The Effect of Early Postpartum Home Visits by Health Visitors: A Natural Experiment

Abstract

The purpose of this study was to assess if the absence of early home visits influenced the mothers' breastfeeding duration and use of medical services. Data from mothers who had given birth during a strike period were compared with data from a reference period with usual work practice. The study included 3,834 newborn and 375 health visitors, 75 of whom worked during the strike period. All families were offered nonstandardized home visits after discharge in the reference period. During the strike, the service was based on individual risk assessment. Overall, no difference in breastfeeding duration between the two periods was seen, but unvisited mothers in the strike period had shorter durations of full breastfeeding than a comparable group of mothers in the reference period (p<.005). Moreover, mothers in the strike period reported a significantly higher use of medical services. The mothers' needs for postnatal visits differed depending on parity: primiparae underlined uncertainty, multiparae underlined previous breastfeeding experience. Mothers had missed out on guidance on all areas of the health visitors' service. Nonstandardized home visits by health visitors were associated with a longer breastfeeding duration. The postnatal visits depended on parity and unmet needs increased the use of medical services.