PregnancyNearly 40 per cent of women discharged from hospital after giving birth were sent home before they were ready, a new report by the Royal College of Midwives (RCM) has revealed.

Additionally, postnatal care does not reach the levels recommended by the National Institute of Health and Care Excellence (NICE) in many cases, meaning women and babies do not receive suitable care or support once they get home.

The report by the RCM calls for an increase in the number of midwives to ensure all women receive the number of postnatal visits they need. The report says this number should be decided by discussions between the woman and the midwife. It also calls for stringent implementation of the NICE postnatal standards to ensure women get consistent and high-quality postnatal care and better continuity of care. 

Currently, two thirds of midwives (65 per cent) say the number of postnatal visits was determined by organisational pressures and not the women’s needs, contrary to best practice recommendations set out by NICE. Additionally, a third of midwives (35 per cent) felt they did not have enough time to discuss a postnatal care plan with the woman. 

More midwives needed

Cathy Warwick, chief executive of the RCM, 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.

“The impact good postnatal care has on women’s experiences and their long-term health should not be underestimated. 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 needed if care is to be of high quality throughout antenatal, labour and postnatal care. The bottom line is that care must be based on clinical need.”

Current NICE guidelines on the length of hospital stay states 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. 

The report is the fourth in a series of five to be published during this year looking at different aspects of postnatal care. It forms part of the RCM’s ‘Pressure Points’ postnatal care campaign focusing on the importance of high quality care after pregnancy. 

To view a copy of the report visit www.rcm.org.uk/pressurepoints.