Surveillance, support and risk in the postnatal period

Abstract

There have been significant changes in the way that maternity services have been organised in recent years. One of the most dramatic has been the significant reduction of time women spend in hospital following childbirth. Yet despite this there has been little debate about whether additional home and community-based support services might be needed for mothers and their newborn infants. At the same time, though, there has been a seemingly parallel occurrence – growing emphasis on the importance of ‘early intervention’ (including the antenatal as well as the postnatal period) to maximise the health and wellbeing of infants and their mothers. This involves the identification of ‘at risk’ families and children, and service provision or surveillance that is home or community-based.

Two recently implemented strategies in South Australia target maternal and child health in the postnatal period. One is a local program which provides home-based support (the ‘Mothercarer’ program). The other is a South Australian government sponsored Universal Home Visiting Program called Every Chance for Every Child. While there are variations in the emphases of the programs, it is suggested that an important trend in policy regarding the postnatal period involves an elision between two kinds of objectives: maternal support in the home, and ‘early intervention’ to minimise the risk of health and social problems. Furthermore, it could be argued that risk assessment through surveillance is being seen as at least as important, if not even more important, than the provision of support. Finally, the trend to early discharge, going hand in hand with the emphasis on surveillance of these programs, suggests a loosening of the medicalised appropriation of the postnatal period in favour of a wider social panopticon.

Key Words:

• Sociology
• postnatal support
• social policy
• perinatal surveillance