The views of mothers and GPs about postpartum care in Australian general practice.

Wendy Brodribb,Aimée Dane,Maria Zadoroznyj

doi:10.1186/1471-2296-14-139

Wendy Brodribb, Aimée Dane + Show 1 more

Open Access

https://doi.org/10.1186/1471-2296-14-139

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Abstract

BackgroundThe postpartum period is a time of increased morbidity for mothers and infants under 12 months, yet is an under-researched area of primary care. Despite a relatively clear framework for involving general practitioners (GPs) in antenatal care, the structure of maternity service provision in some Australian jurisdictions has resulted in highly variable roles of general practice in routine postpartum care. This study aimed to investigate the views and experiences of mothers and GPs about postpartum care in general practice.MethodsThis was a qualitative study of mothers and GPs in rural, regional and metropolitan areas of Queensland, Australia. Semi-structured interviews were conducted with 88 mothers and six general practitioners between September 2010 and February 2012. Interviews were recorded and transcribed verbatim. Data were analysed thematically and compared across groups.ResultsThree main themes emerged: The relationship between the mother and GP; practice management; and GP visits. This paper focuses on the theme GP visits and its subthemes: recommendations for GP visits; scope of practice; and content of a routine visit. Recommendations about GP visits given to mothers varied by birthing sector, obstetric provider and model of maternity care resulting in confusion amongst mothers about the timing and role of GPs in routine postpartum care. Similarly, GPs voiced concerns about a lack of consistent guidelines for their involvement in routine postpartum care. Although ideally placed to provide primary care to mothers and their infants in the postpartum period, the lack of consistent guidelines for the role of GPs is of concern to both the GPs and early parenting women.ConclusionGeneral practice is an important source of postpartum care for mothers and provides a basis for ongoing support for the family. More consistent guidelines and better coordination with other care providers would benefit both mothers and GPs.

Highlights

The postpartum period is a time of increased morbidity for mothers and infants under 12 months, yet is an under-researched area of primary care
This study found, in keeping with other research, that mothers and general practitioner (GP) thought general practice was an important source of postpartum care [21,22,23,26,27,28]
GPs felt hesitant about their role in caring for women and infants whose antenatal care was conducted outside general practice as they were still ostensibly under the care of an obstetrician, paediatrician or hospital based staff, including those involved with a midwifery-led model of care

Summary

Introduction

The postpartum period is a time of increased morbidity for mothers and infants under 12 months, yet is an under-researched area of primary care. Women who birth in public sector hospitals tend to be discharged around day two [15]. They are eligible to be contacted by a registered midwife or child and family health nurse (phone or home visit) within 10 days of hospital discharge and are encouraged to visit their general practitioner (GP) within this time frame [16]. Women who birth in private sector hospitals have longer hospital stays (approximately four days) [15] and return to their obstetrician around six weeks, often with no prior scheduled contact with a health professional. In a recent study 35% of women (16.6% from the private sector and 50.6% from the public sector) in Queensland visited their GP for the suggested mother and infant check within 10 days post-discharge [17]. In another study from regional Southern Queensland most mothers had visited a GP by three months postpartum [18]

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