The postpartum period is the time of highest risk for maternal death. Quality postpartum education is important to minimize risk. We assessed the postpartum education given to Black mothers on post-birth warning signs by conducting a cross-sectional survey of 80 Black women who had given birth in the previous 12 months. Participants completed an electronic questionnaire, and data were analyzed using descriptive and regression models. On average, educational needs were reported by 20 participants as being unmet, 27 as being met, and 30 as being more than met. Only 54.4% of the participants reported receiving education about postpartum warning signs. The percentage of participants able to identify each sign ranged from 11.4% to 35.4%. No participants identified more than five of the nine warning signs, and 25% identified none. Knowledge of post-birth warning signs was significantly associated with the delivery hospital, household income, and education on warning signs before discharge.
AdamsY. J.RayH. (2019). Knowledge of postpartum care and postbirth warning signs among midwives in Ghana. Birth, 47(4), 357–364. https://doi.org/10.1111/birt.12472
2.
AdamsY. J.StommelM.AyoolaA. B.HorodynskiM.MalataA.SmithB. A. (2018). Husbands’ knowledge and attendance at wives’ postpartum care among rural farmers. Health Care for Women International, 39(9), 1020–1037. https://doi.org/10.1080/07399332.2018.1491976
3.
AdamsY. J.SmithB. A. (2018). Integrative review of factors that affect the use of postpartum care services in developing countries. Journal of Obstetric, Gynecologic & Neonatal Nursing, 47(3), 371–384. https://doi.org/10.1016/j.jogn.2018.02.006
4.
AmenuG.MulawZ.SeyoumT.BayuH. (2016). Knowledge about danger signs of obstetric complications and associated factors among postnatal mothers of Mechekel District Health Centers, East Gojjam Zone, Northwest Ethiopia, 2014. Scientifica, 2016, 1–7. https://doi.org/10.1155/2016/3495416
5.
AseltineR. H.Jr.YanJ.FleischmanS.KatzM.DeFrancescoM. (2015). Racial and ethnic disparities in hospital readmissions after delivery. Obstetrics & Gynecology, 126(5), 1040–1047. https://doi.org/10.1097/AOG.0000000000001090
AzizA.Gyamfi-BannermanC.SiddiqZ.WrightJ. D.GoffmanD.SheenJ. J.D’AltonM. E.FriedmanA. M. (2019). Maternal outcomes by race during postpartum readmissions. American Journal of Obstetrics and Gynecology, 220(5), 484.e1–484.e10. https://doi.org/10.1016/j.ajog.2019.02.016
8.
BililignN.MulatuT. (2017). Knowledge of obstetric danger signs and associated factors among reproductive-age women in Raya Kobo district of Ethiopia: A community-based cross-sectional study. BMC Pregnancy and Childbirth, 17(1), 70. https://doi.org/10.1186/s12884-017-1253-4
9.
BintabaraD.MpembeniR. N.MohamedA. A. (2017). Knowledge of obstetric danger signs among recently-delivered women in Chamwino district, Tanzania: A cross-sectional study. BMC Pregnancy and Childbirth, 17(1), 276. https://doi.org/10.1186/s12884-017-1469-3
10.
BogaleD.MarkosD. (2015). Knowledge of obstetric danger signs among child bearing age women in Goba district, Ethiopia: A cross-sectional study. BMC Pregnancy and Childbirth, 15(1), 77. https://doi.org/10.1186/s12884-015-0508-1
11.
BowlesB. C.GibsonM.JansenL. (2020). Continuing education module—the childbirth educator’s role in teaching post-birth warning signs. The Journal of Perinatal Education, 29(2), 90–94. https://doi.org/10.1891/J-PE-D-19-00008
12.
BuchkoB. L.GutshallC. H.JordanE. T. (2012). Improving quality and efficiency of postpartum hospital education. The Journal of Perinatal Education, 21(4), 238–247. https://doi.org/10.1891/1058-1243.21.4.238
13.
DanguraA. D. (2020). Knowledge about childbirth and postpartum obstetric danger signs and associated factors among mothers in Dale district, Southern Ethiopia. BMC Pregnancy and Childbirth, 20(1), 340. https://doi.org/10.1186/s12884-020-02989-7
DavisN. L.SmootsA. N.GoodmanD. A. (2019). Pregnancy-Related Deaths: Data from 14 U.S. Maternal Mortality Review Committees, 2008–2017. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services.
16.
ElyD. M.DriscollA. K. (2020). Infant mortality in the United States, 2018: Data from the period linked birth/infant death file. From the centers for disease control and prevention, National Center for Health Statistics, National Vital Statistics System, 69(7), 1–18.
17.
GeletoA.ChojentaC.MusaA.LoxtonD. (2018). Barriers to access and utilization of emergency obstetric care at health facilities in sub-Saharan Africa: A systematic review of literature. Systematic Reviews, 7(1), 183. https://doi.org/10.1186/s13643-018-0842-2
18.
GeletoA.ChojentaC.MusaA.LoxtonD. (2019). Women’s knowledge of obstetric danger signs in Ethiopia (WOMEN's KODE): A systematic review and meta-analysis. Systematic Reviews, 8(1), 63. https://doi.org/10.1186/s13643-019-0979-7
19.
GiurgescuC.BanksA.DancyB. L.NorrK. (2013). African American women’s views of factors impacting preterm birth. MCN: The American Journal of Maternal/Child Nursing, 38(4), 229–234. https://doi.org/10.1097/NMC.0b013e318293bbbb
JainJ.MorozL. (2017). Strategies to reduce disparities in maternal morbidity and mortality: Patient and provider education. Seminars in Perinatology, 41(5), 323–328. https://doi.org/10.1053/j.semperi.2017.04.010
22.
Joint Commission. (2010). Advancing effective communication, cultural competence, and patient- and family-centered care: A roadmap for hospitals [PDF file]. ///Users/lynnsladek/Downloads/ARoadmapforHospitalsfinalversion727pdf.pdf
23.
KassebaumN. J.BarberR. M.BhuttaZ. A.DandonaL.GethingP. W.HayS. I.KinfuY.LarsonH. J.LiangX.LimS. S.LopezA. D.LozanoR.MensahG. A.MokdadA. H.NaghaviM.PinhoC.SalomonJ. A.SteinerC.VosT.. . . MurrayC. J. L. (2016). Global, regional, and national levels of maternal mortality, 1990–2015: A systematic analysis for the Global Burden of Disease Study 2015. The Lancet, 388(10053), 1775–1812. https://doi.org/10.1016/S0140-6736(16)31470-2
24.
KassebaumN. J.Bertozzi-VillaA.CoggeshallM. S.ShackelfordK. A.SteinerC.HeutonK. R.Gonzalez-MedinaD.BarberR.HuynhC.DickerD.TemplinT.WolockT. M.OzgorenA. A.Abd-AllahF.AberaS. F.AbubakarI.AchokiT.AdelekanA.AdemiZ.. . . LozanoR. (2014). Global, regional, and national levels and causes of maternal mortality during 1990–2013: A systematic analysis for the Global Burden of Disease Study 2013. The Lancet, 384(9947), 980–1004. https://doi.org/10.1016/S0140-6736(14)60696–6
25.
KleppelL.SupleeP. D.StuebeA. M.BinghamD. (2016). National initiatives to improve systems for postpartum care. Maternal and Child Health Journal, 20(S1), 66–70. https://doi.org/10.1007/s10995-016-2171-1
26.
LogsdonM. C.DavisD. W.MyersJ. A.MastersonK. M.RushtonJ. A.LaufA. P. (2018). Do new mothers understand the risk factors for maternal mortality?MCN: The American Journal of Maternal/Child Nursing, 43(4), 201–205. https://doi.org/10.1097/NMC.0000000000000434
27.
LuM. C.HighsmithK.de la CruzD.AtrashH. K. (2015). Putting the “M” back in the maternal and child health bureau: Reducing maternal mortality and morbidity. Maternal and Child Health Journal, 19(7), 1435–1439. https://doi.org/10.1007/s10995-015-1665-6
28.
MarcusC. (2014). Strategies for improving the quality of verbal patient and family education: A review of the literature and creation of the EDUCATE model. Health Psychology and Behavioral Medicine, 2(1), 482–495.
McLemoreM. R.AltmanM. R.CooperN.WilliamsS.RandL.FranckL. (2018). Health care experiences of pregnant, birthing and postnatal women of color at risk for preterm birth. Social Science & Medicine, 201, 127–135. https://doi.org/10.1016/j.socscimed.2018.02.013
31.
MershaA. G. (2018). Male involvement in the maternal health care system: Implication towards decreasing the high burden of maternal mortality. BMC Pregnancy and Childbirth, 18(1), 493. https://doi.org/10.1186/s12884-018-2139-9
32.
MulugetaA. K.GiruB. W.BerhanuB.DemelewT. M. (2020). Knowledge about birth preparedness and complication readiness and associated factors among primigravida women in Addis Ababa governmental health facilities, Addis Ababa, Ethiopia, 2015. Reproductive Health, 17(1), 15. https://doi.org/10.1186/s12978-020-0861-z
33.
OguntundeO.NyenwaJ.YusufF. M.DaudaD. S.SalihuA.SinaiI. (2019). Factors associated with knowledge of obstetric danger signs and perceptions of the need for obstetric care among married men in northern Nigeria: A cross-sectional survey. BMC Pregnancy and Childbirth, 19(1), 123. https://doi.org/10.1186/s12884-019-2271-1
34.
PetersenE. E.DavisN. L.GoodmanD.CoxS.MayesN.JohnstonE.SyversonC.SeedK.Shapiro-MendozaC. K.CallaghanW. M.BarfieldW. (2019). Vital signs: Pregnancy-related deaths, United States, 2011–2015, and strategies for prevention, 13 states, 2013–2017. Morbidity and Mortality Weekly Report, 68, 423–429. https://doi.org/10.15585/mmwr.mm6818e1
RahmanA. E.PerkinsJ.IslamS.SiddiqueA. B.MoinuddinM.AnwarM. R.MazumderT.AnsarA.RahmanM. M.RaihanaS.CapelloC.SantarelliC.El ArifeenS.HoqueD. M. E. (2018). Knowledge and involvement of husbands in maternal and newborn health in rural Bangladesh. BMC Pregnancy and Childbirth, 18(1), 247. https://doi.org/10.1186/s12884-018-1882-2
38.
SalemA.LacourO.ScaringellaS.HerinianasoloJ.BenskiA. C.StancanelliG.VassilakosP.PetignatP.SchmidtN. C. (2018). Cross-sectional survey of knowledge of obstetric danger signs among women in rural Madagascar. BMC Pregnancy and Childbirth, 18(1), 46. https://doi.org/10.1186/s12884-018-1664-x
39.
SomerS. J. H.SinkeyR. G.BryantA. S. (2017). Epidemiology of racial/ethnic disparities in severe maternal morbidity and mortality. Seminars in Perinatology, 41(5), 258–265. https://doi.org/10.1053/j.semperi.2017.04.001
40.
StataCorp. (2017). Stata statistical software: Release 16. StataCorp LLC.
41.
SupleeP. D.BinghamD.KleppelL. (2017). Nurses’ knowledge and teaching of possible postpartum complications. MCN: The American Journal of Maternal/Child Nursing, 42(6), 338–344. https://doi.org/10.1097/NMC.0000000000000371
42.
SupleeP. D.KleppelL.BinghamD. (2016). Discharge education on maternal morbidity and mortality provided by nurses to women in the postpartum period. Journal of Obstetric, Gynecologic & Neonatal Nursing, 45(6), 894–904. https://doi.org/10.1016/j.jogn.2016.07.006
43.
SupleeP. D.KleppelL.Santa-DonatoA.BinghamD. (2016). Improving postpartum education about warning signs of maternal morbidity and mortality. Nursing for Women’s Health, 20(6), 552–567. https://doi.org/10.1016/j.nwh.2016.10.009
44.
TeefeyC. P.DurnwaldC. P. (2017). Strategies to reduce disparities in maternal morbidity and mortality: The role of obesity and metabolic disease. Seminars in Perinatology, 41(5), 287–292. https://doi.org/10.1053/j.semperi.2017.04.005
45.
TokhiM.Comrie-ThomsonL.DavisJ.PortelaA.ChersichM.LuchtersS. (2018). Involving men to improve maternal and newborn health: A systematic review of the effectiveness of interventions. PLoS One, 13(1), e0191620. https://doi.org/10.1371/journal.pone.0191620
46.
VadnaisM. A.DodgeL. E.AwtreyC. S.RicciottiH. A.GolenT. H.HackerM. R. (2012). Assessment of long-term knowledge retention following single-day simulation training for uncommon but critical obstetrical events. The Journal of Maternal-Fetal & Neonatal Medicine, 25(9), 1640–1645. https://doi.org/10.3109/14767058.2011.648971
47.
VanderbiltA. A.WrightM. S.BrewerA. E.MurithiL. K.ConeyP. (2015). Increasing knowledge and health literacy about preterm births in underserved communities: An approach to decrease health disparities, a pilot study. Global Journal of Health Science, 8(1), 83. https://doi.org/10.5539/gjhs.v8n1p83
48.
VedamS.StollK.TaiwoT. K.RubashkinN.CheyneyM.StraussN.McLemoreM.CadenaM.NetheryE.RushtonE.SchummersL.DeclercqE. (2019). The Giving Voice to Mothers study: Inequity and mistreatment during pregnancy and childbirth in the United States. Reproductive Health, 16(1), 1–18. https://doi.org/10.1186/s12978-019-0729-2
WassihunB.NegeseB.BedadaH.BekeleS.BanteA.YeheyisT.AbebeA.uliD.MohammedM.GashawbezS.HussenE. (2020). Knowledge of obstetric danger signs and associated factors: A study among mothers in Shashamane town, Oromia region, Ethiopia. Reproductive Health, 17(1), 4. https://doi.org/10.1186/s12978-020-0853-z
51.
WeissM. E.LokkenL. (2009). Predictors and outcomes of postpartum mothers’ perceptions of readiness for discharge after birth. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 38(4), 406–417. https://doi.org/10.1111/j.1552-6909.2009.01040.x
52.
WeissM. E.PiacentineL. B.LokkenL.AnconaJ.ArcherJ.GresserS.HolmesS. B.TomanS.ToyA.Vega-StrombergT. (2007). Perceived readiness for hospital discharge in adult medical-surgical patients. Clinical Nurse Specialist, 21(1), 31–42. https://doi.org/10.1097/00002800-200701000-00008
53.
World Health Organization, United Nations Children’s Emergency Fund, United Nations Population Fund, World Bank Group & The United Nations Population Division (2019). Trends in maternal mortality 2000 to 2017: Estimates by WHO, UNICEF, UNFPA, World Bank Group, and the United Nations Population Division. World Health Organization, United Nations Children’s Emergency Fund, United Nations Population Fund, World Bank Group & The United Nations Population Division
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