Evaluation of discharge training given by nurses to postpartum mothers to artificial intelligence: an alternative approach to health care

The postpartum period is a critical period of transition to parenthood and the assumption of new roles and responsibilities. Mothers strive to adapt to the changes in the postpartum period and meet their own care and the needs of the newborn [1]. The length of time spent in the hospital after giving delivery varies significantly between nations [2]. In Turkey, if there are no postpartum difficulties, the Ministry of Health advises a minimum hospital stay of 24 h for vaginal deliveries and 48 h for cesarean sections [3]. On the other hand, the average duration of stay is 2.8, and 1.7 days in high-income nations like Australia, and Canada [4]. According to Jones and colleagues’ meta-analysis, shorter hospital stays [less than 48 h for vaginal births and fewer than 96 h for cesarean deliveries] may increase the risk of readmissions for newborns within 28 days of birth [2]. According to Harron and colleagues, longer hospital stays for premature infants decreased the chance of readmission, but full-term infants showed no such risk [5]. Additionally, Lain et al. emphasized that a longer stay can reduce the possibility of readmission because of jaundice [6]. The differences in post-discharge care levels across nations could be the cause of the disparities. For example, postnatal care at home is common in the UK, which may lessen the negative effects of a short hospital stay [7, 8].

There are contradictory findings in the body of research on the connection between the length of hospital stay following delivery and the health of the mother and the baby. A study carried out in Turkey found that most women who had cesarean sections and were released early were not yet ready to return to their regular activities [9]. In a similar vein, a study carried out in the United States of America showed that women who were released from the hospital before the typical duration of stay had a higher chance of stopping breastfeeding prematurely [10]. Furthermore, one study concluded that there was no way to prove or exclude a link between early discharge and maternal and neonatal morbidity [11].

According to these findings, it is critical that the decision of postpartum discharge be made personally, that the expectant mother feels prepared, and that she actively engages in the discharge procedure. Specifically, it is believed that nurses and midwives must provide postnatal mother-infant care and breastfeeding services. Postpartum moms should be educated about newborn care, nutrition, and how to recognize medical emergencies, according to the World Health Organization [WHO] [12, 13]. In this regard, providing moms with discharge education following delivery can help to promote the health of both the mother and the child and avoid any difficulties that may develop during the postpartum phase.

Discharge training provided to postpartum mothers increases the mother’s self-confidence and helps her to better meet the needs related to newborn care [14]. In particular, information about breastfeeding techniques, infant care and symptoms of postpartum depression allows mothers to spend this period in a healthier and more conscious way. It is also reported that discharge training positively affects the health outcomes of the newborn, contributing to the reduction of infection risks and improvement of general health status [15, 16]. Therefore, discharge training is very important for mothers to cope with the difficulties they may face in the postpartum period and to effectively continue the care of their newborn babies. Traditionally, this training is provided face-to-face by nurses and mothers are informed about breastfeeding, infant care, and the postpartum recovery process [17]. However, the acceleration of the digital transformation in healthcare services and the integration of artificial intelligence [AI] technologies may enable the development of new approaches in this field.

AI-enabled systems are used in various fields such as data analysis, decision support systems and patient training in healthcare. With the ability to learn from large data sets, these systems can go beyond traditional methods by providing individualized training and guidance [18, 19]. In particular, postpartum discharge training can be optimized through AI-supported applications and faster and more effective solutions can be offered to the needs of mothers. Previous studies show that mothers who receive adequate training in the postpartum period have a reduced risk of postpartum depression, prolonged breastfeeding and are more competent in infant care [20]. In this context, it is important to compare the effectiveness of traditional training methods provided by nurses and AI-supported training systems. This study aims to compare the effectiveness of AI-assisted education systems with traditional discharge education delivered by nurses. This comparison could optimize healthcare budget, raise patient satisfaction, and increase the quality of healthcare services. The project will evaluate AI’s effectiveness on its own and ascertain whether it can replace nursing education. The study will also look at whether the information moms can get from AI-based systems during the postpartum phase without having to go to a medical facility is as thorough as that given by medical practitioners. This strategy will make it easier to assess AI’s usability and dependability as a substitute teaching technique for postpartum education. In this direction, in the light of current studies and data in the literature, the advantages and disadvantages of discharge training provided by nurses and ChatGPT-4o will be discussed.

Research questions

The findings obtained from the data collected in line with two themes and 13 sub-themes [infant care and maternal care] determined by the researchers as a result of the content analysis considering the guidelines of the World Health Organization and the American Academy of Pediatrics are presented below. In the analyses, the responses of the AI were presented as participants and the responses of the AI were included under each table.

Table 1 presents the sociodemographic characteristics of the participants. Among the nurses who participated in the study, 62.5% were between the ages of 25–34 years and unmarried, 81.25% had a bachelor’s degree, 43.75% had been working in the profession for 6–10 years, 62.5% had been working in their unit for 0–2 years, and 75% had no previous delivery experience (Table 2).

In Table 2, the majority of the nurses stated that attention should be paid to baby signs [e.g., opening the mouth and sticking out the tongue] and breastfeeding training. However, only 3 of the nurses stated that hygiene and breast milk were important.

One nurse stated, “They should be woken up and breastfed every 2 hours, and they should also breastfeed every time the baby cries, and the mother should understand that the baby is hungry from the baby’s signs and feed accordingly, for example, when the baby opens its mouth and sticks out its tongue” [P12] (Table 2).

AI’s response was “encouragement of early and frequent breastfeeding, correct breastfeeding techniques and positions, infant feeding tips, common problems [breast pain and engorgement or insufficient milk] and solutions, father and family support” (Table 2).

Table 3 shows that 36.8% of the nurses stated that attention should be paid to sleep management of the newborn. However, 3 of the nurses stated that the safety and protection of the baby was important.

One nurse stated that “babies sleep in the first days, but breastfeeding should not be postponed in order not to wake them up, they should be woken up at least every 2 hours, even if by force, and breastfeeding should continue, they may be awake at night and sleep during the day in the first days, mothers should not hesitate to get support from their spouses, babies can spend almost 20 hours of the day sleeping in the first 4 months, this is normal” [P3] (Table 3).

AI responded as follows: “sleep needs of babies [sleep duration and cycle], safe sleep environment, establishing a routine, feeding and sleep, baby and parent relationship, support and follow-up” (Table 3).

Additionally, more details on participants’ perspectives on general infant care and umbilical cord care education are detailed in Supplementary Tables 1 and 2. These tables emphasize the importance of hygiene and breastfeeding techniques.

Table 4 shows the responses of the participants about the training on infant health checks. When the responses were examined, half of the nurses mentioned routine health checks, while only one nurse emphasized that the safety of the baby was important (Table 4).

The statement of a nurse who stated that routine health checks are important is as follows: “The baby should be taken to the pediatrician after discharge, vaccinations should be done on time, hearing test should definitely be taken, the baby should be taken to the doctor for routine eye screening and hip dislocation after 2 months, heel blood should be given and followed up [P9]” (Table 4).

The AI responded as follows: “Regular follow-up and controls; vaccination schedule; growth and development monitoring; nutrition and breastfeeding follow-up; general health monitoring; education and awareness raising” (Table 4).

Additionally, participants discussed various aspects of postpartum education, including immunization, rest, nutrition, physical recovery, hygiene [personal care], exercise, and follow-up health checks for mothers [see Supplementary Tables 3 to 9 for detailed information]. For example, supplementary Table 3 focuses on vaccination schedules, while Table 4 highlights the importance of structured rest periods for mothers.

According to Table 5, psychosocial support was emphasized as the most important form of maternal emotional support, while education and environmental arrangements were also important.

The answers given for psychosocial support are as follows:

P9: If she does not want a new pregnancy, she should be told that she should protect herself in advance, contraception methods should be shared and guided, postpartum depression scale should be administered, she should be made aware of unwanted pregnancy, she should be told to talk with her husband and share their emotions and support each other, she should receive support from her husband, she should be made aware of the care of the baby and her husband by making joint decisions (Table 5).

AI: Providing emotional support [family and friends, professional support], monitoring symptoms of postpartum anxiety and depression, self-care and making time for oneself, information, and education (Table 5).

Additionally, participants’ opinions regarding their general perspectives on postpartum discharge education are available in Supplementary Table 10. This table includes complementary views and recommendations that go beyond the specific education categories discussed previously. This information provides valuable context and further emphasizes the importance of a holistic approach to postpartum care.

Postnatal training constitutes an important aspect of nursing care during the hospital stay following delivery. It has a key role in assessing the stability of the physical condition of both the mother and the newborn. Once identified, however, the focus should shift to helping the mother learn to care for herself and her newborn following hospital discharge. In the postpartum discharge training given to mothers by nurses in the present study, sub-themes for umbilical care and maternal home care strategies were created in line with the two themes determined based on the World Health Organization and American Academy of Pediatrics guidelines, and the answers given by the participants and those by artificial intelligence were evaluated according to the World Health Organization [13, 31]. The results of both responses were discussed in line with the literature information in line with the analyses. In the first part of the discussion, infant care was included in the mother’s home care in postpartum discharge training, and in the second part, the mother’s home care was emphasized.

Postpartum discharge training supports the mother’s physical and psychological recovery process and increases her knowledge and skills in newborn care. In this way, mothers can manage the health problems they may encounter in the postpartum period more effectively and better meet the needs of their babies [32]. However, it must be acknowledged that not every mother has the same needs during postpartum care. Women who have experienced high-risk pregnancies or near-fatal events have been shown to have special educational needs that extend beyond the standard postpartum discharge education. Research has demonstrated that these women frequently exhibit substantial deficiencies in their understanding of postpartum warning signs and long-term health consequences. Moreover, support services often prove to be inadequate [33, 34]. In the present study, the majority of the nurses emphasized the importance of baby signs [e.g., opening the mouth and sticking out the tongue] in breastfeeding training, while AI underlined the necessity of recognizing baby signs. As a result of the content analysis, it was observed that although the responses of the nurses and the AI were largely consistent, the nurses gave more specific responses. In this context, it is imperative that postpartum education be comprehensive, inclusive, and adapted to individual needs, particularly for mothers with high-risk pregnancies. The specificity of the responses provided by the nurses in the present study underscores the significance of individualized assistance within the postpartum care continuum. For mothers experiencing high-risk pregnancies, the incorporation of nurses’ experience-based recommendations can facilitate more effective management of the postpartum process. In contrast, while AI’s responses offer a more general perspective, they nevertheless serve as a crucial instrument in identifying critical components of postpartum care and in orchestrating the care process. Consequently, integrating the systematic information provided by AI with the individualized guidance of nurses can offer an effective approach to address the unmet educational needs of mothers with high-risk pregnancies [35, 36].

Given that breastfeeding is extremely important for the mother-child, technology should cover the entire development of the health work process, from the initial idea, elaboration, and implementation to the results [37]. In the study, while the nurses stated that sleep management of the newborn was an important factor, similar results were encountered in the responses of the artificial intelligence. As a result of the content analysis, it is emphasized in both sources that babies should wake up frequently, be fed and provided with a safe and appropriate sleep environment. The American Academy of Pediatrics [AAP] states that newborns should be fed frequently, and this process may affect sleep patterns [38]. In a similar study, it was reported that infants who were fully breastfed generally had longer night and total sleep duration than formula-fed infants [39]. In addition, the mother’s knowledge and skills in general infant care are of great importance in the healthy growth and development of newborn babies. In this study, the majority of the nurses emphasized cleaning and hygiene in general infant care, while artificial intelligence provided a broader perspective in many areas such as nutrition, hygiene, sleep patterns, development, communication and safety. In this context, although the responses of the nurses and artificial intelligence overlapped to a large extent, it was observed that some nurses did not provide detailed information on certain issues or provided incomplete answers. This may indicate that AI-supported applications in healthcare can strengthen the training provided by nurses and work in harmony [36, 38]. However, it has been demonstrated that AI tools are prone to erroneous responses when their training data is insufficient [40, 41]. In a critical domain such as maternal and child health, the provision of incomplete or inaccurate information can result in erroneous decisions by mothers and even pose significant health risks. This underscores the necessity for a re-evaluation of the role of AI in healthcare, suggesting that it should not be considered a replacement for human expertise but rather a complementary tool [42, 43].

Routine vaccination is one of the important factors in protecting the health of newborns. In the present study, the majority of the nurses stated the importance of paying attention to the vaccination schedule in the newborn and the importance of maternal education. The vaccination schedule is critical for protecting children from various infectious diseases [31]. As a result of the content analysis, it was seen that there were parts that did not overlap between the responses of the nurses and the AI. The AAP emphasizes the importance of vaccines for public health and recommends that parents be informed about the side effects of vaccines. It also states that vaccines should be administered correctly, and parents should be supported in this regard. Previous studies have emphasized the role of nurses and healthcare professionals in parents’ decisions about vaccines and trust as important factors in accepting vaccines [35, 44]. These results may show the importance of increasing nurse awareness in raising public health awareness while emphasizing the holistic aspect of the care process with the integration of technological support into nurse training. Nevertheless, there is a concern that overreliance on AI driven education in a critical domain such as routine vaccination may entail certain risks. While the capacity of AI to enhance access to medical and scientific information has been demonstrated [45], it is important to acknowledge its limitations in assessing the multifaceted factors that contribute to vaccine hesitancy, including individual parental concerns, cultural beliefs, and socioeconomic factors. Furthermore, research has demonstrated that parental trust in healthcare professionals is a significant predictor of vaccine acceptance [42, 43]. The empathic approach and communication style of healthcare professionals are not fully replicable by AI, which may have a negative impact on vaccine hesitancy if parents feel disconnected from human expertise. Consequently, while AI can facilitate the organization and dissemination of vaccine education, it is imperative to preserve the pivotal role of human expertise in fostering trust and informed decision-making.

Comprehensive education and support for mothers in the postpartum period play a critical role in protecting their emotional and physical health [46]. In the present study, the majority of the nurses specifically emphasized the supportive role of the family and spouse, while AI focused on emotional support and professional support in general. As a result of the content analysis, it was observed that the nurses individually emphasized the role of spouse, environmental regulation, and family. AI, on the other hand, generally focused on education and information. Artificial intelligence can provide mothers with fast and reliable information by providing access to a large knowledge base. However, as seen in this study, the general guidance provided by AI may not completely overlap with the specific and practical information provided by nurses. Detailed and personalized education provided by nurses may provide more effective education and support when used in combination with general guidance supported by AI. Studies on this subject show that personalized nurse trainings increase the knowledge level of mothers and increase the frequency of applying this knowledge in daily life. Studies indicate that postpartum psychosocial support reduces the risk of depression and increases the general well-being of mothers [47, 48].

In the present study, the topics that the participants wanted to add were analyzed in addition to the last sub-themes. In line with the analysis, the responses given by artificial intelligence and the opinions of the nurses overlap to a great extent. For example, while the nurses stressed the importance of education and family planning, the AI focused on more specific issues such as sexual health and emergency education. In the postpartum period, it is important for mothers to be informed about sexual health and family planning, to be prepared for emergencies and to receive the necessary training [49]. The study also found that the majority of nurses emphasized the necessity of consulting a physician, especially in emergencies. In contrast, AI focused more on routine maternal examinations. According to the content analysis, nurses gave special importance to the necessity of bleeding and infection control, contraceptive methods and specialist examinations during the first 10 days after delivery, while AI generally emphasized education and information processes. Especially for mothers who have experienced maternal complications, discharge training can help them manage this process more consciously and be regularly monitored for possible risks. This education should ensure not only medical follow-up but also support weekly recovery processes and increase the mother’s awareness of postpartum care [50]. The current findings suggest that an individualized and multidisciplinary approach should be adopted in the postpartum care process.

The findings of this study indicate that nurse-led and AI-based education are complementary processes with distinct dynamics. The data suggest that artificial intelligence systems should not be viewed as a replacement for individualized care in healthcare but rather as a complementary tool that supports clinical decision-making. Nurse-led training offers advantages in individualized guidance, emotional support, and patient-specific adaptation. In contrast, AI-assisted education provides significant benefits in immediate information access, standardizing the learning process, and facilitating large-scale training programs but remains limited in delivering individualized care and psychosocial support. In postpartum care, mothers’ need for both information access and emotional support should be carefully considered [50]. A study on the global development of neonatal nursing emphasized that while AI systems can enhance the effectiveness and accessibility of neonatal care, they have limitations in cultural sensitivity and psychosocial support. However, integrating nurse-led individualized education with AI-based guidance systems may help address these limitations [51]. Therefore, combining individualized support provided by nurses with AI systems in postpartum care may yield optimal outcomes for both maternal and infant health.

This study demonstrates that AI-assisted guidance in postpartum discharge training can be a valuable tool. While AI effectively provides general advice, human input is crucial for specific and practical recommendations. Combining detailed, personalized guidance from nurses with AI-supported general information can enhance postpartum care quality and increase patient satisfaction. However, AI-powered systems may not be able to fully assess patients’ emotional states and individual contexts. Especially in conditions such as postpartum depression and anxiety, AI may fall short in providing adequate psychosocial support. Therefore, AI should not be seen as a replacement for human-centered care but rather as a supportive tool to enhance it. The findings suggest that AI-supported mobile technologies can be beneficial in nursing care, reinforcing training and supporting infant development. It is imperative that nurse-specific knowledge be integrated into AI applications in healthcare. For AI to be effectively integrated into clinical nursing practice, nurses must receive comprehensive training in its use. To ensure the efficient utilization of AI-based patient education platforms and clinical decision support systems, training programs should be developed to enhance technological literacy. Additionally, as AI-supported systems are integrated into patient care, nurses must be equipped to assess potential risks related to ethics, data security, and clinical practice. In order to translate these findings into clinical practice, it is essential that AI applications be designed to complement nursing care by integrating real-time patient data and aligning with established discharge education protocols. A close collaboration between healthcare professionals, AI developers, and policymakers is necessary to ensure effective AI integration, usability, and accuracy. In addition, for AI-supported nursing education programs to be implemented sustainably and reliably, they must be developed by the standards set by international health authorities and professional organizations. For AI to be implemented without compromising patient safety, ethical frameworks and regulatory policies must be established. Additionally, guidelines for AI use in healthcare should be defined and integrated into clinical protocols. Future research should concentrate on enhancing the capacity of AI to generate tailored recommendations based on data provided by nurses.