The structure and organisation of home-based postnatal care in public hospitals in Victoria, Australia: A cross-sectional survey

Women Birth. 2016 Apr;29(2):172-9. doi: 10.1016/j.wombi.2015.10.002. Epub 2015 Nov 10.

Abstract

Background: There is limited evidence regarding the provision of home-based postnatal care, resulting in a weak evidence-base for policy formulation and the further development of home-based postnatal care services.

Aim: To explore the structure and organisation of public hospital home-based postnatal care in Victoria, Australia.

Methods: An online survey including mostly closed-ended questions was sent to representatives of all public maternity providers in July 2011.

Findings: The response rate of 87% (67/77) included rural (70%; n=47), regional (15%; n=10) and metropolitan (15%; n=10) services. The majority (96%, 64/67) provided home-based postnatal care. The median number of visits for primiparous women was two and for multiparous women, one. The main reason for no visit was the woman declining. Two-thirds of services attempted to provide some continuity of carer for home-based postnatal care. Routine maternal and infant observations were broadly consistent across the services, and various systems were in place to protect the safety of staff members during home visits. Few services had a dedicated home-based postnatal care coordinator.

Discussion and conclusion: This study demonstrates that the majority of women receive at least one home-based postnatal visit, and that service provision on the whole is similar across the state. Further work should explore the optimum number and timing of visits, what components of care are most valued by women, and what model best ensures the timely detection and prevention of postpartum complications, be they psychological or physiological.

Keywords: Domiciliary; Home-based; Midwifery care; Postnatal; Postpartum.

MeSH terms

  • Adolescent
  • Adult
  • Cross-Sectional Studies
  • Female
  • Health Care Surveys
  • Hospitals, Public / organization & administration*
  • House Calls / statistics & numerical data*
  • Humans
  • Infant
  • Midwifery
  • Patient Satisfaction
  • Postnatal Care / methods
  • Postnatal Care / organization & administration*
  • Pregnancy
  • Rural Population / statistics & numerical data
  • Surveys and Questionnaires
  • Victoria
  • Young Adult