Type and timing of services following postnatal discharge: do they make a difference?

The debate continues as to what constitutes an adequate postnatal follow-up after an early hospital discharge. The main objective of this study was to determine whether the type and timing of postnatal services were associated with mothers' and newborns' health, breastfeeding duration, and maternal assessment of the delay and usefulness of the services they received after discharge.

A telephone survey was conducted one month after a vaginal, uncomplicated delivery by 2,583 mothers who had given birth in five health regions of the Province of Québec, between 1999 and 2003.

The response rate to the survey was 72.1%. Virtually all the newborns (98.1%) had at least one routine contact with a health professional after discharge. Within 72 hours of discharge, 26.0% of the mothers received only a telephone call, 44.3% were visited by a public health nurse, 11.1% of the babies were examined by a physician and 49.5% were examined by a nurse or a physician. Newborns who had a first contact with a health professional within 72 hours of hospital discharge were less likely to have been readmitted to the hospital (adjusted Odds Ratio 0.45; 95% CI 0.21-0.97), while their mothers were less likely to have signs of moderate to severe depression at one month postpartum (adjusted Odds Ratio 0.60; 95% CI 0.45-0.79). The sooner the telephone call and the home visit were received the more likely the women were to have found that the services were useful.

Our findings suggest that the timing, more than the type, of postnatal follow-up after an early obstetrical discharge could make a difference.