Women's experiences of initiating feeding shortly after birth in Ireland: A secondary analysis of quantitative and qualitative data from the National Maternity Experience Survey.

OBJECTIVE: To explore women's experiences of initiating and continuing breast or formula feeding shortly after birth in Ireland's maternity hospitals and units, as well as at home after birth. DESIGN: Mixed methods secondary analysis of qualitative and quantitative data from the Irish National Maternity Experience Survey 2020. SETTING: All 19 maternity hospitals and units in the Republic of Ireland and the national home births service. Women were asked about their maternity care experiences, including antenatal care, care during labour and birth, feeding, and care at home after birth. PARTICIPANTS: A total of 3,205 women who gave birth in October or November 2019 participated in the study (50% response rate). MEASUREMENTS: Free-text comments related to women's experiences of initiating and continuing breast or formula feeding were analysed using thematic analysis. Quantitative data were described using means (SD) and frequencies and percentages. FINDINGS: In the first few days after birth, 41.9% of women breastfed exclusively, 29.0% used formula and breast milk, and 29.1% bottle-fed only. Seven-hundred and twenty women (22.5%) made 824 comments related to feeding. Four themes were identified: (1) support and encouragement from healthcare professionals, (2) information and advice regarding feeding, (3) Pressure to feed in a particular way and (lack of) respect for personal preferences, and (4) hospital environment and resources. KEY CONCLUSIONS: Some women experienced a lack of support with feeding their babies, regardless of feeding method. Clear and concise information on feeding practices and home supports could help to support mothers with breast or formula feeding. IMPLICATIONS FOR PRACTICE: It is important that healthcare professionals provide evidence-based information and support, while respecting women's choices. Lactation consultants could offer training and consistent information to healthcare professionals as well as providing specialist support to mothers who experience problems with breastfeeding during their hospital stay and in the postnatal period.

Assessing the concordance and accuracy between hospital discharge data, electronic health records, and register books for diagnosis of inpatient admissions of miscarriage: A retrospective linked data study.

BACKGROUND: Despite the high prevalence of miscarriage, there are few studies which assess the concordance of a diagnosis of miscarriage in routinely collected health databases. OBJECTIVES: To determine agreement and accuracy for the diagnosis of miscarriage between electronic health records (EHR), the Hospital Inpatient-Enquiry (HIPE) system, and hospital register books in Ireland. METHODS: This is a retrospective study comparing agreement of diagnosis of miscarriage between three hospital data sources from January to June 2017. All inpatient admissions for miscarriage were reviewed from a single, tertiary maternity hospital in Ireland. Kappa, sensitivity, specificity, positive and negative predictive value were calculated. RESULTS: In this retrospective concordance study, EHR records confirmed 96.2% diagnosis of miscarriage of HIPE records, and 95.1% of register books records. A total of 95 records were not recorded in the register books but were recorded in HIPE and EHR. This study found a considerable variability when comparing definitions of type of miscarriage (i.e., missed miscarriage, incomplete, and complete) between the three data sources. CONCLUSION: Although this study found a high concordance in inpatient admissions for miscarriage between EHR, HIPE, and register books, a considerable discrepancy was found when classifying miscarriage between the three data sources.