A call for better care: the impact of postnatal contact services on women's parenting confidence and experiences of postpartum care in Queensland, Australia.

Yvette D Miller,Rachel Thompson,Aimée C Dane

doi:10.1186/s12913-014-0635-9

Abstract

BackgroundUniversal postnatal contact services are provided in several Australian states, but their impact on women’s postnatal care experience has not been evaluated. Furthermore, there is lack of evidence or consensus about the optimal type and amount of postpartum care after hospital discharge for maternal outcomes. This study aimed to assess the impact of providing Universal Postnatal Contact Service (UPNCS) funding to public birthing facilities in Queensland, Australia on women’s postnatal care experiences, and associations between amount and type (telephone or home visits) of contact on parenting confidence, and perceived sufficiency and quality of postnatal care.MethodsData collected via retrospective survey of postnatal women (N = 3,724) were used to compare women who birthed in UPNCS-funded and non-UPNCS-funded facilities on parenting confidence, sufficiency of postnatal care, and perceived quality of postnatal care. Associations between receiving telephone and home visits and the same outcomes, regardless of UPNCS funding, were also assessed.ResultsWomen who birthed in an UPNCS-funded facility were more likely to receive postnatal contact, but UPNCS funding was not associated with parenting confidence, or perceived sufficiency or perceived quality of care. Telephone contact was not associated with parenting confidence but had a positive dose–response association with perceived sufficiency and quality. Home visits were negatively associated with parenting confidence when 3 or more were received, had a positive dose–response association with perceived sufficiency and were positively associated with perceived quality when at least 6 were received.ConclusionsFunding for UPNCS is unlikely to improve population levels of maternal parenting confidence, perceived sufficiency or quality of postpartum care. Where only minimal contact can be provided, telephone may be more effective than home visits for improving women’s perceived sufficiency and quality of care. Additional service initiatives may be needed to improve women’s parenting confidence.

Highlights

Universal postnatal contact services are provided in several Australian states, but their impact on women’s postnatal care experience has not been evaluated
In Queensland, one health professional contact by either telephone or home visit within 10 days of hospital discharge was recommended for all women who birth in public facilities from 2008 [17]
Women were further excluded if they had data missing for parity (n = 18), Aboriginal and/or Torres Strait Islander identification (n = 27), use of English at home (n = 122), highest level of education (n = 24), area of residence (n = 60), distance travelled to birth (n = 22), length of stay in hospital (n = 19), postnatal contact (n = 10), parenting confidence (n = 45), perceived sufficiency of postnatal contact (n = 19), or perceived quality of postnatal care (n = 13)

Summary

Introduction

Universal postnatal contact services are provided in several Australian states, but their impact on women’s postnatal care experience has not been evaluated. This study aimed to assess the impact of providing Universal Postnatal Contact Service (UPNCS) funding to public birthing facilities in Queensland, Australia on women’s postnatal care experiences, and associations between amount and type (telephone or home visits) of contact on parenting confidence, and perceived sufficiency and quality of postnatal care. Health care policies and guidelines in a number of Australian states provide specific recommendations for universal postnatal contact. In Queensland, one health professional contact by either telephone or home visit within 10 days of hospital discharge was recommended for all women who birth in public facilities from 2008 [17]. Publiclyfunded community based post-birth care may be provided by domiciliary midwives employed by birthing facilities, and/or by child and family health nursing services routinely available to new mothers and their children [18]. The purpose of these visits is to assess maternal and infant risk and provide brief interventions (e.g., breastfeeding support) and/or refer to specialist services as needed

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