The Breastfeeding Experience of Mothers in Postnatal Hospital Environments: An Ethnographic Study
- Publication Type:
- Thesis
- Issue Date:
- 2021
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Most Australian infants commence breastfeeding in hospital (96%). By one month post hospital discharge exclusive breastfeeding rates drop to 61.4%. This change suggests that postpartum care fails to meet the longer-term breastfeeding needs of new mothers and infants. Very little research has considered the kind of postnatal hospital accommodation that women experience as having an impact on breastfeeding. The aim of this study was to explore the influence of the hospital postnatal physical environment on the breastfeeding experiences of new mothers.
A qualitative ethnographic study using observations, field notes, reflective diary, photographs and interviews took place in a tertiary-referral, Baby Friendly Health Initiative accredited hospital in New South Wales, Australia. Observations of women and infants accommodated in typical postnatal rooms (single or shared 4-bed rooms) took place, day and night. Semi-structured interviews were undertaken with 10 women and six partners located in either single or shared 4-bed rooms, to discuss their experiences of breastfeeding in their allocated postnatal environment.
Thematic analysis of the data revealed two main themes, ‘’Being on guard’’ and ‘’Building a nest’’, each comprising three subthemes. “Being on guard”, described how women in shared rooms experienced breastfeeding in a cubicle surrounded by curtains that could be opened at any time, leaving them exposed. The subthemes, “You just feel the noise”, “Behind the curtains” and “Babies at the desk”, described how women were unable to rest due to high activity and noise levels, an inability to turn down the lights, and unable to have the support of a partner in sharing the care of their baby, particularly overnight. Women were stressed and in a constant state of high alert, which is counterproductive when breastfeeding. The opposite situation occurred for women in single rooms who did not need to be on guard. “Building a Nest” described how women in both single and shared rooms endeavoured to build a quiet, restful and supportive family space, a nest, in which to initiate breastfeeding. The subthemes, “Space for a supporter to stay”, “Feeling protected and private” and “Furnishings to support breastfeeding” revealed how physical boundaries enhanced privacy, rest, physical and emotional support, critical elements supportive of breastfeeding.
There is an urgent need to implement the Australasian Maternity Health Facility guidelines published by the Australasian health infrastructure alliance in 2017, which recommends postnatal women and families are accommodated in single rooms to be supportive of the needs of breastfeeding women.
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