Quality standard

Quality statement 9: Monitoring for postoperative complications following caesarean birth

Quality statement

Women or people who have had a caesarean birth are monitored for postoperative complications.

Rationale

Postoperative monitoring with regular observations in the immediate post-surgical period by someone with expertise in postoperative care is a key part of managing potential complications associated with surgery, including caesarean birth. This needs to happen alongside the core postnatal care all women or people receive in hospital immediately after giving birth.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Structure

Evidence of local arrangements to ensure that women or people who have had a caesarean birth are monitored for immediate postoperative complications.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.

Process

The proportion of women or people who have had a caesarean birth who were monitored for immediate postoperative complications.

Numerator – the number in the denominator who are monitored for immediate postoperative complications.

Denominator – the number of women or people who have a caesarean birth.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.

Outcome

Rates of complications in women or people who have had a caesarean birth.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.

What the quality statement means for different audiences

Services providers ensure that systems are in place for women or people who have had a caesarean birth to be monitored for postoperative complications.

Healthcare professionals ensure that women or people who have had a caesarean birth are monitored for postoperative complications.

Commissioners ensure that they commission services in which women or people who have had a caesarean birth are monitored for postoperative complications.

Women or people who have had a caesarean birth are monitored for complications following the operation.

Source guidance

Caesarean birth. NICE guideline NG192 (2021, updated 2024), recommendations 1.6.2 to 1.6.7, 1.6.17, 1.7.4 and 1.7.7

Definitions of terms used in this quality statement

Monitoring complications

See the section on monitoring after caesarean birth in NICE's guideline on caesarean birth.

MMBRACE-UK's report Saving lives, improving mothers care (2020) states that NHS England and NHS Improvement are rapidly developing a chart for an early warning score for pregnant and postpartum women, and a clear response pathway. The report provides an example tool called the modified early obstetric warning score (MEOWS) to support monitoring.