Women’s experience of domiciliary postnatal care in Victoria and South Australia: a population-based survey

Abstract

Objective. Despite the expansion of postnatal domiciliary services, we know little about the women receiving visits and how they regard their care. The aim of this study is to examine the provision of postnatal domiciliary care from a consumer perspective. Methods. All women who gave birth in September–October 2007 in South Australia and Victoria were mailed questionnaires 6 months after the birth. Women were asked if they had received a midwifery home visit, and to rate the care they received. Results. More women in South Australia reported receiving a domiciliary visit than in Victoria (88.0% v. 76.0%) and they were more likely to rate their care as ‘very good’ (69.1% v. 63.4%). Younger women, women on a lower income, who were holding a healthcare concession card or who had not completed secondary education were less likely to receive a visit. Conclusion. Although the majority of women in public maternity care in Victoria and South Australia receive domiciliary care and rate it positively, there are significant state-based differences. Those more likely to benefit from domiciliary care are less likely to receive a visit. There is a need to further explore the purpose, aims and content of domiciliary care at individual and state-wide levels. What is known about the topic? Postnatal domiciliary services have expanded dramatically over the past decade as the postpartum hospital stay has shortened. Despite its widespread introduction, there are no mechanisms in place to monitor or evaluate whether these services are meeting women’s expectations. We know little about the women who receive domiciliary postnatal visits in the first week after discharge from hospital, and how they regard their experience of care. What does the paper add? This is the first Australian population-based survey that describes the experience of domiciliary care according to the state in which women reside and to examine the sociodemographic, obstetric and organisational factors associated with the provision of services. What are the implications for practitioners? There were state-based differences in the provision of domiciliary care and whilst the majority of women received domiciliary care and rated it positively, an inverse care law seems to apply: women who were more likely to need and derive benefit from domiciliary care were less likely to receive it. There is a need to further explore the purpose, aims and content of domiciliary care at individual and state-wide levels.