Women and Birth
Volume 22, Issue 4 , Pages 128-133, December 2009

Women's views of postnatal care in the context of the increasing pressure on postnatal beds in Australia

  • Helen L. McLachlan

      Affiliations

    • Division of Nursing and Midwifery, La Trobe University, Bundoora 3086, Victoria, Australia
    • Mother and Child Health Research, La Trobe University, Melbourne, Australia
    • Corresponding Author InformationCorresponding author at: Division of Nursing and Midwifery, La Trobe University, Bundoora 3086, Victoria, Australia. Tel.: +61 3 9479 5955; fax: +61 3 9479 5988.
    • ,
  • Lisa Gold

      Affiliations

    • Deakin Health Economics Unit, School of Health and Social Development, Deakin University, Burwood, Australia
    • ,
  • Della A. Forster

      Affiliations

    • Mother and Child Health Research, La Trobe University, Melbourne, Australia
    • ,
  • Jane Yelland

      Affiliations

    • Healthy Mothers, Healthy Families, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
    • ,
  • Joanne Rayner

      Affiliations

    • Division of Nursing and Midwifery, La Trobe University, Bundoora 3086, Victoria, Australia
    • Mother and Child Health Research, La Trobe University, Melbourne, Australia
    • ,
  • Sharon Rayner

      Affiliations

    • Victorian Public Health Training Scheme, Department of Human Services, Melbourne 3000, Australia

Received 4 November 2008; received in revised form 19 March 2009; accepted 27 April 2009.

Summary 

Background

Despite limited evidence evaluating early postnatal discharge, length of hospital stay has declined dramatically in Australia since the 1980s. The recent rising birth rate in Victoria, Australia has increased pressure on hospital beds, and many services have responded by discharging women earlier than planned, often with little preparation during pregnancy. We aimed to explore the views of women and their partners regarding a number of theoretical postnatal care ‘packages’ that could provide an alternative approach to early postnatal care.

Methods

Eight focus groups and four interviews were held in rural and metropolitan Victoria in 2006 with participants who had experienced a mix of public and private maternity care. These included 8 pregnant women, 42 recent mothers and 2 male partners. All were fluent in English. Focus groups explored participants’ experiences and/or expectations of early postnatal care in hospital and at home and their views of alternative packages of postnatal care where location of care shifted from hospital to home and/or hotel. This paper describes the packages and explores and describes what ‘value’ women placed on the various components of care.

Findings

Overall, women expressed a preference for what they had experienced or expected, which may be explained by the ‘what is must be best’ phenomenon where women place value on the status quo. They generally did not respond favourably towards the alternative postnatal care packages, with concerns about any shorter length of hospital stay, especially for first time mothers. Women were concerned about the safety and wellbeing of their new baby and reported that they lacked confidence in their ability to care for their baby. The physical presence and availability of professional support was seen to alleviate these concerns, especially for first time mothers. Participants did not believe that increased domiciliary visits compensated for forgoing the perceived security and value of staying in hospital. Women generally valued staying in hospital for the length of time they felt they needed above all other factors.

Key conclusions and implications for practice

Women were concerned about shortened postnatal length of hospital stay and these concerns must be considered when changes are planned in maternity service provision. Any moves towards shorter postnatal length of stay must be comprehensively evaluated with consideration given to exploring consumer views and satisfaction. There is also a need for flexibility in postnatal care that acknowledges women's individual needs.

Keywords: Postnatal care, Midwifery, Organisation of care, Focus groups, Women's experiences

 

PII: S1871-5192(09)00045-6

doi:10.1016/j.wombi.2009.04.003

Women and Birth
Volume 22, Issue 4 , Pages 128-133, December 2009

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