Evidence map›Paper›PMID 38925665›Full record

ArticleBMJ global health2024

Postpartum recovery after severe maternal morbidity in Kilifi, Kenya: a grounded theory of recovery trajectories beyond 42 days.

Ursula Gazeley, Marvine Caren Ochieng, Onesmus Wanje, Angela Koech Etyang, Grace Mwashigadi, Nathan Barreh, Alice Mnyazi Kombo, Mwanajuma Bakari, Grace Maitha, Sergio A Silverio and 5 more

Abstract read
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Article in BMJ global health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

15 authors.

Ursula GazeleyDepartment of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK ursula.gazeley@lshtm.ac.uk.ORCID http://orcid.org/0000-0003-3309-7411
Marvine Caren OchiengCentre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya.
Onesmus WanjeCentre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya.
Angela Koech EtyangCentre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya.
Grace MwashigadiCentre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya.
Nathan BarrehCentre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya.
Alice Mnyazi KomboCentre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya.
Mwanajuma BakariCentre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya.
Grace MaithaCentre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya.
Sergio A SilverioDepartment of Women and Children's Health, King's College London, London, UK.
Marleen TemmermanCentre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya.
Laura MageeDepartment of Women and Children's Health, King's College London, London, UK.
Peter von DadelszenDepartment of Women and Children's Health, King's College London, London, UK.ORCID http://orcid.org/0000-0003-4136-3070
Veronique FilippiDepartment of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.ORCID http://orcid.org/0000-0003-1331-3391
PRECISE Network

Funding

Wellcome Trust
6 · The paper itself

Abstract

introductionThe burden of severe maternal morbidity is highest in sub-Saharan Africa, and its relative contribution to maternal (ill) health may increase as maternal mortality continues to fall. Women's perspective of their long-term recovery following severe morbidity beyond the standard 42-day postpartum period remains largely unexplored.

methodsThis woman-centred, grounded theory study was nested within the Pregnancy Care Integrating Translational Science Everywhere (PRECISE) study in Kilifi, Kenya. Purposive and theoretical sampling was used to recruit 20 women who experienced either a maternal near-miss event (n=11), potentially life-threatening condition (n=6) or no severe morbidity (n=3). Women were purposively selected between 6 and 36 months post partum at the time of interview to compare recovery trajectories. Using a constant comparative approach of line-by-line open codes, focused codes, super-categories and themes, we developed testable hypotheses of women's postpartum recovery trajectories after severe maternal morbidity.

resultsGrounded in women's accounts of their lived experience, we identify three phases of recovery following severe maternal morbidity: 'loss', 'transition' and 'adaptation to a new normal'. These themes are supported by multiple, overlapping super-categories: loss of understanding of own health, functioning and autonomy; transition in women's identity and relationships; and adaptation to a new physical, psychosocial and economic state. This recovery process is multidimensional, potentially cyclical and extends far beyond the standard 42-day postpartum period.

conclusionWomen's complex needs following severe maternal morbidity require a reconceptualisation of postpartum recovery as extending far beyond the standard 42-day postpartum period. Women's accounts expose major deficiencies in the provision of postpartum and mental healthcare. Improved postpartum care provision at the primary healthcare level, with reach extended through community health workers, is essential to identify and treat chronic mental or physical health problems following severe maternal morbidity.

Indexed as

Grounded TheoryPostpartum PeriodAdultFemaleHumansKenyaMorbidityPregnancyPregnancy ComplicationsYoung Adultglobal healthmaternal healthmental health & psychiatryqualitative study

Identifiers

PMID38925665
PMCPMC11202725

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