title: The structure and organisation of home-based postnatal care in public hospitals in Victoria, Australia: A cross-sectional survey.
abstract: BACKGROUND
  There is limited evidence regarding the provision of home-based postnatal care, resulting in a weak evidence-base for policy formulation and the further development of home-based postnatal care services.
  
  
  OBJECTIVE
  To explore the structure and organisation of public hospital home-based postnatal care in Victoria, Australia.
  
  
  METHODS
  An online survey including mostly closed-ended questions was sent to representatives of all public maternity providers in July 2011.
  
  
  RESULTS
  The response rate of 87% (67/77) included rural (70%; n=47), regional (15%; n=10) and metropolitan (15%; n=10) services. The majority (96%, 64/67) provided home-based postnatal care. The median number of visits for primiparous women was two and for multiparous women, one. The main reason for no visit was the woman declining. Two-thirds of services attempted to provide some continuity of carer for home-based postnatal care. Routine maternal and infant observations were broadly consistent across the services, and various systems were in place to protect the safety of staff members during home visits. Few services had a dedicated home-based postnatal care coordinator.
  
  
  CONCLUSIONS
  This study demonstrates that the majority of women receive at least one home-based postnatal visit, and that service provision on the whole is similar across the state. Further work should explore the optimum number and timing of visits, what components of care are most valued by women, and what model best ensures the timely detection and prevention of postpartum complications, be they psychological or physiological.
authors.affiliation: Judith Lumley Centre, La Trobe University, 215 Franklin St, Melbourne 3000, Australia; The Royal Women's Hospital, Locked Bag 300, Grattan St and Flemington Rd, Parkville 3052, Australia. Electronic address: d.forster@latrobe.edu.au.
authors.forename: Della A
authors.initials: DA
authors.lastname: Forster
authors.affiliation: Department of General Practice, Monash University, 270 Ferntree Gully Rd, Notting Hill, Vic. 3168, Australia.
authors.forename: Heather
authors.initials: H
authors.lastname: McKay
authors.affiliation: School of Law, University of Canterbury, Private Bag 4800, Christchurch 8041, New Zealand.
authors.forename: Rhonda
authors.initials: R
authors.lastname: Powell
authors.affiliation: School of Public Health, Lund University, Sweden.
authors.forename: Emma
authors.initials: E
authors.lastname: Wahlstedt
authors.affiliation: The Royal Women's Hospital, Locked Bag 300, Grattan St and Flemington Rd, Parkville 3052, Australia; Judith Lumley Centre, La Trobe University, 215 Franklin St, Melbourne 3000, Australia.
authors.forename: Tanya
authors.initials: T
authors.lastname: Farrell
authors.affiliation: The Royal Women's Hospital, Locked Bag 300, Grattan St and Flemington Rd, Parkville 3052, Australia.
authors.forename: Rachel
authors.initials: R
authors.lastname: Ford
authors.affiliation: Judith Lumley Centre, La Trobe University, 215 Franklin St, Melbourne 3000, Australia; School of Nursing and Midwifery, La Trobe University, Bundoora 3086, Australia.
authors.forename: Helen L
authors.initials: HL
authors.lastname: McLachlan
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006779:Hospitals, Public / Q000458:organization & administration*; D006792:House Calls / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008880:Midwifery; D017060:Patient Satisfaction; D011181:Postnatal Care / Q000379:methods / Q000458:organization & administration*; D011247:Pregnancy; D012424:Rural Population / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014739:Victoria; D055815:Young Adult
keywords: Domiciliary; Home-based; Midwifery care; Postnatal; Postpartum