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https://www.infirmiere-canadienne.com/blogs/ic-contenu/2025/12/15/suivi-postnatal-sante-publique-dans-provinces

Learn how the transition from hospital to home connects families to resources across the country

By Rebecca Haber, Meghan Martin, & Michelle Urbina-Beggs
December 15, 2025

Background

Across Canada and internationally, lengths of hospital stay after birth have decreased significantly in recent decades (Lemyre et al., 2018). With earlier discharge from hospital, public health authorities began contacting new birth parents after discharge to check on parent and newborn safety and their transition to the home. The World Health Organization (2022) recommends a minimum of four postnatal care contacts by six weeks postpartum; however, there is no national direction in Canada on how this contact should be carried out.

In this environmental scan we review public health postpartum support practices in Canadian provinces to understand how universal postnatal contact is carried out across the country.

Methods

We interviewed 29 public health representatives from nine provinces and reviewed websites and documents on postpartum follow-up from 10 provinces. Documents reviewed included protocols, guidelines, and evaluation reports.

The information gathered was analyzed and summarized to describe public health postpartum follow-up across Canadian provinces, including common practices and concerns, as well as how postpartum follow-up is situated within the continuum of perinatal care. (Download the Appendix for more details.)

We focus on public health services offered in the first few days postpartum to all families (i.e., universal services). We include some information on targeted services (i.e., those offered only to some families based on criteria) and services offered later in the postpartum period, primarily as they relate to the initial postpartum follow-up provided by public health.

Findings

Models of universal postpartum follow-up

Every province in Canada offers postpartum follow-up to all families. How contact is carried out and by whom varies across the country. (See Table 1.)

Table 1. Models of universal postpartum follow-up in Canadian provinces

*Universal is defined as a service offered to all families.

All jurisdictions aim to contact new birth parents within 24 to 72 hours postpartum. Among provinces where a home visit follows a phone call, Quebec and Prince Edward Island complete the home visit within 72 hours and Manitoba completes within one week. Saskatchewan aims to complete the home visit within 24 to 48 hours for clients at higher health risk. While the models of follow-up listed above are standard for the province, there can be variations in practice owing to human resource constraints or challenges in reaching clients.

In nearly all cases, the follow-up is conducted by a public health nurse. In some jurisdictions, those in care of a midwife are not contacted by public health in the first few days postpartum, as midwives provide early postpartum care. Additionally, some Public Health Units in Ontario have trained hospital nurses to carry out the postpartum assessment in-hospital.

Purpose and content of postpartum follow-up

Provinces across Canada use postpartum follow-up contact to ease the transition from hospital to community and support the safety and stability of the birth parent and newborn. During the follow-up, nurses may conduct a brief screening or a more comprehensive assessment. (See Table 2.) The results of the screening or assessment will help determine whether the client is offered additional services.

Table 2. Service offered during postpartum follow-up in Canadian provinces

Nurses work to build the capacity of birth parents by offering education and guidance on self- and newborn care, including when to seek further health care, and by providing referral and navigation to information resources, primary care, and community services. Postpartum follow-up is an opportunity for nurses to identify potential risks or vulnerabilities for the birth parent and newborn and offer further public health support as needed.

Postpartum screening and assessment are guided by provincial or regional tools that outline questions or topics to go through with birth parents. Commonly covered topics include the following:

• Pregnancy and childbirth (e.g., birth weight, prenatal care, labour and delivery complications)
• Maternal/parental health (e.g., mental health, substance use, access to primary care)
• Psychosocial and social situation (e.g., education, social support, age of the parent)
• Relationships (e.g., parent-newborn attachment, relationship distress/violence)
• Birth parent and newborn health (e.g., postpartum recovery, infant crying/behaviour, infant feeding, developmental risk)
• Adjustment to parenting
• The home environment

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Ongoing postpartum care

There are only a few jurisdictions in which public health nurses offer universal care beyond the initial postpartum follow-up. This may involve a phone call anywhere from 3-8 weeks postpartum and/or a healthy toddler assessment at 18 months of age.

In most jurisdictions, public health support and referral beyond the initial universal postpartum contact is targeted, based on concerns identified by the nurse or family through postpartum screening and assessment. In many provinces, this support is individualized to each family. In addition, several provinces have formal home visiting programs offered until 2 or 3 years of age or school entry, delivered by public health, other government departments, or the community sector.

All jurisdictions noted that families can self-refer to public health. Some jurisdictions offer postpartum services such as infant feeding support, parenting curriculum/workshops, and developmental screening. Many babies are seen by public health for their two-month immunizations, and families may receive additional support or referrals at that time.

Common issues and concerns in postpartum follow-up

While all provinces had established methods for delivering postpartum follow-up, most described challenges in managing staff workload to complete tasks within target time frames. It was sometimes necessary to make adaptations when service volumes exceeded staff capacity.

Interview participants noted the importance of ensuring support was available for priority populations (e.g., birth parents with potential risk based on psychosocial factors and social determinants of health, those without primary care providers, those with very early discharge from hospital, and first-time parents). These factors may influence the urgency of follow-up, the method of follow-up, and additional support beyond initial screening or assessment.

Interview participants also spoke of the need to balance the use of standard screening and assessment tools with ensuring a client-centred, trauma-informed and inclusive approach to service delivery. Standard tools help to ensure that valid and reliable assessments are provided, and they support population health surveillance. At the same time, nurses must use their professional judgment to determine when standard tools are helpful and when they may unintentionally harm the client.

Evaluations of postpartum follow-up programs

Most jurisdictions have not completed formal evaluations of their postpartum follow-up programs; however, Quebec and Ontario have done some work in this area.

In 2016, Quebec’s public health institute (Institut national de santé publique du Québec), conducted a review and developed recommendations on postpartum follow-up (Gamache & Poissant, 2016). They found that rapid follow-up after hospital birth and universal postpartum assessment are widely recognized practices. Supportive elements for postpartum follow-up include collaboration between hospitals and community health services and evidence-based guidelines for implementation tailored to local or organizational context.

A 2023 report exploring Ontario health units’ experience delivering the Healthy Babies Healthy Children program found strong consensus that universal postpartum screening should be maintained, including the use of hospital screening liaison nurses and postpartum screening tool (Jack et al., 2023).

Conclusion

Postpartum follow-up is a unique instance where public health agencies reach nearly every new parent and baby. While formal evaluations of postpartum follow-up in Canada are limited, our findings suggest there is benefit to this universal service. Postpartum follow-up supports the transition from the hospital to the home, connects families to resources, and generates population health data. It is also important to ensuring safety and stability of the birth parent and newborn in a context of limited access to primary care providers and earlier discharge from hospital. Postpartum follow-up should be guided by standard tools while allowing for person-centred care.

Human resource constraints challenge public health agencies to both deliver universal service and offer individualized support to families who would benefit most. Agencies may need to explore alternative models, such as telephone or virtual care for low-risk families. This could allow agencies to maintain universal service, while creating capacity for enhanced service for priority populations. Collaboration between acute care and public health can also support more efficient postpartum care by ensuring families receive appropriate resources at hospital discharge, improving communication between care providers, and identifying families who need more support or intervention.

In future, public health would benefit from further research and evaluations to determine which models of follow-up are most effective for different populations.

References

Gamache, L. & Poissant, J. (2016, November 2). Avis sur le suivi postnatal systématique suite au congé hospitalier. Institut national de santé publique du Québec. https://www.inspq.qc.ca/en/node/6743.

Jack, S.M., Strohm, S., & Rieder, A. for the PHN-PREP Project Team (2023). Healthy Babies Healthy Children Program Practices, Processes, and Policies: Reflections from Ontario’s Health Units. School of Nursing, McMaster University. https://phnprep.ca/wp-content/uploads/2023/08/HBHC-Practices-Report_May2023.pdf.

Lemyre, B., Jefferies, A.L., & O’Flaherty, P. (2018). Facilitating discharge from hospital of the healthy term infant. Paediatrics & Child Health, 23(8), 515–22. https://doi.org/10.1093/pch/pxy127.

World Health Organization. (2022, March 30). WHO recommendations on maternal and newborn care for a positive postnatal experience. https://www.who.int/publications/i/item/9789240045989.

Appendix

Overview of postpartum follow-up by province

Rebecca Haber, M.Sc., is the population and public health regional immunization leader with the Fraser Health Authority.

Meghan Martin, MPH, is the population and public health regional maternal-child health leader with the Fraser Health Authority.

Michelle Urbina-Beggs, RN, MN, CCHN(C), is the population and public health clinical nurse specialist with the Fraser Health Authority.

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