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Results for “Postnatal Care”

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At least 19 recordsLinked to original sources
PubMed2006

Satisfying parents' preferences with regard to various models of postnatal care is cost-minimizing.

BACKGROUND: This study describes three options for postnatal care in Sweden and contains a cost analysis of the options in various combinations. The aim of the study was to calculate the cost of a postnatal care model according to new parents' preferences. METHODS: Staff costs were calculated for various models of postnatal care, comprising the maternity ward, the family suite, and/or the early discharge program. One of the models was based on answers from 342 parents who specified their preferences with regard to postnatal care in the event of another birth. RESULTS: Comparing costs for five different models of postnatal care showed that the proportion of mothers receiving care at the maternity ward crucially influences the total costs. The staff costs differed significantly between the models, ranging from US$448 000 to US$778 000 per 1500 mother-child dyads. MAIN OUTCOME MEASURES: Cost calculation of various care models and parents' preferences for postnatal care. CONCLUSIONS: Because the parents' preferences with regard to postnatal care created one of the most cost-minimizing care models in the study, it would be possible to better meet parent's desires and, at the same time, reduce costs, without increasing risks in comparison with the early discharge program.

Cost Control↗
PubMed1995

Coverage and quality of natal and postnatal care: women's perceptions, Saudi Arabia.

This paper discusses natal and postnatal care services in Saudi Arabia, as revealed by the National Maternal & Child Health Survey of 1991. The latter was based on a national random sample of 150 clusters, with 6306 households, from urban and rural areas, of five geographic regions. The target of 6294 ever-married Saudi women, 15-49 years old included 6020 currently married women, of whom 1050 reported a pregnancy. Data on maternal care were analysed, including where and why natal care was attended, and for both natal and postnatal care, how much and by whom, by respondents' age, urban-rural residence, geographical location, and education of wife and husband. About three-quarters of the respondents had one or more births within the 5 years preceding the survey, with a total of 4777 children under six. Institutional deliveries reached 86 per cent and about 90 per cent of deliveries were attended by physicians or nurses with a ratio of 2:1. Postnatal care attendance amounted to 88 per cent mainly by physicians than nurses with a ratio of 5:1. In general, the above results describe relatively high coverage with natal and postnatal care services, which can still be improved through health education and community support, particularly of the women. Judging by the high level of institutional care and physician involvement, good quality of care is implied, but needs to be further confirmed, by defining morbidity and mortality patterns.

Adolescent↗
PubMed1983

Survey of postnatal care.

A postal survey of the postnatal care received by 250 mothers during the three months after delivery in the North Herts Maternity Unit achieved a response rate of 74.6%. More than 80% of mothers responding felt that they had received adequate help from the hospital staff, community midwife and health visitor but only 50% felt that they had received adequate help from their general practitioner. There seemed to be a need for some relaxation of the policy of length of hospital stay, an increase in the level of postnatal instruction and improvement in the interaction between general practitioner and mothers.

Adult↗
PubMed2002

Postnatal care in hospitals: ritual, routine or individualized.

Postnatal care in hospital continues to include routine recording of observations of temperature, pulse, blood pressure, fundal height, lochia and perineal injury on clinical pathways that allow little if any leeway for individualizing care. This paper discusses the issues of designing a new clinical pathway that encompasses best practice, is woman friendly and allows for individualized care rather than routine rituals.

Critical Pathways↗
PubMed1998

The role of the general practitioner in postnatal care: a survey from Australian general practice.

BACKGROUND: Despite the practice of routine postnatal check-ups, many women experience problems in the months after childbirth. General practitioners (GPs) are involved in routine postnatal care, yet little research has been undertaken to explore this role. AIM: To report the views of Australian GPs as to what physical examination and discussion should take place at the routine six week postnatal check-up and to determine the influence of gender on the approach to the check-up. METHOD: Postal survey of 1104 Australian GPs, yielding an eligible sample of 1022. RESULTS: A total of 715/1022 (70%) usable surveys returned. Over 65% of GPs recommend routine examination of the abdomen, blood pressure, perineum, vagina, pelvic floor, and breasts at the six week check-up. Fewer than a half the sample believed that physical problems (urine and bowel symptoms, back problems), sexual issues, relationship and parenting issues should be routinely discussed. After controlling for age, practice location, obstetric practice, and qualifications, the sex of the GP remains an important factor influencing the GP's approach to postnatal care. Female GPs are three times more likely to believe that maternal feelings should be discussed routinely and about twice as likely to believe that infant sleeping/behaviour, maternal sleeping/diet/tiredness, coping with other children, relationship with partner, and household work should form part of the routine discussion with all recent mothers. CONCLUSIONS: Sex of practitioner and older age (60 years or more) are the two most important influences on a GP's approach to postnatal care. This study indicates a need for GPs to shift their focus from routine examination to indicated examination to allow more time to discuss common postnatal problems.

Adult↗
PubMedDate not supplied

Who's holding the baby?--women's experience of their postnatal care.

This paper examines women's experience of their postnatal care in hospital and at home. It found that over a third of women surveyed had problems caring for themselves and the baby. Breastfeeding mothers were more likely to have problems than bottle-feeding mothers. There was no relationship between having such problems and parity. Women were particularly dissatisfied with postnatal services at home, 45% describing them as inadequate. Satisfaction with services was significantly associated with having sufficient advice from health professionals in hospital and at home. In view of the findings of this paper, it is clear that a strategy is required to identify those most in need of postnatal care and target services accordingly.

Adolescent↗
PubMed2000

General practitioners: their contact with maternal and child health nurses in postnatal care.

OBJECTIVE: To assess the level of contact of general practitioners (GP) with maternal and child health nurses (MCHN) in postnatal care. METHODOLOGY: A postal survey of 1104 Victorian GP was used, with a response rate of 70%. To account for the clustered sampling frame, hierarchical data analysis techniques were used. RESULTS: Half of the GP (351/710) had no contact with their local MCHN in the previous month; and one in 10 had four or more contacts. Eighty-eight per cent of GP described the contact as helpful. In 56% of cases the MCHN was reported as the usual initiator of the contact. The most common reason for contact concerned the baby's physical problems (42%). After adjusting for the number of women seen for the routine 6-week postnatal review and other GP characteristics, male GP were as likely as female GP to report MCHN contact (odds ratio (OR) = 1.00; 95% confidence interval (CI) = 0.67-1.62). General practitioners aged 31-40 years were more likely to report contact with MCHN than GP aged 51-60 (OR = 0.45; 95% CI = 0.22-0.86) as were GP with the FRACGP qualification (OR = 1.64; 95% CI = 1.21-2.45). CONCLUSIONS: This study provides baseline information on the level of GP contact with MCHN as they provide postnatal care. Although there were GP in Victoria who maintained a level of contact with MCHN, almost half reported no contact in the previous month. Most GP who reported contact with MCHN found it useful. This finding should encourage GP and MCHN coordination to improve continuity and postnatal care outcomes.

Attitude of Health Personnel↗
PubMed1993

Satisfaction with postnatal care--the choice of home or hospital.

This paper reports the findings of a study of client satisfaction with postnatal midwifery care. Women could choose one of two forms of care; either domiciliary care following early discharge, or hospital care until discharge. Consumers' perceptions of their postnatal care were examined at the end of the period of care. Women assessed the midwives' interest and caring, education and information provided, their own progress with feeding and baby care, and their own physical and emotional health. They were also asked about their expectations of and gains from postnatal care. The findings indicated that women choosing domiciliary care and women choosing hospital care had different expectations of their postnatal care, but were largely satisfied with the quality of the care they chose. The women who chose domiciliary care rated their postnatal care more highly than the women who stayed in hospital. The findings reinforce the importance of providing women with choices for the maternity care which best suits their needs.

Adult↗
PubMed2003

Redesigning postnatal care: a randomised controlled trial of protocol-based midwifery-led care focused on individual women's physical and psychological health needs.

OBJECTIVES: To develop, implement and test the cost-effectiveness of redesigned postnatal care compared with current care on women's physical and psychological health. DESIGN: A cluster randomised controlled trial, with general practice as the unit of randomisation. Recruited women were followed up by postal questionnaire at 4 and 12 months postpartum and further data collected from midwife and general practice sources. SETTING: Thirty-six randomly selected general practice clusters in the West Midlands Health Region, UK. PARTICIPANTS: All women expected to be resident within recruited practices for postnatal care were eligible for inclusion. Attached midwives recruited 1087 women in the intervention and 977 in the control practice clusters. INTERVENTIONS: The systematic identification and management of women's health problems, led by midwives with general practitioner contact only when required. Symptom checklists and the Edinburgh Postnatal Depression Scale (EPDS) were used at various times to maximise the identification of problems, and individual care and visit plans based on needs. Evidence-based guidelines were used to manage needs. Care was delivered over a longer period. MAIN OUTCOME MEASURES: Women's health at 4 and 12 months, assessed by the Physical and Mental Component Scores (PCS and MCS) of the Short-Form 36 (SF-36) and the EPDS. Women's views about care, reported morbidity at 12 months, health service usage during the year, 'good practice' indicators and health professionals' views about care were secondary outcomes. RESULTS: At 4 and 12 months postpartum the mean MCS and EPDS scores were significantly better in the intervention group and the proportion of women with an EPDS score of 13+ (indicative of probable depression) was significantly lower relative to controls. The physical health score (PCS) did not differ. Health service usage was significantly less in the intervention group as well as reported psychological morbidity at 12 months. Women's views about care were either more positive or did not differ. Intervention midwives were more satisfied with redesigned care than control midwives were with standard care. Intervention care was cost-effective since outcomes were better and costs did not differ substantially. CONCLUSIONS: The redesigned community postnatal care led by midwives and delivered over a longer period, resulted in an improvement in women's mental health at 4 months postpartum, which persisted at 12 months and at equivalent overall cost. It is suggested that further research should focus on: the identification of postnatal depression through screening; whether fewer adverse longer term effects might be demonstrated among the children of the women who had the intervention care relative to the controls; testing interventions to reduce physical morbidity, including studies to validate measures of physical health in postpartum women. Further research is also required to investigate appropriate postnatal care for ethnic minority groups.

Adolescent↗
PubMed2004

Home-based versus hospital-based postnatal care: a randomised trial.

OBJECTIVE: To compare a shortened hospital stay with midwife visits at home to usual hospital care after delivery. DESIGN: Randomised controlled trial. SETTING: Maternity unit of a Swiss teaching hospital. POPULATION: Four hundred and fifty-nine women with a single uncomplicated pregnancy at low risk of caesarean section. METHODS: Women were randomised to either home-based (n= 228) or hospital-based postnatal care (n= 231). Home-based postnatal care consisted of early discharge from hospital (24 to 48 hours after delivery) and home visits by a midwife; women in the hospital-based care group were hospitalised for four to five days. MAIN OUTCOME MEASURES: Breastfeeding 28 days postpartum, women's views of their care and readmission to hospital. RESULTS: Women in the home-based care group had shorter hospital stays (65 vs 106 hours, P < 0.001) and more midwife visits (4.8 vs 1.7, P < 0.001) than women in the hospital-based care group. Prevalence of breastfeeding at 28 days was similar between the groups (90%vs 87%, P= 0.30), but women in the home-based care group reported fewer problems with breastfeeding and greater satisfaction with the help received. There were no differences in satisfaction with care, women's hospital readmissions, postnatal depression scores and health status scores. A higher percentage of neonates in the home-based care group were readmitted to hospital during the first six months (12%vs 4.8%, P= 0.004). CONCLUSIONS: In low risk pregnancies, early discharge from hospital and midwife visits at home after delivery is an acceptable alternative to a longer duration of care in hospital. Mothers' preferences and economic considerations should be taken into account when choosing a policy of postnatal care.

Adult↗