Review Article| Volume 33, ISSUE 6, e492-e504, November 2020

Face-to-face health professional contact for postpartum women: A systematic review

  • Wendy Brodribb
    Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
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  • Glenda Hawley
    Corresponding author at: School of Nursing, Midwifery and Social Work, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, Brisbane, 4067, Australia.
    School of Nursing, Midwifery and Social Work, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, Brisbane, Australia

    Mater Health Services, Raymond Tce, South Brisbane, Australia
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  • Ben Mitchell
    Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
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  • Ann Mathews
    Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
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  • Irena Zakarija-Grković
    Departments of Family Medicine and Clinical Skills, University of Split School of Medicine, Split, Croatia

    Cochrane Croatia, University of Split School of Medicine, Split, Croatia
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Published:December 19, 2019DOI:


      The postpartum period is a time when physical, psychological and social changes occur. Health professional contact in the first month following birth may contribute to a smoother transition, help prevent and manage infant and maternal complications and reduce health systems’ expenditure.
      The aim of this systematic review was to assess the effect of face-to-face health professional contact with postpartum women within the first four weeks following hospital discharge on maternal and infant health outcomes.
      Fifteen controlled trial reports that included 8332 women were retrieved after searching databases and reference lists of relevant trials and reviews.
      Although the evidence was of moderate or low quality and the effect size was small, this review suggests that at least one health professional contact within the first 4 weeks postpartum has the potential to reduce the number of women who stop breastfeeding within the first 4–6 weeks postpartum (Risk Ratio 0.86 (95% Confidence Interval 0.75–0.99)) and the number of women who cease exclusive breastfeeding by 4–6 weeks (Risk Ratio 0.84 (95% Confidence Interval 0.71–0.99)) and 6 months (Risk Ratio 0.88 (95% Confidence Interval 0.81–0.96).
      There was no evidence that one form of health professional contact was superior to any other. There was insufficient evidence to show that health professional contact in the first month postpartum, at a routine or universal level, had an impact on other aspects of maternal and infant health, including non-urgent or urgent use of health services.


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        • Shaw E.
        • Levitt C.
        • Wong S.
        • Kaczorowski J.
        • The McMaster University Postpartum Research Group
        Systematic review of the literature on postpartum care: effectiveness of postpartum support to improve maternal parenting, mental health, quality of life, and physical health.
        Birth. 2006; 33: 210-219
        • Prosser S.
        • Miller Y.
        • Armanasco A.
        • Hennegan J.
        • Porter J.
        • Thompson R.
        Findings from the Having a Baby in Queensland Survey.
        Queensland Centre for Mothers & Babies, The University of Queensland, Brisbane, QLD2012
        • Woolhouse H.
        • Gartland D.
        • Perlen S.
        • Donath S.M.
        • Brown S.
        Physical health after childbirth and maternal depression in the first 12 months postpartum: results of an Australian nulliparous pregnancy cohort study.
        Midwifery. 2014; 30: 378-384
        • Cooklin A.
        • Amir L.H.
        • Jarman J.
        • Cullinane M.
        • Donath S.M.
        • The Castle Study Team
        Maternal physical health symptoms in the first 8 weeks postpartum among primiparous Australian women.
        Birth. 2015; 42: 254-260
        • Woolhouse H.
        • McDonald E.
        • Brown S.
        Women’s experiences of sex and intimacy after childbirth: making the adjustment to motherhood.
        J. Psychosom. Obstet. Gynaecol. 2012; 33: 185-190
        • Woolhouse H.
        • Gartland D.
        • Mensah F.
        • Brown S.
        Maternal depression from early pregnancy to 4 years postpartum in a prospective pregnancy cohort study: implications for primary health care.
        Br. J. Obstet. Gynaecol. 2015; 122: 312-321
        • Schytt E.
        • Lindmark G.
        • Waldenstrom U.
        Physical symptoms after childbirth: prevalence and associations with self-rated health.
        BJOG. 2005; 112: 210-217
        • Gartland D.
        • MacArthur C.
        • Woolhouse H.
        • McDonald E.
        • Brown S.
        Frequency, severity and risk factors for urinary and faecal incontinence at 4 years postpartum: a prospective cohort.
        Br. J. Obstet. Gynaecol. 2016; 123: 1203-1211
        • Bennett R.L.
        • Tandy L.J.
        Postpartum home visits: extending the continuum of care from hospital to home.
        Home Healthc. Nurse. 1998; 16 (quiz 304): 294-303
        • Hiscock H.
        The crying baby.
        Austr. Fam. Phys. 2006; 35: 680-684
        • Bayer J.K.
        • Hiscock H.
        • Wake M.
        Sleep problems in young infants and maternal mental and physical health.
        J. Paediatr. Child Health. 2007; 43: 66-73
        • Bartick M.
        • Schwartz E.B.
        • Green B.D.
        • Jegier B.J.
        • Reinhold A.
        • Colaizy T.T.
        • Stuebe A.M.
        Suboptimal breastfeeding in the United States: Maternal and pediatric health outcomes and costs.
        Matern. Child Nutr. 2017; 13
        • Renfrew M.
        • Pokhrel S.
        • Quigley M.
        • McCormick F.
        • Fox-Rushby J.
        • Dodds R.
        • Williams A.
        Preventing Disease and Saving Resources: The Potential Contribution of Increasing Breastfeeding rates in the UK.
        (Retrieved from London, UK)2012
        • Australian Institute of Health and Welfare
        Australia’s Mothers and Babies 2014 - in Brief. Perinatal Statistics Series no. 32. Cat no. PER 87.
        AIHW, Canberra2016
        • Cuncarr C.
        • Skinner J.
        Quantity or quality of postnatal length of stay? A literature review examining the issues and the evidence.
        N. Z. Coll. Midwives J. 2011; 44: 12-16
        • Lancaster P.
        • Huang J.
        • Pedisich E.
        Australia’s Mothers and Babies 1991.
        (Retrieved from Sydney:)1994
        • Wiegers T.A.
        Adjusting to motherhood: Maternity care assistance during the postpartum period: How to help new mothers cope.
        J. Neonatal Nurs. 2006; 12: 163-171
        • Haran C.
        • van Driel M.L.
        • Mitchell B.L.
        • Brodribb W.E.
        Clinical guidelines for postpartum women and infants in primary care–a systematic review.
        BMC Pregnancy Childbirth. 2014; 14: 51
        • Stumbras K.
        • Rankin K.
        • Caskey R.
        • Haider S.
        • Handler A.
        Guidelines and interventions related to the postpartum visit for low-risk postpartum women in high and middle income countries.
        Matern. Child Nutr. 2016;
        • Brodribb W.E.
        • Zadoroznyj M.
        • Dane A.C.
        Evaluating the Implementation of the Universal Postnatal Contact Services in Queensland: Experiences of Health Care Providers and Mothers.
        (Retrieved from Brisbane, Australia)2012
        • Schmied V.
        • Mills A.
        • Kruske S.
        • Kemp L.
        • Fowler C.
        • Homer C.S.E.
        The nature and impact of collaboration and integrated service delivery for pregnant women, children and families.
        J. Clin. Nurs. 2010; 19: 3516-3526
        • Bull J.
        • McCormick G.
        • Swann C.
        • Mulvihill C.
        • Health Development Agency
        Ante- and Post-Natal Home-Visiting Programmes: A Review of Reviews. Evidence briefing.
        (Retrieved from London)2004
        • Goulet L.
        • D’Amour D.
        • Pineault R.
        Type and timing of services following postnatal discharge: do they make a difference?.
        Women Health. 2007; 45: 19-39
        • Madden J.M.
        • Soumerai S.B.
        • Lieu T.A.
        • Mandl K.D.
        • Zhang F.
        • Ross-Degnan D.
        Length-of-stay policies and ascertainment of postdischarge problems in newborns.
        Pediatrics. 2004; 113: 42-49
        • Mandl K.D.
        • Homer C.J.
        • Harary O.
        • Finkelstein J.A.
        Effect of a reduced postpartum length of stay program on primary care services use by mothers and infants.
        Pediatrics. 2000; 106: 937-941
        • Yonemoto N.
        • Dowswell T.
        • Nagai S.
        • Mori R.
        Schedules for home visits in the early postpartum period.
        Cochrane Database Syst. Rev. 2017; CD009326
        • Lavender T.
        • Richens Y.
        • Milan S.
        • Smyth R.
        • Dowswell T.
        Telephone support for women during pregnancy and the first six weeks postpartum.
        Cochrane Database Syst. Rev. 2013; CD009338
        • McFadden A.
        • Gavine A.
        • Renfrew M.
        • Wade A.
        • Buchanan P.
        • Taylor J.
        • MacGillivray S.
        Support for healthy breastfeeding mothers with healthy term babies.
        Cochrane Database Syst. Rev. 2017; (DOI: 001110.001002/14651858.CD14001141.pub14651855)CD001141
        • Liberati A.
        • Altman D.G.
        • Tetzlaff J.
        • Mulrow C.
        • Gøtzsche P.C.
        • Ioannidis J.P.A.
        • Moher D.
        The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration.
        PLoS Med. 2009; 6e1000100
        • Review Manager (RevMan) Version 5.3
        Copenhagen: The Nordic Cochrane Centre.
        The Cochrane Collaboration, 2014
      1. Higgins J. Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. The Cochrane Collaboration, 2011
        • Guyatt G.
        • Oxman A.
        • Akl E.
        • Kunz R.
        • Vist G.
        • Brozek J.
        • Schünemann H.
        GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables.
        J. Clin. Epidemiol. 2011; 64: 383-394
        • Murphy F.
        Effects of Post-Discharge Nursing Visits on Emotional and Parental Adjustment of Postpartum Women. (PhD).
        Texas Woman’s University, Denton, Texas1989
        • Bashour H.N.
        • Kharouf M.H.
        • AbdulSalam A.A.
        • El Asmar K.
        • Tabbaa M.A.
        • Cheikha S.A.
        Effect of postnatal home visits on maternal/infant outcomes in Syria: a randomized controlled trial.
        Public Health Nurs. 2008; 25: 115-125
        • Di Napoli A.
        • Di Lallo D.
        • Fortes C.
        • Franseschelli C.
        • Armeni E.
        • Guasticchi G.
        Home breastfeeding support by health professionals: findings of a randomized controlled trial in a population of Italian women.
        Acta Paediatr. 2004; 93: 1108-1114
        • Escobar G.J.
        • Braveman P.A.
        • Ackerson L.
        • Odouli R.
        • Coleman-Phox K.
        • Capra A.M.
        • Lieu T.A.
        A randomized comparison of home visits and hospital-based group follow-up visits after early postpartum discharge.
        Pediatrics. 2001; 108: 719-727
        • Furnieles-Paterna E.
        • Hoyuelos-Camara H.
        • Montiano-Ruiz I.
        • Penalver-Julve N.
        • Fitera- Lamas L.
        Randomized comparative study of the puerperal visits in the mothers house and in the health center [Spanish] [Estudio comparativo y aleatorizado de la visita puerperal en el domicilio de la madre y en el centro de salud].
        Matronas Profesion. 2011; 12: 65-73
        • Gagnon A.J.
        • Dougherty G.
        • Jimenez V.
        • Leduc N.
        Randomized trial of postpartum care after hospital discharge.
        Pediatrics. 2002; 109: 1074-1080
        • Gunn J.
        • Lumley J.
        • Chondros P.
        • Young D.
        Does an early postnatal check-up improve maternal health: results from a randomised trial in Australian general practice.
        Br. J. Obstet. Gynaecol. 1998; 105: 991-997
        • Labarere J.
        • Gelbert-Baudino N.
        • Ayral A.-S.
        • Duc C.
        • Berchotteau M.
        • Bouchon N.
        • Pons J.-C.
        Efficacy of breastfeeding support provided by trained clinicians during an early, routine, preventive visit: a prospective, randomized, open trial of 226 mother-infant pairs.
        Pediatrics. 2005; 115: e139-146
        • Lakin A.
        • Sutter M.
        • Magee S.
        Newborn well-child visits in the home setting: a pilot study in a family medicine residency.
        Fam. Med. 2015; 47: 217-221
        • Laliberté C.
        • Dunn S.
        • Pound C.
        • Sourial N.
        • Yasseen A.
        • Millar D.
        • Lacaze-Masmonteil T.
        A randomized controlled trial of innovative postpartum care model for mother-baby dyads.
        PloS One. 2016; 11e0148520
        • Lieu T.
        • Braveman P.
        • Escobar G.
        • Fischer A.
        • Jensvold N.
        • Capra A.
        A randomized comparison of home and clinic follow-up visits after early postpartum hospital discharge.
        Pediatrics. 2000; 105: 1058-1065
        • McKeever P.
        • Stevens B.
        • Miller K.
        • MacDonell J.W.
        • Gibbins S.
        • Guerriere D.
        • Coyte P.C.
        Home versus hospital breastfeeding support for newborns: a randomized controlled trial.
        Birth. 2002; 29: 258-265
        • Paul I.M.
        • Beiler J.S.
        • Schaefer E.W.
        • Hollenbeak C.S.
        • Alleman N.
        • Sturgis S.A.
        • Weisman C.S.
        A randomized trial of single home nursing visits vs office-based care after nursery/maternity discharge: The Nurses for Infants Through Teaching and Assessment After the Nursery (NITTANY) Study.
        Arch. Pediatr. Adolesc. Med. 2012; 166: 263-270
        • Pugh L.
        • Milligan R.
        Nursing intervention to increase the duration of breastfeeding.
        Appl. Nurs. Res. 1998; 11: 190-194
        • Salazar I.
        • Sainz J.
        • Garcia E.
        • Marrugal V.
        • Garrido R.
        Influence of early postpartum home visits on the detection and clinical course of postpartum depression.
        Progresos de Obstetricia y Ginecologia. 2011; 54: 65-70
        • Steel O’Connor K.O.
        • Mowat D.L.
        • Scott H.M.
        • Carr P.A.
        • Dorland J.L.
        • Tai K.F.W.Y.
        A randomized trial of two public health nurse follow-up programs after early obstetric discharge.
        Can. J. Public Health. 2003; 94: 94-103
        • Hannula L.
        • Kaunonen M.
        • Tarkka M.T.
        A systematic review of professional support interventions for breastfeeding.
        J. Clin. Nurs. 2008; 17: 1132-1143