Preface

This book presents a global perspective on contemporary challenges in postnatal care.

Chapter 1, "Perspective Chapter: Psychosocial Screening and Assessment in the Private Sector in Australia during the Postnatal Period", is a perspective chapter discussing psychosocial screening and assessment in the postnatal period in the private sector in Australia. Postnatal mental health issues have long-term effects on families. Rates of maternal death by suicide are highest in the first year after giving birth. Thus, it is essential to screen and assess women for mental health issues. Women with mental health issues need to be identified early and referred to services to enhance their chance of an optimal outcome for their family. A sustainable model is essential to ensure that an appropriate healthcare professional identifies risks/concerns and engages with women who decline assistance. Timely postnatal psychosocial screening and assessment for private sector women is crucial, but barriers exist. This chapter discusses possible solutions to these challenges.

Chapter 2, "Barriers and Challenges in the Acceptance and Continuation of Postpartum Intrauterine Contraceptive Device", focuses on barriers and challenges in the acceptance of intrauterine contraceptive devices (IUCDs). These devices range from temporary birth-spacing methods to permanent birth-limiting methods. Despite the advantages of these devices, the acceptance and long-term uptake of IUCDs are lacking, and thus, have little impact on fertility rates in countries that would benefit from such. This is due to provider and logistical barriers in addition to family views. Although the uptake of IUCDs is insufficient for lowering total fertility rates, it is a relevant option for women. However, information, education, and communication (IEC) strategies, counseling, insertion training, and addressing prejudices about devices are needed.

Chapter 3, "Perspective Chapter: Contemporary Challenges in Postnatal Care in Low- and Middle-Income Countries", discusses neonatal and maternal burdens in low- and middle-income countries. There is a need to enhance maternal well-being and support newborn care, as maternal and neonatal mortality remains high. This objective aligns with the World Health Organization's Sustainable Development Goals, which are hoped to be achieved by the end of 2030. The chapter discusses strategies to reach a positive postnatal outcome, barriers to achieving this outcome, and unmet needs for family planning related to poor postpartum education. Strengthening health systems is essential to improve optimal care for families. These include infrastructure, equipment, water, sanitation, energy, and staff. Postnatal care affects the facility, household, and community levels.

Chapter 4, "Breastfeeding by Mothers with Cesarean Section Delivery", discusses Cesarean section deliveries and their association with lower breastfeeding rates. This is partly due to the separation of mother and baby, delay in early initiation of breastfeeding, and lack of milk supply. Therefore, a Cesarean delivery is an obstacle to early breastfeeding initiation. Healthcare providers must provide education to mothers to encourage them to breastfeed or to have a normal delivery to enhance their chances of breastfeeding.

Chapter 5, "Addressing Postnatal Challenges: Effective Strategies for Postnatal Care", highlights how mothers undergo numerous physical, economic, psychological, and sociological changes after giving birth. Challenges of motherhood include the decision to breastfeed, perinatal medical conditions and complications, and more. This chapter presents strategies for addressing postnatal challenges as well as strategies to improve patient information management, organizational standards, and protocols and policies. The chapter also examines the role of the midwife in postpartum care. Health organizations and regulatory bodies need to provide leadership to achieve a safe healthcare system and ensure an adequate work environment to provide competent quality care that promotes maternal well-being.

Chapter 6, "Perspective Chapter: Challenges to Postnatal Care in Sub-Saharan Africa – A Review", examines the postnatal period and the associated risk of neonatal and maternal mortality. Essential care for the family is needed to improve family mortality and morbidity. However, access to essential perinatal care is challenging, especially in resource-limited settings. This chapter highlights challenges to postnatal care in sub-Saharan Africa, where uptake of postnatal care is lacking, resulting in high postnatal neonatal and maternal morbidity mortality rates. Challenges include limited healthcare infrastructure, poor access to basic health services, poverty, cultural practices, illiteracy, marginalization of women, and political issues. Innovative approaches are needed to increase postnatal care provision to improve access and usage of postnatal care in the area, improve maternal and child health outcomes, and ultimately achieve the Sustainable Development Goals by 2023. Women in sub-Sahara Africa must be empowered economically and socially and provided with education, improved healthcare infrastructure, trained healthcare professionals, and high-quality postnatal care.

I would like to thank the authors for their contributions.

**Dr. Tanya Connell** The University of Sydney, Sydney, Australia

**1**

Section 1

Barriers

Section 1
