Abstract

Objective The study aimed to evaluate healthcare use during the postnatal period (PNC) for mothers and their babies, the content of care received, mothers’ perceived quality of care, and the factors influencing these perceptions.

Methods The study analyzed postnatal survey from the maternal eCohort conducted at the Mexican Institute of Social Security (IMSS), which included 973 women aged 18 to 49 recruited after their first antenatal care visit with a family physician at 48 family medicine clinics in eight states in Mexico. We assessed PNC use, content of care and perceived quality using descriptive analysis. We used Poisson multivariable regression analysis to investigate the factors influencing women’s perceptions of higher quality of care during PNC.

Results 29.4% of women and 12.0% of infants lacked healthcare during the postnatal period. Most women who received PNC attended consultations at IMSS (72.3%), while 17.7% combined IMSS with other providers, and 10% used only private services. Infants received 82.4% of recommended care, compared to 66.7% for mothers. The median perceived quality of care among women was 25 points on a scale of 8 to 40. Areas of opportunity include promoting the importance of postnatal consultations among health personnel and women, reducing waiting times, and improving the content and length of consultations. Factors associated with better perceived quality included being over 35, receiving better content of care for infants, and being treated by private providers, while lower education levels, prior pregnancies, and poor health were associated with lower perceived quality.

Conclusion Improvements are needed to ensure all women and infants receive comprehensive postnatal care and perceive it as high quality.

Competing Interest Statement

SVD, MPC, DPM, and CQF are employed by the IMSS, yet IMSS played no role in the design and conduct of the study, in the collection, management, analysis, and interpretation of the data, or in the preparation, review, or approval of the manuscript. CA had declared that no competing interests exist.

Funding Statement

This work was supported by the Call for Funding of the Research Protocols of Transversal Health Research Networks of the Mexican Institute of Social Security for the fiscal year 2023-2024. (R-2022-785-064; grant-recipient-SVD; https://www.imss.gob.mx/profesionales-salud/investigacion/convocatorias). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The study was approved by the Instituto Mexicano del Seguro Social National Research and Ethics Committees (R-2022-785-064). Before participating in the study, all women provided written informed consent form.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

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Yes

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Yes

AbbreviationsIMSSMexican Institute of Social SecurityPAHOPan American Health OrganizationPNCPostnatal careQuESTQuality Evidence for Health System Transformation networkWHOWorld Health Organization