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Australia’s current postnatal care guidelines and need for a cohesive set of recommendations

14 May, 2024

The Living Evidence for Australian Pregnancy and Postnatal care (LEAPP) guidelines project is the first national initiative to provide Australia’s maternity providers and services with a living guideline to inform their delivery of postnatal care. 

While Australia has benefited from a national pregnancy care guideline, postnatal care has relied on various sub-national and international guidelines which has resulted in varied standards, quality and experiences of care around the country. 

Amanda Blair, PhD candidate at the University of Melbourne and Burnet Institute, says her team wanted to compare Australia’s guideline recommendations with the guidelines produced by the World Health Organization (WHO) and the United Kingdom’s National Institute for Health and Care Excellence (NICE). 

“The aim was to see if Australia’s guideline recommendations agreed or disagreed with these international guidelines, but also to identify any gaps in Australia’s guideline recommendations.

“Through an electronic database search and a manual search of relevant websites, we found 31 Australian guidelines published since 2010 that included recommendations about routine care for healthy women and newborns in the postnatal period.

“Reassuringly, in our comparison to 67 WHO/NICE guideline recommendations, most corresponding Australian recommendations agreed. We found only six WHO/NICE recommendations where one or more Australian guidelines disagreed, and three WHO/NICE recommendations that were not present in a single Australian guideline,” Blair said.

Recommendation disagreements and gaps 

This process also identified recommendations that commonly appeared in Australia’s guidelines that were not present in either the NICE or WHO guidelines, particularly two recommendations that were specific to Australia’s Indigenous populations: 

  1. To consider the cultural appropriateness of mental health screening tools and management interventions for Australia’s Indigenous populations
  2. To provide Indigenous Australian women the option to have an Aboriginal health worker present at postnatal appointments, particularly for appointments of a sensitive nature.

The LEAPP guideline has an opportunity to reconcile the inconsistencies and gaps in postnatal care guidance to standardise postnatal care services across Australia and improve health and wellbeing outcomes for women, newborns, and families across the country.