A baby's interactions with its parents during the first weeks of life are an important pre-requisite for its continued wellbeing . When parents begin to understand and react to the infant's basic needs they develop feelings of security about their new role as parents . The ways in which provision of health care services during the early postnatal period may impact the new family is a subject which should be constantly under our surveillance. A recent Australian study has shown that, within existing models of care, women in the early postnatal period have fears and anxieties about their competence as new mothers and their ability to care for the new baby . Studies show that mothers' and fathers' experiences during the childbirth period influence not only the child but also their own subsequent well-being [3–5]. Research has demonstrated effects of these experiences on parental relationships [3, 4] and effects on the child have been suggested . Earlier Swedish research into factors which influence choice and experiences of early discharge after childbirth has indicated the importance of a sense of security for the individual's experience of parenthood in the early postpartum period [7–9].
It was reported in 1995 that postnatal maternal morbidity was extensive and unrecognised  and since then numerous studies of maternal postnatal wellbeing have considered physical, psychological and psychosocial problems [11–15]. Lonstein  states that many women experience emotional disregulation and Skari et al.  showed in their Norwegian study that 37% of the mothers and 13.5% of the fathers reported psychological distress such as anxiety and depression, a few days after childbirth. In a Swedish study which measured women's satisfaction with their postnatal care at two months and one year, 26% of women were not satisfied with their postnatal care and amongst the risk factors for dissatisfaction was the presence of many physical symptoms . The authors of the study discussed the possibility that although anxiety and depression seemed not to be associated with low satisfaction it was possible that these problems caused some amount of somatisation which then appeared as a risk factor for dissatisfaction.
According to some research  support, counselling, understanding and information, given to women by midwives in the postnatal period may provide benefits to psychological wellbeing although a review of the literature showed that the evidence for the use of postpartum talks was inconclusive . Persson and Dykes  found that early postnatal security was dependent on parents' perceptions of the midwife's empowering behaviour, a sense of affinity within the family, a sense of autonomy and control and a sense of wellbeing which included manageable breastfeeding. Based on these results an instrument ("Parents' Postnatal Sense of Security", PPSS) is under development  which may be used to evaluate whether care offered enhances feelings of security during this sensitive period.
Although there are exceptions to the rule, maternity care in Sweden continues to a great extent to be fragmented, despite attempts to create services where midwives alternate between antenatal, birthing and postnatal care units. Continuity of care giver through the childbearing process is not a common feature of usual maternity care in Sweden. Midwives are the primary care providers for women at low risk of complications and these midwives are mostly community-based. It is these midwives who provide preparation for parenthood classes. In Sweden postnatal care has undergone changes, particularly regarding the length of stay, but also regarding the amount of own responsibility that new parents are expected to take . Puerperal care of the mother and baby has in the last two decades been considerably reduced from the six weeks stipulated by the WHO in 1998 . The length of hospital stay in Sweden for healthy primiparous women experiencing a normal delivery has decreased over a fifteen year period from approximately one week to 48 hours.
The organisation of postnatal care of families after discharge differs from hospital to hospital according to the preferences of the obstetrician-in-charge of the local obstetrics and gynaecology unit. Most hospitals require the mother and baby to stay at the hospital for observation for a minimum of six hours after the birth. Paediatricians' preferences determine the timing of examination of the newborn baby which also varies between hospitals. At some hospitals the baby is examined at six hours of age, before discharge and at others the family may leave the hospital without examination of the baby and return for examination when the baby is approximately 12 hours old. Some hospitals offer home visits by a midwife from the hospital where the birth took place, some offer telephone follow-up and others require the parents themselves to make contact with the hospital maternity services if needed. During the first days, advice and information is given regarding breastfeeding, care of the newborn infant and the health of both mother and infant. After this period, a short written summary of the birth and early postnatal period is sent to the district nurse who takes over responsibility for care of the baby and the breastfeeding dyad. Within 10 days of discharge the district nurse carries out a home visit.
In the Australian study which showed that women in the early postnatal period have anxieties and fears regarding their parenting role, the authors suggested that care providers should be sensitive to the needs of individuals when planning postnatal services . In Sweden, shortened length of puerperal care has been implemented with little recognition or concern for what these changes might entail for the health and welfare of the new family. It is of great importance that changes in postnatal care are evaluated both in relation to safety and parents' experiences of security.
At a hospital in southern Sweden a development project has been carried out which aimed to establish a new model of care by making the antenatal midwife the first line carer for mothers discharged from hospital but not yet in the care of the district nurse. Midwives at the antenatal clinics work to a case load and the rate of continuity of care giver before the birth is high in the whole district (unpublished data). The project aimed to increase continuity of care giver after the birth and to make maximum use of the relationship to and knowledge of the family which the antenatal midwife builds up during the months of pregnancy. Regional guidelines for care in pregnancy state that the appropriate number of midwife visits for women with a low-risk pregnancy is approximately eight.
At the hospital in question there are two wards for care after birth; one family-oriented ward and one traditional postnatal ward which cares for mothers with birth complications. The family-oriented ward also has a breastfeeding clinic, available for booked visits all days of the year and which is staffed by the midwives who work on the ward. No home visits are carried out after discharge from this hospital. Women are given telephone numbers where they can reach a hospital midwife 24 hours a day. Midwives occasionally make a spontaneous telephone call to women for whom they feel some kind of concern. Families return to the family-oriented ward for follow-up visits after discharge. The midwives alternate between the family ward and the traditional postnatal ward, which means that it is in no way certain that the woman will recognise the midwife whom she meets for the follow-up visit. Earlier research carried out at this hospital regarding fear of childbirth [22, 23] has increased awareness amongst the midwives about the value of postpartum talks. However, short hospital stays can make it difficult for the midwife who attended the woman at the birth to talk to the mother before she leaves the hospital.
It is important that new forms of care are evaluated to ensure that services are not weakened for new families. Rates of neonatal re-admissions were monitored in the project but no scientific evaluation of the effect the new model of care has on parents' postpartum experiences has previously been carried out.
The objectives of this study were to evaluate two models of postnatal care using a questionnaire incorporating the PPSS instrument, and to test the reliability and validity of the instrument.