title: A call for better care: the impact of postnatal contact services on women's parenting confidence and experiences of postpartum care in Queensland, Australia.
abstract: BACKGROUND
  Universal postnatal contact services are provided in several Australian states, but their impact on women's postnatal care experience has not been evaluated. Furthermore, there is lack of evidence or consensus about the optimal type and amount of postpartum care after hospital discharge for maternal outcomes. This study aimed to assess the impact of providing Universal Postnatal Contact Service (UPNCS) funding to public birthing facilities in Queensland, Australia on women's postnatal care experiences, and associations between amount and type (telephone or home visits) of contact on parenting confidence, and perceived sufficiency and quality of postnatal care.
  
  
  METHODS
  Data collected via retrospective survey of postnatal women (N = 3,724) were used to compare women who birthed in UPNCS-funded and non-UPNCS-funded facilities on parenting confidence, sufficiency of postnatal care, and perceived quality of postnatal care. Associations between receiving telephone and home visits and the same outcomes, regardless of UPNCS funding, were also assessed.
  
  
  RESULTS
  Women who birthed in an UPNCS-funded facility were more likely to receive postnatal contact, but UPNCS funding was not associated with parenting confidence, or perceived sufficiency or perceived quality of care. Telephone contact was not associated with parenting confidence but had a positive dose-response association with perceived sufficiency and quality. Home visits were negatively associated with parenting confidence when 3 or more were received, had a positive dose-response association with perceived sufficiency and were positively associated with perceived quality when at least 6 were received.
  
  
  CONCLUSIONS
  Funding for UPNCS is unlikely to improve population levels of maternal parenting confidence, perceived sufficiency or quality of postpartum care. Where only minimal contact can be provided, telephone may be more effective than home visits for improving women's perceived sufficiency and quality of care. Additional service initiatives may be needed to improve women's parenting confidence.
authors.affiliation: School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, 4059, Australia. yvette.miller@qut.edu.au.|School of Psychology, The University of Queensland, Brisbane, QLD, 4072, Australia. yvette.miller@qut.edu.au.
authors.forename: Yvette D
authors.initials: YD
authors.lastname: Miller
authors.affiliation: School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, 4059, Australia. aimee.dane@qut.edu.au.
authors.forename: Aimée C
authors.initials: AC
authors.lastname: Dane
authors.affiliation: School of Psychology, The University of Queensland, Brisbane, QLD, 4072, Australia. rachel.l.thompson@dartmouth.edu.|The Dartmouth Institute for Health, Policy and Clinical Practice, Dartmouth College, Hanover, NH, 03755, USA. rachel.l.thompson@dartmouth.edu.
authors.forename: Rachel
authors.initials: R
authors.lastname: Thompson
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006792:House Calls; D006801:Humans; D008875:Middle Aged; D016487:Parenting; D010351:Patient Discharge; D011181:Postnatal Care / Q000706:statistics & numerical data; D049590:Postpartum Period; D011247:Pregnancy; D011787:Quality of Health Care; D011793:Queensland; D012189:Retrospective Studies; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D055815:Young Adult