Postnatal care across the Northern Ireland and Republic of Ireland border: A qualitative study exploring the views of mothers receiving care, and midwives and public health nurses delivering care

Background: In developed countries, shorter postnatal hospital stays have been reported in the literature over the last two decades. In the UK, a reduction in the number of postnatal home visits by midwives has been noted. In Northern Ireland (NI) midwives care for all mothers for a period not less than ten days and longer if necessary. In the Republic of Ireland (ROI), the public health nurse visits less often initially, but provides care for families with infants over a longer period up to, and including, the school years. Aim: To explore whether professional home postnatal care in NI and ROI meets mothers' expectations and needs. This study was designed to explore mothers' experiences of different models of postnatal care from each side of the border to inform decisionmaking about universal versus targeted home visiting. Participants. A total of 20 mothers resident in NI and 20 mothers resident in ROI took part in the study, along with five lead supervisors of midwives in NI, 12 community midwives in NI and one regional ROI service manager. Settings. The community and hospitals in NI and the community in ROI. Methods: Data collected using digitally recorded interviews and focus groups, and analysed using analytic induction procedures. Findings: Four main themes emerged from the data - mothers' experiences of postnatal visits, advice given, out-of-hours help and continuity of care. ROI mothers valued home visits up to three months after the birth, but wanted more visits in the early postnatal period. More advice about maternal health and more help with infant-feeding were required. Some ROI mothers travelled across the border for home postnatal care by NI midwives. NI midwives reported routine visiting patterns. Conclusions and implications for practice. The tension between too many or too few home visits suggests that visiting health professionals need to negotiate the visiting pattern with mothers to meet their individual needs. Recommendation: The establishment of a dedicated, community-based, midwifery service with out-of-hours support for mothers has been recommended.