Mothers’ health at risk in rush to get them out of hospital

THE pressure to rush women out of hospital after they give birth could be damaging their health and wellbeing, a damning report on maternity care in Scotland has found.

Health boards across the country are facing demands to make savings in almost every sector of the NHS, and experts say postnatal care in Scotland is struggling to cope with the cuts.

Postnatal care has been dubbed a “Cinderella service” by midwives, and new research has found that reducing bed time on maternity wards can have “serious implications” for the quality of care that women receive after they have a baby.

The report, by the University of Stirling and supported by the Royal College of Midwives, found that while funding for post-natal wards has decreased, community-based maternity care has also been reduced in some areas.

“Postnatal care in Scotland is struggling,” said Helen Cheyne, professor of mid­wifery research at the University of Stirling.

“There is a lot of pressure on the NHS to reduce costs, and at the same time to maintain – or even improve the quality of its services.

“If you discharge people early, then yes it does save money, but not really that much and it can also have serious implications for the quality of care post-natal women receive.”

The report found that reducing the average length of stay on a typical post-natal ward by six hours reduced costs by 8 per cent.

Prof Cheyne, who led the research, said reducing the length of hospital stay in Scotland was “largely about saving money”.

She added: “In the mid-1980s, women generally stayed in hospital for six to seven days following a normal delivery, and the best part of ten days if they had a C-section.

“If somebody has a normal birth and is well and healthy and already has children and wants to go home early then I would have no concerns. But childbirth is a challenging experience, and for first-time mums we need to make sure they have support at home.

“New mums may need help feeding their babies, and more and more often pregnant women present with complex pregnancies – nearly 30 per cent of all births are now by C-section and so we have women recovering from serious surgeries. We also have a big increase in obesity and diabetes.

“There is a general concern among midwives that discharging women early without quality community care will see a rise in women turning up to A&E, or to their GP with medical problems.

“Scotland has aspirations to be the best place in the world to raise children, but post-natal care in this country is struggling. That’s why it’s often referred to as a Cinderella service.”

Gillian Smith, director of the Royal College of Midwives in Scotland, said she had concerns about discharging women home early from hospital.

She said: “You can send as many women home as quickly as you like, but if we don’t have adequate care in the community then we have a problem. For high-risk women you might have a cheaper service that is not adequate.

Last night Public Health Minister Maureen Watt said: “The length of a mother’s stay in hospital following the birth of their baby is influenced by a number of factors, including the type of delivery, condition of mother and baby and the wishes of the family. Many maternity units across Scotland now have 6-12-hour discharges as a norm, but decisions around discharge must always be based on what is best for mother and baby.

“Our review of maternity and neonatal services is underway, and post-natal care will be part of this review which will ensure that every mother and baby continues to get the best possible care from Scotland’s heath service. The Royal College of Midwives is a key partner in the review and it is important that their views are considered as part of the review process.”