Worrying lack of support in postnatal care – RCM

Almost 50% of new mothers were not told within 24 hours of giving birth about the crucial signs and symptoms of potentially life-threatening conditions for them and their newborn, a survey has revealed.

The Royal College of Midwives’ (RCM) second report, as part of its Pressure Points campaign, which examines whether maternity teams have the time to provide adequate postnatal care and vital advice, revealed that only a quarter (24%) of mothers recalled receiving information about what signs and symptoms to look for.

Over a third (36%) of midwives and maternity support workers said that they would like to be able to do more for mothers and babies.

Midwives were asked about the factors determining the decision about the number of postnatal visits women had. And, surprisingly, only 24% of midwives said that this was determined by the women’s needs, while an overwhelming two-thirds said this was determined by a hospital’s “organisational” pressures.

Chief executive of the RCM Cathy Warwick said: “It is clear that our members are taking the strain of an underfunded and under resourced postnatal service. A service that without sufficient means can lead to harmful consequences on the health of mothers and children that the maternity team struggle to care for.”

In light of the findings, the report has made five recommendations:

• Providers of NHS maternity care need to recruit enough midwives andMaternity Support Workers and organise their service so that they can provide a better standard of postnatal care in hospital and community settings.
• Organisations providing maternity care must ensure that midwives have ‘protected time’ to keep abreast of new national standards and guidelines and they that they also have the opportunity to input into how national standards are implemented at a local level.
• Midwife shortages need to be addressed. If there were more midwives they would be able to spend more time with student midwives on clinical placements and improve their learning experience.
• Those providing maternity care need to employ enough midwives to ensure that maternity staff have the time to give women vital information about their safety and their baby’s safety.
• Midwives should be entrusted to make clinical decisions about the most appropriate level of postnatal visiting, depending on the needs of each mother and baby rather than organisational or financial constraints.

Sally Russell, co-founder of Britain's biggest parenting site Netmums, said: “Forewarned is forearmed, so it is deeply worrying that almost half of new mums aren't being informed what to watch for. Many conditions are easier to treat if women realise sooner they are at risk of becoming unwell, so it is vital this information gets to them early.”

In response to the research, Marylyn Haines Evans, public affairs chair of the National Federation of Womens Institutes (NFWI), added that the report paints another disappointing and worrying picture of the state of postnatal care. 

“This area remains a cause of concern and these findings clearly demonstrate that there is still significant room for improvement,” she said.

Last year the NFWI’s own research, Support Overdue, undertaken with NCT, revealed the maternity experiences of 5,500 women and identified that as many as 60% of women want more postnatal support. 

Haines Evans said: “Women spoke of feeling ‘like a burden’ and described visits and appointments with rushed midwives who had ‘their resources clearly stretched.’ 

“We also identified a worrying postcode lottery for postnatal care; while the NICE guideline appears to provide a robust framework for delivering postnatal services, guidance is not applied systematically across areas resulting in unacceptably wide variations in the quality and standard of care across different parts of the country.”

Tell us what you think – have your say below, or email us directly at [email protected]