Global Utilities

Issue: July 2005

News

Major differences in postnatal care

Victorian mothers and their newborn babies experience major variations in postnatal care – for example in the length of time they spend in hospitals after birth.

Postnatal care practices in many hospitals are not based on evidence – reflecting the fact that there is limited evidence available to guide care, and many hospitals do not have guidelines on which to base various aspects of postnatal care. In addition, staff-patient ratios for postnatal care are perceived to be inadequate and fail to take into account care of the infant as a separate person.

These are some of the findings of the first comprehensive study in Australia examining hospital postnatal care in depth from the caregivers’ perspectives.

The study was carried out by La Trobe University’s Mother & Child Health Research Centre (MCHR) and the Clinical School of Midwifery and Neonatal Nursing Studies.

It examined how care is organised and provided in different hospitals in Victoria; what constraints there are on the provision of postnatal care; and what initiatives are being undertaken to improve service delivery.

Having a baby is the most common reason for hospitalisation in Australia and each year around 63,000 women give birth in Victoria. The review of hospital postnatal care was based on findings from MCHR surveys of recent mothers. For more than a decade women have been less satisfied with the care they received in hospital following the birth compared with the care they received during pregnancy, labour and birth.

La Trobe’s Dr Helen McLachlan, one of the study’s authors, says the study found that, as well as variations in the length of hospital stay, differences in postnatal care include staffing levels, the practice of routine observations, documentation, and the assessment and support of mothers with particular psychosocial needs.

Key recommendations from the study include:

  • That an evidence-base be developed to guide early postnatal care with a focus on more individualised care.
  • That hospitals providing postnatal care use appropriate guidelines in care provision. In the longer term, the Victorian Department of Human Services (DHS) should develop agreed state-wide guidelines for hospital postnatal care.
  • That a review of staff-patient ratios be undertaken by the Australian Nursing Federation, the Australian College of Midwives and DHS.
  • That priority be given to the recruitment of midwives, particularly in rural Victoria.

The research was carried out by Ms Della Forster, Dr McLachlan, Ms Jane Yelland, Ms Jo Rayner and Professor Judith Lumley. It was funded by the Telstra Foundation’s Community Development Fund and the William Buckland Foundation, and launched at a seminar on postnatal care at the Royal Women’s Hospital in May.

Further details about the report are available on www.latrobe.edu.au/mchr/PinC.html

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Last Updated:29 February, 2008

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