SaHF DMBC Volume 1 Edition 1.1.pdf - Shaping a healthier future

Illustrative patient journey maternity care – Sarah’s difficult labour, continued
Postnatal
care and
admission to
postnatal
ward
Hospital
postnatal
care
▪
▪
▪
▪
Postoperatively Sarah and her baby boy are transferred to the postnatal ward
for monitoring
Whilst recovering from anaesthesia, Sarah is observed on a 1-to-1 basis. All
seems well so she is then monitored every half an hour for the next couple of
hours and then hourly by her midwife.
Two days after the birth, Sarah feels a bit down and quite tearful. She wants to
go home, but she is finding breastfeeding difficult; her midwife encourages her
to continue and spends some time discussing the benefits and that initial
difficulty is a common problem. They also talk through the labour and the need
for an emergency C-section with Sarah and her partner. They agree that so
long as she feels happier and confident with her breast feeding, she can soon
be discharged.
On the 2nd day, the baby has a documented baby check.
Discharge
and follow up
in community
▪
▪
▪
▪
Before she is discharged, Sarah and her partner are given their baby‟s personal
child health record, and the Birth to Five information book. They are also given
contraceptive advice (which will be reiterated by her midwife and GP)
Sarah‟s usual midwife visits her at home several times to check she and the baby
are well. The midwife encourages Sarah to continue to breastfeed.
On day 7, the midwife (with Sarah‟s permission) performs a bloodspot screening
test.
As care shifts from the midwife to the health visitor Sarah is offered a joint home
visit involving them both. From this point onwards the health visitor will support
Sarah and her partner
Footnote: *Patient story adapted from Maternity services, DoH (2005), * Routine checks in accordance with NICE guidelines include: check size of abdomen, measure blood pressure, and urinanalysis.
Source: Standards for maternity care : report of a working party. London : RCOG, 2008; Safer childbirth : minimum standards for the organisation and delivery of care in labour . London : RCOG, 2007;
Towards better births : a review of maternity services in England. (2007). Healthcare Commission Maternity Review, National Institute for Health and Clinical Excellence (NICE). Intrapartum care:
care of healthy women and their babies during childbirth. London: NICE; 2007, Future Role of Consultant: A working party report (2005). RCOG
7a. Clinical vision, standards and service models 136