Evaluation of postnatal home visits by the community midwife in the primary care setting

Abstract

The postnatal period marks the establishment of a new phase of family life for women and their partners and the beginning of the lifelong health record for newborn babies. This study investigated whether the current postnatal home care system in Malta is meeting the individual needs of women receiving the service during the puerperium. The study population was mothers of child-bearing age, who delivered in the public hospital between October and December 2007. The study also included the community midwives working within the M.M.D.N.A. delivering postnatal home visits. The research was conducted in two phases. Initially the community midwives randomly chose 200 mothers and hand delivered a questionnaire on the third and last home postnatal visit. However, the response rate was low 28% (n=56). Therefore, a different approach was taken. The M.M.D.N.A. midwives posted questionnaires together with a reminder letter to all mothers who delivered in December 2007 (n=286). The response rate was much higher (n=133 =46.5%). When comparing responses in both approaches it was found that there was no difference and therefore all the questionnaires returned were in the data analysis to obtain a larger sample (n= 189). In the second phase a mini focus group was held with all three community midwives to elicit their perceptions regarding the quality of home postnatal visits they provided. Each midwife provides between 12 and 14 post natal visits within a 5 hour working day which translates into approximately 20 minutes per visit to include travelling time. The study revealed that newly delivered mothers appreciated that they are being visited by the midwife at home to give them support and advice on how to take care of themselves and their baby. However, they reported that more and longer visits should be provided according to their individual needs. The study showed clearly that there is a need for change in the system of home postnatal visits.