[After care for puerperal women. A literature review]

The length of stay in hospital after child delivery has decreased in almost all western countries over the last decades. It is unclear what the consequences of an early discharge regarding the feelings of women in childbed are and which types of caring after discharge are provided.

To investigate the literature on how early discharge is defined and which are the consequences on young mothers. Particular focus is set on services including relief in household.

The term "early discharge" is defined very broadly depending on each country and its health policy. The well-being of women in childbed, mostly influenced by fatigue and postnatal depression, has a frightening prevalence rate. It has been demonstrated that post delivery fatigue is not a short time disturbance of energy level but exhaustion lasting several months. Postnatal depression is rarely measured in women and accordingly, is not treated. All investigated longitudinal studies show that the assumption that physical and mental normality is restored within eight weeks is not true. The decision to discharge was rarely based on scientific knowledge but on economical factors. In the investigated after delivery service models practical services in household are hardly described. Housekeeping seems to be no part of interdisciplinary tasks.

Satisfaction and self-experience in women after delivery seem to depend on their control of decision making about endurance, frequency and timing of support. Early discharge is increasing and must be accompanied by competent support and advice by well prepared home carers.