‘Plan Z and then off the edge of a cliff’: An interpretative phenomenological analysis of mothers’ experience of living with a slow-to-heal Caesarean wound

• Published in: Midwifery 2024-10, Vol.137, p.104104, Article 104104
• Main Authors: Djatmika, Clementine, Lusher, Joanne, Williamson, Heidi, Harcourt, Diana
• Format: Article
• Language: English
• Subjects: Caesarean birth; Delayed wound healing; Postnatal care; Qualitative; Women's experiences
• ISSN: 0266-6138; 1532-3099; 1532-3099
• DOI: 10.1016/j.midw.2024.104104

•Slow-to-heal post Caesarean wounds may maintain women's feelings of loss of agency stemming from the Caesarean birth experience.•Physical wounds and symptoms, such as prolonged pain may represent and intensify feelings of bodily failure.•Inability to perform ‘Motherhood’ duties due to prolonged recovery may also negatively impact postnatal adjustment and feelings of self-efficacy.•Professionals may focus on biomedical aspects of wound healing and fail to recognise the emotional implication of slow-to-heal Caesarean wounds.•Recovery from delayed Caesarean wound healing is distinctive from other types of injuries, in that the concept of healing is nuanced by subjective ‘Good Mothering’ beliefs of birth and ‘Motherhood’ rites of passage. Studies indicate that complex postsurgical wound healing can significantly alter biopsychological markers responsible for recovery. Yet, there is a lack of research investigating women's experience of living with slow-to-heal Caesarean birth wounds. This is an important area of investigation considering the increase of factors associated with surgical births and poor wound healing in the UK and globally. The aim of this study was to explore women's experiences of living with a slow-to-heal Caesarean wound. Semi-structured interviews were conducted with seven women who had lived experience of slow-to-heal Caesarean wounds. Narratives were analysed using Interpretative Phenomenological Analysis (IPA) approach. Analysis of women's narratives revealed three interlinking superordinate themes of 1) ‘Tied to that event’: healing physical and emotional wounds, 2) The ‘good mother’ and the ‘good patient’: negotiating being a carer and being cared for, and 3) ‘Adjusting to a new normality’. Overall, slow-to-heal wounds embodied women's perceptions of agency over their Caesarean birth experience and achievement of a new motherhood identity. Wherein, successful healing would encompass a sense of normality defined by subjective notions of regaining expected roles and daily activities, previous bodily functions, and maternal status within their families that became disrupted due to delayed wound healing. Women's narratives support discourse surrounding Caesarean birth and recovery as a biopsychosocial phenomenon. This has important ramifications regarding research and treatment programmes for postnatal women with complex healing that are largely described as ‘invisible’.