Exploring Australian knowledge and practice for maternal postnatal transition of care between hospital and primary care: A scoping review.

Problem: Despite the significance of the perinatal period, postnatal care remains insufficient for optimising long-term health.

Background: The perinatal period is a vulnerable time in a woman's life-course health trajectory. Supporting transitions from hospital to primary care is essential to promote health and guide evidence-based follow-up care.

Aim: The aims are to (i) explore existing knowledge and practice in Australia regarding maternal postnatal transitions of care between hospital and primary care and (ii) understand the enablers and barriers to implementing optimal postnatal discharge and handover of care from the maternity to primary health setting.

Methods: A scoping review was conducted according to PRISMA-ScR guidelines. Medline, Embase, CINAHL, Scopus and The Cochrane Library were searched using MeSH terms, subject headings and keywords. Full-text articles in English were included from 1st January 2010-8 th June 2024.

Results: Eighteen studies were included, 14 focused on care in specific states and four Australia-wide. Maternal postnatal transition of care between hospital and primary care varied. Critical components of care that were valued by women and healthcare providers and promoted effective care transitions were grouped into four concepts: "Woman-centred discharge planning and process", "Integrated care", "Follow-up care" and "Continuity of care". Discharge communication across Australian health services is diverse. Women and healthcare providers require clear discharge communication that highlights complications, guides follow-up and promotes continuity.

Conclusion: Australian postnatal transition between hospital and primary care is inconsistent and ineffective. Lack of robust handover between services hinders evidence-based follow-up care after postnatal discharge from hospital, particularly following pregnancy complications.