Postnatal and neonatal care after home birth: A community-based study in Nepal

Background: In Nepal, the majority of women who give birth at home do not visit a health facility for postnatal and neonatal care. Objectives: This study investigated postnatal and neonatal care practices of women who give birth at home in a central hills district of Nepal. Design: This study is a part of community-based prospective study in the Kaski district of Nepal. Postnatal and neonatal care practices were collected via structured questionnaires. Setting: Kaski district of Nepal. Participants: 92 postpartum women who gave birth at home. Outcome measures: Postnatal care at a health facility and neonatal care practices. Findings: Approximately 90% (83/92) of women who gave birth at home were assisted by non-skilled birth attendants, and 67% (62/92) received no postnatal care at a health facility within a week post delivery. The main reason for not having postnatal care at a health facility was 'no perceived need' (52/62, 83.9%). With regard to neonatal care practices, 67% (62/92) used a delivery kit, 79% (73/92) washed their hands before handling their babies, 70% (64/92) bathed their babies on the second day of birth, while all dried and wrapped their babies with a cloth within half an hour of the birth. However, only 46% (42/92) reported skin-to-skin contact within one hour after birth. Conclusions: The results suggest that there is great scope to strengthen community-based postnatal and neonatal care to screen for and identify postnatal and neonatal problems, especially at home birth. (C) 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.