Pregnancy difficulties during the pandemic have been well-documented, but postnatal care has been hit hard, too, with in-person visits from midwives and health visitors limited.

Former The Apprentice contestant and political commentator Michelle Dewberry revealed she had not seen a health visitor once in nine months for her premature baby.

Experts are warning that babies’ developmental and wellbeing issues may have been missed. In non-pandemic times, midwifery visits generally take place in the first 10 days after a baby arrives home and then a health visitor takes over.

Dr Mary Ross-Davie, director for professional midwifery at the Royal College of Midwives, says midwives have worked hard to continue providing in-person care and that there have been positive examples of virtual support.

But an “on-its-knees maternity service” – there is a shortage of 3,000 midwives in England – combined with staff sickness from Covid-19 has meant decisions “do have to be made about what is emergency, essential care”.

“If that postnatal care isn’t there, that is a real gap. It’s a gap in the experience of women and it is also a gap in women getting really good advice and support about their baby’s health,” Dr Ross-Davie tells i.

It is a similar picture for health visitors in England, with staff numbers cut by 31 per cent since 2015. During the pandemic, the service was drastically scaled back. In some areas, up to 63 per cent of health visitors were redeployed to help with coronavirus. Only 21 per cent of parents with babies aged two months or under have had a face-to-face appointment with a health visitor, according to family support organisation Home-Start.

Alison Morton, acting executive director at the Institute of Health Visitors (IHV), is concerned about what is going on in the other 79 per cent of homes. The identification of serious childhood conditions is being delayed and neurodevelopmental conditions are not being recognised through virtual appointments.

“The vital role that health visitors play is that safety net for invisible children,” says Ms Morton.

“As services are starting to open up again, they’ve got very long waiting times. These children won’t get that time back. If babies are living in environments where there are higher levels of mental health problems, domestic violence or other risk factors, these children are at significantly higher risk of poorer outcomes.”

‘I didn’t mention how hard it had been’

Khalesa Chowdhury desperately wanted to breastfeed her son when he was born in September, just as she had with her older two children. But she struggled. Usmaan wasn’t latching on, leaving him increasingly hungry, and she was becoming sore, tearful and low.

Although she had a virtual meeting and two in-person appointments with her midwife at the GP surgery, Mrs Chowdhury kept quiet about the difficulties. Midwives were overstretched and she didn’t want to be another burden.

“I don’t place blame on the midwives because they did ask me those routine questions – I should have been a little bit more honest, but I felt pressure to get the routine things like the baby’s weight done, get myself checked and get out of there. So I didn’t mention how hard it had been.”

The 38-year-old from Hampshire is grateful that a health visitor came to her home. The health visitor suspected Usmaan had tongue-tie, making breastfeeding difficult. After a procedure to divide his tongue at 17 days old, motherhood became easier for Mrs Chowdhury.

“Physically I wouldn’t have been able to feed him, and that would have taken quite a mental toll on me because it’s something I felt quite passionately about.”

The rate of serious incidents has increased by 36 per cent for babies under one during the first half of lockdown, according to the IHV.

For Debra Bick, professor of clinical trials in maternal health at Warwick Medical School, the pandemic has highlighted how postnatal care for mothers has been “neglected”.

“If you’re going home and you’ve got a nasty perineal tear, if there’s nobody to check and ask if it’s recovering properly, if you’re suffering any side effects such as incontinence, that woman will then be putting up with those problems for a long, long time,” she says, urging women to seek reassurance.

The Department of Health and Social Care said: “Specialist and inpatient perinatal mental health services have remained open throughout the pandemic – offering digital and remote support – and all GP practices are required to deliver Maternity Medical Services including postnatal checks for new mothers in person, by phone or by video consultation.”