Only one in every four new mothers in the kingdom attend their postnatal care appointments after childbirth, according to a recently published Bahrain-focused study.
This is among the key findings of a study titled, ‘Factors Influencing Women’s Attendance to Postnatal Clinics in the Primary Healthcare Centres in the Kingdom of Bahrain, 2023’, conducted by a group of researchers from the Arabian Gulf University.
“Despite the significance of postnatal care for maternal health, the attendance rate of mothers at postnatal clinics (PNCs) in primary healthcare (PHC) centres in Bahrain is low,” researchers note, in the abstract of the study.
The new study published in the peer-reviewed Cureus medical journal sheds light on why many mothers in Bahrain skip crucial postnatal clinic (PNC) visits after childbirth.
It found that only 27 per cent of mothers surveyed reported attending a PNC appointment. Of the 319 surveyed participants, 31pc were unaware of the existence of PNC within the primary healthcare system, while 42pc were aware but did not attend the clinic.
“Postnatal care is very important for new mothers, especially in the puerperium (post-partum) period, lasting for 40 days after childbirth,” King Hamad American Mission Hospital obstetrics and gynecology consultant Dr Hana Isa Akleh told the GDN.
“Approximately six weeks after childbirth, we ask new mothers to book an appointment so we can do ensure there are no infections in the birth canal and conduct a pap smear test to screen for cervical cancer.
“This appointment is crucial to prevent future abnormalities, especially if the patient has any chronic diseases like hypertension or diabetes.”
Other health-related matters are also discussed.
A total of 319 mothers who brought their children to PHC centres in Bahrain between the ages of six and 12 months in January 2023 were interviewed in this study.
Out of the participants, only 87 attended the PNC after the last delivery, while 99 reported that they were unaware of PNC in PHC centres in Bahrain, and thus they did not attend and 133 participants were aware but did not schedule an appointment.
“In Bahrain, the postnatal visit consists of a single appointment that can be scheduled between six weeks and six months after delivery,” researchers added.
“Despite being important, accessible and cost-free, the annual statistics from the Central Informatics Organisation of Bahrain’s 2019 internal audit revealed that only 29pc of those who had attended antenatal clinics in PHC centres in Bahrain had availed themselves of postnatal care services at PHC centres.”
Among 220 mothers who were aware of the PNC in PHC centres in Bahrain, healthcare providers such as doctors and midwives informed 66pc about it at antenatal visits, or at the post-delivery stage.
Of those, healthcare providers counselled 34pc about the importance of PNC, while the remaining were not.
Approximately 59pc of those who missed counselling about the importance of postnatal care did not attend the clinic after delivery.
Out of 146 participants who were aware of the presence of PNC in PHC, 76pc reported not receiving counselling from healthcare providers regarding the services offered at the PNC.
Of those who did not attend PNC, 41pc cited child responsibility as the primary reason, while 38pc perceived it as not important and 37pc did not want a pelvic examination. Mothers could cite multiple reasons for not attending.
The study proposes a multi-pronged approach to increasing PNC attendance.
“To enhance awareness, we propose incorporating postnatal visits into antenatal counselling during the third trimester and introducing online booking and rescheduling services,” researchers noted.
“Varied schedules, offering evening hours, and tele-consultations can accommodate mothers with childcare responsibilities.
“Furthermore, optimising health education tools, such as boards, brochures, short message service (SMS) and media, alongside strengthening department clerks’ roles, will effectively disseminate information and emphasise the importance of postnatal care.”
According to Royal Bahrain Hospital obstetrics and gynecology consultant Dr Maha Haroun AlRabadi, the key to improving attendance is clearer communication.
“I have found that letting the patients know exactly what to expect during the postnatal appointments, and setting specific appointments for them to come in, helps ensure their attendance,” she told the GDN.
“At the one or two-week mark, they come in so we can check for any complications from childbirth, at the six-week mark for a check-up of their uterus health and for contraception advice and eight weeks after pregnancy, for their pap smear test.
“These appointments are also critical because we can work with mothers on any postpartum mental and emotional health concerns as well.
“While telemedicine is certainly an option, especially for those who are travelling, it is not my preferred one, because documenting and organising these consultations can be a challenge.”
naman@gdnmedia.bh
&uuid=(email))