Experiences of Early Postnatal Discharge Home as Perceived by Mothers and Healthcare Professionals

Official title

Expériences du Retour à Domicile Post-natal précoce Par Les mères et Les Professionnels de santé : enquête Qualitative Sur Les Pratiques et Besoins

Overview

In recent years, the average length of stay in maternity units has decreased, leading to the development of early postnatal discharge home (EPDH) programs. Postnatal follow-up is a major public health issue, as it supports the physical and psychological well-being of mothers and newborns, helps parents adjust to their new roles, and promotes health prevention and education. International studies show that mothers expect longer and more comprehensive follow-up, particularly regarding child development, sexuality, contraception, and returning to work. In France, EPDH has existed since the early 2000s and is offered to low-risk mothers and newborns shortly after birth, with two or three follow-up visits at home or in healthcare facilities. As these programs are expected to expand, there is a need to better understand the experiences and needs of both mothers and healthcare professionals. This qualitative study, conducted in the Val-de-Marne department, aims to explore how they experience early discharge at individual, organizational, and medical levels. It seeks to identify the factors that contribute to positive or negative postnatal experiences and to compare local findings with existing international research.

Detailed description

In recent years, the average length of stay in maternity units has decreased, and various early postnatal discharge home programs have been implemented. From a public health perspective, postnatal follow-up involves multiple challenges: it helps ensure the physical and psychological well-being of both mother and child and provides parents with support in caring for their newborn. During a period of vulnerability, it supports parents in their new roles while also contributing to health promotion and prevention (health behaviors, intra-family violence, etc.).

At the international level, several studies have identified the expectations of mothers and parents, who report a need for longer follow-up focused on child development, sexuality, contraception, and return to work.

In France, early postnatal discharge home (EPDH) has existed since the early 2000s. It is offered to low-risk women and newborns (as defined by the French National Authority for Health), two days after a vaginal birth and three days after a cesarean section. The program includes two or three follow-up visits, either at home or in a healthcare setting.

Early postnatal discharge programs are expected to expand as part of the reorganization of peri- and postnatal care, which requires the development of community-based services enabling mothers to access healthcare professionals as close as possible to their homes. This entails gaining a better understanding of the actual needs of mothers and healthcare professionals across different regions, which are characterized by considerable diversity.

This study is conducted in order to document the needs of mothers and healthcare professionals who experience early postnatal discharge home (EPDH) in the Val-de-Marne department.

It is a qualitative study that does not aim to test a hypothesis, but rather to document lived experiences in order to propose explanatory hypotheses. Accordingly, the study is grounded in the following research questions:

* How do healthcare professionals and mothers experience early postnatal discharge home in Val-de-Marne, at the individual, collective, organizational, familial, and medical levels, among others? * According to them, what are the dimensions of a positive or negative postnatal experience? What are their needs and expectations? * Do the experiences of mothers and healthcare professionals (as documented in this study) overlap with those identified in the predominantly international literature, or do they differ?

Interventions

• Other The study is qualitative, prospective, and multicenter. Participation is offered to centers and individuals with experience of early postnatal discharge home who meet the inclusion criteria
  To document the experiences of those involved, the Intercommunal Hospital Center of Créteil (CHIC), the Perinatal Network of Val-de-Marne (RPVM), and the Ile-de-France Regional Health Agency (ARS) are conducting a study with women and healthcare professionals who experience early postnatal discharge home in Val-de-Marne. The originality of this approach lies in using a qualitative methodology to understand early discharge home in all its complexity, giving due importance to the subjectivity and

Primary outcome measures

• The results of the thematic data analysis (see above "Data Analysis"). [Time frame: Eight months]

Eligibility criteria

Selection of Maternity

Inclusion criteria

• Public maternity unit in Val-de-Marne offering mothers early discharge home and willing to participate

Exclusion criteria

• Maternity unit opposed to participation

Selection of Home Care Professionals

Inclusion criteria

-Healthcare professional involved in the follow-up of early postnatal discharge home for women in Val-de-Marne and willing to participate in the study

Inclusion criteria

-Person with expertise in early return home and willing to participate

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Observational model

Other

Study locations

Center list to be confirmed — check the primary protocol.

Identifiers

NCT: NCT07425665 · BbDom94

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗