Lack of Patient Preparation for the Postpartum Period and Patients’ Satisfaction With Their Obstetric Clinicians

Abstract
OBJECTIVE: To assess whether lack of patient preparation for common physical and emotional postpartum symptoms is associated with patient satisfaction with obstetric clinicians. METHODS: We conducted a telephone survey of 724 postpartum women. Women were interviewed 2 weeks postpartum to assess self-perceived preparation for 11 common physical and emotional postpartum symptoms, overall preparation for the postpartum experience, physical and emotional symptoms, experience with the health care system, satisfaction with clinician, and other factors. The associations of patient satisfaction with preparation, access to care, demographics, and other factors were examined. RESULTS: Many women were not prepared to expect common postpartum physical and emotional symptoms. Only 24% of the women surveyed were prepared to expect urinary incontinence, and fewer than half were prepared to expect breastfeeding problems, hair loss, hemorrhoids, large mood swings, and anxiety. Lack of preparation for common physical and emotional symptoms was associated with lower satisfaction with the clinician. After adjusting for demographic factors, having a regular doctor, access, physical and emotional symptom status, and other factors, rating the clinician as excellent was associated with preparation for common physical and emotional symptoms (odds ratio 1.08, 95% confidence interval 1.01-1.16), more access, and overall preparation for the postpartum experience. Satisfaction with the clinician was associated with return for postpartum visit within 3 months of delivery (P<.001). CONCLUSION: Lack of preparation for the postpartum experience, including failure to discuss common physical and emotional symptoms, is associated with reduced patient satisfaction with obstetric clinicians. LEVEL OF EVIDENCE: II