Postnatal care provided by UK midwifery units and the impact of the Covid-19 pandemic: a survey using the UK Midwifery Study System (UKMidSS)

Background Postnatal care supports healthy transitions to parenthood, mother-infant relationships, and breastfeeding establishment. Highly valued by women and families, it is often an area where parents report low satisfaction compared with other areas of maternity care. Most research about postnatal care is hospital-focused. Little is known about postnatal services provided by midwifery units, and any changes to this provision since the COVID-19 pandemic. Aim To describe postnatal care services provided by UK midwifery units and examine the extent to which provision was affected by the COVID-19 pandemic. Methods We carried out a national survey online between January-June 2022 using the United Kingdom Midwifery Study System (UKMidSS). We asked about postnatal care provision in alongside midwifery units (AMU) and freestanding midwifery units (FMU), before the COVID-19 pandemic (July-December 2019) and shortly after restrictions were eased (January-June 2022). Findings Overall 131 (67%) midwifery units responded to the survey, 76 (62%) AMUs and 55 (75%) FMUs, from 75% of eligible NHS organisations. In 2022, 66% of AMUs reported that women typically stayed for 6-24 hours after a straightforward birth, while 70% of FMUs reported typical postnatal stays of <6 hours. For 2019, significantly more FMUs reported providing outpatient postnatal services compared with AMUs (98% vs 57%, p<0.001). From 2019 to 2022 there were significant reductions in partners staying overnight in midwifery units (65% to 42%, p<0.001), and in the provision of outpatient postnatal breastfeeding groups (23% to 15%, p<0.01) and other postnatal groups (7% to 2%, p=0.02). Conclusions The findings document the ways in which postnatal care provision differs between AMUs and FMU, with potential consequences for choice and experience for women. They are also congruent with evidence that maternity care was adversely affected by the COVID-19 pandemic, including a reduction in postnatal visiting for partners and in postnatal group support services.