Culturally Competent Postpartum Care for Puerto Rican Women: Results of a Qualitative Study

Objective:  With projected Hispanic population growth, health care utilization will increase proportionately.  Hispanics have been identified as a population at risk for health disparities and Hispanic women receive fewer preventive services, experience a higher incidence of postpartum complications, and report less satisfaction with the quality of care than non-Hispanic Blacks or Whites.  Puerto Ricans are in greater jeopardy of having poor health outcomes than any other Hispanic sub-group yet there have been few studies on this topic. 

Design: A descriptive qualitative study was conducted that examined infant care and self-care knowledge acquisition needs and issues among primiparous Puerto Rican women in the post-partum period. 

Setting: A northeastern U.S. community.  

Sample: A purposive sample was selected via the social network sampling method.  Twenty-two primiparous Puerto Rican women were included who had no severe intrapartum or postpartum complications and were discharged home with their full-term, medically uncomplicated infant within the previous 2 year period.       

Methods: Participants completed a demographic information form with established face and content validity.  Thirty to sixty-minute semi-structured individual interviews were conducted at community sites and continued until saturation of data was achieved.  Participants verified transcribed interviews.  Data were analyzed using content analysis.  Demographic data were analyzed using descriptive statistics.  Methods to enhance rigor and trustworthiness of the analysis were employed. 

Results:  Results supported findings from the literature regarding self-care and infant care information needs and concerns of new mothers.  However, low literacy, language barriers, low socioeconomic status, and access issues were significant for this cultural group.  Themes emerged such as Transition to motherhood which included Physical recovery from childbirth, and Mental adjustment to life-change.   A theme entitled Influence of culture contained sub-themes related to Family influence, Dilemmas of cultural practices, and Cultural conflict.  Often research-based information from health professionals contrasted with culturally-influenced advice of trusted friends and family, forcing new mothers to decide which advice to follow and dividing their loyalties.

Conclusion/Implications for nursing practice: With population growth and increased utilization of services, funding will be increasingly challenging but nurses are well-positioned to create innovative programming and to advocate for legislation to support this vulnerable population.  Encouraging self-efficacy in decision-making empower Puerto Rican new mothers to employ practices that safely incorporate evidenced-based health teaching and cultural practices into the care of themselves and their infants.  Increasing cultural competence may be invaluable in improving health outcomes and client satisfaction measures for Puerto Rican clients.   

Keywords:  Cultural competence, Hispanic, Primiparas, Qualitative study