The report also says that women are not getting the level of postnatal care recommended by NICE and that continuity of care is suffering, leading to poorer care for women and their babies.
The report makes a number of recommendations to help improve postnatal care. These include having enough midwives to ensure all women receive the number of postnatal visits they need. It also recommends that the appropriate number of visits should be decided by the midwife in discussion with the woman.
The report also argues for the implementation of the NICE postnatal standards to ensure women get consistent and high-quality postnatal care and better continuity of care.
Research* by the RCM found that over two-thirds (65%) of midwives said the number of postnatal visits was determined by organisational pressures and not the women’s needs. This is completely contrary to the recommendations of NICE.
Cathy Warwick, chief executive of the RCM (pictured above), said: “The continuing shortage of midwives particularly in postnatal care and the need to ensure cover for women in labour means that organisational needs are preventing midwives giving care based on clinical need and women are not getting the best possible postnatal care.
“This can have a massive impact on the health and wellbeing of the mother and her baby after the birth and well into the future.”
Midwives also say that there is often not enough time to give women all the information they would like to about postnatal care. Worryingly in the survey only a third (35%) of midwives and maternity support workers said they had enough time to review the postnatal care plan with women.
The RCM argues that the care being offered cannot possibly be expected to meet women’s needs when there is not even enough time to discuss what these needs might be.
The report also highlights the views and experiences of women from a survey conducted by the RCM and Netmums**. The large number of women who said they were discharged before they were ready is a real concern.
NICE recommends that the “length of stay in a maternity unit should be discussed between the individual woman and her healthcare professional, taking into account the health and well-being of the woman and her baby and the level of support available following discharge. This is clearly not happening.
A comment from a woman who responded to the survey highlights the problems: “I saw so many different midwives, both before and after the birth of my baby they had not a hope of offering the kind of care that I wanted. I never had a chance to get to know and trust any of them, and they never had a chance to get to know me”.
Warwick added: “Postnatal care should always be based on women’s needs and not on funding or organisational issues. This reinforces the need for more midwives. Numbers have been increasing but not fast enough and England remains seriously short of the numbers.”
*The Surveys of midwives, student midwives and maternity support workers were conducted in September and November 2013. 2,123 midwives, 950 student midwives and 98 maternity support workers responded to the surveys.
** The survey was conducted on the Netmums website from 13th to 27th September 2013. 486 women from across the UK, but mainly England, responded to the survey.