OBJECTIVE: To investigate the views and experiences of postnatal hospital care of a representative sample of Victorian women who gave birth in Victoria, Australia, in 1999. DESIGN: Postal survey sent to women 5-6 months after giving birth. SETTING: Victoria, Australia. PARTICIPANTS: 1616 women who gave birth in Victoria in a 2-week period in September 1999. FINDINGS: 50.8% of women described their postnatal care in hospital as 'very good'. After adjusting for parity, method of birth, length of stay, model of care and socio-demographic characteristics, specific aspects of care with the greatest negative impact on the overall rating of postnatal care were as follows: midwives perceived as rushed and too busy (adjusted OR = 4.59 [95% CI 3.4-6.1]), doctors and midwives perceived as not 'always' sensitive and understanding (adjusted OR = 3.88 [2.8-5.5]), support and advice about going home not 'very helpful' (adjusted OR = 3.18 [2.3-4.5]), help and advice about baby feeding not 'extremely helpful' (adjusted OR = 3.27 [2.1-5.1]), not being given advice about baby feeding (adjusted OR = 2.84 [1.2-6.9]). Staying in hospital only 1-2 days (adjusted OR=2.00 [1.2-3.4]), and not knowing any of the midwives in the postnatal ward (adjusted OR = 1.80 [1.3-2.4]) were also associated with less positive ratings of postnatal hospital care. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The 2000 Survey shows that women rate early postnatal care in hospital far less favourably than care in pregnancy, labour and birth. The findings indicate that interactions with caregivers are a major influence on women's overall rating of postnatal hospital care. Acting on these findings requires a greater focus on communication and listening skills, attention to staffing levels, and leadership promoting more women-centred care in postnatal wards.