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.

Notes

This case relates to a complaint made to HDC in 2020. We aim to investigate complaints as promptly as possible, while ensuring natural justice and the interests of all the parties involved to provide information, and respond to evidence put forward by others is considered.

The f ull report of this case can be viewed on HDC’s website - see HDC's ' Latest Decisions'.

Names have been removed from the report to protect privacy of the individuals involved in this case.

We anticipate that the Commissioner will name providers found in breach of the Code, unless it would not be in the public interest, or would unfairly compromise the privacy interests of an individual provider or a consumer.

More information for the media and HDC’s naming policy can be found on our website here.

HDC promotes and protects the rights of people using health and disability services as set out in the Code of Health and Disability Services Consumers' Rights (the Code).

HDC acknowledges the significant pressure the health and disability system is currently under with limited capacity to respond to the demands placed upon it. However, notwithstanding these challenges, people’s rights under the Code continue to apply.

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