News and Events

2005 Media Releases

Launch of La Trobe University review of hospital postnatal care

The first comprehensive study in Australia examining early or hospital postnatal care in depth from the caregivers’ perspectives will be launched by La Trobe University’s Mother & Child Health Research and the Clinical School of Midwifery and Neonatal Nursing Studies tomorrow, Friday, 27 May.

The study examines 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.

It was carried out by Ms Della Forster, Dr Helen McLachlan, Ms Jane Yelland, Ms Jo Rayner and Professor Judith Lumley.

The launch will be held at the Royal Women’s Hospital, Yvonne Bowden Auditorium, 231 Grattan St, Carlton at 0925 as part of a seminar on postnatal care.

Having a baby is the most common reason for hospitalisation in Australia. Each year, around 63,000 women given birth in Victoria. For more than a decade, Victorian women have been less satisfied with the care they received in hospital following the birth compared with the care they received, during pregnancy and labour.

The main findings of the study are:

• Care providers were enthusiastic and committed to ensuring care was of high quality
• Major differences exist in how postnatal care is provided across the state (eg in staffing, routine observations, documentation, assessing ans supporting mothers with particular psychosocial needs and length of hospital stay).
• Many of these practices are not based on evidence, and most (or the majority) hospitals do not have guidelines on which to base care.
• There were many barriers identified to the provision of quality care (which may go toward explaining why women are less satisfied with their care).

Barriers to provision of care include:

• Postnatal units are busy, often chaotic environments.
• Staffing is a key barrier to care: one midwife (or nurse) looks after 5 mothers and 5 babies during the day, 6 mothers and 6 babies during the afternoon and 8 mothers and 8 babies during the night. The ratios do not take this into account and they do not consider:
1. The growing caesarean rate (over one quarter of women (27%)).
2. The increased needs of many babies now cared for in the postnatal wards rather than in the special care nurseries.
• Staff shortages are of particular concern in rural Victoria with recruitment and retention key issues.
• Priority is often given to other areas of maternity care (ie birth suite and antenatal).
• There is a lack of opportunity for women to rest.

The key recommendations from the study are:

• That an evidence-base be developed to guide early postnatal care in areas such as the length of the hospital stay following birth and and the use of routine observations, 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 should develop an 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 Victorian Department of Human Services
• That priority be given to the recruitment of midwives, particularly in rural areas of Victoria.

There were two methods of data collection for the study: a questionnaire was sent to all public hospitals in Victoria that provided postnatal care and thirty-eight interviews were undertaken with midwives (including unit managers, associate unit managers and clinical midwives) and in some cases a medical practitioner from each selected hospital.

The research was funded by the Telstra Foundation’s Community Development Fund and The William Buckland Foundation.

For further information:

Dr Helen McLachlan, Tel: 03 8341 8528.