The structure and organisation of home-based postnatal care in public hospitals in Victoria, Australia: A cross-sectional survey

BackgroundThere is limited evidence regarding the provision of home-based postnatal care, resulting in a weak evidence-base for policy formulation and the further development of home-based postnatal care services.AimTo explore the structure and organisation of public hospital home-based postnatal care in Victoria, Australia.MethodsAn online survey including mostly closed-ended questions was sent to representatives of all public maternity providers in July 2011.FindingsThe response rate of 87% (67/77) included rural (70%; n = 47), regional (15%; n = 10) and metropolitan (15%; n = 10) services. The majority (96%, 64/67) provided home-based postnatal care. The median number of visits for primiparous women was two and for multiparous women, one. The main reason for no visit was the woman declining. Two-thirds of services attempted to provide some continuity of carer for home-based postnatal care. Routine maternal and infant observations were broadly consistent across the services, and various systems were in place to protect the safety of staff members during home visits. Few services had a dedicated home-based postnatal care coordinator.Discussion and conclusionThis study demonstrates that the majority of women receive at least one home-based postnatal visit, and that service provision on the whole is similar across the state. Further work should explore the optimum number and timing of visits, what components of care are most valued by women, and what model best ensures the timely detection and prevention of postpartum complications, be they psychological or physiological.