Midwifery in the Postnatal Period: A Systematic Review of the Literature

Abstract

The time after birth is a critical period for a woman and her baby, which is frequently not given as much attention as during pregnancy and labour. Aim: This systematic review aims to present the contemporary parameters of midwifery care in the postnatal period. Method: The review was performed based on PRISMA methodology. Six hundred seventy eight publications were identified in the electronic scientific databases, Pubmed, Cochrane Library, BioMed Central and Google Scholar using the following keywords: “Midwifery Care”, “Postpartum Care”, “Postnatal Care”, “Community Midwifery”, “Health Promotion”, “Women’s Views”. No time limit set for the search, which was completed in 2016. Articles’ inclusion criteria were English language and relevance after content analysis. Duplicate records were removed; the remaining database was screened and checked for eligibility. In total 355 articles were included after content analysis and the categorized key findings are presented. Results: There is consistent research evidence indicating that the policy of early postnatal discharge combined with home midwifery support reduces costs and in some cases improves the satisfaction, health and wellbeing of both mother and neonate. Individualised postnatal care planning is considered as optimal when includes approximately weekly visits for around five weeks providing women with adequate guidance regarding the newborn care, parenting advice, enhancement of mother’s social support networks, and promotion of exclusive breastfeeding. Having a healthy diet, exercise and postpartum weight management are widely reported as very important parameters and it seems that they contribute to the reduction of postnatal depression. Use of technology including text messages, e-mails, phone calls, social networks (e.g. facebook) and console games (e.g. Wii fit plus), may be useful in some cases to help promote healthy eating behaviours, improving social support and physical activity. However, personal contact for providing health information is by far the most effective means of communication. Conclusion: Continuity of midwifery-led care at home is beneficial as it provides a multi-disciplinary network of consultation and referral with other care providers.