New report calls for improved postnatal care in UK

Released on: 28 April 2011

A shocking new report out today by NCT, the UK’s largest parenting charity, shows new mums are left unprepared and unsupported by the NHS after they’ve had a baby and calls on the NHS to improve postnatal care in the UK.

Many women feel their needs aren’t being met, leaving them feeling confused, abandoned and let down. NCT is now calling for immediate improvement to services before it’s too late.

The report ‘Postnatal Care – a Cinderella story?’ examines women’s experiences of NHS maternity services and is based on a survey of 1260 first time mums¹. The findings show many mums are being let down just when they need services most. Many of those surveyed said they felt helpless, isolated and abandoned by the care they received in hospital and made frequent references to seeing different midwives at each contact, receiving conflicting advice particularly in relation to feeding, staff shortages, insensitivity and even rudeness from healthcare staff.

Of mums surveyed, 42% thought there were only ‘sometimes’ or ‘never’ enough midwives to help them in hospital, as opposed to ‘always’ or ‘mostly’ enough. Furthermore, 57% didn’t get all the emotional support they needed in hospital within the first 24 hours.

In addition, mums who’d had operative births (forceps, ventouse or caesarean) had the greatest gaps in care which is concerning since their needs are the greatest² - 43% of mums who’d had a caesarean said their emotional needs weren’t met within 24 hours to a month after the birth, and 30%, who'd had a caesarean found midwives only kind and understanding some of time or never. Postnatal care in a birth centre or after a birth at home, however, was more positively perceived.

The survey shows that the emotional support, physical care and information given to first-time mums are also sadly lacking – less than half (41%) had all the emotional support they needed in the first 24 hours, 56% said they got all the physical care they needed and only 45% received all the information and advice they needed. Plus, despite guidance from NICE to say all women should have a personalised postnatal care plan, 96% were not involved in a plan.

New mum Anita Thatcher says: “The night I spent in hospital after my daughter was born was awful. My bed had no way of calling the nurse station as the button was broken. Back at home I struggled. I had a haemorrhage 13 days after the birth and ended up back in hospital. I had to wait until 5pm the next day just for some paperwork to be signed off so I could be discharged.”

Clare Wilson from the North East says: “After the birth of my son, born by emergency caesarean, I couldn’t lift him out of the cot and there was no-one around to help. I had to ask another mother on the ward to lift him up to me. A day after, midwives encouraged me to shower but no one came with me. I could barely walk, nearly fell over and was bleeding all over the floor and trying to clean it up. It was really scary and upsetting. I remember feeling very thirsty and had to keep calling for water, but it took a while before anyone came. I missed a meal too, because you had to go out of the ward to fetch it and I couldn’t walk that far.”

Anne Fox, Head of Campaigns and Public Policy, NCT said; “It’s clear postnatal care urgently needs improvement - our report paints a dreadful, shocking picture of care in the UK – we’re letting women and their babies down. Evidence shows that supporting women and babies at this vital time can have a major impact on future health and learning. Our report recommends NHS trusts and boards need to listen to what local women tell them about the services provided and set objectives for improving postnatal care, agree practical strategies and monitor their progress.”

The report also found when it came to baby feeding, support was inadequate, particularly for mums in hospital. Of those surveyed 52% felt they didn’t get consistent advice about feeding, and less than half of first time mums (45%) said they got all the help and support they needed in the first 24 hours, with similar rates for a week and up to a month after the birth. However, positively, 79% of mums were encouraged to have skin to skin contact in the first hour after birth, which can help with feeding and bonding.

After the birth, most women had a visit from a midwife, health visitor or maternity support worker, with most women receiving a visit three or four times. The majority of women (71%) wanted to see the same midwife throughout their care, but 51% ended up seeing three or more different midwives after discharge from a maternity unit or birth at home.

Anne Fox continues, “Many of the problems these women highlight seem to be due to staff shortages or lack of visits once they had left hospital – and this issue needs to be addressed if the quality of postnatal care is to be improved, particularly for vulnerable women. Being a new mum should be a positive experience and support for mums in those early days and months is vital. Action is needed to improve postnatal care in UK and we’re calling on every health service to work to improve the support provided and end the situation whereby postnatal care is the Cinderella service.”

All recent major maternity policy developments, and the NICE recommendations for postnatal care, have put women’s experiences after the birth under greater scrutiny. However, this report highlights existing postnatal care services are falling short of meeting women’s needs and expectations at a time of tremendous change for them.

In order to ensure that women receive high quality, safe, effective postnatal care that meets their individual needs and their babies, NCT has set out ten steps for all four country governments and local NHS services to put into practice including implementing the NICE postnatal care guidelines and ensuring every woman has a co-ordinating health professional responsible for ensuring she has the right care, at the right time, and a personalised postnatal care plan. 
The report was designed to replicate aspects of the NCT postnatal care survey carried out in 1999-2000 in order to capture the current state of postnatal care today and to help shape further policy development. It shows there seems to have been very limited improvements in postnatal care and possibly an overall decline in the extent to which woman-centred quality standards are being met.

Over the last 50 years, NCT has been working to improve parents’ experiences. With 105,000 members and over 10,000 volunteers, NCT supports up to a million parents each year through its information and supporter services. The charity also campaigns to improve services and facilities to help build skilled and confident parents for the future.

To download a copy of the report ‘Postnatal Care – a Cinderella story?’ visit – www.nct.org.uk/cinderella