Maternity standards
Postnatal care refers to care provided to the woman/birthing person and newborn in the period immediately after the birth (hours to a day) and extending up to six weeks (42 days). Effective postnatal care planning should promote consistency in care and continuity of carer and support the safe and person-centred transition of midwifery care to the health visitor. Where appropriate, the woman should offered additional support from the family nurse partnership.21
In line with the national maternity pathway and guidance, the first hour after birth (known as the ‘golden hour’), should prioritise bonding and attachment, minimising the separation of the woman and her baby. Staff should support wider family-centred care and involvement. Tailored information and support should be offered to women enable early attachment and bonding and to provide practical help with the care of their baby. This includes offering assistance with initial and subsequent infant feeds and access to dedicated breastfeeding support, where requested.
Physical examinations and wellbeing assessments of the women or the baby in the first one to two hours after birth should minimise disruptions and avoid unnecessary separation. Ongoing risk assessments should be carried out using validated tools such as MEWS, with escalation in line with local pathways where concerns arise.
NHS boards should ensure that women and their babies who require inpatient, high-dependency or intensive care in non-maternity settings also receive appropriate postnatal midwifery and obstetric assessment and care. Standard 9 outlines the requirements for women and their babies who need unscheduled, emergency or critical care.
Local pathways should be in place to support safe transfer of care and discharge into community midwifery. Where the coordination of care should be undertaken by a specialist (including an obstetrician, neonatologist or paediatrician), this should be documented and shared with maternity and community teams.
A midwife is responsible for assessing individual needs and coordinating the postnatal care of both the woman and her baby, regardless of where the woman gave birth. Postnatal home visits should be tailored to the individual needs of the woman and her baby and follow the national maternity pathway. Newborn physical examination, screening and vaccinations should be carried out in line with national guidance. Additional support may be required after multiple or specific births, such as Caesarean births, and care plans should be updated at each visit to reflect changing needs.
Midwives should share relevant information with the woman's GP to support continuity of care and appropriate follow up for both the woman and her baby. When midwifery care is extended due to complexity or additional needs, this is clearly recorded and shared with the multidisciplinary team.
Midwives should offer guidance and support to help strengthen the parent–infant relationship, support infant development and build parental confidence, which will contribute to improved long-term outcomes. Provision of ongoing skilled feeding support, including breastfeeding support, should also be offered to help address early challenges and improve feeding success.
Discussion of sexual health, pelvic floor recovery and contraception are essential aspects of holistic postnatal care. Providing timely and tailored information enables women to make informed decisions, supports physical recovery and helps prevent unplanned pregnancy. Midwives should offer women tailored information and support about safe sleeping practices to help reduce the risk of sudden unexpected death in infancy.
Routine trauma-informed enquiry about gender-based violence should be an integral component of postnatal care. Ongoing assessment of social complexities and safety is required throughout the postnatal period to ensure that women receive appropriate support, safeguarding and referral where needed, in line with the national maternity pathway's requirement for continuous, trauma-informed assessments.
Clear information about local services and support networks ensures women and families know how to access additional help and helps reduce isolation.
Women (and, where appropriate, their care partners) should have meaningful opportunities to discuss their labour and birth experiences with appropriate healthcare professionals and services. These discussions should allow time for questions and take place both in the immediate postnatal period and in the months after birth.