Exploring Mothers’ Experiences and Perceptions of Postpartum Care in King Khaled University Hospital: A Qualitative Study

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In Saudi Arabia, traditional practices and systemic challenges influence the accessibility and quality of postnatal services. This study explores the mothers’ lived experiences during the early postnatal period and identifies strengths, gaps, and culturally relevant needs. Methods: A reflexive qualitative design was employed using semi-structured interviews with 20 postpartum mothers at King Khaled University Hospital, Riyadh. Participants were selected through purposive sampling. Findings were interpreted through the World Health Organisation (WHO) Postnatal Care Guidelines and Pender’s Health Promotion Model. Results: Interviews with 20 mothers revealed four overarching themes that shape their experiences of postpartum care: physical recovery and birth experience, informational and educational support, emotional and social support, and systemic and cultural influences. Mothers reported significant gaps in pain management, postpartum education, and structured follow-up, particularly after discharge, which left many feeling unprepared and overwhelmed. Experiences of childbirth ranged from empowering and respectful to distressing, with inadequate communication and inconsistent pain relief contributing to negative experiences. Informational support was fragmented, especially in relation to breastfeeding and newborn care, with limited access to dedicated services. Emotional well-being was strongly influenced by staff interactions, family support, and the absence of nursery services, with many women describing feelings of neglect, anxiety, or isolation. Systemic and cultural factors, including ward conditions, staff responsiveness, and traditional postpartum practices, further shaped women’s experiences. Conclusion: Postpartum experiences are shaped by interrelated physical, emotional, social, and cultural factors. Mothers in this study reported unmet needs in pain management, education, discharge preparation, and nursery support, which often left them feeling unprepared and vulnerable. Positive experiences of respectful care, family support, and culturally rooted practices highlight the value of compassionate and contextually sensitive approaches. Strengthening postnatal services through tailored support, follow-up, and integration of cultural practices with evidence-based care is essential to improve maternal recovery and well-being. Postpartum care Childbirth Qualitative research Saudi Arabia Mothers’ perceptions Figures Figure 1 Background Postpartum or postnatal care refers to the comprehensive medical, emotional, and educational support provided to mothers and newborns immediately after childbirth [ 1 ]. During this period, women undergo significant physiological and psychological changes, such as uterine involution, hormonal shifts, initiation of breastfeeding, and heightened vulnerability to complications including infection, haemorrhage, and mental health disorders [ 2 ]. To safeguard maternal and neonatal health, the World Health Organisation (WHO) recommends at least three postnatal visits in the first six weeks; however, adherence to these recommendations varies widely depending on healthcare access, cultural practices, and maternal awareness [ 1 , 3 ]. Despite progress in maternal health, postpartum care remains under prioritised. The WHO reported in 2023 that over 700 women die each day from preventable pregnancy- and childbirth-related causes. In 2021, 40% of mothers in low- and middle-income countries received no postnatal care within six weeks of delivery, reflecting persistent gaps in infrastructure, awareness, and access to services [ 4 , 5 ]. Essential services such as breastfeeding support, hygiene education, immunisation guidance, and psychosocial care are often absent or inconsistent. Globally, up to one in five women experience postpartum mental health disorders, including depression and anxiety, yet these frequently go undiagnosed and untreated in settings without routine screening. Early detection through validated tools, such as the Edinburgh Postnatal Depression Scale, can improve outcomes for mothers and infants alike [ 6 – 8 ]. Postnatal care provision varies greatly across contexts. High-income countries such as the United Kingdom and Sweden typically offer comprehensive programs that integrate routine mental health screening, breastfeeding support, and home visits, reducing maternal morbidity and strengthening outcomes [ 1 , 9 ]. By contrast, low- and middle-income countries face enduring challenges, including workforce shortages, financial barriers, and reliance on traditional birth attendants. In regions such as Sub-Saharan Africa and South Asia, only 30% of women receive skilled postnatal care within two days of childbirth [ 10 ]. In Saudi Arabia, healthcare is delivered through both governmental and private sectors. The Ministry of Health (MOH) oversees more than half of national services, including free maternity care in public hospitals and primary care centres. Employer-sponsored insurance extends coverage to private-sector employees, while other government bodies (e.g., Ministry of the Interior, National Guard, Ministry of Defence) operate specialised facilities. The private sector provides roughly 20% of total services. Maternal care, including antenatal, intrapartum, and postnatal care, is delivered in line with national clinical guidelines that follow international standards. The MOH’s Mother-and-Baby-Friendly Childbirth Initiative promotes evidence-based and respectful maternity care, while strengthening mother–infant bonding [ 11 , 12 ]. While quantitative research has addressed clinical outcomes, emotional and cultural dimensions of postpartum care remain underexplored [ 13 ]. Few qualitative studies have examined women’s experiences in tertiary hospital settings. This study, therefore, explores maternal perspectives at King Khaled University Hospital (KKUH) in Riyadh to identify strengths and areas for improvement in postpartum care, education, and service delivery. Methods Study Design This study adopted a reflexive qualitative design to explore the postpartum care experiences of mothers at King Khalid University Hospital (KKUH). Semi-structured interviews were employed, allowing for the in-depth exploration of participants’ unique perspectives while ensuring comprehensive coverage of core postpartum care topics. Study Setting This study was conducted at KKUH, a tertiary-level academic institution affiliated with King Saud University Medical City in Riyadh, Saudi Arabia. KKUH was selected due to its comprehensive postnatal care services and its status as a teaching hospital, ensuring access to a diverse sample of postpartum mothers. Data collection took place over one month, from January 15 to February 16, 2025, within the Postnatal Units. Sampling and Recruitment Strategy A purposive sampling approach was used to recruit postpartum mothers receiving care in the postnatal units at (KKUH). Eligible participants were those who had recently given birth, were physically and mentally able to participate, and provided written informed consent. Mothers were excluded if they experienced severe complications that hindered participation or if they declined or withdrew consent. A total of 20 mothers were interviewed, which provided sufficient information to capture diverse experiences and enable meaningful, in-depth analysis [14,15]. Participants were identified with the assistance of nursing staff, who provided a list of eligible postpartum patients in the postnatal units. Mothers who were available and met the inclusion criteria were approached in person, informed about the study objectives and procedures, and invited to participate. Interview Procedures Semi-structured interviews were conducted in the postnatal care unit of KKUH, either in private or shared rooms, depending on patient placement. The interviews explored birth experiences, maternal adjustment, inpatient care, discharge preparation, emotional well-being, family support, cultural influences, and suggestions for improvement. While most interviews took place in private rooms, two were conducted in shared rooms, with verbal and written consent. Measures were taken to maintain privacy and confidentiality. Each interview lasted between 30 and 45 minutes, following a flexible interview guide that allowed participants to share their experiences of postpartum care in detail. Prior to formal data collection, the interview guide was pilot tested with four postpartum mothers who were not part of the main study. Feedback from the pilot led to rewording several questions to enhance clarity and cultural relevance. Data Collection and Management With participant consent, all interviews were audio-recorded and accompanied by field notes to capture non-verbal cues and contextual details. A short socio-demographic questionnaire was used to collect participant characteristics, including age, marital status, education, employment, nationality, parity, and mode of delivery. In the postnatal ward, the researcher approached eligible mothers and conducted interviews in a comfortable and private setting. To accommodate participant preferences, two versions of the interview guide were available; nineteen interviews were conducted in Arabic, and one was conducted in English. All data were anonymised and stored securely on password-protected devices in accordance with institutional data management and ethics policies. Data Analysis Data were analysed using Braun and Clarke’s reflexive thematic analysis [15]. Transcripts were read several times and inductively coded to capture key themes. ATLAS.ti software supported the organisation of codes, which were refined through an iterative and reflexive process. To enhance rigour, two researchers (FA & NA) independently coded a subset of transcripts and discussed their interpretations. Differences were viewed as opportunities to enrich understanding, and discussions continued until agreement was reached. While coding was inductive, interpretation of themes was informed by the WHO Postnatal Care Guidelines [1] and Pender’s Health Promotion Model [16]. The WHO framework informed the analysis of care practices such as breastfeeding, physical recovery, and follow-up. At the same time, Pender’s model provided insight into social and behavioural influences, including mental health and support networks. The relationship between the emergent themes and these frameworks is illustrated in Figure 1 and detailed further in Appendix G. A reflexive approach was maintained throughout the analysis, with the research team acknowledging how their professional backgrounds in public health and women’s health could influence the interpretation of participant narratives. Regular discussions were held to challenge assumptions, enhance analytic rigour, and ensure that the themes accurately reflected the mothers’ perspectives rather than the researcher's preconceptions. Ethical Considerations Ethical approval was obtained from the Institutional Review Board (IRB) at King Saud University (Approval No. E-24-9376) and the Nursing Research Unit at King Khalid University Hospital (KKUH). All participants received detailed information about the study and provided written informed consent before participation. The study adhered to established ethical principles, including respect for persons, beneficence, and maintenance of confidentiality. Results Twenty postpartum mothers who had recently given birth agreed to participate in this study. Participants varied in age, nationality, educational background, employment status, marital duration, mode of delivery, and parity. Table 1 presents descriptive data for participant characteristics. Table 1. Socio-demographic characteristics of participants (N = 20) Characteristic n % Age 18-24 25-29 30-34 35-39 40 years and above 4 3 3 5 4 20% 20% 15% 25% 20% Nationality Saudi Non-Saudi 17 3 85% 15% Education Intermediate School High School Diploma Bachelor’s Degree Postgraduate (Master’s) 1 3 1 14 1 5% 15% 5% 70% 5% Employment Employed Unemployed Student 7 11 2 35% 55% 10% Marital Duration Less than 1 year 1–3 years 4–6 years 7–10 years More than 10 years 1 7 5 4 3 5% 35% 25% 20% 15% Mode of Delivery Vaginal delivery Caesarean section A ssisted delivery (vacuum) Mixed delivery (VD & CS) 7 11 1 1 35% 55% 5% 5% Parity 1 (First birth) 2–3 births 4–5 births 6 or more births 6 8 2 4 30% 40% 10% 20% Total 20 100% Overview of Emerging Themes Thematic findings revealed multiple dimensions shaping maternal recovery and satisfaction, including physical health, emotional well-being, breastfeeding support, newborn care education, access to health information, social support, hospital environment, birth experiences, pain management, discharge planning, and cultural practices. The structure of these themes and subthemes is presented in Table 2 . Table 2. Themes and subthemes emerging from interviews (N = 20) Themes Subthemes Physical recovery and birth experience Physical health; Pain management; Birth experience Informational and educational support Breastfeeding support; Newborn care education; Health information resources; Discharge experience Emotional and social support Emotional well-being; Family and social support; Lack of nursery support Systemic and cultural influences Hospital environment and staff interaction; Cultural beliefs and practices Physical Recovery and Birth Experience Mothers’ experiences of physical recovery following childbirth revealed significant gaps in postnatal support, pain management, and informational guidance. This sense of abandonment was especially acute during the first days after discharge, when they were expected to care for their newborns while navigating pain, fatigue, and unanswered concerns about their healing. Navigating Recovery with Unmet Needs Mothers described the postpartum period as physically and emotionally taxing, characterised by pain, fatigue, and a lack of structured support. While expected to heal and care for their newborns, many felt unprepared and unsupported. Conflicting advice, absence of follow-up, and unclear information about what to expect left several women feeling overwhelmed and isolated during recovery. “I was discharged two hours ago, but I’m still in the room waiting for my husband to pick me up. I keep feeling sore and swollen, especially in my legs. No one told me if that’s normal. I’m honestly scared something’s wrong, but I didn’t want to keep calling the nurses and seem overdramatic.” (PNC13) Mothers who underwent Caesarean sections particularly struggled with mobility, pain, and caring for their newborns when adequate assistance was unavailable. “They told me I should rest and recover, but at the same time, I was left alone with my baby, expected to walk, carry him, and manage everything. I didn’t even know how to hold him properly without pain.” (PNC02) Several mothers emphasised the need for education about the postpartum body. They felt unprepared for the intensity and duration of physical symptoms and desired a clearer roadmap for healing. “I thought the pain would ease after a day or two, but it didn’t. My back hurt, the stitches are sore, and even getting out of bed wasn’t easy. One night, I tried to stand up to feed my baby and just had to sit down again. I was too tired and uncomfortable. I kept wondering if this was all normal. I wish someone had explained what to expect and how long recovery might take. It would’ve made things feel a little less overwhelming.” (PNC16) Birth Experience: Between Empowerment and Emotional Distress Women highlighted the powerful role of pain management, communication, and emotional support in shaping their childbirth experiences. For many, the quality of care they received during labour significantly influenced their emotional well-being and perception of the birth experience. Timely and compassionate responses to pain contribute to a sense of care and respect. One participant described feeling deeply cared for, despite experiencing a serious complication during labour: “it was my first delivery, and… I had a natural birth, but I suffered a tear in my uterus during labour and started bleeding a lot… Even though today is my third day in the hospital, I’m still in so much pain. The antenatal and delivery wards were honestly amazing; the doctors, nurses, and midwives were kind and respectful. I felt like a VIP.” (PNC18) Insufficient pain relief and dismissive responses from staff were especially prevalent among mothers who delivered vaginally, causing some women to feel neglected and emotionally distressed. “The pain was sharp and constant for days, but they only gave me Panadol [paracetamol]. One night, it got really bad, I rang the nurse and asked for stronger pain relief, but no one came. I waited for so long and eventually just took a Panadol from my purse. I couldn’t even sit to breastfeed properly. I cried from the pain alone in my room, and felt like they thought I was exaggerating.” (PNC04) In contrast, mothers who had a caesarean delivery described a more responsive and respectful birth experience. “The nurse checked on me every few hours and made sure I had the medication I needed. When I said the pain was coming back, she didn’t wait; she called the doctor. That made me feel seen and cared for.” (PNC18) Beyond physical discomfort, women’s broader experiences of childbirth reflected a spectrum of emotional responses, from empowerment and reassurance to fear and confusion. Some participants felt supported and actively involved, while others described feeling uninformed and excluded during the labour process. “I didn’t know what was happening. They kept telling me to push, but no one told me if the baby was okay or how long it would take. I was in pain and terrified, and I felt invisible in the room. It was like they were doing things to me, not with me.” (PNC12) “I was screaming and panicking, I honestly thought I couldn’t do it. But the nurse stayed right beside me… she held my hand tight and she comforted me by reciting a Dua [prayer]) during my pain... She told me, ‘You’re strong, you’re doing great, Allah is with you.’ That moment… I’ll never forget it. It gave me strength when I had none.” (PNC14) Some participants described lingering emotional effects from their birth experiences, especially when they felt excluded from decision-making or unprepared for sudden changes. A lack of clear communication during urgent situations left some women feeling invisible, scared, and uncertain about what was happening to their bodies. “I remember… at first, they told me things were progressing slowly, but later, a nurse came in and said, ‘We need to take you for a C-section. It’s urgent.’ I was confused; no one had explained anything clearly before that. I overheard someone mention that my cervix wasn’t dilating, but no one actually sat down and told me what was happening. My husband wasn’t there yet… I was alone, scared, and just said okay because I didn’t know what else to do. Even now, when I think about it, there’s this heaviness… like no one saw me, just the medical situation. Alhamdulillah, the baby is healthy, but it still hurts how everything was rushed and unclear.” (PNC10) Informational and Educational Support Mothers’ experiences revealed persistent gaps in the timing, accessibility, and clarity of postpartum education. Many participants expressed a strong desire for guidance, tailored support, and follow-up that extended beyond discharge. Inconsistencies in Lactation Support Breastfeeding was a central concern among participants, often shaping their early emotional adjustment. Some mothers described positive encounters with supportive lactation consultants. “The lactation consultant didn’t rush me. She sat with me, showed me how to position my baby, and reassured me every time I got emotional. I was so afraid I wouldn’t be able to do it, but she helped me believe in myself.” (PNC17) By contrast, a lack of immediate, hands-on support caused some individuals to experience distress and self-doubt. Some mothers reported feeling abandoned during moments of vulnerability. “It’s been five years since my last baby, and this is my first time having a C-section. My baby wasn’t latching, and I kept asking for help. One nurse came and just said, ‘Keep trying,’ then left. I sat there feeling unsure and overwhelmed, not knowing what I was doing wrong. No one came back to check. I started doubting myself and just wished someone had stayed a bit longer to guide me.” (PNC03) Several participants emphasised that breastfeeding education should start during pregnancy and that mothers should have opportunities to consult with lactation specialists after discharge. Although the hospital offers a dedicated breastfeeding education clinic, it is available only to inpatients on Thursdays, which mothers felt was inadequate for their needs for timely and ongoing support. They strongly recommended that breastfeeding support be available throughout the week to provide timely and continuous access. “No one really told me what to expect about breastfeeding before I gave birth. They just said, ‘We’ll help you after.’ But after delivery, I was in so much pain… I could barely sit. I tried to feed him, but it hurt, and I wasn’t sure I was doing it right. One of the nurses was kind; she helped a bit, but then she mentioned the breastfeeding clinic is only open on Thursdays, and I’ll probably be discharged before that. I’m a first-time mum, and I just need someone to stay with me for a bit longer… to really show me how. Not just say, ‘You’ll get used to it.’ I keep thinking, what if I go home still unsure? I don’t want to feel lost when I leave.” (PNC10) “They told me before delivery that I could go to the breastfeeding clinic if I needed help, but it’s only open on Thursdays. I gave birth on Sunday, and I’m still here... but no one has come to help me yet. I don’t have a car; my husband works long hours. Even if I were discharged, how could I come back just for that? It’s not realistic. I really needed the support while I’m here, not days later. Honestly, they should have someone available every day, even just for a few hours. New mums like me shouldn’t feel lost trying to figure everything out alone.” (PNC18) “Lift to Figure It Out Alone” Mothers consistently described a lack of structured education on newborn care, which left them feeling anxious and unprepared during the critical first days at home. Many mothers lacked guidance on basic topics such as bathing, feeding cues, umbilical cord care, and infant sleep patterns. “Last night, I just kept staring at my baby, worried she might stop breathing. I didn’t know what was normal. Was her stool supposed to look like that? Was she crying too much? No one really explained anything or gave me a guide on what to expect. I’m still here in the hospital, but I already feel anxious about going home.” (PNC18) Several participants expressed frustration with the assumption that they would instinctively know how to care for their newborns. Instead of receiving comprehensive instruction, they were often left to rely on trial and error or external sources. “ The nurses acted like I should already know how to hold him, burp him, everything. But no one had shown me anything. I kept asking questions, but I felt like a burden. ” (PNC13) Fragmented Guidance and Its Consequences Mothers described receiving inconsistent, rushed, or incomplete advice from different healthcare staff, which led to confusion, anxiety, and diminished trust in clinical guidance. “I kept trying to breastfeed, but I wasn’t sure if my baby was actually getting milk. I asked for help… one nurse just said, ‘Keep putting him on the breast, he’s fine.’ But then, later, another nurse told me, ‘If he keeps crying, that means he’s not getting any.’ I didn’t know who to believe. I was tired, in pain… and honestly scared that he was still hungry. I just sat there thinking, ‘Why isn’t there one clear answer?’ I needed someone to show me… like, really explain… what to look for and what’s normal or not?” (PNC12) Despite concerns about reliability, many mothers relied on online platforms or informal networks because the professional support they encountered often felt fragmented, generic, or inaccessible outside of scheduled appointments. “Since I gave birth, the nurses kept encouraging me to breastfeed, but no one really showed me how to do it properly. They were nice, but always seemed to be in a rush. I kept trying, but I wasn’t sure if I was doing it right. The next day, my mom came, and she was the one who actually showed me how to position the baby and what to look for. That really helped. I think I just needed someone to sit with me and explain it from the start.” (PNC19) “ I ended up Googling everything, even though I didn’t want to. I wish they had given us a booklet, an app, or something that was trustworthy and local. I wanted to rely on the hospital, but the advice wasn’t the same. ” (PNC07) Discharge Without Direction Mothers consistently described the discharge process as abrupt and poorly explained. Many reported being sent home within 24 hours of delivery with little preparation, unclear guidance, and few chances to raise their concerns. “It was my first baby, and I really didn’t feel ready to be discharged. I thought I’d stay a few days to learn and adjust, but the nurse said if everything looked fine, the doctor would discharge me in a few hours. I kept hoping to ask him if I could stay a bit longer. I felt anxious; I didn’t even know how to hold my baby properly. My mother isn’t in Riyadh, so I felt completely alone and scared to go home. But they said it’s hospital policy to leave the next day if everything is stable. I just needed a little more time, just one extra day to feel more confident.” (PNC12) The lack of structured and clear discharge planning left many mothers feeling anxious, unprepared, and unsupported. Discharge protocols appeared to prioritise clinical stability over emotional readiness and practical competence. “The baby’s doctor came with the nurse and checked him, then said he was ready to go home. Later, my doctor came in, did a quick check, and said I could be discharged too. But honestly, I didn’t feel ready yet. It was my first baby, and I still had pain and a lot of questions. I thought someone would sit with me and explain things more, perhaps provide me with a paper or a phone number to call if I needed support. Instead, it just felt a bit rushed, like once everything looked fine medically, I was expected to leave. I just wish there was more guidance before going home.” (PNC19) The Importance of Emotional and Social Support Many participants described feeling emotionally vulnerable in the early days after birth and emphasised the impact of interpersonal interactions, whether compassionate or neglectful, on their mental well-being. The availability or absence of family support and institutional assistance, such as nursery care, further influenced their experience of emotional security, exhaustion, and coping. The Need for Acknowledgement and Empathy Mothers frequently described the early postpartum period as a time of emotional vulnerability, often compounded by physical exhaustion and uncertainty about their new responsibilities. While some felt supported, others noted a stark lack of attention to their mental well-being. One mother reflected on the disconnect between physical and emotional care: “ Physically, I was healing, but inside, I was scared and overwhelmed. No one asked how I felt. The nurse just asked if I had pain or fever. I needed someone to check on my emotions, too, not just my temperature. ” (PNC13) Many mothers described experiencing little to no acknowledgement of their mental health needs by healthcare providers. One participant recounted crying unexpectedly and feeling overwhelmed by intrusive thoughts, only to be met with a dismissive response from staff: “I don’t know… I kept feeling down, and I couldn’t explain why. I told the nurse I was crying for no reason, and she said, ‘It’s just hormones.’ But it didn’t feel like just hormones. There wasn’t even a mirror in the room or in the bathroom, I want to see myself. I hadn’t showered in four days because they said the shower was at the end of the hallway, and I had to walk there. I felt dirty, uncomfortable, and just… not myself. At night, I was alone with my thoughts. My baby was next to me, and I kept checking if he was breathing. No one explained whether what I was feeling was normal or how to manage it. I think all these little things added up, and I just felt... neglected.” (PNC20) Despite these challenges, small gestures of kindness from healthcare providers had a lasting emotional impact. “ One midwife smiled at me and sat down just to ask how I was really doing. She didn’t rush. I’ll never forget that moment. It helped more than the medicine. ” (PNC17) The Role of Family and Social Networks in Postpartum Experiences Family and social networks play a crucial role in shaping women’s experiences after childbirth, acting as either a protective buffer or a source of emotional stress. For many participants, close support from mothers, sisters, or husbands significantly eased the transition into motherhood. This support provided both emotional reassurance and practical assistance with newborn care and physical recovery. Often, it filled the gaps left by clinical care and was described as essential for coping during the early postpartum days. “ My mom stayed with me every night in the hospital. She did everything, helped me shower, held the baby when I felt pain. Without her, I don’t think I could’ve coped. ” (PNC09) The presence of a trusted caregiver offered comfort, reduced stress, and allowed some mothers to rest, heal, and emotionally adjust. However, this support was not available to everyone. Many reported a significant lack of social or family assistance, often due to geographical distance or demanding work schedules. This absence of support intensified feelings of helplessness, especially during night-time when emotional and physical exhaustion were at their highest. “I’m not from Riyadh… and my mom couldn’t come. My husband works long hours, so most of the time, it’s just me... During pregnancy, they kept telling me the baby’s pulse was high… even after birth, I noticed he’d breathe fast sometimes. I didn’t know if that was normal... At night… when he cried and wouldn’t settle, I’d just sit there watching him, wondering if something was wrong. I felt scared… and really unsure of what to do. I just wish someone were here.” (PNC06) Some participants hired external help, while others relied on friends or neighbours for guidance after discharge. Support systems varied widely among mothers, with some receiving ongoing assistance and others feeling lost and isolated. “ Honestly, I was lucky… my friends visited me, and my sister came and stayed with me for the first few days. She’s had three kids, so she knew what to do. But not everyone has that, you know? Some of the girls here were saying they’ll be going home alone with no one around. One of the ladies next to me even said she hired a nanny for a month, just so she doesn’t go crazy. I thought about it too, but… It’s too expensive. Sometimes I wish there was a place or number to call, just someone to guide me step by step. Because after discharge, you are kind of on your own. ” (PNC17) Lack of Nursery Support The absence of nursery services emerged as a significant barrier to postpartum recovery, particularly among mothers recovering from caesarean deliveries or caring for twins. Many participants had anticipated temporary assistance with newborn care in the initial recovery period, but were surprised to find that such support was unavailable. This lack of structured help left them physically strained and emotionally distressed during a period of acute vulnerability. “ After my C-section, I could barely move. I was shaking and in pain, but I had to sit up every few hours to feed and change my baby. I asked if there was any nursery service, and the nurse said, ‘We don’t offer that.’ I was shocked. ” (PNC16) For mothers with twins or significant birth complications, the demands were intensified. Without access to additional support, basic tasks became overwhelming both physically and emotionally. “ I had twins, and I was completely exhausted. One baby needed more attention, and I couldn’t keep up. I had no one to take them even for ten minutes. I thought I would collapse. ” (PNC11) Some mothers described feelings of helplessness and inadequacy when they were unable to meet their infants’ needs due to pain or fatigue. In addition, some mothers reported technical issues, such as non-functional call buttons, which further compounded their distress: “I was really struggling after the birth… I couldn’t lift my baby, I was in pain, tired, and just needed someone to help me for a bit. I kept pressing the call button again and again, but no one came. Later I found out it wasn’t even working. I tried to stand up and walk while holding onto the wall, and that’s when a nurse saw me and got upset, saying, ‘Why didn’t you call?’ I told her I had been trying for hours. Then she said, ‘We don’t have a nursery here, you have to manage on your own.’ But I really couldn’t. I just needed help, even for a short while.” (PNC02) Systemic and Cultural Influences Participants highlighted the impact of the physical care environment, staff behaviour, and communication patterns within the hospital setting, as well as how traditional postpartum beliefs influenced recovery routines, decision-making, and interactions with medical advice. Hospital Environment and Staff Interaction Mothers shared how the physical environment and interactions with staff influenced their postpartum experience. Some reported feeling supported by having private rooms and receiving responsive care, while others expressed discomfort due to unclean conditions or inconsistent communication. Participants noted that the hospital environment had a significant impact on their ability to rest and recover. Factors such as privacy, cleanliness, and staff responsiveness either alleviated or increased their stress. For some mothers, being moved to a private room was a transformative experience. “ They just transferred me to a private room, and I finally felt like I could rest. Before that, it was noisy and crowded. Privacy made a big difference in calming me down. ” (PNC15) In contrast, others encountered substandard hygiene and delayed responses that diminished their sense of dignity and trust in the system. “ My bed sheets were dirty when I arrived, stains from the previous patient. I asked for new ones, and no one came for hours. I felt like I wasn’t being treated with dignity. ” (PNC04) One mother explained that the physical conditions in the postnatal ward left her feeling disappointed and undermined her sense of dignity. She described being denied simple requests, such as an extra pillow or a clean bedsheet, and noted the presence of blood stains in the bathroom, which negatively shaped her experience. “But when I moved to the postnatal ward, the experience completely changed. I asked for an extra pillow, but they said there were none. I also asked to change the bedsheet; it looked old and unwashed. They said no. And when I went to the bathroom, I saw blood stains from the previous patient. It was really disappointing.” (PNC18) Communication breakdowns between patients and rotating staff added significantly to the emotional burden of the postpartum experience. Several mothers described feeling frustrated and unseen due to the lack of continuity in care, which disrupted the rapport and trust they had with their healthcare providers. As one participant noted, the frequent changes in nursing staff required her to retell her story and re-explain her needs repeatedly. “ They kept changing the nurses, and each one would ask me the same questions again. It felt like they didn’t read my file. I had to keep explaining everything from the beginning. ” (PNC05) Cultural Traditions and Postpartum Recovery Participants described receiving advice from both healthcare providers and family members, sometimes receiving conflicting messages. Cultural norms strongly influenced mothers’ postpartum behaviours and expectations, especially around rest, diet, and caregiving. Many participants described the traditional Al-Nifas period, a forty-day period of rest following childbirth, as a source of comfort and support. For some, this tradition facilitated healing by ensuring that family members shared responsibilities such as newborn care and household tasks. “In our tradition, we rest completely for forty days after giving birth. My mom helped me with my first baby, and now she’s doing the same with my second. She takes care of the meals, helps change the baby, and even lifts things for me. It really gives me the chance to rest and recover... Every day, she makes me hot shamar tea [fennel]. She says it’s good for cleaning the womb and settling the stomach. I grew up watching her make it for my aunts and cousins after they gave birth too, so it just feels normal, comforting even. ” (PNC08) However, adherence to cultural practices sometimes clashed with medical advice, particularly regarding the postpartum diet. Participants reported receiving conflicting recommendations from family members and healthcare providers, resulting in confusion. While these traditions offered comfort and familiarity, they sometimes contradicted hospital guidance, leaving mothers caught between cultural expectations and clinical recommendations. “ In my family, we’re told not to eat meat after a C-section because it’s hard to digest. The nurse said it’s fine, but my mom insisted I wait. I was torn between the two. In our village in the Philippines, this is something we always follow; my mom believed that eating meat too soon could cause complications. Even though the hospital gave me the okay, I just couldn’t go against my family’s way. ” (PNC01) These tensions reflect how cultural authority, particularly from older family members, can shape maternal behaviour even when clinical advice differs. While some mothers deferred to traditional wisdom, others, especially younger or more educated participants, expressed a preference for evidence-based guidance. “ My relatives had a lot of advice, what to eat, what not to do, but I chose to listen to the doctors. I just felt safer that way. ” (PNC15) Discussion The study identified the multifaceted nature of mothers’ postpartum experiences. Participants reported needs spanning physical recovery, emotional well-being, breastfeeding support, and culturally responsive care. While several gaps emerged, including inconsistent responses to pain management, lack of breastfeeding education, limited emotional support, and insufficient discharge preparation, participants also recognised areas of strength. These included respectful and compassionate staff interactions, timely access to medical care, and the vital role of family involvement in supporting recovery. Physical recovery is a crucial factor in determining mothers’ postpartum experiences, particularly in the first days following childbirth. Participants described weakness, pain, and mobility limitations post birth that compromised their ability to perform basic self-care and meet the immediate needs of their newborns. Inadequate pain management after childbirth has been linked to delayed physical recovery, early cessation of breastfeeding, increased risk of peripartum mood disorders, and challenges in establishing mother–infant bonding [ 17 – 21 ]. Acute postpartum pain has been linked to a substantially increased risk of postpartum depression, with one study reporting a three-fold greater likelihood among those with severe pain. Moreover, higher pain levels immediately after delivery correlate with poorer mother–infant attachment and reduced parenting self-efficacy [ 22 ]. Providing tailored pain management, mobility support, and proactive follow-up care addresses women’s physical health needs and plays an important role in strengthening maternal confidence and enhancing overall well-being [ 23 – 25 ] Postpartum mothers who felt heard, reassured, and emotionally validated during their hospitalisation reported greater satisfaction and increased confidence in caring for their newborns. Women who have experienced delayed or fragmented care that resulted in severe complications advocated for structured follow-up visits and ongoing support after discharge to improve postpartum outcomes and experiences [ 26 , 27 ]. It has been established that a mother's sense of emotional safety is closely linked to her overall satisfaction with the quality of care provided postpartum [ 28 ]. Similar associations have been reported where emotional support during the immediate postpartum period was linked to improved maternal mental well-being, stronger mother–infant bonding, and higher engagement in recommended postpartum practices [ 29 , 30 ]. Family and social support are essential components of postpartum recovery. Research indicates that higher perceived social support can significantly reduce the risk of postpartum depression, anxiety, and impaired bonding among new mothers [ 29 ]. Additionally, a study involving 564 women found that partner and family support is linked to improved maternal functioning following childbirth [ 31 ]. In contrast, mothers who lacked sufficient family presence often reported feelings of isolation, insecurity in caring for their newborn, and limited awareness of available resources, underscoring the need for enhanced support structures within both the family and healthcare systems [ 32 , 33 ]. A substantial gap exists in postpartum education, particularly regarding breastfeeding, infant care, physical recovery, and recognition of danger signs. These gaps may reflect systemic issues such as high staff workload or the absence of standardised discharge protocols [ 34 ]. Saudi mothers were found to have inadequate breastfeeding knowledge and were frequently swayed by formula marketing and myths [ 35 ]. Offering breastfeeding support to newly postpartum women significantly reduces the risk of stopping exclusive breastfeeding before six months [ 36 ]. Structured, in-hospital education has been shown to enhance maternal outcomes [ 37 ]. For instance, a meta-analysis reported significant improvements in mothers’ self-confidence following newborn care education programs [ 38 ], and a study in Ghana found that providing educational material on warning signs before discharge increased mothers’ ability to recognise post-birth complications nearly fivefold, and almost 28-fold when four or more complications were discussed [ 39 ]. Discharge readiness is closely linked to the quality of structured postpartum education provided to mothers prior to their hospital discharge. Evidence indicates that hospital discharge decisions often prioritise institutional efficiency over patient readiness, resulting in premature discharges. This can increase maternal stress, lead to postpartum blues, and leave postpartum care needs unmet [ 40 ]. In line with WHO recommendations, discharge planning should encompass individualised guidance and clear postnatal instructions to ensure a smooth transition from hospital to home care [ 1 ]. A significant and under‑explored issue is the limited nursery support available to mothers recovering from caesarean birth or complicated vaginal delivery, without caregiver assistance. Postoperative pain and restricted mobility made tending to their newborns difficult [ 41 ]. At KKUH, nursery services are unavailable unless Neonatal Intensive Care Unit care is required, consistent with both national policy and the Mother –and –Baby -Friendly Maternity Care Initiative’s emphasis on rooming‑in [ 11 ]. While rooming‑in supports breastfeeding and bonding, emerging evidence suggests it may also increase maternal pain and anxiety, especially for unassisted mothers after caesarean section, highlighting the potential benefit of short-term staff-assisted newborn care to facilitate rest and enhance postoperative recovery [ 41 , 42 ]. These findings underscore the importance of tailoring postnatal support to individual maternal needs, ensuring that policies balance bonding with adequate recovery and well-being. Postpartum practices are strongly shaped by cultural traditions, influencing maternal recovery, hygiene, nutrition, and newborn care [ 43 – 45 ]. Across different societies, these practices often include designated rest periods and organised family support, which can ease the transition into motherhood while promoting physical and emotional well-being [ 43 ]. In Saudi Arabia, many women observe the 40-day confinement period known as Nefas [ 46 ]. However, such customs are often not integrated with formal health education or structured follow-up, creating a disconnect between traditional beliefs and evidence-based care [ 44 ]. Similarly, in China, the practice of zuò yuè zi also prioritises rest and support but may delay timely engagement with healthcare providers [ 13 ]. These global examples show that cultural traditions can either facilitate or hinder optimal postpartum care, depending on how well they align with medical guidance. Culturally sensitive strategies are therefore needed to support maternal and infant health while respecting traditional beliefs [ 1 , 16 ]. Strengths and Limitations: This study provides valuable insights into the postpartum care experiences of mothers in a Saudi tertiary hospital. A key strength is the qualitative design, which enabled the collection of rich, first-hand maternal narratives. The use of a bilingual interview guide, which included both Arabic and English, enhanced inclusivity and supported transferability. The purposive sampling strategy ensured diversity across delivery types and socio-demographic backgrounds, strengthening the relevance of the findings. Although themes were developed inductively, interpretation was guided by the WHO Postnatal Care Guidelines and Pender’s Health Promotion Model [ 1 , 16 ], providing theoretical depth and enhancing trustworthiness. Viewing the findings through these frameworks offered a structured lens for understanding how women perceive and navigate postnatal care in this context. This study has several limitations. Conducting some interviews in shared postnatal wards may have compromised auditory privacy and influenced participants’ openness. As all interviews were conducted in a public hospital, the experiences of mothers in private hospitals, where care models may differ, were not represented. The single-site design may also limit the generalizability of the findings, although contextual information has been provided to support transferability. Although strategies to enhance trustworthiness were implemented, including dual coding and independent verification, the influence of researcher bias and social desirability cannot be entirely excluded. Despite these limitations, the study offers valuable insights to inform practice and guide future research in comparable contexts. Implications for Policy, Practice, and Future Research This study emphasises the need for standardised national guidelines on postpartum care in Saudi Arabia. These guidelines should include mandatory mental health screening, structured breastfeeding support, and patient-centred discharge protocols. We recommend that Healthcare professionals, including nurses, health educators, lactation consultants, and physicians, receive training to deliver culturally sensitive, holistic care that addresses both clinical and emotional needs. While rooming-in encourages infant bonding and breastfeeding, some mothers, especially those recovering from caesarean sections or complicated vaginal deliveries, may find it challenging to care for their newborns immediately after birth. We recommend policies that establish clear standards for postnatal care, including the availability of nursery services and newborn care support for mothers who experience a challenging postpartum recovery. In such cases, nursery services can provide vital support and ease maternal recovery, ensuring the safety of both mother and baby. Pain management is a crucial yet often overlooked aspect of the postpartum experience. The WHO Postnatal Care Guidelines emphasise that managing physical discomfort and delivering individualised post-surgical care are essential to respectful and high-quality postnatal services [ 1 ]. Since each woman may experience varying levels of intensity and different childbirth complications, it is crucial to tailor pain relief approaches to meet individual needs. This individualised care ensures sufficient physical comfort and supports emotional stability, ultimately promoting a more positive postpartum experience. Future studies should expand to other regions of Saudi Arabia, particularly rural and underserved areas, and include comparisons across both public and private hospitals to capture differences in service delivery and patient experience. Research is also needed on postpartum family planning counselling and the role of digital tools, structured home visits, and partner-inclusive programs. Such evidence can guide scalable, evidence-based improvements in maternal care services nationwide. Conclusion This study highlights the multidimensional nature of postpartum experiences, revealing how physical recovery, emotional well-being, breastfeeding support, newborn care education, social networks, hospital environment, and cultural practices interact to shape maternal satisfaction and outcomes. Mothers consistently identified gaps in pain management, structured education, discharge planning, and access to nursery support, which left them feeling vulnerable and unprepared during a critical period of transition. These findings reinforce the need for integrated, tailored postnatal care that balances medical guidance with cultural sensitivity, ensures adequate education and follow-up, and provides additional support for women with heightened physical and emotional needs. Addressing these gaps requires greater alignment between hospital policies, professional practices, and community support systems to strengthen recovery, promote maternal confidence, and safeguard the well-being of both mothers and infants. Abbreviations IRB – Institutional Review Board KKUH – King Khalid University Hospital MOH – Ministry of Health PNC – Postnatal Care WHO – World Health Organisation Declarations Ethics approval and consent to participate This study was approved by the Institutional Review Board (IRB) of King Saud University (IRB Ref No: E-24-9376). Informed consent was obtained from all participants prior to their involvement in the study. Participants were assured of confidentiality and their right to withdraw at any time without consequences. Consent for publication This research was conducted with official approval from the Nursing Research Unit at KKUH. The unit granted permission to publish the findings, with acknowledgment included in the manuscript. No identifiable participant information is presented. Availability of data and materials The datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request. Competing interests The authors declare that they have no competing interests. Funding No specific funding was received for this study. Authors' contributions FA and NA conceptualised the study. FA conducted data collection. FA and NA jointly conducted the formal analysis. Both authors contributed to the development of the methodology. FA prepared the original draft of the manuscript, and both FA and NA reviewed and edited the final version. All authors read and approved the final manuscript. Acknowledgements The authors sincerely thank the postpartum mothers who shared their experiences as part of this study. We gratefully acknowledge the Nursing Research Unit at KKUH for granting official approval and facilitating access to participants. 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Cite Share Download PDF Status: Published Journal Publication published 09 Mar, 2026 Read the published version in BMC Pregnancy and Childbirth → Version 1 posted Editorial decision: Revision requested 23 Nov, 2025 Reviews received at journal 22 Nov, 2025 Reviews received at journal 20 Nov, 2025 Reviewers agreed at journal 15 Nov, 2025 Reviewers agreed at journal 13 Nov, 2025 Reviewers agreed at journal 12 Nov, 2025 Reviewers agreed at journal 11 Nov, 2025 Reviewers agreed at journal 02 Nov, 2025 Reviews received at journal 28 Oct, 2025 Reviewers agreed at journal 28 Oct, 2025 Reviewers agreed at journal 28 Oct, 2025 Reviewers invited by journal 22 Oct, 2025 Editor invited by journal 13 Oct, 2025 Editor assigned by journal 12 Oct, 2025 Submission checks completed at journal 12 Oct, 2025 First submitted to journal 12 Oct, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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16:34:00","extension":"xml","order_by":10,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":151609,"visible":true,"origin":"","legend":"","description":"","filename":"f2f2ab699db1432eb93c8b8fc433017e1structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7840409/v1/57e8464aba9d83efd6d8da85.xml"},{"id":95170572,"identity":"29beb1e9-7528-4220-b201-d778dfe9a75a","added_by":"auto","created_at":"2025-11-05 06:28:46","extension":"html","order_by":11,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":167268,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7840409/v1/72857ffbd2c5718ae6f79d90.html"},{"id":95227656,"identity":"d4b993c9-1272-49ed-8811-b894791eb6ec","added_by":"auto","created_at":"2025-11-05 16:32:42","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":129403,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eMapping of Postpartum Care Themes to WHO Postnatal Care Guidelines (2022) and Pender’s Health Promotion Model (2011)\u003c/em\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7840409/v1/79d7010392e50157bba9e0a2.png"},{"id":104740060,"identity":"8303de4d-1c4c-4afb-a4e3-e656a9f77655","added_by":"auto","created_at":"2026-03-16 16:14:57","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1198522,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7840409/v1/bfecb056-2dca-46e3-9a65-aeefff4d8b30.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Exploring Mothers’ Experiences and Perceptions of Postpartum Care in King Khaled University Hospital: A Qualitative Study","fulltext":[{"header":"Background","content":"\u003cp\u003ePostpartum or postnatal care refers to the comprehensive medical, emotional, and educational support provided to mothers and newborns immediately after childbirth [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. During this period, women undergo significant physiological and psychological changes, such as uterine involution, hormonal shifts, initiation of breastfeeding, and heightened vulnerability to complications including infection, haemorrhage, and mental health disorders [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. To safeguard maternal and neonatal health, the World Health Organisation (WHO) recommends at least three postnatal visits in the first six weeks; however, adherence to these recommendations varies widely depending on healthcare access, cultural practices, and maternal awareness [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eDespite progress in maternal health, postpartum care remains under prioritised. The WHO reported in 2023 that over 700 women die each day from preventable pregnancy- and childbirth-related causes. In 2021, 40% of mothers in low- and middle-income countries received no postnatal care within six weeks of delivery, reflecting persistent gaps in infrastructure, awareness, and access to services [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Essential services such as breastfeeding support, hygiene education, immunisation guidance, and psychosocial care are often absent or inconsistent. Globally, up to one in five women experience postpartum mental health disorders, including depression and anxiety, yet these frequently go undiagnosed and untreated in settings without routine screening. Early detection through validated tools, such as the Edinburgh Postnatal Depression Scale, can improve outcomes for mothers and infants alike [\u003cspan additionalcitationids=\"CR7\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e\u003cp\u003ePostnatal care provision varies greatly across contexts. High-income countries such as the United Kingdom and Sweden typically offer comprehensive programs that integrate routine mental health screening, breastfeeding support, and home visits, reducing maternal morbidity and strengthening outcomes [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. By contrast, low- and middle-income countries face enduring challenges, including workforce shortages, financial barriers, and reliance on traditional birth attendants. In regions such as Sub-Saharan Africa and South Asia, only 30% of women receive skilled postnatal care within two days of childbirth [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn Saudi Arabia, healthcare is delivered through both governmental and private sectors. The Ministry of Health (MOH) oversees more than half of national services, including free maternity care in public hospitals and primary care centres. Employer-sponsored insurance extends coverage to private-sector employees, while other government bodies (e.g., Ministry of the Interior, National Guard, Ministry of Defence) operate specialised facilities. The private sector provides roughly 20% of total services. Maternal care, including antenatal, intrapartum, and postnatal care, is delivered in line with national clinical guidelines that follow international standards. The MOH\u0026rsquo;s Mother-and-Baby-Friendly Childbirth Initiative promotes evidence-based and respectful maternity care, while strengthening mother\u0026ndash;infant bonding [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eWhile quantitative research has addressed clinical outcomes, emotional and cultural dimensions of postpartum care remain underexplored [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Few qualitative studies have examined women\u0026rsquo;s experiences in tertiary hospital settings. This study, therefore, explores maternal perspectives at King Khaled University Hospital (KKUH) in Riyadh to identify strengths and areas for improvement in postpartum care, education, and service delivery.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eStudy Design\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study adopted a reflexive qualitative design to explore the postpartum care experiences of mothers at King Khalid University Hospital (KKUH). Semi-structured interviews were employed, allowing for the in-depth exploration of participants\u0026rsquo; unique perspectives while ensuring comprehensive coverage of core postpartum care topics.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy Setting\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted at KKUH, a tertiary-level academic institution affiliated with King Saud University Medical City in Riyadh, Saudi Arabia. KKUH was selected due to its comprehensive postnatal care services and its status as a teaching hospital, ensuring access to a diverse sample of postpartum mothers. Data collection took place over one month, from January 15 to February 16, 2025, within the Postnatal Units.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSampling and Recruitment Strategy\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA purposive sampling approach was used to recruit postpartum mothers receiving care in the postnatal units at (KKUH). Eligible participants were those who had recently given birth, were physically and mentally able to participate, and provided written informed consent. Mothers were excluded if they experienced severe complications that hindered participation or if they declined or withdrew consent. A total of 20 mothers were interviewed, which provided sufficient information to capture diverse experiences and enable meaningful, in-depth analysis [14,15].\u003c/p\u003e\n\u003cp\u003eParticipants were identified with the assistance of nursing staff, who provided a list of eligible postpartum patients in the postnatal units. Mothers who were available and met the inclusion criteria were approached in person, informed about the study objectives and procedures, and invited to participate.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInterview Procedures\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSemi-structured interviews were conducted in the postnatal care unit of KKUH, either in private or shared rooms, depending on patient placement. The interviews explored birth experiences, maternal adjustment, inpatient care, discharge preparation, emotional well-being, family support, cultural influences, and suggestions for improvement. While most interviews took place in private rooms, two were conducted in shared rooms, with verbal and written consent. Measures were taken to maintain privacy and confidentiality. Each interview lasted between 30 and 45 minutes, following a flexible interview guide that allowed participants to share their experiences of postpartum care in detail.\u003c/p\u003e\n\u003cp\u003ePrior to formal data collection, the interview guide was pilot tested with four postpartum mothers who were not part of the main study. Feedback from the pilot led to rewording several questions to enhance clarity and cultural relevance.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Collection and Management\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWith participant consent, all interviews were audio-recorded and accompanied by field notes to capture non-verbal cues and contextual details. A short socio-demographic questionnaire was used to collect participant characteristics, including age, marital status, education, employment, nationality, parity, and mode of delivery.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn the postnatal ward, the researcher approached eligible mothers and conducted interviews in a comfortable and private setting. To accommodate participant preferences, two versions of the interview guide were available; nineteen interviews were conducted in Arabic, and one was conducted in English.\u003c/p\u003e\n\u003cp\u003eAll data were anonymised and stored securely on password-protected devices in accordance with institutional data management and ethics policies.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData were analysed using Braun and Clarke\u0026rsquo;s reflexive thematic analysis [15]. Transcripts were read several times and inductively coded to capture key themes. ATLAS.ti software supported the organisation of codes, which were refined through an iterative and reflexive process. To enhance rigour, two researchers (FA \u0026amp; NA) independently coded a subset of transcripts and discussed their interpretations. Differences were viewed as opportunities to enrich understanding, and discussions continued until agreement was reached.\u003c/p\u003e\n\u003cp\u003eWhile coding was inductive, interpretation of themes was informed by the WHO Postnatal Care Guidelines [1] and Pender\u0026rsquo;s Health Promotion Model [16]. The WHO framework informed the analysis of care practices such as breastfeeding, physical recovery, and follow-up. At the same time, Pender\u0026rsquo;s model provided insight into social and behavioural influences, including mental health and support networks. The relationship between the emergent themes and these frameworks is illustrated in Figure 1 and detailed further in Appendix G.\u003c/p\u003e\n\u003cp\u003eA reflexive approach was maintained throughout the analysis, with the research team acknowledging how their professional backgrounds in public health and women\u0026rsquo;s health could influence the interpretation of participant narratives. Regular discussions were held to challenge assumptions, enhance analytic rigour, and ensure that the themes accurately reflected the mothers\u0026rsquo; perspectives rather than the researcher\u0026apos;s preconceptions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Considerations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval was obtained from the Institutional Review Board (IRB) at King Saud University (Approval No. E-24-9376) and the Nursing Research Unit at King Khalid University Hospital (KKUH).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAll participants received detailed information about the study and provided written informed consent before participation. The study adhered to established ethical principles, including respect for persons, beneficence, and maintenance of confidentiality.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eTwenty postpartum mothers who had recently given birth agreed to participate in this study. Participants varied in age, nationality, educational background, employment status, marital duration, mode of delivery, and parity. \u003cstrong\u003eTable 1\u003c/strong\u003e presents descriptive data for participant characteristics.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1.\u003c/strong\u003e Socio-demographic characteristics of participants (N = 20)\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"549\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristic\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 181px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 181px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003e18-24\u003c/p\u003e\n \u003cp\u003e25-29\u003c/p\u003e\n \u003cp\u003e30-34\u003c/p\u003e\n \u003cp\u003e35-39\u003c/p\u003e\n \u003cp\u003e40 years and above\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 181px;\"\u003e\n \u003cp\u003e20%\u003c/p\u003e\n \u003cp\u003e20%\u003c/p\u003e\n \u003cp\u003e15%\u003c/p\u003e\n \u003cp\u003e25%\u003c/p\u003e\n \u003cp\u003e20%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNationality\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eSaudi\u003c/p\u003e\n \u003cp\u003eNon-Saudi\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 181px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e85%\u003c/p\u003e\n \u003cp\u003e15%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eEducation\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eIntermediate School\u003c/p\u003e\n \u003cp\u003eHigh School\u003c/p\u003e\n \u003cp\u003eDiploma\u003c/p\u003e\n \u003cp\u003eBachelor\u0026rsquo;s Degree\u003c/p\u003e\n \u003cp\u003ePostgraduate (Master\u0026rsquo;s)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 181px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003cp\u003e15%\u003c/p\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003cp\u003e70%\u003c/p\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eEmployment\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eEmployed\u003c/p\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003cp\u003eStudent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 181px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e35%\u003c/p\u003e\n \u003cp\u003e55%\u003c/p\u003e\n \u003cp\u003e10%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital Duration\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 181px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003eLess than 1 year\u003c/p\u003e\n \u003cp\u003e1\u0026ndash;3 years\u003c/p\u003e\n \u003cp\u003e4\u0026ndash;6 years\u003c/p\u003e\n \u003cp\u003e7\u0026ndash;10 years\u003c/p\u003e\n \u003cp\u003eMore than 10 years\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 181px;\"\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003cp\u003e35%\u003c/p\u003e\n \u003cp\u003e25%\u003c/p\u003e\n \u003cp\u003e20%\u003c/p\u003e\n \u003cp\u003e15%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMode of Delivery\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 181px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVaginal delivery\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eCaesarean section\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eA\u003cstrong\u003essisted delivery\u0026nbsp;\u003c/strong\u003e(vacuum)\u003c/p\u003e\n \u003cp\u003eMixed delivery (VD \u0026amp; CS)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 181px;\"\u003e\n \u003cp\u003e35%\u003c/p\u003e\n \u003cp\u003e55%\u003c/p\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eParity\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e1 (First birth)\u003c/p\u003e\n \u003cp\u003e2\u0026ndash;3 births\u003c/p\u003e\n \u003cp\u003e4\u0026ndash;5 births\u003c/p\u003e\n \u003cp\u003e6 or more births\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 181px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e30%\u003c/p\u003e\n \u003cp\u003e40%\u003c/p\u003e\n \u003cp\u003e10%\u003c/p\u003e\n \u003cp\u003e20%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 181px;\"\u003e\n \u003cp\u003e100%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 181px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eOverview of Emerging Themes\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThematic findings revealed multiple dimensions shaping maternal recovery and satisfaction, including physical health, emotional well-being, breastfeeding support, newborn care education, access to health information, social support, hospital environment, birth experiences, pain management, discharge planning, and cultural practices.\u0026nbsp;The structure of these themes and subthemes is presented in \u003cstrong\u003eTable 2\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2.\u003c/strong\u003e Themes and subthemes emerging from interviews (N = 20)\u003c/p\u003e\n\u003ctable border=\"0\" cellpadding=\"0\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eThemes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 391px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSubthemes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePhysical recovery and birth experience\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 391px;\"\u003e\n \u003cp\u003ePhysical health; Pain management; Birth experience\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInformational and educational support\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 391px;\"\u003e\n \u003cp\u003eBreastfeeding support; Newborn care education; Health information resources; Discharge experience\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEmotional and social support\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 391px;\"\u003e\n \u003cp\u003eEmotional well-being; Family and social support; Lack of nursery support\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSystemic and cultural influences\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 391px;\"\u003e\n \u003cp\u003eHospital environment and staff interaction; Cultural beliefs and practices\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Physical Recovery and Birth Experience\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMothers\u0026rsquo; experiences of physical recovery following childbirth revealed significant gaps in postnatal support, pain management, and informational guidance. This sense of abandonment was especially acute during the first days after discharge, when they were expected to care for their newborns while navigating pain, fatigue, and unanswered concerns about their healing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eNavigating Recovery with Unmet Needs\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMothers described the postpartum period as physically and emotionally taxing, characterised by pain, fatigue, and a lack of structured support. While expected to heal and care for their newborns, many felt unprepared and unsupported. Conflicting advice, absence of follow-up, and unclear information about what to expect left several women feeling overwhelmed and isolated during recovery.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;I was discharged two hours ago, but I\u0026rsquo;m still in the room waiting for my husband to pick me up. I keep feeling sore and swollen, especially in my legs. No one told me if that\u0026rsquo;s normal. I\u0026rsquo;m honestly scared something\u0026rsquo;s wrong, but I didn\u0026rsquo;t want to keep calling the nurses and seem overdramatic.\u0026rdquo;\u003c/em\u003e (PNC13)\u003c/p\u003e\n\u003cp\u003eMothers who underwent Caesarean sections particularly struggled with mobility, pain, and caring for their newborns when adequate assistance was unavailable.\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;They told me I should rest and recover, but at the same time, I was left alone with my baby, expected to walk, carry him, and manage everything. I didn\u0026rsquo;t even know how to hold him properly without pain.\u0026rdquo;\u003c/em\u003e (PNC02)\u003c/p\u003e\n\u003cp\u003eSeveral mothers emphasised the need for education about the postpartum body. They felt unprepared for the intensity and duration of physical symptoms and desired a clearer roadmap for healing.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;I thought the pain would ease after a day or two, but it didn\u0026rsquo;t. My back hurt, the stitches are sore, and even getting out of bed wasn\u0026rsquo;t easy. One night, I tried to stand up to feed my baby and just had to sit down again. I was too tired and uncomfortable. I kept wondering if this was all normal. I wish someone had explained what to expect and how long recovery might take. It would\u0026rsquo;ve made things feel a little less overwhelming.\u0026rdquo;\u0026nbsp;\u003c/em\u003e(PNC16)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eBirth Experience: Between Empowerment and Emotional Distress\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWomen highlighted the powerful role of pain management, communication, and emotional support in shaping their childbirth experiences. For many, the quality of care they received during labour significantly influenced their emotional well-being and perception of the birth experience. Timely and compassionate responses to pain contribute to a sense of care and respect. One participant described feeling deeply cared for, despite experiencing a serious complication during labour:\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;it was my first delivery, and\u0026hellip; I had a natural birth, but I suffered a tear in my uterus during labour and started bleeding a lot\u0026hellip; Even though today is my third day in the hospital, I\u0026rsquo;m still in so much pain. The antenatal and delivery wards were honestly amazing; the doctors, nurses, and midwives were kind and respectful. I felt like a VIP.\u0026rdquo;\u0026nbsp;\u003c/em\u003e(PNC18)\u003c/p\u003e\n\u003cp\u003eInsufficient pain relief and dismissive responses from staff were especially prevalent among mothers who delivered vaginally, causing some women to feel neglected and emotionally distressed.\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;The pain was sharp and constant for days, but they only gave me Panadol [paracetamol]. One night, it got really bad, I rang the nurse and asked for stronger pain relief, but no one came. I waited for so long and eventually just took a Panadol from my purse. I couldn\u0026rsquo;t even sit to breastfeed properly. I cried from the pain alone in my room, and felt like they thought I was exaggerating.\u0026rdquo;\u0026nbsp;\u003c/em\u003e(PNC04)\u003c/p\u003e\n\u003cp\u003eIn contrast, mothers who had a caesarean delivery described a more responsive and respectful birth experience.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;The nurse checked on me every few hours and made sure I had the medication I needed. When I said the pain was coming back, she didn\u0026rsquo;t wait; she called the doctor. That made me feel seen and cared for.\u0026rdquo;\u003c/em\u003e (PNC18)\u003c/p\u003e\n\u003cp\u003eBeyond physical discomfort, women\u0026rsquo;s broader experiences of childbirth reflected a spectrum of emotional responses, from empowerment and reassurance to fear and confusion. Some participants felt supported and actively involved, while others described feeling uninformed and excluded during the labour process.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;I didn\u0026rsquo;t know what was happening. They kept telling me to push, but no one told me if the baby was okay or how long it would take. I was in pain and terrified, and I felt invisible in the room. It was like they were doing things to me, not with me.\u0026rdquo;\u003c/em\u003e (PNC12)\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;I was screaming and panicking, I honestly thought I couldn\u0026rsquo;t do it. But the nurse stayed right beside me\u0026hellip; she held my hand tight and she comforted me by reciting a Dua [prayer]) during my pain... She told me, \u0026lsquo;You\u0026rsquo;re strong, you\u0026rsquo;re doing great, Allah is with you.\u0026rsquo; That moment\u0026hellip; I\u0026rsquo;ll never forget it. It gave me strength when I had none.\u0026rdquo;\u0026nbsp;\u003c/em\u003e(PNC14)\u003c/p\u003e\n\u003cp\u003eSome participants described lingering emotional effects from their birth experiences, especially when they felt excluded from decision-making or unprepared for sudden changes. A lack of clear communication during urgent situations left some women feeling invisible, scared, and uncertain about what was happening to their bodies.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;I remember\u0026hellip; at first, they told me things were progressing slowly, but later, a nurse came in and said, \u0026lsquo;We need to take you for a C-section. It\u0026rsquo;s urgent.\u0026rsquo; I was confused; no one had explained anything clearly before that. I overheard someone mention that my cervix wasn\u0026rsquo;t dilating, but no one actually sat down and told me what was happening. My husband wasn\u0026rsquo;t there yet\u0026hellip; I was alone, scared, and just said okay because I didn\u0026rsquo;t know what else to do. Even now, when I think about it, there\u0026rsquo;s this heaviness\u0026hellip; like no one saw me, just the medical situation. Alhamdulillah, the baby is healthy, but it still hurts how everything was rushed and unclear.\u0026rdquo;\u0026nbsp;\u003c/em\u003e(PNC10)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformational and Educational Support\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMothers\u0026rsquo; experiences revealed persistent gaps in the timing, accessibility, and clarity of postpartum education. Many participants expressed a strong desire for guidance, tailored support, and follow-up that extended beyond discharge.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eInconsistencies in Lactation Support\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBreastfeeding was a central concern among participants, often shaping their early emotional adjustment. Some mothers described positive encounters with supportive lactation consultants.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;The lactation consultant didn\u0026rsquo;t rush me. She sat with me, showed me how to position my baby, and reassured me every time I got emotional. I was so afraid I wouldn\u0026rsquo;t be able to do it, but she helped me believe in myself.\u0026rdquo;\u003c/em\u003e (PNC17)\u003c/p\u003e\n\u003cp\u003eBy contrast, a lack of immediate, hands-on support caused some individuals to experience distress and self-doubt. Some mothers reported feeling abandoned during moments of vulnerability.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;It\u0026rsquo;s been five years since my last baby, and this is my first time having a C-section. My baby wasn\u0026rsquo;t latching, and I kept asking for help. One nurse came and just said, \u0026lsquo;Keep trying,\u0026rsquo; then left. I sat there feeling unsure and overwhelmed, not knowing what I was doing wrong. No one came back to check. I started doubting myself and just wished someone had stayed a bit longer to guide me.\u0026rdquo;\u0026nbsp;\u003c/em\u003e(PNC03)\u003c/p\u003e\n\u003cp\u003eSeveral participants emphasised that breastfeeding education should start during pregnancy and that mothers should have opportunities to consult with lactation specialists after discharge. Although the hospital offers a dedicated breastfeeding education clinic, it is available only to inpatients on Thursdays, which mothers felt was inadequate for their needs for timely and ongoing support. They strongly recommended that breastfeeding support be available throughout the week to provide timely and continuous access.\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;No one really told me what to expect about breastfeeding before I gave birth. They just said, \u0026lsquo;We\u0026rsquo;ll help you after.\u0026rsquo; But after delivery, I was in so much pain\u0026hellip; I could barely sit. I tried to feed him, but it hurt, and I wasn\u0026rsquo;t sure I was doing it right. One of the nurses was kind; she helped a bit, but then she mentioned the breastfeeding clinic is only open on Thursdays, and I\u0026rsquo;ll probably be discharged before that. I\u0026rsquo;m a first-time mum, and I just need someone to stay with me for a bit longer\u0026hellip; to really show me how. Not just say, \u0026lsquo;You\u0026rsquo;ll get used to it.\u0026rsquo; I keep thinking, what if I go home still unsure? I don\u0026rsquo;t want to feel lost when I leave.\u0026rdquo;\u0026nbsp;\u003c/em\u003e(PNC10)\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;They told me before delivery that I could go to the breastfeeding clinic if I needed help, but it\u0026rsquo;s only open on Thursdays. I gave birth on Sunday, and I\u0026rsquo;m still here... but no one has come to help me yet. I don\u0026rsquo;t have a car; my husband works long hours. Even if I were discharged, how could I come back just for that? It\u0026rsquo;s not realistic. I really needed the support while I\u0026rsquo;m here, not days later. Honestly, they should have someone available every day, even just for a few hours. New mums like me shouldn\u0026rsquo;t feel lost trying to figure everything out alone.\u0026rdquo;\u0026nbsp;\u003c/em\u003e(PNC18)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026ldquo;Lift to Figure It Out Alone\u0026rdquo;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMothers consistently described a lack of structured education on newborn care, which left them feeling anxious and unprepared during the critical first days at home. Many mothers lacked guidance on basic topics such as bathing, feeding cues, umbilical cord care, and infant sleep patterns.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;Last night, I just kept staring at my baby, worried she might stop breathing. I didn\u0026rsquo;t know what was normal. Was her stool supposed to look like that? Was she crying too much? No one really explained anything or gave me a guide on what to expect. I\u0026rsquo;m still here in the hospital, but I already feel anxious about going home.\u0026rdquo;\u003c/em\u003e\u0026nbsp; (PNC18)\u003c/p\u003e\n\u003cp\u003eSeveral participants expressed frustration with the assumption that they would instinctively know how to care for their newborns. Instead of receiving comprehensive instruction, they were often left to rely on trial and error or external sources.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;\u003cem\u003eThe nurses acted like I should already know how to hold him, burp him, everything. But no one had shown me anything. I kept asking questions, but I felt like a burden.\u003c/em\u003e\u0026rdquo; (PNC13)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eFragmented Guidance and Its Consequences\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMothers described receiving inconsistent, rushed, or incomplete advice from different healthcare staff, which led to confusion, anxiety, and diminished trust in clinical guidance.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cem\u003e\u0026ldquo;I kept trying to breastfeed, but I wasn\u0026rsquo;t sure if my baby was actually getting milk. I asked for help\u0026hellip; one nurse just said, \u0026lsquo;Keep putting him on the breast, he\u0026rsquo;s fine.\u0026rsquo; But then, later, another nurse told me, \u0026lsquo;If he keeps crying, that means he\u0026rsquo;s not getting any.\u0026rsquo; I didn\u0026rsquo;t know who to believe. I was tired, in pain\u0026hellip; and honestly scared that he was still hungry. I just sat there thinking, \u0026lsquo;Why isn\u0026rsquo;t there one clear answer?\u0026rsquo; I needed someone to show me\u0026hellip; like, really explain\u0026hellip; \u0026nbsp;what to look for and what\u0026rsquo;s normal or not?\u0026rdquo;\u003c/em\u003e (PNC12)\u003c/p\u003e\n\u003cp\u003eDespite concerns about reliability, many mothers relied on online platforms or informal networks because the professional support they encountered often felt fragmented, generic, or inaccessible outside of scheduled appointments.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;Since I gave birth, the nurses kept encouraging me to breastfeed, but no one really showed me how to do it properly. They were nice, but always seemed to be in a rush. I kept trying, but I wasn\u0026rsquo;t sure if I was doing it right. The next day, my mom came, and she was the one who actually showed me how to position the baby and what to look for. That really helped. I think I just needed someone to sit with me and explain it from the start.\u0026rdquo;\u003c/em\u003e (PNC19)\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;\u003cem\u003eI ended up Googling everything, even though I didn\u0026rsquo;t want to. I wish they had given us a booklet, an app, or something that was trustworthy and local. I wanted to rely on the hospital, but the advice wasn\u0026rsquo;t the same.\u003c/em\u003e\u0026rdquo; (PNC07)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eDischarge Without Direction\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMothers consistently described the discharge process as abrupt and poorly explained. Many reported being sent home within 24 hours of delivery with little preparation, unclear guidance, and few chances to raise their concerns.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;It was my first baby, and I really didn\u0026rsquo;t feel ready to be discharged. I thought I\u0026rsquo;d stay a few days to learn and adjust, but the nurse said if everything looked fine, the doctor would discharge me in a few hours. I kept hoping to ask him if I could stay a bit longer. I felt anxious; I didn\u0026rsquo;t even know how to hold my baby properly. My mother isn\u0026rsquo;t in Riyadh, so I felt completely alone and scared to go home. But they said it\u0026rsquo;s hospital policy to leave the next day if everything is stable. I just needed a little more time, just one extra day to feel more confident.\u0026rdquo;\u0026nbsp;\u003c/em\u003e(PNC12)\u003c/p\u003e\n\u003cp\u003eThe lack of structured and clear discharge planning left many mothers feeling anxious, unprepared, and unsupported. Discharge protocols appeared to prioritise clinical stability over emotional readiness and practical competence.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;The baby\u0026rsquo;s doctor came with the nurse and checked him, then said he was ready to go home. Later, my doctor came in, did a quick check, and said I could be discharged too. But honestly, I didn\u0026rsquo;t feel ready yet. It was my first baby, and I still had pain and a lot of questions. I thought someone would sit with me and explain things more, perhaps provide me with a paper or a phone number to call if I needed support. Instead, it just felt a bit rushed, like once everything looked fine medically, I was expected to leave. I just wish there was more guidance before going home.\u0026rdquo;\u003c/em\u003e (PNC19)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe Importance of Emotional and Social Support\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMany participants described feeling emotionally vulnerable in the early days after birth and emphasised the impact of interpersonal interactions, whether compassionate or neglectful, on their mental well-being. The availability or absence of family support and institutional assistance, such as nursery care, further influenced their experience of emotional security, exhaustion, and coping.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eThe Need for Acknowledgement and Empathy\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMothers frequently described the early postpartum period as a time of emotional vulnerability, often compounded by physical exhaustion and uncertainty about their new responsibilities. While some felt supported, others noted a stark lack of attention to their mental well-being. One mother reflected on the disconnect between physical and emotional care:\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;\u003cem\u003ePhysically, I was healing, but inside, I was scared and overwhelmed. No one asked how I felt. The nurse just asked if I had pain or fever. I needed someone to check on my emotions, too, not just my temperature.\u003c/em\u003e\u0026rdquo; (PNC13)\u003c/p\u003e\n\u003cp\u003eMany mothers described experiencing little to no acknowledgement of their mental health needs by healthcare providers. One participant recounted crying unexpectedly and feeling overwhelmed by intrusive thoughts, only to be met with a dismissive response from staff:\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;I don\u0026rsquo;t know\u0026hellip; I kept feeling down, and I couldn\u0026rsquo;t explain why. I told the nurse I was crying for no reason, and she said, \u0026lsquo;It\u0026rsquo;s just hormones.\u0026rsquo; But it didn\u0026rsquo;t feel like just hormones. There wasn\u0026rsquo;t even a mirror in the room or in the bathroom, I want to see myself. I hadn\u0026rsquo;t showered in four days because they said the shower was at the end of the hallway, and I had to walk there. I felt dirty, uncomfortable, and just\u0026hellip; not myself. At night, I was alone with my thoughts. My baby was next to me, and I kept checking if he was breathing. No one explained whether what I was feeling was normal or how to manage it. I think all these little things added up, and I just felt... neglected.\u0026rdquo;\u003c/em\u003e (PNC20)\u003c/p\u003e\n\u003cp\u003eDespite these challenges, small gestures of kindness from healthcare providers had a lasting emotional impact.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;\u003cem\u003eOne midwife smiled at me and sat down just to ask how I was really doing. She didn\u0026rsquo;t rush. I\u0026rsquo;ll never forget that moment. It helped more than the medicine.\u003c/em\u003e\u0026rdquo; (PNC17)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eThe Role of Family and Social Networks in Postpartum Experiences\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFamily and social networks play a crucial role in shaping women\u0026rsquo;s experiences after childbirth, acting as either a protective buffer or a source of emotional stress. For many participants, close support from mothers, sisters, or husbands significantly eased the transition into motherhood. This support provided both emotional reassurance and practical assistance with newborn care and physical recovery. Often, it filled the gaps left by clinical care and was described as essential for coping during the early postpartum days.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;\u003cem\u003eMy mom stayed with me every night in the hospital. She did everything, helped me shower, held the baby when I felt pain. Without her, I don\u0026rsquo;t think I could\u0026rsquo;ve coped.\u003c/em\u003e\u0026rdquo; (PNC09)\u003c/p\u003e\n\u003cp\u003eThe presence of a trusted caregiver offered comfort, reduced stress, and allowed some mothers to rest, heal, and emotionally adjust. However, this support was not available to everyone. Many reported a significant lack of social or family assistance, often due to geographical distance or demanding work schedules. This absence of support intensified feelings of helplessness, especially during night-time when emotional and physical exhaustion were at their highest.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;I\u0026rsquo;m not from Riyadh\u0026hellip; and my mom couldn\u0026rsquo;t come. My husband works long hours, so most of the time, it\u0026rsquo;s just me... During pregnancy, they kept telling me the baby\u0026rsquo;s pulse was high\u0026hellip; even after birth, I noticed he\u0026rsquo;d breathe fast sometimes. I didn\u0026rsquo;t know if that was normal... At night\u0026hellip; when he cried and wouldn\u0026rsquo;t settle, I\u0026rsquo;d just sit there watching him, wondering if something was wrong. I felt scared\u0026hellip; and really unsure of what to do. I just wish someone were here.\u0026rdquo; (PNC06)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eSome participants hired external help, while others relied on friends or neighbours for guidance after discharge. Support systems varied widely among mothers, with some receiving ongoing assistance and others feeling lost and isolated.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;\u003cem\u003eHonestly, I was lucky\u0026hellip; my friends visited me, and my sister came and stayed with me for the first few days. She\u0026rsquo;s had three kids, so she knew what to do. But not everyone has that, you know? Some of the girls here were saying they\u0026rsquo;ll be going home alone with no one around. One of the ladies next to me even said she hired a nanny for a month, just so she doesn\u0026rsquo;t go crazy. I thought about it too, but\u0026hellip; It\u0026rsquo;s too expensive. Sometimes I wish there was a place or number to call, just someone to guide me step by step. Because after discharge, you are kind of on your own.\u003c/em\u003e\u0026rdquo; (PNC17)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eLack of Nursery Support\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe absence of nursery services emerged as a significant barrier to postpartum recovery, particularly among mothers recovering from caesarean deliveries or caring for twins. Many participants had anticipated temporary assistance with newborn care in the initial recovery period, but were surprised to find that such support was unavailable. This lack of structured help left them physically strained and emotionally distressed during a period of acute vulnerability.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;\u003cem\u003eAfter my C-section, I could barely move. I was shaking and in pain, but I had to sit up every few hours to feed and change my baby. I asked if there was any nursery service, and the nurse said, \u0026lsquo;We don\u0026rsquo;t offer that.\u0026rsquo; I was shocked.\u003c/em\u003e\u0026rdquo; (PNC16)\u003c/p\u003e\n\u003cp\u003eFor mothers with twins or significant birth complications, the demands were intensified. Without access to additional support, basic tasks became overwhelming both physically and emotionally.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;\u003cem\u003eI had twins, and I was completely exhausted. One baby needed more attention, and I couldn\u0026rsquo;t keep up. I had no one to take them even for ten minutes. I thought I would collapse.\u003c/em\u003e\u0026rdquo; (PNC11)\u003c/p\u003e\n\u003cp\u003eSome mothers described feelings of helplessness and inadequacy when they were unable to meet their infants\u0026rsquo; needs due to pain or fatigue. In addition, some mothers reported technical issues, such as non-functional call buttons, which further compounded their distress:\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;I was really struggling after the birth\u0026hellip; I couldn\u0026rsquo;t lift my baby, I was in pain, tired, and just needed someone to help me for a bit. I kept pressing the call button again and again, but no one came. Later I found out it wasn\u0026rsquo;t even working. I tried to stand up and walk while holding onto the wall, and that\u0026rsquo;s when a nurse saw me and got upset, saying, \u0026lsquo;Why didn\u0026rsquo;t you call?\u0026rsquo; I told her I had been trying for hours. Then she said, \u0026lsquo;We don\u0026rsquo;t have a nursery here, you have to manage on your own.\u0026rsquo; But I really couldn\u0026rsquo;t. I just needed help, even for a short while.\u0026rdquo;\u0026nbsp;\u003c/em\u003e(PNC02)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSystemic and Cultural Influences\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParticipants highlighted the impact of the physical care environment, staff behaviour, and communication patterns within the hospital setting, as well as how traditional postpartum beliefs influenced recovery routines, decision-making, and interactions with medical advice.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eHospital Environment and Staff Interaction\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMothers shared how the physical environment and interactions with staff influenced their postpartum experience. Some reported feeling supported by having private rooms and receiving responsive care, while others expressed discomfort due to unclean conditions or inconsistent communication. Participants noted that the hospital environment had a significant impact on their ability to rest and recover. Factors such as privacy, cleanliness, and staff responsiveness either alleviated or increased their stress. For some mothers, being moved to a private room was a transformative experience.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;\u003cem\u003eThey just transferred me to a private room, and I finally felt like I could rest. Before that, it was noisy and crowded. Privacy made a big difference in calming me down.\u003c/em\u003e\u0026rdquo; (PNC15)\u003c/p\u003e\n\u003cp\u003eIn contrast, others encountered substandard hygiene and delayed responses that diminished their sense of dignity and trust in the system.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;\u003cem\u003eMy bed sheets were dirty when I arrived, stains from the previous patient. I asked for new ones, and no one came for hours. I felt like I wasn\u0026rsquo;t being treated with dignity.\u003c/em\u003e\u0026rdquo; (PNC04)\u003c/p\u003e\n\u003cp\u003eOne mother explained that the physical conditions in the postnatal ward left her feeling disappointed and undermined her sense of dignity. She described being denied simple requests, such as an extra pillow or a clean bedsheet, and noted the presence of blood stains in the bathroom, which negatively shaped her experience.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;But when I moved to the postnatal ward, the experience completely changed. I asked for an extra pillow, but they said there were none. I also asked to change the bedsheet; it looked old and unwashed. They said no. And when I went to the bathroom, I saw blood stains from the previous patient. It was really disappointing.\u0026rdquo;\u0026nbsp;\u003c/em\u003e(PNC18)\u003c/p\u003e\n\u003cp\u003eCommunication breakdowns between patients and rotating staff added significantly to the emotional burden of the postpartum experience. Several mothers described feeling frustrated and unseen due to the lack of continuity in care, which disrupted the rapport and trust they had with their healthcare providers. As one participant noted, the frequent changes in nursing staff required her to retell her story and re-explain her needs repeatedly.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;\u003cem\u003eThey kept changing the nurses, and each one would ask me the same questions again. It felt like they didn\u0026rsquo;t read my file. I had to keep explaining everything from the beginning.\u003c/em\u003e\u0026rdquo; (PNC05)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eCultural Traditions and Postpartum Recovery\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParticipants described receiving advice from both healthcare providers and family members, sometimes receiving conflicting messages. Cultural norms strongly influenced mothers\u0026rsquo; postpartum behaviours and expectations, especially around rest, diet, and caregiving. Many participants described the traditional Al-Nifas period, a forty-day period of rest following childbirth, as a source of comfort and support. For some, this tradition facilitated healing by ensuring that family members shared responsibilities such as newborn care and household tasks.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;In our tradition, we rest completely for forty days after giving birth. My mom helped me with my first baby, and now she\u0026rsquo;s doing the same with my second. She takes care of the meals, helps change the baby, and even lifts things for me. It really gives me the chance to rest and recover... Every day, she makes me hot shamar tea [fennel]. She says it\u0026rsquo;s good for cleaning the womb and settling the stomach. I grew up watching her make it for my aunts and cousins after they gave birth too, so it just feels normal, comforting even.\u003c/em\u003e\u0026rdquo; (PNC08)\u003c/p\u003e\n\u003cp\u003eHowever, adherence to cultural practices sometimes clashed with medical advice, particularly regarding the postpartum diet. Participants reported receiving conflicting recommendations from family members and healthcare providers, resulting in confusion. While these traditions offered comfort and familiarity, they sometimes contradicted hospital guidance, leaving mothers caught between cultural expectations and clinical recommendations.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;\u003cem\u003eIn my family, we\u0026rsquo;re told not to eat meat after a C-section because it\u0026rsquo;s hard to digest. The nurse said it\u0026rsquo;s fine, but my mom insisted I wait. I was torn between the two. In our village in the Philippines, this is something we always follow; my mom believed that eating meat too soon could cause complications. Even though the hospital gave me the okay, I just couldn\u0026rsquo;t go against my family\u0026rsquo;s way.\u003c/em\u003e\u0026rdquo; (PNC01)\u003c/p\u003e\n\u003cp\u003eThese tensions reflect how cultural authority, particularly from older family members, can shape maternal behaviour even when clinical advice differs. While some mothers deferred to traditional wisdom, others, especially younger or more educated participants, expressed a preference for evidence-based guidance.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;\u003cem\u003eMy relatives had a lot of advice, what to eat, what not to do, but I chose to listen to the doctors. I just felt safer that way.\u003c/em\u003e\u0026rdquo; (PNC15)\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe study identified the multifaceted nature of mothers\u0026rsquo; postpartum experiences. Participants reported needs spanning physical recovery, emotional well-being, breastfeeding support, and culturally responsive care. While several gaps emerged, including inconsistent responses to pain management, lack of breastfeeding education, limited emotional support, and insufficient discharge preparation, participants also recognised areas of strength. These included respectful and compassionate staff interactions, timely access to medical care, and the vital role of family involvement in supporting recovery.\u003c/p\u003e\u003cp\u003ePhysical recovery is a crucial factor in determining mothers\u0026rsquo; postpartum experiences, particularly in the first days following childbirth. Participants described weakness, pain, and mobility limitations post birth that compromised their ability to perform basic self-care and meet the immediate needs of their newborns. Inadequate pain management after childbirth has been linked to delayed physical recovery, early cessation of breastfeeding, increased risk of peripartum mood disorders, and challenges in establishing mother\u0026ndash;infant bonding [\u003cspan additionalcitationids=\"CR18 CR19 CR20\" citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eAcute postpartum pain has been linked to a substantially increased risk of postpartum depression, with one study reporting a three-fold greater likelihood among those with severe pain. Moreover, higher pain levels immediately after delivery correlate with poorer mother\u0026ndash;infant attachment and reduced parenting self-efficacy [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Providing tailored pain management, mobility support, and proactive follow-up care addresses women\u0026rsquo;s physical health needs and plays an important role in strengthening maternal confidence and enhancing overall well-being [\u003cspan additionalcitationids=\"CR24\" citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]\u003c/p\u003e\u003cp\u003ePostpartum mothers who felt heard, reassured, and emotionally validated during their hospitalisation reported greater satisfaction and increased confidence in caring for their newborns. Women who have experienced delayed or fragmented care that resulted in severe complications advocated for structured follow-up visits and ongoing support after discharge to improve postpartum outcomes and experiences [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. It has been established that a mother's sense of emotional safety is closely linked to her overall satisfaction with the quality of care provided postpartum [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Similar associations have been reported where emotional support during the immediate postpartum period was linked to improved maternal mental well-being, stronger mother\u0026ndash;infant bonding, and higher engagement in recommended postpartum practices [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eFamily and social support are essential components of postpartum recovery. Research indicates that higher perceived social support can significantly reduce the risk of postpartum depression, anxiety, and impaired bonding among new mothers [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Additionally, a study involving 564 women found that partner and family support is linked to improved maternal functioning following childbirth [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. In contrast, mothers who lacked sufficient family presence often reported feelings of isolation, insecurity in caring for their newborn, and limited awareness of available resources, underscoring the need for enhanced support structures within both the family and healthcare systems [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eA substantial gap exists in postpartum education, particularly regarding breastfeeding, infant care, physical recovery, and recognition of danger signs. These gaps may reflect systemic issues such as high staff workload or the absence of standardised discharge protocols [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Saudi mothers were found to have inadequate breastfeeding knowledge and were frequently swayed by formula marketing and myths [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Offering breastfeeding support to newly postpartum women significantly reduces the risk of stopping exclusive breastfeeding before six months [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. Structured, in-hospital education has been shown to enhance maternal outcomes [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. For instance, a meta-analysis reported significant improvements in mothers\u0026rsquo; self-confidence following newborn care education programs [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e], and a study in Ghana found that providing educational material on warning signs before discharge increased mothers\u0026rsquo; ability to recognise post-birth complications nearly fivefold, and almost 28-fold when four or more complications were discussed [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eDischarge readiness is closely linked to the quality of structured postpartum education provided to mothers prior to their hospital discharge. Evidence indicates that hospital discharge decisions often prioritise institutional efficiency over patient readiness, resulting in premature discharges. This can increase maternal stress, lead to postpartum blues, and leave postpartum care needs unmet [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]. In line with WHO recommendations, discharge planning should encompass individualised guidance and clear postnatal instructions to ensure a smooth transition from hospital to home care [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eA significant and under‑explored issue is the limited nursery support available to mothers recovering from caesarean birth or complicated vaginal delivery, without caregiver assistance. Postoperative pain and restricted mobility made tending to their newborns difficult [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]. At KKUH, nursery services are unavailable unless Neonatal Intensive Care Unit care is required, consistent with both national policy and the Mother \u0026ndash;and \u0026ndash;Baby -Friendly Maternity Care Initiative\u0026rsquo;s emphasis on rooming‑in [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. While rooming‑in supports breastfeeding and bonding, emerging evidence suggests it may also increase maternal pain and anxiety, especially for unassisted mothers after caesarean section, highlighting the potential benefit of short-term staff-assisted newborn care to facilitate rest and enhance postoperative recovery [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. These findings underscore the importance of tailoring postnatal support to individual maternal needs, ensuring that policies balance bonding with adequate recovery and well-being.\u003c/p\u003e\u003cp\u003ePostpartum practices are strongly shaped by cultural traditions, influencing maternal recovery, hygiene, nutrition, and newborn care [\u003cspan additionalcitationids=\"CR44\" citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]. Across different societies, these practices often include designated rest periods and organised family support, which can ease the transition into motherhood while promoting physical and emotional well-being [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]. In Saudi Arabia, many women observe the 40-day confinement period known as Nefas [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e]. However, such customs are often not integrated with formal health education or structured follow-up, creating a disconnect between traditional beliefs and evidence-based care [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]. Similarly, in China, the practice of zu\u0026ograve; yu\u0026egrave; zi also prioritises rest and support but may delay timely engagement with healthcare providers [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. These global examples show that cultural traditions can either facilitate or hinder optimal postpartum care, depending on how well they align with medical guidance. Culturally sensitive strategies are therefore needed to support maternal and infant health while respecting traditional beliefs [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e\u003cdiv id=\"Sec25\" class=\"Section2\"\u003e\u003ch2\u003eStrengths and Limitations:\u003c/h2\u003e\u003cp\u003eThis study provides valuable insights into the postpartum care experiences of mothers in a Saudi tertiary hospital. A key strength is the qualitative design, which enabled the collection of rich, first-hand maternal narratives. The use of a bilingual interview guide, which included both Arabic and English, enhanced inclusivity and supported transferability. The purposive sampling strategy ensured diversity across delivery types and socio-demographic backgrounds, strengthening the relevance of the findings. Although themes were developed inductively, interpretation was guided by the WHO Postnatal Care Guidelines and Pender\u0026rsquo;s Health Promotion Model [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e], providing theoretical depth and enhancing trustworthiness. Viewing the findings through these frameworks offered a structured lens for understanding how women perceive and navigate postnatal care in this context.\u003c/p\u003e\u003cp\u003eThis study has several limitations. Conducting some interviews in shared postnatal wards may have compromised auditory privacy and influenced participants\u0026rsquo; openness. As all interviews were conducted in a public hospital, the experiences of mothers in private hospitals, where care models may differ, were not represented. The single-site design may also limit the generalizability of the findings, although contextual information has been provided to support transferability. Although strategies to enhance trustworthiness were implemented, including dual coding and independent verification, the influence of researcher bias and social desirability cannot be entirely excluded. Despite these limitations, the study offers valuable insights to inform practice and guide future research in comparable contexts.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec26\" class=\"Section2\"\u003e\u003ch2\u003eImplications for Policy, Practice, and Future Research\u003c/h2\u003e\u003cp\u003e This study emphasises the need for standardised national guidelines on postpartum care in Saudi Arabia. These guidelines should include mandatory mental health screening, structured breastfeeding support, and patient-centred discharge protocols. We recommend that Healthcare professionals, including nurses, health educators, lactation consultants, and physicians, receive training to deliver culturally sensitive, holistic care that addresses both clinical and emotional needs.\u003c/p\u003e\u003cp\u003eWhile rooming-in encourages infant bonding and breastfeeding, some mothers, especially those recovering from caesarean sections or complicated vaginal deliveries, may find it challenging to care for their newborns immediately after birth. We recommend policies that establish clear standards for postnatal care, including the availability of nursery services and newborn care support for mothers who experience a challenging postpartum recovery. In such cases, nursery services can provide vital support and ease maternal recovery, ensuring the safety of both mother and baby.\u003c/p\u003e\u003cp\u003ePain management is a crucial yet often overlooked aspect of the postpartum experience. The WHO Postnatal Care Guidelines emphasise that managing physical discomfort and delivering individualised post-surgical care are essential to respectful and high-quality postnatal services [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Since each woman may experience varying levels of intensity and different childbirth complications, it is crucial to tailor pain relief approaches to meet individual needs. This individualised care ensures sufficient physical comfort and supports emotional stability, ultimately promoting a more positive postpartum experience.\u003c/p\u003e\u003cp\u003eFuture studies should expand to other regions of Saudi Arabia, particularly rural and underserved areas, and include comparisons across both public and private hospitals to capture differences in service delivery and patient experience. Research is also needed on postpartum family planning counselling and the role of digital tools, structured home visits, and partner-inclusive programs. Such evidence can guide scalable, evidence-based improvements in maternal care services nationwide.\u003c/p\u003e\u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study highlights the multidimensional nature of postpartum experiences, revealing how physical recovery, emotional well-being, breastfeeding support, newborn care education, social networks, hospital environment, and cultural practices interact to shape maternal satisfaction and outcomes. Mothers consistently identified gaps in pain management, structured education, discharge planning, and access to nursery support, which left them feeling vulnerable and unprepared during a critical period of transition.\u003c/p\u003e\u003cp\u003eThese findings reinforce the need for integrated, tailored postnatal care that balances medical guidance with cultural sensitivity, ensures adequate education and follow-up, and provides additional support for women with heightened physical and emotional needs. Addressing these gaps requires greater alignment between hospital policies, professional practices, and community support systems to strengthen recovery, promote maternal confidence, and safeguard the well-being of both mothers and infants.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eIRB \u0026ndash; Institutional Review Board\u003c/p\u003e\n\u003cp\u003eKKUH \u0026ndash; King Khalid University Hospital\u003c/p\u003e\n\u003cp\u003eMOH \u0026ndash; Ministry of Health\u003c/p\u003e\n\u003cp\u003ePNC \u0026ndash; Postnatal Care\u003c/p\u003e\n\u003cp\u003eWHO \u0026ndash; World Health Organisation\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Institutional Review Board (IRB) of King Saud University (IRB Ref No: E-24-9376). Informed consent was obtained from all participants prior to their involvement in the study. Participants were assured of confidentiality and their right to withdraw at any time without consequences.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was conducted with official approval from the Nursing Research Unit at KKUH. The unit granted permission to publish the findings, with acknowledgment included in the manuscript. No identifiable participant information is presented.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo specific funding was received for this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFA and NA conceptualised the study. FA conducted data collection. FA and NA jointly conducted the formal analysis. Both authors contributed to the development of the methodology. FA prepared the original draft of the manuscript, and both FA and NA reviewed and edited the final version. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors sincerely thank the postpartum mothers who shared their experiences as part of this study. We gratefully acknowledge the Nursing Research Unit at KKUH for granting official approval and facilitating access to participants. We also thank the staff of King Saud University for their administrative support during the research process.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eWorld Health Organisation. 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Front Pediatr. 2020;8:53. doi:10.3389/fped.2020.00053.\u003c/li\u003e\n \u003cli\u003eProkopowicz A, Stańczykiewicz B, Uchmanowicz I, Zimmer M. How to improve the care of women after childbirth in the rooming‑in unit: a prospective observational study. Int J Environ Res Public Health. 2022;19(23):16117. doi:10.3390/ijerph192316117\u003c/li\u003e\n \u003cli\u003eDennis CL, Fung K, Grigoriadis S, Robinson GE, Romans S, Ross L. Traditional postpartum practices and rituals: a qualitative systematic review. Womens Health (Lond). 2007;3(4):487\u0026ndash;502. doi:10.2217/17455057.3.4.487\u003c/li\u003e\n \u003cli\u003eLeMasters K, Andrabi N, Zalla L, Hagaman AO, Chung EO, Gallis JA, Turner EL, Bhalotra S, Sikander S, Maselko J. Maternal depression in rural Pakistan: The protective associations with cultural postpartum practices. BMC Public Health. 2020;20(1):68. doi:10.1186/s12889-020-8176-0\u003c/li\u003e\n \u003cli\u003eGrigoriadis S, Robinson GE, Fung K, Ross LE, Chee CY, Dennis CL, Romans S. Traditional postpartum practices and rituals: Clinical implications. Can J Psychiatry. 2009;54(12):834-40. doi:10.1177/070674370905401206\u003c/li\u003e\n \u003cli\u003eAl-Zahrani A, Almutairi W, Elsaba H, Alzahrani S, Alzahrani S, Althobaiti L, Turkestani O. Primiparous adaptation with postpartum health issues in Jeddah City, Kingdom of Saudi Arabia: A quantitative study. \u003cem\u003eNurs Rep (Pavia).\u003c/em\u003e 2021;11(4):775-86. doi:10.3390/nursrep11040074\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-pregnancy-and-childbirth","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prch","sideBox":"Learn more about [BMC Pregnancy and Childbirth](http://bmcpregnancychildbirth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/prch/default.aspx","title":"BMC Pregnancy and Childbirth","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Postpartum care, Childbirth, Qualitative research, Saudi Arabia, Mothers’ perceptions","lastPublishedDoi":"10.21203/rs.3.rs-7840409/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7840409/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground:\u003c/h2\u003e\u003cp\u003ePostpartum care is essential for maternal and newborn well-being, yet it remains under-prioritised in many healthcare systems. In Saudi Arabia, traditional practices and systemic challenges influence the accessibility and quality of postnatal services. This study explores the mothers\u0026rsquo; lived experiences during the early postnatal period and identifies strengths, gaps, and culturally relevant needs.\u003c/p\u003e\u003ch2\u003eMethods:\u003c/h2\u003e\u003cp\u003eA reflexive qualitative design was employed using semi-structured interviews with 20 postpartum mothers at King Khaled University Hospital, Riyadh. Participants were selected through purposive sampling. Findings were interpreted through the World Health Organisation (WHO) Postnatal Care Guidelines and Pender\u0026rsquo;s Health Promotion Model.\u003c/p\u003e\u003ch2\u003eResults:\u003c/h2\u003e\u003cp\u003eInterviews with 20 mothers revealed four overarching themes that shape their experiences of postpartum care: physical recovery and birth experience, informational and educational support, emotional and social support, and systemic and cultural influences. Mothers reported significant gaps in pain management, postpartum education, and structured follow-up, particularly after discharge, which left many feeling unprepared and overwhelmed. Experiences of childbirth ranged from empowering and respectful to distressing, with inadequate communication and inconsistent pain relief contributing to negative experiences. Informational support was fragmented, especially in relation to breastfeeding and newborn care, with limited access to dedicated services. Emotional well-being was strongly influenced by staff interactions, family support, and the absence of nursery services, with many women describing feelings of neglect, anxiety, or isolation. Systemic and cultural factors, including ward conditions, staff responsiveness, and traditional postpartum practices, further shaped women\u0026rsquo;s experiences.\u003c/p\u003e\u003ch2\u003eConclusion:\u003c/h2\u003e\u003cp\u003ePostpartum experiences are shaped by interrelated physical, emotional, social, and cultural factors. Mothers in this study reported unmet needs in pain management, education, discharge preparation, and nursery support, which often left them feeling unprepared and vulnerable. Positive experiences of respectful care, family support, and culturally rooted practices highlight the value of compassionate and contextually sensitive approaches. Strengthening postnatal services through tailored support, follow-up, and integration of cultural practices with evidence-based care is essential to improve maternal recovery and well-being.\u003c/p\u003e","manuscriptTitle":"Exploring Mothers’ Experiences and Perceptions of Postpartum Care in King Khaled University Hospital: A Qualitative Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-05 06:28:41","doi":"10.21203/rs.3.rs-7840409/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-11-23T19:09:11+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-22T20:21:03+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-20T19:32:46+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"66642613630456921301188205368721111024","date":"2025-11-15T06:09:29+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"198598931168190755596797741112693431479","date":"2025-11-13T20:24:56+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"251355788156683380902318502111432855447","date":"2025-11-12T15:56:32+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"160597908909451677042067485336887235572","date":"2025-11-12T03:30:12+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"116032779099100335569044977428246410544","date":"2025-11-02T20:43:48+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-28T21:33:37+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"49312306071135979031913888606525550571","date":"2025-10-28T17:21:28+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"206442811108572762109628386170957355151","date":"2025-10-28T14:54:41+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-23T03:00:32+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-10-13T21:29:31+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-13T00:47:23+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-13T00:47:16+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Pregnancy and Childbirth","date":"2025-10-12T11:44:53+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-pregnancy-and-childbirth","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prch","sideBox":"Learn more about [BMC Pregnancy and Childbirth](http://bmcpregnancychildbirth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/prch/default.aspx","title":"BMC Pregnancy and Childbirth","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"df9e7737-0c12-4753-97b0-0651991c2943","owner":[],"postedDate":"November 5th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-03-16T16:09:53+00:00","versionOfRecord":{"articleIdentity":"rs-7840409","link":"https://doi.org/10.1186/s12884-026-08919-3","journal":{"identity":"bmc-pregnancy-and-childbirth","isVorOnly":false,"title":"BMC Pregnancy and Childbirth"},"publishedOn":"2026-03-09 15:59:57","publishedOnDateReadable":"March 9th, 2026"},"versionCreatedAt":"2025-11-05 06:28:41","video":"","vorDoi":"10.1186/s12884-026-08919-3","vorDoiUrl":"https://doi.org/10.1186/s12884-026-08919-3","workflowStages":[]},"version":"v1","identity":"rs-7840409","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7840409","identity":"rs-7840409","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}