Quality statement 9: Emotional wellbeing and infant attachment

Quality statement

Women have their emotional wellbeing, including their emotional attachment to their baby, assessed at each postnatal contact.

Rationale

The baby's relationship with the mother (or main carer) has a significant impact on the baby's social and emotional development. In turn, the woman's ability to provide a nurturing relationship is partly dependent on her own emotional wellbeing. Regular assessment of the woman's emotional wellbeing and the impact of this on her attachment to her baby may lead to earlier detection of problems.

Quality measures

Structure

Evidence of local arrangements that women have their emotional wellbeing, including their emotional attachment to their baby, assessed at each postnatal contact.

Data source: Local data collection.

Process

a) Proportion of women whose emotional wellbeing, including emotional attachment to their baby, is assessed at each postnatal contact.

Numerator – the number of postnatal contacts in the denominator in which the mother's emotional wellbeing, including emotional attachment to the baby, is assessed.

Denominator – the number of postnatal care contacts.

Data source: Local data collection.

b) Proportion of women whose emotional wellbeing, including their emotional attachment to their baby, is assessed at a postnatal contact 5–7 days after the birth.

Numerator – the number of women whose emotional wellbeing, including their emotional attachment to their baby, is assessed at a postnatal contact 5–7 days after the birth.

Denominator – the number of women receiving a postnatal contact 5–7 days after the birth.

Data source: Local data collection.

c) Proportion of women whose emotional wellbeing, including their emotional attachment to their baby, is assessed at a postnatal contact 10–14 days after the birth (at the midwifery and health visitor handover when the woman and baby are discharged from the care of the community midwifery team to the care of the health visitor).

Numerator – the number of women whose emotional wellbeing, including their emotional attachment to their baby, is assessed at a postnatal contact 10–14 days after the birth.

Denominator – the number of women receiving a postnatal contact 10–14 days after the birth.

Data source: Local data collection.

d) Proportion of women whose emotional wellbeing, including their emotional attachment to their baby, is assessed at a postnatal contact 6–8 weeks after the birth.

Numerator – the number of women whose emotional wellbeing, including their emotional attachment to their baby, is assessed at a postnatal contact 6–8 weeks after the birth.

Denominator – the number of women receiving a postnatal contact 6–8 weeks after the birth.

Data source: Local data collection.

e) Proportion of women whose emotional wellbeing, including their emotional attachment to their baby, is assessed at a postnatal contact 16 weeks after the birth.

Numerator – the number of women whose emotional wellbeing, including their emotional attachment to their baby, is assessed at a postnatal contact 16 weeks after the birth.

Denominator – the number of women receiving a postnatal contact 16 weeks after the birth.

Data source: Local data collection.

Outcome

a) Incidence of postnatal mental health problems.

Data source: Local data collection.

b) Incidence of mother‑to‑baby emotional attachment problems.

Data source: Local data collection.

What the quality statement means for different audiences

Service providers ensure that systems are in place so that women are asked about their emotional wellbeing, including their mother‑to‑baby emotional attachment, assessed at each postnatal contact.

Healthcare practitioners ensure that women have their emotional wellbeing, including their mother‑to‑baby emotional attachment, assessed at each postnatal contact.

Commissioners ensure that they commission services that have local agreements to ensure women have their emotional wellbeing, including their mother‑to‑baby emotional attachment, assessed at each postnatal contact.

Women have their emotional wellbeing, including their relationship with their baby (called 'emotional attachment'), assessed at each postnatal contact.

Source guidance

Postnatal care up to 8 weeks after birth (2015) NICE guideline CG37 recommendations 1.2.22 [key priority for implementation] and 1.4.5

Definitions of terms used in this quality statement

Postnatal contacts

Women and their babies should receive the number of postnatal contacts that are appropriate to their care needs. A postnatal contact is a scheduled postnatal appointment that may occur in the woman or baby's home or another setting such as a GP practice, children's centre or this could be a hospital setting where women and/or the baby requires extended inpatient care.

Emotional wellbeing

Being happy and confident and not anxious or depressed.

[NICE's guideline on social and emotional wellbeing: early years, glossary]

Mother‑to‑baby emotional attachment

This involves the formation of a secure bond between the mother and the baby, in which the mother responds sensitively and appropriately to the baby's signals, providing an environment in which the baby feels secure.

Equality and diversity considerations

Communication between women (and their families) and members of the maternity team is a key aspect of this statement. Relevant adjustments will need to be in place for anyone who has communication difficulties, and for those who don't speak or read English.