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Table 1 A Chronological Account of Post-Birth Care Plans in Policy

From: Policy, evidence and practice for post-birth care plans: a scoping review

Policy document, Author and Year of Publication

Country

Overview and Relevance to Post-Birth Care Planning

National Service Framework (NSF) for Children, Young People and Maternity Services Department of Health and Social Care 2004

England

Emphasises the importance of a fully personalised care plan spanning pregnancy, childbirth and the post-birth period, but lacks detail on what this should encompass postnatally.

States the importance of ‘continuity of support’ throughout the maternity journey as well as an ‘individualised, flexible, woman-focused approach to care and support’.

National Institute for Health and Care Excellence (NICE), − Postnatal care up to 8 weeks after birth CG 37 NICE 2006 (last updated in 2015)

UK

Introduced the idea of post-birth care plans, stating that “a documented, individualised postnatal care plan should be developed with the woman ideally in the antenatal period or as soon as possible after birth” (1.1.3).

These need to be tailored to meet the needs of each woman and include relevant factors from the antenatal, intrapartum and post-birth period and revisited at each contact.

It is stated that a well-developed plan would improve continuity of care.

Maternity Matters Department of Health 2007

England

‘Personalised care plans’ for the antenatal period and birth are mentioned, no specific mention of extending this to the post-birth period.

Highlights the importance of both personalised care and continuity of the care-giver throughout pregnancy and into the post-birth period.

Pathways for Maternity Care NHS Trust March 2009

Scotland

Reiterates the importance of an individualised care plan as per NICE guidance

Professional support should be individualised according to the needs of the woman and baby.

Continuity of care/ carer should be encouraged both antenatally and postnatally.

A Refreshed Framework for Maternity Care in Scotland The Maternity Services Action Group Scottish Government 2011

Scotland

No explicit reference to PBCP, but states that post-birth care should be delivered in line with national guidelines (including the NICE guidelines). Also, makes a brief reference to ‘maternity care planning’, but does not elaborate on what this entails.

Women and babies should have an assessment of their needs with ongoing assessment at every post-birth contact.

Recognises the importance of personalised care and continuity of care and carer, but does not explicitly state that this should be the same midwife for antenatal and post-birth periods.

Postnatal Care Program Guidelines for Victorian Health Services, State of Victoria’s Department of Health and Human Services 2012

Australia

Recommends that post-birth care planning starts during the antenatal period and should include the woman’s preferred location and timing of her care.

Post-birth care should be “women-centred”.

Promotes continuity of care and carer throughout the maternity care pathway.

Optimizing Postnatal Care American College of Obstetricians and Gynecologists (ACOG) 2016

USA

Planning for post-birth care should begin during pregnancy by developing a postpartum care plan specific to each woman.

Continuity of care and good communication are key.

Post-birth care planning should be based on discussions intimating a conversational style.

National Maternity Review - Better Births NHS 2016

England

Recommends that all women have a ‘personalised care plan’ for their whole maternity pathway.

Highlights the importance of more personalised care.

Post-birth care should be led by the woman’s named midwife who should assist the woman in developing the post-birth part of her personalised care plan.

The Best Start: A Five-Year Forward Plan for Maternity and Neonatal Care in Scotland - Executive Summary Report Scottish Government 2017

Scotland

Options for post-birth support should be discussed by woman and midwife during pregnancy and the woman’s decisions recorded in a shared personalised care plan, reviewed throughout the maternity journey.

Provides key recommendations around the ‘continuity of carer’, an individualised model of care, and keeping woman and baby at the centre of care.

Implementing Better Births – a Resource Pack for Local Maternity Services NHS 2017

England

All women should have a personalised care plan for the whole maternity journey. The post-birth part of the plan should be considered before the birth and revisited throughout.

All women should be offered assistance and support to form the care plan but it should be ‘owned’ by the woman. The discussion that informs the care plan should be viewed as a ‘conversation’.