title: Beyond the hospital door: a retrospective, cohort study of associations between birthing in the public or private sector and women's postpartum care.
abstract: BACKGROUND
  In Australia, maternity care is available through universal coverage and a parallel, competitive private health insurance system. Differences between sectors in antenatal and intrapartum care and associated outcomes are well documented but few studies have investigated differences in postpartum care following hospital discharge and their impact on maternal satisfaction and confidence.
  
  
  METHODS
  Women who birthed in Queensland, Australia from February to May 2010 were mailed a self-report survey 4 months postpartum. Regression analysis was used to determine associations between sector of birth and postpartum care, and whether postpartum care experiences explained sector differences in postpartum well-being (satisfaction, parenting confidence and feeling depressed).
  
  
  RESULTS
  Women who birthed in the public sector had higher odds of health professional contact in the first 10 days post-discharge and satisfaction with the amount of postpartum care. After adjusting for demographic and postpartum contact variables, sector of birth no longer had an impact on satisfaction (AOR 0.95, 99% CI 0.78-1.31), but any form of health professional contact did. Women who had a care provider's 24 hour contact details had higher odds of being satisfied (AOR 3.64, 95% CI 3.00-4.42) and confident (AOR 1.34, 95% CI 1.08- 1.65).
  
  
  CONCLUSIONS
  Women who birthed in the public sector appeared more satisfied because they had higher odds of receiving contact from a health professional within 10 days post-discharge. All women should have an opportunity to speak to and/or see a doctor, midwife or nurse in the first 10 days at home, and the details of a person they can contact 24 hours a day.
authors.affiliation: Discipline of General Practice, School of Medicine, The University of Queensland, Royal Brisbane and Women's Hospital, Level 8, Health Sciences Building, Herston, QLD, 4029, Australia. w.brodribb@uq.edu.au.
authors.forename: Wendy
authors.initials: W
authors.lastname: Brodribb
authors.affiliation: Institute for Social Science Research, School of Social Science, The University of Queensland, 4th floor, GPN3 (Building 39A), St Lucia, QLD, 4072, Australia. m.zadoroznyj@uq.edu.au.
authors.forename: Maria
authors.initials: M
authors.lastname: Zadoroznyj
authors.affiliation: Queensland Centre for Mothers & Babies, School of Psychology, The University of Queensland, Hood St, St Lucia, QLD, 4072, Australia. m.nesic@uq.edu.au.
authors.forename: Michelle
authors.initials: M
authors.lastname: Nesic
authors.affiliation: School of Nursing and Midwifery, The University of Queensland, Level 2, Edith Cavell Building, UQ Herston Campus, Herston, QLD, 4029, Australia. s.kruske@uq.edu.au.
authors.forename: Sue
authors.initials: S
authors.lastname: Kruske
authors.affiliation: School of Public Health and Social Work, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, QLD, 4059, Australia. yvette.miller@qut.edu.au.
authors.forename: Yvette D
authors.initials: YD
authors.lastname: Miller
mesh_terms: D000328:Adult; D019052:Depression, Postpartum / Q000523:psychology / Q000628:therapy; D005260:Female; D006771:Hospitals, Maternity / Q000706:statistics & numerical data; D006801:Humans; D008880:Midwifery / Q000706:statistics & numerical data; D016487:Parenting / Q000523:psychology; D036801:Parturition / Q000523:psychology*; D010351:Patient Discharge / Q000706:statistics & numerical data; D010549:Personal Satisfaction; D011181:Postnatal Care / Q000706:statistics & numerical data*; D049590:Postpartum Period / Q000523:psychology; D011247:Pregnancy; D017149:Private Sector / Q000706:statistics & numerical data*; D017150:Public Sector / Q000706:statistics & numerical data*; D011793:Queensland; D012189:Retrospective Studies; D057566:Self Report; D011795:Surveys and Questionnaires; D019472:Universal Health Insurance; D055815:Young Adult