Introduction
Amiably, research into women’s transition to motherhood has demonstrated that many women are often unprepared for the transition to parenthood, and particularly self-care and baby care. Several studies have also found that women’s postnatal needs are not being met, The National Health and Medical Research Council (1996) suggests that many women feel abandoned during the postpartum period. Notably, Tarkka, Paunonen and Laippala (2000 in Barnes, et al. 2008 pp. 33-34), have noted that motherhood has been described as unique experience and is seen as significant rite of passage and entry into adulthood (Crouch and Mandersen, 1993; Mercer, 1981 in Barnes, et al. 2008 pp. 33-34). Some women feel ill-prepared (McVeigh, 2000 in Barnes, et al. 2008 pp. 33-34), experiencing sense of loss, isolation and fatigue (Rogan, Shmied, Barclay, Everitt and Wyllie, 1997 in Barnes, et al. 2008 pp. 33-34) as the overwhelming tiredness (McQueen and Mander, 2003; McVeigh, 2000; Tarkka, Paunonen and Laippala, 1999 in Barnes, et al. 2008 pp. 33-34), along such unrelenting demands of child care. Aside, Nystrom and Ohrling (2004 in Barnes, et al. 2008 pp. 33-34) have highlighted some difficulties new mothers face, suggesting that having primary responsibility for the infant leads to feelings of powerlessness, guilt, loss, anger, and resentment.
Moreover, agreeing to research that in families transitions represent periods of change where there are shifts in their lifestyles from one stage to another (Price, McKenry and Murphy, 2000). Pregnancy and the transition to parenthood is major developmental period with important implications for parents, for child and parent relationship and the infant's development. Research has consistently demonstrated that it is stressful event and brings about more profound changes than any other developmental stage of the family life cycle (Osofsky and Osofsky, 1984; Cowan and Cowan, 1995, Priel and Besser, 2002). Women report massive changes to lifestyle and routines, easy adaptation is not usual uniformly problematic and is not bound by any timeframe (Oakley, 1980; Mercer, 1986). Many studies dealing transition to parenthood have asked new parents retrospectively about their experiences and needs during their pregnancy and in the early perinatal period rather than prospectively (Cowan and Cowan, 1992; McKellar, Pincombe and Henderson, 2006; de Montigny, Lacharite and Amyot, 2006). However, these often include women who attend antenatal/postnatal classes, therefore excluding women from certain socio-economic deprived backgrounds, and focus on women and not of their respective partners (Pridham and Chang, 1992).
Evaluate current midwifery practice in the provision of routine postnatal care
McCourt et al (1998, p. 73) have asserted that, the midwifery practices have been in the position of optimal success as presence of care path demonstration is of strong assumption as there relates to proper maternity services as it should be put into practice as such policy should comply to postnatal care maternity service as postnatal services provided by midwives will be integral to the understanding of postnatal care underpinnings and domains. Research study done by has demonstrated that women are satisfied with one on one postnatal care exercised by midwives as certain actions and practices have to be assessed in accordance to effective care as well as midwife practice the gaining of better understanding of women's needs in lieu to postnatal maternity service.
MacArthur et al (2002, p. 378) have noted that some of postnatal care incurs to physical and psychological morbidity which may not be addressed by midwife led care, which tends to focus on routine examinations as there should be application of cluster based trial to assess community postnatal care that has been the responsibility of midwifery as there designs upon identifying as well as managing of self care and baby care within postnatal period. Thus, asserted that midwives from practices have provided effective postnatal care as care must be comprehensive and exclusive as led by certain midwives as it can be with or without routine contact with physicians.
Agreeing to the practice in which midwives utilizes symptom checklists as well as the application and execution of a postnatal depression scaling as there identification and recognition of health needs and guidelines for postnatal care and management linked for woman needs as she faces motherhood reality. The nee to support transition of women from motherhood to parenthood by means of teaching and giving baby care training, what are some dos and don’ts of mother and baby care relationship and it is ideal to start from the basics such as proper handling of the newborn, correct positions during breastfeeding and baby bathing as well as what to do in times of baby care problems such as baby have skin rashes and other concerns. Thus, midwifery practices are in better action to take account of women's views about self care and baby care. The need to reconsider as well as redesign of postnatal care so that it is midwife oriented as well as flexible and tailoring to the needs and concerns of a mother as she becomes parent to her child as midwives does amiably help improve women's cognitive health and reduce probable depression for instance, during three to four months under postpartum period.
Practice for ideal midwifery care can be preferred to obstetrician care and did not lead to any deficits in clinical outcomes as there maybe features of midwifery provision as maintain the spirit of childbirth policy changes as from the perspective of maternal well being in a physical and psychological matter, the practice initiatives can be highly successful to the transition phase of women from motherhood to parenthood stage. Several midwives remain positive about working to provide effective postnatal care as service dedication and satisfaction are influenced by barriers to effective care beyond control, which limits the time available to spend with women for support and attention.
Midwives have reviewed aims of postnatal care to include education and support of women with breastfeeding and parenting skills, helping in women's physical recovery after pregnancy and birth. Midwives’ perception of factors that influence women's satisfaction with postnatal care is consistent with what people knew such as views towards continuity of care, individualized unrushed care as well as flexibility in routine based practices. Thus, with evidence from midwives and women about certain unsatisfactory nature of current provision and organization of postnatal care, innovative driven strategies and approaches to midwife practice oriented episode to detailed postnatal care should be explored in a proper context formation and awareness to care.
It is imperative to recognize as well as evaluate practice led effectiveness of midwifery based care such as for the reduction of postnatal depression ratios in women mostly those women who have background histories of maternal depression. Meanwhile current midwifery practices does have pressing impact on motherhood to parenthood domains but the practice will adhere to a successful transition that engages women to adopt postnatal care particular giving in of baby care as extensive as possible and that midwifery will imply to essential care contribution as geared for ideal care of the child-bearing women with several health issues and problems.
According to research investigation by McKellar, Pincombe and Henderson (2006, p.358) that the “reduction of time available to midwives during the hospital postnatal stay suggests that there is a need to review postnatal care as innovative strategies are required which give attention to specific family needs and assist in the transition to parenthood and new ideas and changes are not always readily accepted in midwifery practice”. McKellar, Pincombe and Henderson (2006, p.359) have further noted that there appears that the provision of hospital postnatal care has been influenced by an underlying culture in midwifery practice, which in turn, has impeded the change required to enhance postnatal care.
Evidence-based recommendations for the provision of effective postnatal care for women and their babies
Waldenstrom et al (2000, p. 156) have indicated that, although policy makers have suggested improved continuity of midwifery can possibly increase women's satisfaction with care in childbirth, evidence based on trials is lacking. New models of care, such as birth centers and team midwife care, try to increase the continuity of care and caregiver. The need to evaluate the effect of new team midwife care program with postnatal care after pregnancy. Practice and midwife care has been associated with increased satisfaction as noticeable for postnatal care and that, midwife care is important to increase satisfaction with postnatal care relating to effective self and baby care giving and other ways.
There is need for research to provide such voice to midwives in identifying the barriers and current problems in organization of maternity care such as in Australian based perspective as there analyses issues affecting current practice in midwifery. Indeed, the invisibility of midwifery does ensure certain ongoing strategic control of maternity services and denial of several rights of women to have full coverage and access of midwifery care. Lavender et al (1998, p. 215) have concluded that, the support, counseling, understanding, and explanation given to women by midwives in the postnatal period provides benefits to psychological well-being. Maternity units have a responsibility to develop a service that offers all women the option of attending a session to discuss their labor. Further, integrating to the reorganisation of maternity services to enable women to receive continuity of care has benefits for women and that benefits of known labor midwife needs further investigation and proof study.
Barclay et al (1997, p. 719) implied such application of analysis providing in conceptualization of motherhood enabling the development of strategies for midwives and others helping women negotiate postnatal and baby care challenge. However, the practice of midwifery care is of better stature upon having ideal experience to appraise the quality and relevance of currently available research evidence to develop best practice model of women care in transition phase in which the midwife is the leader for the postnatal care ways as for example, the practice of offering women flexible visit schedule and continuity of care throughout the postnatal period in accordance to validation of contemporary midwifery profession and practice realized through successful implementation and evaluation of midwifery based care effectiveness for women and their babies. Several midwives have worked in such groups within health clinics but women usually see more than one midwife during the period of pregnancy and women with uncomplicated pregnancies will continue the midwifery care, whereas others may be placed under consultant obstetric care case by case basis.
There is a need to engage into postnatal classes/workshops to be realized and run by midwives offered to couples from around 2 weeks after pregnancy , covering issues such as after birth care, hygiene, baby care such as breastfeeding and ensure aspects of better parenting handling. The uptake of classes will vary depending upon the area and postnatal reunion session can be offered as most women give birth in maternity hospitals and return home within the first or second postnatal day as a parent taking the baby home without much practical baby care instruction. In addition, the providing of effective postnatal guidelines (NICE, 2006) as parents are given contact details for their midwives and will depending on woman's individual requirement, to have visitations at home for several weeks.
Thus, pressures on maternity services have resulted in reduction in home visits and there receive minimal number of visits at home from the midwife as effective and reliable source of postnatal and baby care information and someone to whom women in transition could turn to for advice and support. The need to recognize and be aware of ample source of information given out by midwives particular the MHZ Pregnancy Book as there implies to comprehensive guide given to expectant parents (Department of Health, 2007) in support of various materials such as leaflets.
Setting proper ways for breastfeeding – transition oriented women gain advice and information about breastfeeding from midwives, either in antenatal/postnatal classes where videos might be used or through giving brochures or leaflets to read. Postnatal, women could understand why the changes had taken place but would have preferred to have been warned in advance and becoming parent form major transitional period in new parent's life. Highlighting inter-connectedness of diverse elements in women’s lives and that change in one area as the baby, affects the areas, demonstrating the need for parents to continue the feeling of awareness and preparation towards transition reality
Conclusion
Therefore, there highlighted women transition from such postnatal care as noted by evaluative points towards the practice of midwifery care and its process as there allows motherhood presence turning preparation for parenthood, as there implies to evaluation and provision for effective postnatal care among women and their babies as this put emphasis and relevance to midwifery care, health providers and researchers upon improvement of midwife led practice for postnatal care. Integrating functions of midwives as there influence on new parents in lieu to postnatal class/workshops to discuss experiences of becoming mothers and parents as well as encourage women to attend sessions about proper baby care such as on breastfeeding to achieve parenting awareness and actively promote effective ways to discuss potential changes in the postnatal care. Future research in the provision should examine effectiveness of methods by which information and support can be offered to women in transition whilst not imposing work on healthcare professionals.
Indeed, the encouraging of mothers as they are parents to attend postnatal classes to talk about concerns and experiences after child birth. Thus, research is needed to explore fathering roles in postnatal care. To allow effective midwifery training and update practices to the profession to incur positive maternal input in a well documented manner, know certain interventions as effectively as possible, improving experience of mother care in the postnatal period. Thus, the need to provide basis for understanding salient needs of postnatal parents from such wider and ample perspective.
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