Maternity services require high quality where the outcomes are compared favorably in order to improve and respond to the needs brought forward by the family. Primary maternity services entail giving care and attention to the woman through antenatal, birthing and postnatal care where the risks are kept as low as possible. These services are kept safe and effective through structures given by care providers that ensure appropriate assessment, timely referral and access to secondary services. Women in this stage will be referred to secondary services and then tertiary services which provide higher level of medical care. This structure enables midwives to provide care across the continuum and apply the holistic nature of their skills. It also gives women the opportunity to receive the type of care they demand (Morrell et al, 2009).
In most parts of the world primary maternity services are provided to ensure safety and cost effective care for majority of women with uncomplicated pregnancies of normal risks (Hendricks, 2006). They also enjoy health outcomes and satisfaction that is developed to the extent of enhancing the provision of primary maternity services. These services are driven by the responsiveness that occurs due to: the requests made by women for a range of choices of high quality maternity services which offer continuity of care and are more responsive to their needs (Hendricks, 2006). This maybe coupled with the evidence of cost effectiveness provided by primary maternity services. Similarly, there are higher levels of professionalization of the midwife workforce which ensures the provision of opportunities for increased professional autonomy (Hendricks, 2006). The opportunities are aligned with the strengthened capacity to provide continuity of care which may improve satisfaction and subsequently recruitment and retention in the midwives services (Hendricks, 2006).
Additionally, there are the crucial workforce shortages that imply the imperative that the respective skills of maternity care professionals are utilized efficiently and appropriately in order to meet the needs of the women (Clement, 2012). Primary maternity services are provided for women who have normal pregnancies with low risks. It helps in covering areas that extend from the pregnancy, labor and birth as well as the post natal period. The midwives in this case apply various principles that guide them in the provision of primary health care (Clement, 2012). These principles are utilized in discharging practices and they range from provision of postnatal care in accordance with the principles of individualized care. They also ensure that services provided enable women to make informed and timely decisions pertaining their maternity care and are able to feel in control of their birthing experience. Additionally, they ensure that maternity services and care are provided in ways that obey their culture in appropriate and responsive ways according to the needs of each woman (Clement, 2012).
The principles applied by midwives also extend to maximizing their potential as well as that of other medical practitioners and where appropriate other health professionals such as pediatricians and aboriginal health workers specific knowledge, skills and attributes to provide a collaborative. They also ensure coordinated multidisciplinary approaches to maternity service delivery. This is coupled with the fact that they aim at offering continuity of care, and whenever possible of care as the key element of quality care (Barnes and Rowe, 2007). They ensure that maternity services are maintained at high quality, safe and sustainable and provided within an environment of evidence based best practice care. Midwives also ensure continued access to best practice maternity services and care at local level. This occurs through the recognition of the fact that the benefits of local access must be considered within a quality and safe structure (Barnes and Rowe, 2007).
In addition to this, midwives apply the principle of providing the required balance between primary level care and access to appropriate levels of medical expertise that are required at the clinics. Their work reduces the inequalities found in the health institutions by aboriginal women as well as mothers. These principles ensure that women are offered the opportunities to share more information about their birth experiences and enquire about the care they received during the labor (Davies et al, 2003). This occurs through the fact that midwives offer consistent information and elaborate explanations that empower the women to take care of their own health and that of their baby as well as recognize symptoms that may require discussion. Midwives use hand-held maternity records as well as postnatal care plans and personal child health records in order to promote communication with women (Davies et al, 2003).
Postnatal length of stay refers to the total amount of time that any woman in labor should be discharged after they have delivered their baby. This period has not been appropriately estimated as it may differ depending on the health of the woman and the condition of the baby. However, the postnatal length of stay ensures that the length of stay or rather the discharge of women who have undergone uncomplicated pregnancies and not had any caesarean birth between 24-48 hours should occur through a cost effective approach. The length of stay in this case allows the midwives to discharge the woman after a period of about 4-5 days (Fetterolf, 2008). These aspects are compared with the fact that depends on where the woman had her baby and the type of birth she went through (Fetterolf, 2008). Similarly, the policies applied may also be used as a determining factor as well as the choice of the woman. There are instances where the woman may choose to go home after they have given birth. These factors may also be determined by the fact whether the woman or the baby are in perfect condition or may have developed any complications (Fetterolf, 2008).
The NSW length of stay on the other hand relies on factors that are governed by external aspects. These include: budget restraints and the drive by private health insurers to save costs. In private hospitals the women may stay even longer than the recommended period because the hospitals will be making money out of the whole process (Morrell et al, 2009). The longer the woman stays the more money the hospitals makes. This strategy is wrong in that the health of the woman is not given first priority. The hospitals aim at making money at the expense of the woman and the child. Private hospitals are profit making entities that offer services in exchange for good prices. They do not consider the health of the patients or even their welfare (Morrell et al, 2009). For instance, if a woman in labor was to approach them and she is not insured, they will attend to her but will not give more attention to her health as they will not be making any money out of it. Similarly, if she was to be admitted, the y will ensure that her stay will be limited as much as possible unless she is willing to pay them for her stay (Morrell et al, 2009).
Evidently, postnatal care is a continuous process where care should be provided to the women through her pregnancy (Pair man and Pincombe, 2010). It should focus on the provision of consistent advice and support for the recovery from pregnancy and the birth as well as identifying the appropriate management strategies at an early stage. The midwives should provide physical and psychological support to the women who should be coupled with attending to their emotional and social health needs and the facilitation of the right ways of starting their family life (Pair man and Pincombe, 2010). This should be accompanied by the proper organization of the postnatal maternity services in order to bring out the crucial principles of care and clinical components. Midwives should be guided by the fact that they are required to enquire about the woman’s health and well being (Pair man and Pincombe, 2010). This gives the women some sense of attention and experience of common physical health problems. They should also offer constituent information and encouragement to the woman and her family to report any concerns related to their physical, social, mental or even emotional health (Pair man and Pincombe, 2010).
The postnatal length of stay in the maternity unit should be discussed between the individual woman and her health care professional. This should be done with the consideration of the health and well being of the woman and the baby. Similarly, midwives and medical practitioners in this field should evaluate the level of support the woman is viable to receive after she is discharged. It should be a point of consideration made after considering perspectives given by the woman (Taylor, 2009). Local protocols that entail written communication should help the woman in terms of knowing the right places to seek help (Taylor, 2009). Additionally, the age of the mother should be considered at this stage due to the fact that many teenage girls are getting pregnant these days. It is the role of the midwives as well as medical professional to some extent to give sound advice to the mother and offer them the opportunity to share their experience at any level (Taylor, 2009).
References
Barnes, M., & Rowe, J. (2007). Child, youth, and family health: Strengthening communities. Sydney: Churchill Livingstone Elsevier.
Clement, I. (2012). Manual of community health nursing. New Delhi: Jaypee Brothers Medical Publishers.
Davies, Bronwen R.; Howells, Sarah; Jenkins, Meryl. (2003). ISSUES AND INNOVATIONS IN NURSING PRACTICE Early detection and treatment of postnatal depression in primary care. Journal of Advanced Nursing, 44(3), 248-255.
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Hendricks, V. C. (2006). Psychiatric disorders in pregnancy and the postpartum: Principles and treatment. Totowa, N.J: Humana Press.
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Morrell CJ; Slade P; Warner R; Paley G; Dixon S; Walters SJ; Brugha T; Barkham M; Parry GJ; Nicholl J, BM (2009). Clinical effectiveness of health visitor training in psychologically informed approaches for depression in postnatal women: pragmatic cluster randomized trial in primary care. Publisher: British Medical Association; 15(338).
Pair man, S., Tracy, S. K., Thorogood, C., & Income, J. (2010). Midwifery: Preparation for practice. Chats wood, Australia: Elsevier Australia.
Taylor, J., & Themessl-Huber, M. (2009). Safeguarding children in primary health care. London, UK: Jessica Kingsley Publishers.
