided with education at all.

HOW NEW PARENTS PREFER TO LEARN

The parents said they would prefer learning about important things one-on-one from the nurse and particularly liked the bathing and diapers demonstrations. Other options they liked and used were apps or videos on their phone.

Some of the participants said that they did not fully engage in the educational materials offered during their stay or at home due to feeling tired or overwhelmed, but mostly because they weren’t pointed out by their nurse. Those who engaged with discharge books and other print materials in the hospital and later at home mentioned that they were specifically told to do so, and they did refer to them and find them helpful once they were made aware of them.

They also appreciated the nurse hotlines provided after birth and being informed of local community resources, though some got lost in a sea of paperwork in their discharge folder.

Most importantly, however, they said that they would have preferred learning crucial information about the postpartum period BEFORE the baby was born, when they were more clear-minded and less overwhelmed.

WHAT ARE THE GAPS?

In a discussion of what might have motivated them to engage in the educational materials during their stay, most said that timing and emphasis on what was important to learn would have made a difference. Some were frustrated about being offered education when it was not convenient for them, like when they were tired, sleeping, or trying to shower. A few said that if the nurse caught them at a good time, they did listen to what was said, and they engaged more in the learning materials. Some were offered videos on their television, but they weren’t always easy to hear or to focus on and this left them feeling more stressed.

They were also concerned about contradictory information given by different hospital staff. Some needed more information on breastfeeding and sleep. Others mentioned that the nurses focused a lot on breastfeeding and newborn care but offered very little education on maternal care and postpartum health, as far as they could remember. This made them feel like their own health was less important than their baby’s. It also drew focus on the importance of including partners or support people in education when possible (because provided education isn’t always retained!). Most were left feeling like they did not get enough information for a smooth transition home and that they were not aware enough of the signs of postpartum preeclampsia, hemorrhage, infection, or PMAD.

WHY IS THIS IMPORTANT?

The Joint Commission and other national health organizations speak to the need to bring awareness around critical postpartum issues, and the lack of education these participants found could have led to difficulties or tragedy. Learning warning signs and safety information regarding the postpartum period is of utmost importance. According to the CDC, in 2021, 1,205 women died of maternal causes in the US and that was up from 861 in 2020 and even less in 2019. For additional perspectives on this, in 2021 there were 32.9 deaths per 100,000 live births but in 2020, the rate was 23.8. You may have heard that over 80% of those deaths are preventable. Non-Hispanic Black people have more than double the chance of dying in the postpartum as Non-Hispanic White people.

CLOSING THE GAPS

We know that not all pregnant people take a childbirth or other class that would touch on postpartum topics. In the group we worked with 62% took some type of prenatal class, mostly childbirth education or breastfeeding basics. Some were unable to get to class due to COVID, and others took an online or virtual class during that time. For those that did not take a class, their main learning came from books that the pregnant mother read alone or with her partner.

What can we do better?

Educate prenatally about postpartum---design specific classes and provide essential information online during pregnancy that reaches all patients, whether or not they take a traditional class
Prioritize discharge teaching to the most important topics and send patients home with additional information they can access when it becomes relevant to them
Have nurses point out the educational materials available and refer to them (or better yet, teach from them!) in the hospital
Follow up with patients in the weeks after birth or provide a hotline and links to community resources (via paper and digitally where they are easy to find!)
Use educational materials that help you standardize messaging and provide continuity of care
Involve partners and support people in education sessions
If videos are played at the bedside, be sure parents can hear them clearly and can stop and start them as needed (also consider videos they can watch on their own phone)

Perhaps you are already doing some or all the above, or perhaps you could use a little help. In addition to speaking with parents, InJoy interviewed a group of nurses and managers to develop our Complete Postpartum Teaching Solution, which provides solutions to many of challenges of providing postpartum education. Helping all pregnant parents learn what to expect in the hospital, when they bring the baby home, and important warning signs may help reduce the morbidity and mortality rates in the US and ultimately help parents have a better experience. One participant summed it up well with, “You don’t know what you don’t know until you realize you need to know it.”

Related InJoy Products:

Debbie Young, MSL, ICCE, LCCE, CLC, ICBD, is the Customer Relations Manager at InJoy. Working with families as an educator and doula since 1987 and after using InJoy products in her work since 1994, Debbie joined the InJoy team in 2013. She continues to be involved with families as a doula and a childbirth educator on a part-time basis. She teaches, writes and speaks on various birth, postpartum and building family subjects. Debbie is a past president of DONA International and was the Managing Editor for the International Doula for eight years. She is the current President Elect for ICEA.

She has a BA in Health Promotion: Women’s Health and a Master’s in Leadership through Grand Canyon University. Debbie has interviewed many leading professionals in the Maternal/Child field.