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Caesarean delivery: A risk factor for subsequent preterm birth

Objective: This study examined women’s experiences of recovery and infection (prevention) after caesarean birth. Further, it sought women’s views on the PREPS (Vaginal Preparation at caesarean section to Reduce Endometritis and Prevent Sepsis – a feasibility study of chlorhexidine gluconate) Trial. Design: Qualitative; using focus groups and telephone interviews. Methods Two focus groups and six telephone interviews were carried out between September and October 2017 with a total of 21 women who had undergone caesarean sections in the preceding six months. Focus groups and individual telephone interviews were audio-recorded and transcribed verbatim; a thematic analysis was conducted using NVIVO 11. Results: Women’s priorities in relation to recovery from caesarean births centred on pain (or the lack thereof), mobility (walking and/or driving) and the ability to resume caregiving and everyday activities. Many reported not knowing ‘what’s normal’ in relation to wound healing and did not feel confident in their ability to identify signs of infection. Prevention of womb infection is a major goal of the PREPS trial, however, the majority of participants were not aware that womb (as opposed to wound) infection was a possibility post caesarean birth. While many participants reported receiving some information regarding recovery and infection of varied quality, the majority reported that advice given post-surgery was difficult to recall. Conclusion: Additional strategies are needed to educate women regarding the signs and symptoms of infection after a caesarean section. Women post-caesarean section expressed the need for additional written information. They would overwhelmingly support research in this area