Academic advises NICE on new postnatal care standard

Friday 19 July 2013
Dr Julie Wray

A leading midwifery academic from the University of Salford is helping to shape the quality of care given to new mothers and their babies through her contribution to the National Institution for Health and Care Excellence’s (NICE) ‘Postnatal Care’ quality standard.

Dr Julie Wray was chosen for the NICE panel which produced the new standard because of her specialist research into the needs of women and babies following childbirth, and whether the postnatal care system currently meets them.

While many first-time mothers report benefitting from good-quality postnatal care, research from the National Childbirth Trust shows that this can vary widely. Around one in eight report being highly critical of the care they received, and cite insensitivity, inconsistent care and lack of emotional support due to too few home visits as reasons.

To standardise and improve the quality of care provided, the Postnatal Care quality standard has been produced to support the measurable improvement of services.

In order to reduce sudden infant death syndrome, also known as ‘cot death’, there are guidelines to measure whether safer infant sleeping is discussed at each postnatal contact. More than 300 babies die of this syndrome each year, with certain behaviours increasing the risk.

Most women who experience emotional changes in the immediate postnatal period feel better up to two weeks after the birth, but if they still feel depressed or anxious after this period there can be an increased risk of mental health problems. The standard recommends that women with ‘baby blues’ should be assessed for mental health issues if the feelings have not been resolved 10-14 days after giving birth.

The emotional wellbeing of women should be measured by factors such as emotional attachment to the baby, which can be assessed at each postnatal contact. This will help with the baby's social and emotional development through the woman's ability to provide a nurturing relationship.

There are also recommendations for measuring whether information about bottle feeding is discussed with the mothers of formula-fed babies to prevent any of the potentially serious infections that can develop if milk is not prepared safely.

Dr Wray of the School of Nursing, Midwifery & Social Work, said: “For too long postnatal care has been the ‘Cinderella’ of maternity care. These standards are timely and evidence-based with huge scope to improve postnatal care and the support that new mothers deserve after birth. I am proud to have been involved in the work having undertaken research in this area for the past 15 years.”

Professor Gillian Leng, Deputy Chief Executive and Director of Health and Social Care at NICE, said: "The period immediately following the birth of a new baby is an exciting, life-changing time, both for the mother, her partner and their family.

"However, such great changes can sometimes feel overwhelming for the mother, so it is important that there are standards in place that outline clear, sensible ways to support and care for women during this hugely significant time in their lives.”