Maternal self-care in the early postpartum period: An integrative review

Objective: To clarify the concept of maternal self-care in the early postpartum period and to develop a conceptual framework of mothers’ self-care needs. Design: An integrative review concept analysis method was used as described by Whittemore and Knafl (2005). As part of this data analysis process, a matrix based on Orem's self-care theory was developed to facilitate a structured and systematic analysis of the data. Data sources: CINAHL, Embase, PubMed, and Web of Science. Review methods: After systematic and rigorous literature searches, the title and abstract of 1535 studies were scanned while applying five exclusion criteria. This resulted in 29 studies for full text review. Eventually, nine studies were appraised by two quality assessment tools and selected for the analysis. Results: Guided by Orem's self-care theory, we have built a conceptual framework that depicts maternal self-care in the early postpartum period. Mothers’ self-care needs involve numerous and diverse activities, tasks, and emotions, which can be categorised into three themes: universal, developmental, and health self-care needs. Their ability to perform these needs is subjected to various internal and external factors as well as the societal context they live in. Conclusions: Our review indicated that maternal self-care needs, already in the first few days postpartum, go beyond mothers’ physical health as it extends to their emotional well-being as well. Postpartum care is, however, generally centred around physical self-care needs putting mothers’ emotional self-care needs at risk of neglection. Further research is needed to determine how individualised care innovations can promote maternal self-care.