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

McLachlan, Helen L., Gold, Lisa, Forster, Della A., Yelland, Jane, Rayner, Joanne and Rayner, Sharon 2009, Women's views of postnatal care in the context of the increasing pressure on postnatal beds in Australia, Women and birth, vol. 22, no. 4, pp. 128-133, doi: 10.1016/j.wombi.2009.04.003.

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Title Women's views of postnatal care in the context of the increasing pressure on postnatal beds in Australia
Author(s) McLachlan, Helen L.
Gold, LisaORCID iD for Gold, Lisa orcid.org/0000-0002-2733-900X
Forster, Della A.
Yelland, Jane
Rayner, Joanne
Rayner, Sharon
Journal name Women and birth
Volume number 22
Issue number 4
Start page 128
End page 133
Total pages 6
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2009-12
ISSN 1871-5192
Keyword(s) postnatal care
organisation of care
focus groups
women's experiences
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.
Language eng
DOI 10.1016/j.wombi.2009.04.003
Field of Research 111006 Midwifery
Socio Economic Objective 920208 Health Inequalities
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2009, Australian College of Midwives
Persistent URL http://hdl.handle.net/10536/DRO/DU:30019804

Document type: Journal Article
Collection: Public Health Research, Evaluation, and Policy Cluster
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