Research "Quality of recovery of women after childbirth"

What is the experience of Ukrainian mothers after giving birth? Do they know how to recover? Is there anyone they can turn to for help? And how has the war affected this?

These issues formed the basis of a study conducted by the non-governmental organisation Generation of Mothers Lada. Its aim was to identify the key challenges faced by women and develop recommendations for improving medical, social and informational support. This is the first comprehensive study in Ukraine to cover the physiological, psychological, social and legal dimensions of a woman's life after childbirth.

About the study

The study focuses on women who gave birth in Ukraine, are caring for a child or children, and are in the postpartum period. The sample included women who, at the time of the survey, were between 1.5 and 7.5 months postpartum, as they had already completed the postpartum recovery period but could still remember various aspects of it in detail.

In addition, the organisation reviewed current Ukrainian legislation regulating postpartum issues and studied support systems for women in Poland, the Netherlands, Spain, the United Kingdom, Germany and Canada.

About the physiological condition of women

39% of women surveyed had the main symptoms of possible gynaecological complications and pelvic organ dysfunction in the first two months after giving birth; 18% of women who had these symptoms did nothing about them.

41% of respondents reported the main symptoms of possible hormonal and dermatological disorders and a deficiency of nutrients and trace elements in the first two months after giving birth. Almost half of the women who had these symptoms did nothing about them.

Among the reasons for not seeking professional help, respondents cited: lack of time due to constant childcare, perception of symptoms as normal, financial difficulties, and lack of access to doctors in their locality.

About the psychological state of women

96% of women experienced psychological difficulties in the first months after giving birth. Only 7% sought professional help, while 45% turned to loved ones, and 18% took no action.

Women most frequently reported the following conditions:

• lack of energy or fatigue (74%), irritability
• (73%), tearfulness (73%), apathy, loss of interest or pleasure (72%), disturbances
• sleep — insomnia or hypersomnia (70%), anxiety or fear (65%), depressed
• mood (61%).

Factors influencing the quality of postpartum recovery

Postpartum recovery for all women surveyed was complicated by a number of socio-economic and socio-psychological, external and internal factors.

This process was most influenced by the war and related dangers, mobilisation or the risk of mobilisation of a partner, financial difficulties, and the general physical and psychological condition after childbirth.

Financial difficulties were common in the first months after giving birth, with 72% of women experiencing them. 10% of respondents said they had to take out consumer loans or borrow money to cover basic needs.

The data also indicates a lack of awareness among women. Only 42% of respondents were aware of the consequences of childbirth and took preventive measures, while 32% learned about the problems only after they had already manifested.

Comparison with international experience

The analysis shows that most European countries and Canada have already adapted their medical technology documents to modern approaches to postnatal care. The national clinical protocols of these countries were updated in 2022–2023 and contain recommendations on:

• assessment of a woman's health in the postpartum period;
• improvement in the mother's mental health;
• the mother's diet and physical activity;
• contraception;
• measures to protect the health of newborns;
• breastfeeding;
• schedule of doctor's appointments in the postpartum period;
• involving the partner in the woman's postpartum recovery.

In Ukraine, postnatal care is regulated by several clinical protocols, which are now outdated and do not comply with current WHO recommendations.

Thus, the organisation proposes to review the regulatory and legal acts governing childbirth and the postpartum period and update them in accordance with the current WHO recommendations "WHO Recommendations on Postpartum Recovery for Women" (2022), which replaced the previous WHO recommendations of 2013, expanding them from 12 to 63 points.

You can download the full report of the study "Quality of Women's Recovery after Childbirth" using the form below.

The study was conducted by the NGO "Generation of Mothers Lada" in partnership with the Ministry of Health of Ukraine, with the support of the Office of Action and the Government of Canada, as part of the "Women's Voices and Leadership – Ukraine" project implemented by the Ukrainian Women's Fund.

Advocacy and information activities regarding the research results are implemented with the support of the Askold and Dir Foundation, administered by ISAR Unity within the framework of the project "Strong Civil Society in Ukraine - a Driver of Reforms and Democracy" funded by Norway and Sweden.