International models of home maternity care as instruments of health promotion and prevention

Background:

Postpartum care can have lasting influence on maternal and child health if aspects of health promotion and prevention can be incorporated. In-patient maternity care in Germany is progressively limited to a few days postpartum. Ambulatory check-ups are performed by certified midwives. Internationally, maternity support workers assist midwives in caring for mothers in the first weeks postpartum. These support workers perform various tasks in caring for mother, newborn and siblings in the family.

Methods:

We identified models of home based maternity care in the United Kingdom, the Netherlands and Germany, and evaluated their roles in health promotion and prevention by identifying aspects of job descriptions pertaining to these subjects. Exploratory interviews were performed to further evaluate different models of care.

Results:

Various models of home maternity care were identified. Education of maternity support workers varied from non-educated volunteers to nursing school graduates. Health promotion and prevention aspects of home based maternity care varied from performing routine checks and promoting breastfeeding, to identifying child abuse, promoting psychosocial health and preventing sudden infant death.

Conclusion:

Internationally, health promotion and prevention were major aspects of maternity support workers job descriptions. In Germany, maternity support workers performing home based maternity care is an emerging model of care, with volunteer based models being widely applied and promoted, while professionalized home maternity care is not always fully reimbursed. Structured implementation of professional home maternity care can contribute to maternal and child health.