Cureus
Navigating Puerperal Sepsis Prevention Following Caesarean Section: Mothers’ Experiences, Self-Care Practices, and Information Needs in a Tertiary Hospital in Southwestern Uganda
By Rachel Luwaga, Deborah Shindell, Francis Bajunirwe and 2 others.
Abstract
Introduction Caesarean section is associated with an increased risk of postoperative complications, including surgical site infection and puerperal sepsis. The period after discharge is particularly important because mothers and their families assume greater responsibility for wound care, hygiene, recognition of danger signs, and care-seeking. Although previous studies have identified gaps in post-caesarean self-care, limited qualitative evidence from Uganda describes how mothers experience, understand, and practice infection prevention measures after returning home. This study explored the experiences and practices of mothers in preventing puerperal sepsis following caesarean section at Mbarara Regional Referral Hospital (MRRH). Methods A descriptive phenomenological study was conducted among mothers who had undergone caesarean section and had been discharged from Mbarara Regional Referral Hospital. Participants were recruited purposively from the postnatal ward and communities within a 10-km radius of the hospital. Sixteen mothers participated in semi-structured, in-depth interviews conducted in English or Runyankore. Interviews were audio-recorded, transcribed verbatim, and translated where necessary. Data were analyzed inductively using thematic analysis following Braun and Clarke’s six-phase approach. Saturation was reached by Participant 015 and confirmed by Participant 016. Results Four themes emerged: experiences in acquiring knowledge on the prevention of puerperal sepsis, experiences in self-care, maternal practices in the prevention of puerperal sepsis, and access to and understanding of information on the prevention of puerperal sepsis. Mothers reported receiving information from health workers, relatives, other mothers, and community members, with some advice being conflicting. Poor communication, inadequate explanation of discharge information, and language barriers limited mothers’ understanding. Mothers practiced personal and wound hygiene, hand hygiene, medication adherence, mobilization, and management of postpartum bleeding. However, pain, lack of support, and financial constraints made some practices difficult to implement. Mothers also reported practices influenced by informal advice, including the use of salt water, honey, and herbs on wounds. Although mothers recognized several danger signs, recognition did not always result in timely care-seeking. Mothers preferred practical, visual, and locally appropriate education, including the use of local languages and pictures. Conclusion Mothers reported various practices to prevent puerperal sepsis following caesarean section, alongside challenges related to inconsistent information, limited social support, physical difficulties, and financial constraints. The findings highlight the need for clear, practical, culturally appropriate discharge education that considers mothers’ experiences and the support available during recovery.



