From Expectation to Reality: Why Postnatal Care Needs to Change, and How We’re Responding at Hesta Health

When we talk about pregnancy and birth, we often think about joy. New beginnings. The “happiest time of your life”.

But when you listen carefully to women and birthing parents, it’s clear this is not a universal experience. In reality, this period of time is more complex, more emotional, and far more demanding than most people are prepared for.

A new report from the National Childbirth Trust (NCT), From Expectation to Reality: Parents’ experiences of pregnancy, birth, and life with a newborn, brings together the voices of over 2,000 new and expectant parents across the UK. What they describe is not a lack of resilience, effort, or love, but a system that too often fails to support women and birthing parents when they need it most.

At Hesta Health, this report quantifies and validates why we exist. It confirms what so many women and birthing parents quietly tell us: the gap between what you expect after birth, and what actually happens, is vast, and the consequences are real.

Things have to be different. That’s why we’re building Hesta.

The expectation gap no one warns you about

The NCT report shows that nearly half of parents felt more worried than excited during pregnancy. Many entered maternity services already anxious: about safety, about how they would be treated, about whether they would be listened to.

And yet, pregnancy is still culturally framed as a time when women and birthing parents should feel grateful, glowing, and happy.

That mismatch between expectation and reality doesn’t disappear after birth. It widens.

While 8 in 10 parents say they enjoy early days with their baby, the same report shows that in the first three months after birth:

• Almost 9 in 10 parents felt overwhelmed at least some of the time, with more than one in five saying they always felt overwhelmed.

• Over 6 in 10 experienced loneliness or isolation at least some of the time, with more than one in ten saying they always felt lonely. 

• Nearly 7 in 10 felt scared at least some of the time, with more than one in ten saying they always felt scared. 

This isn’t down to individual failure. This is an understandable human response to a profound physical, emotional, and identity shift, which is made harder by a system that checks in briefly, then largely steps away.

At Hesta, we believe honesty matters. Becoming a parent is life-changing, but it is also destabilising. Pretending otherwise doesn’t protect women and birthing parents.  It leaves them unprepared and unsupported.

When care becomes fragmented, women pay the price

One of the clearest messages from the NCT report is that postnatal care is the weakest part of the maternity pathway.

After birth, many women describe falling into a care vacuum:

• One postnatal check, often rushed

• Little continuity

• Unclear routes back into care, especially after discharge from hospital or after the six week check

• Mental health concerns minimised or normalised away

Nearly a quarter of parents said they didn’t have regular access to healthcare support in the weeks and months after birth. Another quarter said they couldn’t access help when they needed it.

Women and birthing parents, and their babies and families, suffer as a result of this fragmentation. The report highlights that mental health-related causes account for a third of maternal deaths between six weeks and one year after pregnancy. These are not rare edge cases. They are preventable failures of early recognition, continuity, and proactive care.

At Hesta Health, we don’t believe support should only appear once someone reaches crisis point. Care should begin earlier, and stay with women and birthing parents for as long as recovery takes.

Being listened to is a form of care

The report also reveals how many women and birthing parents feel dismissed during pregnancy and birth.  Around one in five didn’t feel listened to or respected during their pregnancy. And over a third felt pressured into decisions they didn’t want during birth. We know that birth experiences that women and birthing parents find traumatic can have lasting emotional and psychological impacts.  This isn’t a reflection on individual clinicians, but reflects a systemic issue; as the NCT report points out, when services are under pressure, conversations about care become rushed and transactional.  The system pushes care into tick-box exercises instead of creating space and time to truly build trust or explore options. It’s no surprise this leaves women and birthing parents feeling like decisions are made about their bodies without them.

Feeling heard is not a “nice to have”. It directly affects outcomes, trust, and long-term wellbeing.

At Hesta, we start from a simple premise: women are experts in their own bodies. Our role is not to rush, override, or patronise, but to explain, listen, and support informed decision-making at every step.

This principle sits at the heart of our care model and our content. We explain the “why”, not just the “what”. We create space for questions. We don’t assume there is one right path,  only the right path for you.

Inequality is not incidental, it is systemic

The NCT report makes clear that experiences of maternity and postnatal care vary sharply by ethnicity, income, sexuality, disability, and language.

Parents from Black, Asian, and mixed-heritage backgrounds report greater fear about safety and treatment. LGBTQIA+ parents are more likely to feel their individual circumstances are not considered. Lower-income families experience consistently poorer care. Language barriers undermine informed consent. It is not just experiences that vary, this inequality is reflected in differential health outcomes for mothers and babies of minoritised populations.

These are not isolated problems. They are structural.

Hesta Health’s core belief that every woman deserves excellent healthcare - not just those with time, money, or the “right” kind of story - means we don’t treat equity as an afterthought. We actively design care, content, and communication that recognises difference, reduces friction, and meets women where they are.

Better care is not just about more resources. It’s about building systems that are fair, flexible, and human.

Why preparation and expectation-setting matter

One of the most hopeful findings in the NCT report is the impact of antenatal education. Parents who took an antenatal course were significantly more likely to:

• Feel prepared for birth

• Make informed decisions

• Give consent confidently

• Feel supported postnatally

This reinforces something we see every day: information, when delivered with care, is empowering.

At Hesta, content is part of healthcare. We see education as a form of early intervention, helping women and birthing parents understand what’s normal, what’s not, and when to seek support.

That’s why we always focus not just on reassurance, but on realism. We talk openly about recovery timelines. About mental health. About uncertainty. About the parts of motherhood that feel harder than expected.

Because women and birthing parents deserve truth, and the right tools to navigate it.

Why we’re building Hesta Health now

We are launching Hesta Health at a moment when the cracks in postnatal care are no longer invisible, but they are still too often ignored.

Our first mission is simple and ambitious: to radically improve women and birthing parents' health journeys in the two years after childbirth.

We are building a comprehensive postnatal service that:

• Puts recovery first, physical and emotional

• Offers continuity, not one-off check-ins

• Combines clinical excellence with compassion

• Uses technology to reduce friction, not replace human care

• Treats women and birthing parents as whole people, not side notes to their babies

We are not here to replace the NHS. As the NCT also acknowledged, we recognise and deeply respect the thousands of midwives, doctors and healthcare professionals who continue to deliver compassionate, skilled care under immense pressure. The challenges parents experience are not a reflection of individual effort, but of a system stretched beyond its limits. 

But women and birthing parents deserve better, right now.  That’s why at Hesta Health, we’re addressing those system constraints by delivering postnatal care that goes further, and  providing continuity, early intervention and compassionate support that raises the bar of what good care can look like.

A call for better, together

The NCT report is clear: parents are asking for change. Not later. Now.

At Hesta Health, we share that urgency. We believe better postnatal care should not be a luxury, but accessible to every woman and birthing parent. And while systemic change takes time, support is needed today.

As we launch in the next few weeks, we are listening. Learning. Building alongside the women and birthing parents we serve. If you’re a new or expectant mother or birthing parent, your voice matters here. If you’ve ever felt dismissed, rushed, or left to figure it out alone, you are not the problem.

The system needs to do better. And we are committed to being part of that change.