Postnatal care vital to maintaining the health and well-being of women and new-born babies

The importance of comprehensive postnatal care and support, and the difficulties that can arise when aspects are lacking were highlighted in a decision by Deputy Commissioner Rose Wall, who found a midwife in breach of the Code of Health and Disability Services Consumers’ Rights (the Code).

In her decision, Ms Wall found the midwife failed to provide a woman and her new-born baby services with reasonable care and skill. She also emphasised the significance of comprehensive record-keeping, and the role of handover at the end of service provision, to maintain continuity of care.

A woman, living in a more rural locality, who was pregnant with her first child engaged a self-employed registered midwife as her lead maternity carer. There were particular challenges for the midwife as she was working beyond her normal geographical area.

This case focused on lapses in the postnatal care provided to the woman and her new-born baby by the midwife. Unfortunately the midwife did not provide the anticipated number of postnatal consultations to the woman in the period following her C-section. As a result, relatively common problems that can develop for women and new-born babies in such circumstances were not appropriately managed.

Ms Wall highlighted her significant concerns about aspects of the care provided by the midwife, including failures to store patient notes adequately; provide the appropriate number of postnatal visits to the woman; assess and manage the baby’s reflux and colic; adequately treat the woman’s mastitis, and failing to discharge or refer the woman to appropriate services at the end of the postnatal period.

Ms Wall recommended that the Midwifery Council of New Zealand (NZCOM) consider whether a review of the midwife’s competence was warranted. She also recommended the midwife provide a written apology to the woman, complete an NZCOM record-keeping course for midwives, and make a number of changes to her clinical practice in relation to record-keeping, communication and follow up procedures.

"Complaints offer a valuable learning opportunity for health care professionals - they lead to positive change and improved service delivery for future consumers. I am pleased to see the midwife has made changes to her practice and undergone further training," says Ms Wall.