Abstract
BackgroundPostnatal care continually attracts less attention than other parts of the childbirth year. Many regions consistently report poor maternal satisfaction with care in the post-birth period. Despite policy recommending post-birth planning be part of maternity services there remains a paucity of empirical evidence and reported experience using post-birth care plans. There is a need to report on post-birth care plans, identify policy and guideline recommendations and gaps in the current empirical research, as well as experiences creating and using post-birth care plans.MethodsThis scoping review accessed empirical literature and government and professional documents from 2005 to present day to build a picture of current understanding of policy imperatives and existent published empirical evidence. The review was informed by the Arksey and O’Malley approach employing five stages.ResultsThe review revealed that post-birth care planning is promoted extensively in health policy and there is emergent evidence for its implementation. Yet there is a paucity of practice examples and only one evaluation in the UK. The review identified four overarching themes: ‘Positioning of post-birth care planning in policy; ‘Content and approach’; ‘Personalised care and relational continuity’; Feasibility and acceptability in practice’.ConclusionsEmpirical evidence supports post-birth care planning, but evidence is limited leaving many unanswered questions. Health care policy reflects evidence and recommends implementation of post-birth care plans, however, there remains a paucity of information in relation to post-birth care planning experience and implementation in practice. Women need consistent information and advice and value personalised care. Models of care that facilitate these needs are focused on relational continuity and lead to greater satisfaction. It remains unclear if a combination of post-birth care planning and continuity of carer interventions would improve post-birth outcomes and satisfaction. Gaps in research knowledge and practice experience are identified and implications for practice and further research suggested.
Highlights
The birth of a new baby heralds a time of transitions bringing new roles and responsibilities, demands and challenges for parents and families [1]
There are several evaluation surveys and policy documents that indicate that women appreciate post-birth planning, consistent advice and desire continuity of support preferably with a care provider, in the main a midwife, who they have come to know over time
The findings clearly highlight the significance of relationships and we propose that implementing post-birth care plan (PBCP) within a fragmented system not based on relational continuity is worthwhile but would have limited effect
Summary
The birth of a new baby heralds a time of transitions bringing new roles and responsibilities, demands and challenges for parents and families [1]. How care is delivered within this period greatly differs, depending on individual, organisational and cultural factors and maternal satisfaction is often reported as poor [1,2,3,4,5]. References made in the literature and policy refer to ‘postnatal’, ‘postpartum’, ‘post-birth’ and the ‘fourth trimester’ [8] and are often used interchangeably. Many regions consistently report poor maternal satisfaction with care in the post-birth period. Despite policy recommending post-birth planning be part of maternity services there remains a paucity of empirical evidence and reported experience using post-birth care plans. There is a need to report on post-birth care plans, identify policy and guideline recommendations and gaps in the current empirical research, as well as experiences creating and using post-birth care plans
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