New mothers 'let down' by postnatal care, says NCT report

Many new mothers are being let down by the care they receive after having a baby, a survey suggests.

In a survey of 1,260 first-time mothers by the National Childbirth Trust (NCT), less than half said they got the advice and support needed after giving birth.

The parenting charity said the survey showed a "shocking" level of postnatal care and warned the NHS had to improve.

The Royal College of Midwives said more money should be invested in maternity services.

The survey was carried out online between October 2009 and January 2010 on a self-selecting group of women who had given birth in the previous 12 months.

The majority of those who completed the survey had given birth in hospital and 95% were NCT members.

The survey found that 42% of mothers thought there were "sometimes" or "never" enough midwives to help them in hospital.

And while 56% said they got all the physical care they required, only 45% said they got all the information and advice they needed.

Guidance from NICE (the National Institute for health and Clinical Excellence) says all women should have a personalised postnatal care plan, yet 96% said they did not have one.

Clare Perris, who lives in Dorset, had a traumatic time giving birth to her daughter Emily, now nearly two-years-old.

A long, painful labour was followed by an emergency caesarean.

Thirty-six hours later, having not seen a doctor since the operation, she was moved to a postnatal ward.

"But I didn't see any midwives again. I was in a very vulnerable position, I was shell-shocked and trying to recover from abdominal surgery and I had difficulty breast-feeding - but nobody was checking on me or offering support."

Less than 72 hours after the birth, she was at home dealing with a screaming, colicky baby.

"I saw lots of different midwives at home but never saw the same one twice.

"They all had different viewpoints so although the physical care I received at home was good, there was no emotional or psychological support.

"I could feel myself tipping back into postnatal depression."

In the end it was a year before Clare started to feel better.

"There needs to be a special type of care which caters for women who've gone through a traumatic birth or pregnancy," she says.

"I feel that my midwives were trained to recognise postnatal depression but not to help me through it."

Of the women surveyed, 52% had given birth with forceps, ventouse or by caesarean section, which is slightly higher than the latest figures for women who had operative births in England in 2007-2008 (48%).

These women generally have the greatest needs when it comes to postnatal care, but the survey found that they experienced the biggest gaps in care.

Of mothers who had a caesarean, 43% said their emotional needs were not met within 24 hours to a month after the birth.

And 30% who had a caesarean found that midwives were only kind and understanding some of the time, or never.

Postnatal care in a birth centre or after birth at home was rated more positively.

Support for baby feeding is a recurring topic for many new mothers, but less than half said they got all the help and support they need in the early days.

Anne Fox, head of campaigns and public policy at the National Childbirth Trust, said postnatal care urgently needed 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."

She added: "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."

Louise Silverton, deputy general secretary of the Royal College of Midwives, said: "This report paints a disappointing picture of postnatal care.

"The extra money and additional midwives from the previous government, whilst very welcome, still leaves us playing catch-up with the birth-rate, and we are still a long way short of bridging the gap."

A spokesperson for the Department of Health said it was working to improve the quality of maternity care and extend the choices available to every pregnant woman, and to recruiting an extra 4,200 health visitors to help support to women after birth.