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Could we have a MN campaign for improved Postnatal care?

(358 Posts)
AtYourCervix Wed 06-Jul-11 10:56:59

Reading the many threads on here it appears that Postnatal care is the most frequently complained about area of the maternity service.

In-patient stays in hospital - Women feel neglected, ignored and unsupported and Postnatal visits at home are rushed and women are 'lucky' to see a midwife 3 times.

I strongly suspect that with NHS cutbacks ths is only going to get worse and I think it is not good enough.

Ideas and opinions please.

Tuppenyrice Wed 06-Jul-11 11:01:36

I think we need a campaign that targets society in general to allow women to recover from childbirth and rest. Getting up & about, doing the school run 24 hours after the birth etc all too common now. If we could educate the husbands and extended family inti realising that superwoman is a myth then being kicked out of hospital within 12 hours of the baby being born might not be so terrible. Women need a bit of looking after!

Meglet Wed 06-Jul-11 14:26:16

Agreed.

FWIW I was sobbing with pain / fed up with the midwives after my EMCS, mum spoke to the head midwife and she came round to see me and apologised for the situation and insisted I was to buzz for everything. She said she wasn't happy about the post natal care. The midwife in my birth relfections apt had a good rant about the post-natal care and the nurses in the gynea ward after my hysterectomy didn't have a good word to say about the PNN care on the maternity ward.

I was on pain relief for 6 weeks following my EMCS as I was made to get up and try and get back to normal.

I was on paracetamol for 7 days after my planned cs and 4 days after my hysterectomy as I didn't lift a finger. The PN care first time around still makes me sad angry even 5 years on. I know its lack of money but I wish it didn't have to be that way.

AtYourCervix Tue 26-Jul-11 17:38:52
gallicgirl Tue 26-Jul-11 18:13:35

FWIW the info I had about post-natal care is what made me determined to have a home birth. I had fabulous care during my HB and wouldn't ever consider a hospital birth unless I absolutely had to.

nojustificationneeded Wed 27-Jul-11 10:02:07

Absoloutley with you on this, like someones idea on the other thread about a mumsnet headed card

- how to get your food
- how to manage after a c section
- how to access breastfeeding help
- how to best help yourself in hospital
- how to complain

A mumsnet pamphlet with exerts from the mumsnet baby book or basic care info but in mumsnet style i,e dont worry about all this crap, as long as x and x is okay your fine.

MNHQ, please please please read the thread at the link above, pages and pages of women detailing their horrific -- and largely unnecessary -- experiences on postnatal wards, all across the country.

Women and babies are suffering, in some cases with long-lasting medical problems and PND, because of this.

There are women saying they will never have another baby because of this.

I can hardly think of a more worthwhile campaign for MN to take up.

jinxediam Wed 27-Jul-11 10:34:07

This is a brilliant idea for a campaign. I didn't complain after my experience as I was too ill and exhausted to do so which saddens me as it makes what I went through seem ok.

A postnatal ward with 2 night midwives and over 28 ladies is not acceptable.

Being immobile/numb/bedbound and expected to get your own food is not acceptable.

No access to painkillers/decent sanitation is not acceptable.

Having to rely on other patients visitors to get to my choking baby as the buzzers didnt work is not acceptable.

Being shouted/belittled/ignored for needing help is not acceptable.

I never expected the birth to be a hotel experience but I didn't expect to have to desperately phone family members for water, food, painkillers and beg them to get me out of there! God help the many women on my ward that I met that couldn't speak much English.

A dog at my local vets would have been treated with more dignity.

'A dog at my local vets would have been treated with more dignity.'

This is so true, great point!

MumblingRagDoll Wed 27-Jul-11 10:46:42

I second the idea about being expected to walk down long corridors for meals when you''re stitched up 12 hours after a section...pushing your newborn in their crib in front of you. Nobody comes to offer a drink of anything...Ihad to shout for water....couldn't walk....no tea or anthing unless my partner fetched a flask.

I was shaking and in agony and still had to get my meals. My partner was not allowed in one ay because my sster had already visited. hmm and I had my quota.

Nobody came to help me bathe the baby for 48 hours but they would not discharge me.

Mrsxstitch Wed 27-Jul-11 10:56:07

I agree we need a campaign but have no idea how to do it.

BagofHolly Wed 27-Jul-11 11:13:39

Glad you like my card idea! Whilst societal change is the ideal scenario, I think we could do with some quick wins which start to make a difference immediately and DON'T rely heavily on extra resources/mw/£, even though it's pretty much acknowledged that's what's needed longer term.

If every woman was given basic information even on basic "housekeeping" that alone would improve patient experience.

*Does anyone know what Key Performance Indicators there are in inpatient maternity services that we could hook into? *That way we would be on the same side as the Trusts, perhaps helping them meet targets, and enabling a more open and productive relationship in the longer term.

The temptation is to go steaming in with a litany of failure, whereas we might achieve more by partnering.

BagofHolly Wed 27-Jul-11 11:50:39

Oh no! Hope my know-allness hasn't killed the thread! sad

Would definitely support a campaign for better postnatal care and for more postnatal midwives. My experience was horrific, but I think all of the problems wouldn't have happened if there was more staff. Let me know if there is any way I can help
PS. I'm NHS in scotland and supposedly we don't have a midwive shortage! <hollow laugh>

allhailtheaubergine Wed 27-Jul-11 11:57:32

Just posted this on the other thread by mistake so will repeat here:

The thing that puzzles me - my antenatal care at the hospital was brilliant; my care in labour was faultless; the same nurses all rotate between the three sections - so why was my post partum care so bloody diabolical?

What is it that changes between about to have a baby (good) / actually having a baby (good) / just had a baby (lamentable)?

What can we / they take from the other two and apply to post natal care?

BagofHolly Wed 27-Jul-11 12:01:39

Just posted reply on other thread

VivaLeBeaver Wed 27-Jul-11 12:05:51

It's because the staffing levels on the postnatal ward are the worst. This is because it's the least risky time so less chance of something happening that is so bad it results in loads of compensation being paid out.

The midwives are stressed and and at times this can/will result in women being snapped at, etc. I'm not defending midwives who are rude to women at all. I agree with what someone on the other thread said about it taking the same time to be polite to someone as to be rude to them. Just saying that sometimes midwives feel like they're at breaking point. The midwives I see sat there crying, thinking they can't carry on are always the ones on the postnatal ward.

Though I guess there are also some who are just nasty cows for no reason.

KristinaM Wed 27-Jul-11 12:18:45

I Support the need for a campaign

Its not just about staff shortages, there seemed to be plenty staff when i was in hospital

We need a cuture change in the wards particularly from the nursing staff. There seems to be an attitude that post natal patitenst are whinging nuisances who need to be kept in their place. I suspect its about power and control. I woudl be interetd to hear what the experts on teh feminist threads make of it

We dont hear anout men who have had major abmoninal surgery having pain relief or water withheld and told to queue for their food. Or indeed told that there is no food left. They dont seem to need to get their wives or mothers to intervene withthe staff to get them adequate care. Why is this?

PumpkinBones Wed 27-Jul-11 12:23:36

I am in support of a campaign. I think maybe it hasn't been done before, or is seen as a difficult thing to do, because of the variations between hospitals - ie food arrangements, visiting, etc, so any sort of pre-printed info would be difficult - but all postnatal wards could use the same template to provide information AND should be collecting feedback when people leave hospital about their experiences. Most of us would find it very difficult to challenge an agressive staff member but would be able to write down who had been rude to them, and also who had ben helpful - I know this would be an administrative burden potentially but surely there is a way it could be executed, would a patient liason service for example help?

posterofagirl Wed 27-Jul-11 12:35:39

Just some of my suggestions

1. Every woman should have a named midwife per shift who spends 10 mins after handover with them and finds out what they need/ let's them know what they can reasonably do given staff levels etc.
3.Women are given their own medication to manage unless it is a controlled drug, ditto calpol for baby.

Both of these ideas are free and would make a lot of difference IMO.

notcitrus Wed 27-Jul-11 12:47:14

Adding my name to call for this campaign.
I did write and complain about my postnatal care (antenatal care was fine, delivery care wonderful), and they said they were going to produce cards for every bed telling women when and where food was served, that there was a room with a telly and sofa in it for breastfeeding etc, what symptoms to look for, etc.

Apparently the reason daytime postnatal care was OK if rushed and nighttime care was appalling was that night MWs all came from an agency as they couldn't get cover otherwise. Surely this must be more expensive than properly staffing the ward? And doesn't excuse them being less good than the day staff.

Though in fact care assistants would be cheaper and still make a huge difference, being able to clean up women who needed a clean bed, give glasses of water, pass you your baby if you're on a drip/had a cs and can't reach the cot where your baby got put, etc.

allhailtheaubergine Wed 27-Jul-11 12:49:31

You know what would be really helpful and easy to implement?

A poster on the wall of the ward explaining the staff by uniform / duites.

I must have seen 100 different hospital care workers in various permutations of blue hospital scrubs. I had no idea who was a doctor, who was an SHO, who was a nurse, who was a midwife and who was a dinner lady.

It matters because when you can see cross, overworked carers snapping at people for asking the wrong question to the wrong person it makes you nervous to ask your own question.

I had one young woman sidle into my cubicle, mutter something about conjunctivitis and sidle out again. I eventually found out she was the doctor I had been asking to see to discuss mine and my baby's fever for 2 days.

BagofHolly Wed 27-Jul-11 12:51:32

That's a good idea. Some places already do it but it needs to be implemented better - like a poster on each ward.

Iggly Wed 27-Jul-11 12:59:26

I agree too. My postnatal care wasn't as bad as some experiences but I remember being appalled at the food - recovering after a birth and they offered one cold slice of beef with limp lettuce for lunch hmm plus being manhandled by midwives at every shift change and asked "what are you doing???" when I was humming to my new baby. Also I could barely walk to the food trolley (in the corridor) to get a meal so would lose out. Thank god my wonderful MIL made me meals every day otherwise I would have starved. Also don't get me started on the BF "help" with someone telling me I was feeding fine when DS couldn't latch on - now I realise this was because my milk had come in so boobs were too big!
I meant to complain but a) it's so bloody difficult to work out how so lost the will and b) I was so tired with a newborn I lost the will again!

Had a nosy around the web and found this from a King's Fund report this year looking at postnatal care:

'For me, the most striking finding is the potential for task-shifting. Highly qualified medical staff – who should be focused on the highest risk women – currently perform tasks that midwives could do just as effectively, while midwives perform duties that could be undertaken by nurses, and nurses, doctors and midwives undertake clerical work that should be done by administrative staff. This has serious implications for the safety and cost-effectiveness of services.'

Their basic point is that more staff are needed, but there's no point throwing more staff into an inefficient system.

But it makes me think -- are there hospital volunteer programmes in England? I'm actually from the States, and when I was a teenager a big thing was 'candy striping', volunteering a few hours a week at a local hospital. (anyone could do it but a lot of them were young people) Obviously you're not treating patients but you do a lot of the little things, definitely fetching food and water, sitting with patients who are upset, helping them to the bathroom and things. This freed up time for skilled staff and helped keep patients calmer.

Is there anything like that here?

MissyBrookes Wed 27-Jul-11 13:42:20

I have already complained about my antenatal care at the N&NUH, so am dreading the postnatal care as its the same ward with the same staff..

Absolutely astonishing and i am almost tempted to refuse to go back. If i wasn't too scared to have my first baby at home with no pain relief id happily climb in my own bath and give birth.

Unfortunately the next nearest hospital is an extra 30 mins away, so about 50mins drive IF there is no traffic on the A12. Thats at the JPUH in Gorleston and i really cannot fault them at all.

A short summary of faults include 3 different types of false information being written in my notes, a big crossed out section in my notes where another patients care was written in, being left for hours with no painkillers after being told the MW would be back in 20 mins - that was at 3pm and no one came back until the next day, my notes being lost, gaining another patients clinical details when i went to collect them (test results, hosp and NHS numbers, addresses and telephone numbers)

The majority of this could have been avoided if the MWs had stood around the desk sharing information about patients and COMMUNICATING with each other, instead of sharing tips on which brand of fake fucking tan was the best....

Also, i noticed at the JPUH my notes never left the end of my bed. When a member of staff was to write in them they had to first confirm my name, dob and hospital numbers and then they had to tell me what was being written while they were writing it. I never saw my notes at the N&N except when i had to return to the hosp to collect them - and even then i wasn't ID, they just handed them over. I could have been ANYONE!

I dread to think, if this is how you are treated whilst you are at risk of pre-term labour, how lax they will be when i return to actually have my baby. I'm lucky my mum is a midwife and will be there with me. Luckily she works at one of the hospitals mentioned in the thread as being one of the BETTER for post natal and antenatal care.

I am backing this campaign 100% - something needs to be done about this, i thought i was the only one who had had a crap time and had to complain, but as it turns out i wasn't just making a fuss over nothing.

sprinkles77 Wed 27-Jul-11 14:05:19

Count me in. Post natal was dreadful. Some of the midwifes were OK, but several things stick in my mind, following my EMCS
1. Theatre staff had put a pad between my legs. Fell out (nothing holding it in place, I didn't know it was there) when I got up. Blood everywhere, including on pressure stockings. Stood there for ages (couldn't move cos attached to catheter and drip). When someone finally came to help I got a big telling off for being out of bed. Noone had said I couldn't.
2. They took 10 hours to get me clean stockings. In the wrong size. Good job they were a size too big, cos I'd swollen up so badly I could barely get them on (obviously noone helped me).
3. They really frightened me about DS's reluctance to feed. Surely they should have known that a 12 hour old baby who had IUGR due to dodgy placenta, whose induction had started 4 days previously and failed was probably going to be too tired to eat.
4. That after 4 days of failed induction, no sleep for the same period and EMCS, I was unlikely to have much milk to offer anyway, so some time to rest rather than being bullied into attempting feeding with cups and bottles would have been more appropriate.
5. That it took 36hrs to get me discharged after DS had been declared OK to go home. Just cos there were no doctors.
6. That after than it took another 6 hours.
7. that I lost nearly a litre of blood, and noone mentioned it till I was about to be discharged and was given iron to take home.

If there is a next time I will probably have an ELCS. I will also probably discharge myself as soon as they take the catheter out and I have done a wee, so hopefully within 24 hrs.

i know that they are understaffed. I know they are rushed off their feet. I know that there were people there sicker than me with sicker children. But a little care and respect would help. Some clear information instead of misguided opinion. An understanding that while the staff see what is happening everyday, to new mums the whole experience is often emotionally and physically overwhelming, often the first time they've experienced it, and is life changing.

kenobi Wed 27-Jul-11 14:15:17

Count me in, not because my care was bad - on the contrary - but because while I being looked after generally very well, at the same time less than 3 miles away a friend's bladder nearly ruptured after the MWs on the admittedly very busy ward refused to empty her colostomy bag.

This was at a large, well-respected west London hospital which has a quiet reputation on the side for terrible pn care.

That level of postcode lottery is unacceptable.

kenobi Wed 27-Jul-11 14:22:42

aubergine - I love your idea. I too fell foul of not knowing what the uniforms meant and asking the wrong person. I also found it weird they'd get a bit cross about it. I know nothing about hospital working policies and uniforms - how could I possibly know who to ask?!

spidercatcher Wed 27-Jul-11 14:28:03

Do count me in. My experience was really horrendous and definitely contributed to my post-natal depression. I won't bore anyone with details but I'm still scared of the idea of having more children after that.

I second (third? fourth? er?) the idea of cards for patients; possibly with a map to show where things are like visitor rooms, kitchens and loos. It's not always obvious.

Some training for care assistants in the medical tasks they're supposed to do - Royal Berkshire in Reading use a lot of them, but I found some of the tasks (taking blood samples for instance) would need training that not many of them appeared to have had (taking blood involves pulling, not pushing in air..)

A whiteboard at the foot of every bed with any key information (like - note: baby to be given antibiotics on SCBU ward at 3am) writ large so that care assistants or midwives can easily see what they need to do without having to leaf through notes. (DD had three missed appointments because nobody thought to tell me until the nice people at SCBU came down to see if there was a problem)

I know that post-natal wards are desperately short-staffed and I do feel for the HCPs who work there. As a (HCP's words) ignorant first-timer who didn't know ANYTHING, it would have been lovely to have access to something straightforward that told me what I should be doing instead of having to ask harangued HCPs about it. Such as - your baby will need to be weighed and examined within the first x time after coming to the ward. Bring them to x location at x time or let us know if you have problems doing so.

Interesting about the varying experiences on notes - I never saw mine and neither did anyone else by the looks of it! Nobody seemed to know I'd had a C section, but everyone seemed to think I had pre-eclampsia which I didn't..

nojustificationneeded Wed 27-Jul-11 14:39:41

We need a booklet like others have said, can we work with the hospitals, explaining the things bagofholly mentioned. Where to get meals, how to get advice and help etc.

A bit specific to the hospital which details who is who in uniform

A basic bit like I said before with non patronising advice for new mums.

Willing to help, find out info about uniforms from hospitals, design or print.

Llanarth Wed 27-Jul-11 15:00:27

agree with BagofHolly's card idea, not least because having it all set out in a leaflet left on each bed when you enter the ward would mean that there would be lots of less buzzing for the MW's, freeing them up to respond to clinical requests.

(I can see how frustrating it must be for a midwife to answer a buzzer from someone asking how she should go about ordering food for tomorrow's breakfast, when there are hundreds of clinical duties to attend to. I can almost see how some might be snappy and patronising in those circumstances. But if the information isn't provided, how does the mum find out such info?)

Additional facts to include - what is the discharge procedure, maybe simple babycare instructions - stump care, the procedure for nappy changes (for us it was a very complicated procedure involving specific sinks, hospital-provided containers but your own cotton wool), where the clinical waste bins are (and what should go in there versus the bedside bins) etc.

Campaign still needs to address the understaffing and poor amenities though.

nojustificationneeded Wed 27-Jul-11 15:15:21

"Additional facts to include - what is the discharge procedure, maybe simple babycare instructions - stump care, the procedure for nappy changes (for us it was a very complicated procedure involving specific sinks, hospital-provided containers but your own cotton wool), where the clinical waste bins are (and what should go in there versus the bedside bins) etc."

Yes yes to all Llanarths suggestions, come on mumsnet sod Emmas Diary! We need practical information wrote by real parents!

KatieMiddleton Wed 27-Jul-11 15:19:01

I agree. It is my latest campaign. We seem go be losing HV service round here too.

WillbeanChariot Wed 27-Jul-11 15:25:22

I would definitely support a campaign. The cards are a great idea.

My care wasn't too bad but to throw in a simple suggestion, could wards try to keep women whose babies are in NICU/SCBU together in one bay rather than dotted around surrounded by other babies.

These are all great ideas. I think it would be good if the information could be put on posters on the walls as well (in case booklet gets lost in shuffle) with illustrations for mums with less English.

I got given a load of booklets when I was discharged, they were all pretty much useless. This sounds like a better use of resources!

hildathebuilder Wed 27-Jul-11 15:33:35

As I mentioned on the other thread I agree very strongly with Willbean on keeping women with babies in NICU and SCBU together. It is better for us, as someone nearby understands what you are going though and will udnerstand if you fear you rbaby may die, and better for the other mothers who really really don't want to hear us sobbing away while trying to stop their babies crying. It would also be easier for the midwives and doctors as we are all around on the postnatal wards when we are banned from the NICUs due to wardrounds, and we need different advice and support from those whose babies are with us (emotional support, counselling, expressing help, as well as information on long term practical issues like parking discounts when you are discahregd without your baby).

Also, hospitals should be more realistic in terms of telling you what to bring with you. I was encouraged to bring lots of cozy but unnecessary stuff, they should have told me to bring my own paracetamol, food, water, wipes, etc. (thank god I did).

nojustificationneeded Wed 27-Jul-11 16:07:39

Ohh great ideas everyone, I know people at several hospitals so could probably get contacts! very interested in helping with this.

WillbeanChariot Wed 27-Jul-11 16:17:30

And to add another of my pet bugbears, if the Bounty people must be allowed in (they wouldn't be if it was up to me) tell them who not to go and see. This would again be easier if all the NICU mums were together. I was far too polite to the Bounty lady who came in with a camera and demanded to know where my baby was.

I'd like to help too -- I'm not in the UK anymore but would be happy to do some online editing/design of any information sheets or what have you.

Was just thinking that maybe they should be laminated. Bit messy, the postnatal ward smile

tigana Wed 27-Jul-11 16:53:35

yes.

need info for the full on daft anxiety things like "I need a pee...can i leave my baby alone in the hideous plastic fishtank by the side of my bed while i shuffle to the toilet?"

also need to improve the CARE.

Pressure on Dept of health, sHas and PCTs to add a KPI/contract incentive around pt experience on PN wards (eg "90% patients respond with excellent or good when asked about pn care in a survey").
Thing is...why (i mean, apart form the blindingly obvious)? Can we find anything about improved outcomes? reduced re-admissions? reduced need for medication (PND?)

UntamedShrew Wed 27-Jul-11 16:58:51

I've been involved in a campaign for better maternity care for multiple mums which focused largely on postnatal care as this was clearly where the majority of problems lie. So, if anyone does do anything with this idea and wants to know how we got on/ what we did please feel free to get in touch via PM.

nojustificationneeded Wed 27-Jul-11 17:45:22

Mumsnet HQ where are you? , Im fired up on this now, I have designer documents open blush

MrsChemist Wed 27-Jul-11 17:51:55

Do you think that this is something that could be organised with the help of PALS? I'm sure I saw a few PALS leaflets last time I was in hospital

nojustificationneeded Wed 27-Jul-11 17:55:33

I think so Mrschemist, PALS are rather good here and Ive noticed info leaflets from several independent groups and charities helping people at ours.

That's a very good question... what is the why? I think you could break it down into several categories:

1. Fewer short-term complications for mothers and babies
We have seen many stories here of serious medical complications from lack of attention.

2. Fewer long-term complications
Many women feel their PND or other difficulties can be traced to poor postnatal care.

For both sets of complications, would need to provide whatever data is available (surveys?)

3. Improved efficiency
They should love this! Some of the things we are talking about, like information sheets, would allow staff to concentrate on more important things.

4. Professional ethics
In short, it goes against every code of professional ethics for staff to treat women in the way that many women here have documented over the years. It is simply not acceptable and should not be tolerated.

I saw an NCT press release for a survey they did on postnatal care -- it's possible the survey itself was very good, but I found the press release to be very counterproductive. The leading finding that they emphasised was that women are not receiving enough emotional support or being treated with enough kindness on the postnatal wards. Now, this is probably true, but it is too easy for people to dismiss that -- to say, well, the NHS is not there to provide emotional support. So I think it's important, in giving a rationale for change, to emphasise the more tangible problems and costs, the kind of things that people can't really argue with.

KristinaM Wed 27-Jul-11 18:13:30

I am strugglijg to understand how this is all about staffimg levels and the need for more mw. I was in for 24 hours aftre a ECS. Aftre i left recovery and went onto the ward, the only " nursing" care i recieved was

Remmoval of cathtere 1min
Replacig bag on drip. Ditto
Dispensing of 2( i think ) doses of drugs -i understand this is a two person job, so say a total of 8 minutes

So say 10 minutes. Allow a further 10 minutes to write these event up. That a total of 20 mins in 24 hours. Obviously i needed a higher level of input as a cs patient. So im wondering, what did they do for teh rest of their shift? Apart from sitting around the desk for most of the night, chatting loudly to their colleagues and keeping the patients awake?

When i had a instrumental delivery i was told they were too busy tko give any care as they were helping the cs patientshmm

KristinaM Wed 27-Jul-11 18:21:12

All the thimg i needed help with could easily be done ny a HCA

Passing the baby to be fed wne i was bed bound
Food and water whei was bed bound
Returning the bbay to cot befroe i fell asleep and dropped him on the floor
Adjusting the bed so i coudl breast feed ( despite having given birth to a breast fed baby apparently)
" watching " my baby while i went to the loo and had a shower ( we were notvLlowed to leave the baby unatended)
providing a clean pad and blanket

I rrealise that i am speaking from my own experince, but lots of women on the other thread seem to have had similar complaints

allhailtheaubergine Wed 27-Jul-11 18:23:17

YES YES YES to a map explaining what facilities are available and where they are.

Ds latched on within 30 minutes of being born and refused to let go for most of the next 24 hours. To give my poor, sore nipples a chance I walked up and down the corridor for hours and hours that first night. It was either feeding, walking or screaming baby. Every lap of the corridor I passed the midwives sitting at their desk. At about 4.30am one of them asked me why I didn't try rocking him in the breastfeeding room?

WHAT BREASTFEEDING ROOM?????????????

Yup, there was a lovely room just opposite my ward with nursing chairs, footstools, magazines, breast pumps, dimmed lighting, a radio...

And not one of those women had thought to mention it to me

BagofHolly Wed 27-Jul-11 18:44:01

Gosh this is fascinating stuff! I no longer have journal access but there are plenty of published studies about the various aspects of postnatal care, which could be referenced.

I wonder if we could find a "tame" maternity services commissioning manager?

Fwiw I think steering well clear of Nct would be a good idea - they don't necessarily have the finest reputation in relation to acute maternity services. I'd also be wary of going via Maternity Services Liaison Committees either as in my experience they don't have the teeth to really implement fast, and can sometimes be a vehicle for paying lipservice to patient involvement. [ducks for cover!]

Llanarth Wed 27-Jul-11 19:13:07

I'm wondering, with the current economic climate, whether a campaign to improve postnatal care founded on increasing staff numbers could ever be successful/implemented.

Whereas the info cards described here (perhaps along with a charter about dignity/respect in postnatal care) is much more likely to be adopted.

If such cards meant that MW are able to instead focus on clinical needs rather than the minutae/caretaking of the ward, then some (but not all) of the appalling clinical issues flagged in the other thread might be avoided. It wouldn't be a perfect solution, but it would at least stand a chance of being adopted...

HomemadeCommunistRussia Wed 27-Jul-11 20:47:10

Another vote for an improvement in antenatal care based on giving Mums better information. Here's my post from 19.20 Tuesday in case it got lost in the flood: smile

I don't think these places can ever be pleasant; all these sore, tired, panicky people + screaming babies, bedlam is bound to ensue.

I had some snotty nurses/midwives, but they were a bit better with me when they realised I was 27 and not 17 (Sometimes looking young is not a good thing) I really felt for the actual teenage mothers.

There were some rules that didn't seem to make any sense-why did we have to have food that the lady in our bed from the day before had ordered?

I think that it would help if during antenatal classes more attention was paid to explaining what it might be like after the birth. I for one was convinced (both times <stupid>) that I would go home within 12 hours and have no problems. I did not really prepare myself for my time in post-natal.

A lot of the stuff that the staff are trying to do on the in post natal could be done antenatally, like how to change a nappy and bath a baby.

Rules could be on display so people know when and where food is available, what kind of help they can expect, and not expect, which bathroom to use and so on.

Things like discharge papers, really need to be sorted out throughout the NHS I think, as it seems to be exactly the same on the paediatric wards I've been on too. It seems quite normal for people to wait until the next day to be discharged, because it's such a low priority for the DRs which of course makes sense, but I'm sure in the 21st century a better system could be used.

That feeling of being trapped and wanting to go home and sleep is horrible, especially 3 days PP.

We could all help ourselves to some extent by bringing food and supplies and by seeking out some hands on practice with real babies and by going on the tour of the ward before hand so we know our way around.

Of course having a baby hardly ever goes to plan.

I whole heartedly support this campaign

My care was average. Best quote: "well, I could sort out your discharge paperwork so you can go home, or I could look after all the other women on the ward. Which do you want me to do?"

lalalahahaha Wed 27-Jul-11 20:59:06

I think improved information for post natal women should also include more information and communication relating to the post natal visits from the midwives. I remember waiting at home for hours for the midwife to come and visit, only to ring up and be told yes she is definitely coming, until I rang up to be told, oh no She won't be coming now, it's too late.

I think the midwives should make contact to let you know that you are on the list, roughly what time they expect to be there, ask you if there are any problems etc. Those visits were really important when I had my first because I needed them to tell me that everything was all right! I also think they should come more frequently for women who need/want them to. Good support in those early days at home might help to ward off post natal depression for some. I think it would also really help if midwives/health visitors could put new mums on touch with others in the same area. That's another way to prevent pnd.

nojustificationneeded Wed 27-Jul-11 21:31:20

Lala I was told that midwifes were deliberately vague about times and days because they wanted to make sure you stayed in in the early days with a newborn as in ye older day rules when a newborn shouldnt have been out of house.

I think that can attribute to PND, for me being stuck in the house alone with a crying baby and the same four walls while h was at work sent me insane.

nojustificationneeded Wed 27-Jul-11 21:33:23

I dont think we are going to get major action in terms of staffing and attitude but I do think by providing some of the information people have suggested we can certainly make the experience better or at least empower new mums to know what they are entitled to expect.

peekmum Wed 27-Jul-11 21:46:55

I think there sould be enough supprt for women to stay in hospital/maternity rest for up to 7 days. fair enough - i know some women just want to get home and that's fine but for others who may have had a difficult birth/first babies/have a hectic homes life etc it gives time to recupperate, bond and concentrate solely on baby. It gives you chance to establish breastfeeding, get to know your new baby and recover. All of this conveyor belt action pisses me off. I actually asked to stay in hospital an extra day as I just didn't feel ready to go home 12 hours after giving birth.

wearenotinkansas Wed 27-Jul-11 22:09:20

Would definitely support a campaign. I can't think of any other major procedure/surgery where you would get a ward full of patients in recovery without a nurse in attendance overnight. Also, standards of cleanliness could easily be improved - as well as general health care/assistance.

I think women who have just given birth generally have enough on their hands without kicking up a fuss about the post-natal care - so it gets sidelined by managers. What is more - I don't think consultants are generally interested in recovery for most women - so they don't prioritize it either.

Where do I sign??

MrsJRT Wed 27-Jul-11 22:14:44

Just from a midwifery perspective an average day on the ward can be thus: you're given between 8 & 12 high risk women, inintroduce myself to them all, have a quick chat about their night, take a set of obs and do the baby check, take any required blood and document everything I've done. Then I prepare myself for the ward round where I have to be up to speed with all womens histories. I then set about following any plans of care made by the medical staff, answer buzzers as and when and again document care. Chase up blood results and start discharging women who are able to go home, interrupted by a new admission, orientate them to the ward, assist with tube feeding a small baby, attend the complex social needs of a methadone user and a baby who is withdrawing. Contact social workers and community midwives to ensure discharge plans are in place for those who require extra support. Document. Again. Assist with breadtfeeding, give out medication, apologise as haven't been able to discharge, assist with breadtfeeding, answer buzzers. Document, emergency buzzer goes, women having huge haemmorhage, assist other staff stabilising woman, try and get on top of discharges. Apologise, document. It's never-ending. Rudeness is not acceptable but we desperately need more staff. I think this is a great campaign for mumsnet to get behind and as a hcp recognise it is completely necessary but I thought I'd just give you a look from the other side of the fence as I saw someone was asking just what we do all day.

BagofHolly Wed 27-Jul-11 22:18:39

MrsJRT, can I pump you for info?

Who has the most power to influence change at ward level in your dept?

Having read THIS thread which of our suggestions do you think wouldake the most difference to patients?

And which would be most welcomed by ALL staff?

Ta!

gallicgirl Wed 27-Jul-11 22:21:12

I think it's important to point out that this is in no way a witch hunt. We just want more funding for more midwives and more training.

BagofHolly Wed 27-Jul-11 22:25:15

Well that's one nice outcome Gallicgirl, but I dint think it's necessarily the first one. I understand your feeling the need to clarify there's no blaming here, just finding a way through.

MrsJRT Wed 27-Jul-11 22:26:43

I guess the ward sister has a lot of power in terms of change on the shop floor but any power they are given normally comes from the head of midwifery. The information sheet is a good idea but many women are just not motivated to read info at that point, I don't mean it in a derogatory fashion but it's an exhausting emotional time in your life and if someone was to thrust a bit of paper into your hands it'd be unlikely to be read straight away. That's not to say it's not a good idea, perhaps given antenatally though? But then the info will probably have been forgotten at the critical point. I don't know what the answers are, it is something colleagues and peers have debated many a time. I watch this thread with interest though and will no doubt come back to it.

BagofHolly Wed 27-Jul-11 22:34:42

I wasn't thinking a bit of paper, more a laminate card on the side of the locker/tied to the telly/in the day room/in the toilet etc etc. And PERHAPS a staff version relating to orientation, eg;
Have you:-

Welcomed the patient
Introduced yourself
Given a laminate card
Pointed out the toilets and refreshments

Etc.

PelvicFloorOfSteel Wed 27-Jul-11 22:35:18

Brilliant idea for a campaign.smile

Something which comes across from MrsJRT's post is how hard it is to find time to discharge people because it's always non-emergency, so it keeps slipping down the list even though getting rid of patients quicker makes the workload smaller. I had to wait 12 hours to be discharged when I had DS1, during that time I was blocking a bed, needed feeding and I desperately wanted to get away. I think there must be a better way to prioritise discharging (where this is what the patient wants, I have every sympathy for people who felt shoved out of hospital before they were ready it just wasn't where I wanted to be) leaving midwives free to cope with the patients who actually need to be there.

BagofHolly Wed 27-Jul-11 22:36:40

What do you think? I'm sure all this has been debated before but where do you think it might have fallen down? What could we learn?

messybedhead Wed 27-Jul-11 22:37:04

I wholeheartedly agree with the idea of a Mumsnet campaign and I posted my experience on the other thread.

But...

at the top of the page under the topic Mumsnet Campaigns it says:

PLEASE NOTE: This topic is for discussions about campaigns Mumsnet is running or may be planning to run. It's not the place for promoting other campaigns or petitions. If you do that here, we will either delete your thread or move it to a more appropriate place on our boards.

Let's hope this thread isn't lost.

nojustificationneeded Wed 27-Jul-11 22:39:50

Sending out info at later antenatal appointments might be a good idea, having laminated copies by each bed or at least on each bay for when baby is born and asleep and you are bored stupid enough up to reading it.

Thank you for posting MrsJRT, it's great to hear from people actually doing this work.

I'm surprised you think information sheets aren't a good idea though. Of course I was exhausted but I still needed to know certain things and it was so frustrating waiting ages to get any information or help.

Oh good catch messy! Yikes, I didn't see that blush

But I might interpret that to mean you shouldn't discuss campaigns being run by other people, so asking MN to start a campaign might still be okay...

MrsJRT Wed 27-Jul-11 22:56:01

Nooooo I didn't say they weren't a good idea, I specifically said they were but I'm just wondering about the best timing for these info sheets. I know when I was on the PN ward I was given a handful of leaflets that I barely glanced at as I was so busy gazing adoringly at my newborn whilst trying to keep my eyes open. I think perhaps a two pronged attack might be beneficial, initial info given at parentcraft perhaps with laminated versions at various points on the postnatal ward. Or perhaps as an insert to your antenatal handheld notes, I know as a first time mum I devoured every bit of info in those notes such was my excitement to actually have a set of them!

messybedhead Wed 27-Jul-11 23:24:51

Ah ok dreamingbohemian hopefully you are right.

I see there are lots of different threads under this topic about starting mumsnet campaigns and they still stand so this one should be okay too.

lalalahahaha Wed 27-Jul-11 23:48:43

MrsJRT's post from the midwife's point of view was very interesting. I'm sure that the main problem is a lack of staff. But in both hospitals where I have given birth, it was very clear that several midwives knew very little about breastfeeding. Thus us definitely an area of postnatal care that needs tp be addressed. One of the hospitals (Liverpool women's) us in a region with among the lowest rates of breastfeeding in the country and I'm not surprised. I saw women who had had caesarians who couldn't even pick up their babies struggling to feed and the midwives didn't really help them. It was definitely partly a time issue bur also a lack of knowledge.

Ah sorry MrsJRT, I misunderstood you blush Thanks for clarifying. Great suggestions!

ada07 Thu 28-Jul-11 00:50:12

Wholeheartedly support a campaign.

My atrocious experience on a postnatal ward is 15+ years ago. Shameful that exactly the same sort of things are still happening now. I didn't complain as it wasn't a priority at the time and I expected a poor service.

Why can some units provide an undeniably positive experience and others not? What has happened to sharing 'good practice'? Would more complaints help this inequity.

Laminated information sheet sounds a great idea.

Am loathe to suggest more involvement of voluntary workers [Big society issues]

PenguinArmy Thu 28-Jul-11 04:09:37

It is a odd one as more support is needed but a lot of isn't needed by midwifes per se. I had no idea about dinners but never asked as I had pre arranged DH to bring it all in assuming I wouldn't get anything anyway (am vegan).

Although one of the helpers brought me in some toast and took DD away as she had been awake for hours and I was on the verge of crying.

Most helpers were great, had ones who told to buzz every time I wanted to feed her, didn't change a nappy myself. Although I felt the focus was on making sure DD was fed as I left the hospital not setting me for long term success.

As others have said more information would be great. I noticed a MW on here said she introduced and caught up with her ladies, I never had that.

Llanarth Thu 28-Jul-11 07:00:33

I assumed I wouldn't be allowed to bring food in, so it never crossed my mind to get DH to do so. If I had known I was allowed to (via an info sheet) that would have improved the quality of my stay enormously - my hospital meal the first night after giving birth was a corned beef sandwich and a yoghurt.

Even including really stupid things about where you/your visitors should go to collect a vase from to put flowers in would free up buzzer time.

I personally would devour a laminated

Llanarth Thu 28-Jul-11 07:03:03

<sorry, DS distracted me>

....devour a lamintated card upon admission to the ward - but then I'm the kinda gal who always reads the hotel info upon check-in

notcitrus Thu 28-Jul-11 09:12:42

I think something to refer to is vital, because even if staff do a wonderful explanation of everything on the ward, someone who's just given birth is not going to remember half of it. In my case most of the explanation was given to my terp before I got to the ward, and then to us while all we could think about was 'is ds in SCBU going to live?' I certainly wasn't listening.

Turned out there was a wonderful explanatory poster - outside the entrance to the ward, which we only saw 3 days later as we left! Totally useless!
It would have been great if copies of that had been given out when we had tours, or at an antenatal visit - the tour of the postnatal ward implied you'd be well looked after and there were loads of staff on call to deal with any questions then. Couldn't be further from the truth!

Anything that is only going to cost say £200/year to maintain (copies of info will go missing), but means half the women on the ward use their buzzer say twice less than otherwise, because they don't need to ask 'When is lunch and how do I get it', must be value for money.

Also a question about discharge - once a paediatrician has signed off your baby as OK to go home, is there any reason why you can't just walk out? Ds and I finally got the all-clear at 10am but weren't 'allowed' out until 5.30 because it turned out we had to have the official lecture on contraception (surely no-one takes it seriously right then?), and someone kept wanting someone else to sign some forms, and it meant another 8 hours of being forced to stay awake rather than be at home.

WOuld it make someone's life really difficult if next time I just say 'Look, I'm taking my officially-OK baby away right now, this is my name' and walked off?

kenobi Thu 28-Jul-11 10:02:03

Anything that is only going to cost say £200/year to maintain but means half the women on the ward use their buzzer say twice less than otherwise, must be value for money.

A laminated sheet is something that could easily be sponsored, meaning no cost AT ALL to the NHS. I know a lot of people find the relentless branding of the UK very annoying but if a service this simple and helpful could have the costs farmed out, even better.

I reckon someone like Pampers/Huggies would leap at the chance to have their branding handed to just about every single mother in the country.

Not sure I'd let baby milk brands do it though...

JustineMumsnet (MNHQ) Thu 28-Jul-11 10:19:31

Hi all,
Thanks for your thoughts on this - reading about people's experiences it certainly seems like there is a lot of room for improvement. It would be good to see if there is simple list of requests/actions we could hone things down to. We'll sticky the thread for a bit so it gets to as wide an audience on here as possible over the next couple of weeks. Please do add your thoughts and experiences if you haven't already and please do also raise any potential problems/ objections if anyone has any.

Thanks.

paddypoopants Thu 28-Jul-11 10:21:23

I would absolutely back this campaign- my postnatal experience was horrible and it was the single worst thing about the birth of my ds. Thinking about it just wants to make me cry. Understaffing at night was basically the issue I think. If the staff are rude it is probably because they have so much to do. Care during the day was haphazard- I only got painkillers once in 2 days. Tonnes of breastfeeding help bizarrely but no actual medical help.
If they haven't the staff to look after vulnerable women they should at least let their partners stay overnight.

nojustificationneeded Thu 28-Jul-11 10:30:57

Just to add I would be willing to approach, print and laminate for at least my local hospitals, I have "contacts" at Blackpool, Bolton and Wigan hospitals smile on wards and in offices in Boltons case.

PelvicFloorOfSteel Thu 28-Jul-11 10:34:03

notcitrus You can just walk out, the staff can't make you stay, although it does appear to create a paperwork nightmare.

I waited to be discharged with DS1. I had DS2 at home but had to go into hospital for stitches (although it turned out I could have had the stitches done at home afterwards), the second the stitches were finished I said "I'm leaving now", gathered my stuff together and walked out. The midwife had to chase me with my notes!

Did cause no end of issues as we had to go back for DS2's baby check up and he had no hospital paperwork, I had no drug chart and I had been given my labour notes, which should have been retained by the hospital. I still have no regrets about getting home to my own shower and then snuggling up with DS2 in my own bed instead of waiting to be discharged properly though.

Justine, thank you so much!

From reading both threads, I might suggest prioritising two things:

One practical: the information sheets (or whatever we want to call them)

In an environment where women need to care for their babies, 24 hours a day, frequently alone, whilst recovering from childbirth as well as medical complications, they need to have as much information as possible to see that the needs of their baby and themselves are met. Currently, the only way to get this information is to ask midwives and other staff, thereby distracting them from more important clinical care. Thus, we ask that postnatal wards be required to provide written and easy accessible instructions on their policies and procedures to every incoming patient. This will improve the ability of mothers to provide their own care and free up staff time to care for patients.

It should be noted that this would cost very little to implement and may have significant efficiency savings.

One political: let's hold David Cameron to his pledge to increase the number of midwives

At a time when NHS resources are stretched to the limit, it may seem infeasible to call for expanded staffing in one area. However, if the emphasis today really is on efficiency and best practice, then hiring more midwives will reduce costs across other areas of practice and in the long run.

[providing we can find the studies that would give this evidence]

It would also be great to do something at the professional level, i.e., to highlight the professional code of conduct for postnatal staff and improved monitoring or training to deal with abusive or negligent staff. But in this economic climate, I'm not sure that will get off the ground. Perhaps something minor could be done though, like have some kind of professional code of conduct posted on the wall or acknowledged in the information sheet.

Actually, perhaps the sheet could mention who to contact if you need to make a formal complaint. The midwives on these threads have encouraged people to complain, saying that's the only way things will get better, so can we make it easier for people to do so?

I am happy to contribute with writing/editing (and roping all my friends into this!)

MrsJRT Thu 28-Jul-11 10:50:49

No there is no reason why you can't just walk out but it causes an administrative mess. Also things like hearing checks, follow up appointments and community midwife visits can get missed. Also if you leave without your notes if you do get a community visit it means that the cmw has no idea what kind of delivery you had, what was done on the postnatal ward or who cared for you in the hospital, meaning vital information can get list or miscommunicated. That said I completely understand why you might not want to wait for your discharge medication but it really isn't our fault the hospital pharmacy only delivers once a day or the labs haven't processed your bloods or the doctors are busy on delivery suite or the paeds are attending a compromised baby. Gawd, I'm getting defensive now and I'm really trying not to because I know postnatal care leaves a lot to be desired but I guess it's just important to me that people understand that just because midwives are the most visible presence on the ward doesn't mean we aren't working to other peoples timetables and workloads a lot of the time. Which brings us full circle back to the understaffing issue, which is rife throughout the NHS not just in midwifery. Sometimes if you are in the middle of something you have to drop it as someone else is available to do something you have been waiting for them to do and it's the only time they can fit it in and so we have to work around them.

Oh and also -- we should perhaps emphasise in this that it's a two-way street, that patients also need to respect the staff and other patients. The threads have also told of really awful patients making life difficult for everyone. So perhaps the information sheet should also ask patients to respect the rules and each other.

MrsJRT Thu 28-Jul-11 10:53:46

Ok so exactly what information would be beneficial to a bleary eyed new mum on the busy postnatal ward? First things first. How to identify staff?

MrsJRT -- I hope you don't mind me asking this. Let's say you had a chance to sit down with David Cameron and ask him to fulfil his pledge to hire 3000 more midwives, even though the NHS has to make cuts and the economy is taking, etc.

From your inside knowledge and experience, what do you think is the most convincing argument? It's obvious that understaffing is a huge problem. Why do you think it's not being dealt with?

Are there other things that could be cut and the money used to hire more midwives?

nojustificationneeded Thu 28-Jul-11 11:01:32

Ok so we need

- whos who in terms in staff
- basic map of ward, where and how to access food, if theres a breast feeding room or other rooms to utilise
- Basic health care advice
- basic baby care advice

I think it would be great to also get a copy out in the later antenatal period with a list of what you will REALLY need on the ward as recommended by mums, there were things I took I didnt need and things I didnt take that would have been really useful!

and maybe a section with quotes from other mums answering things new mums stress about. You know can I do such a thing, is this ok?

Oh sorry, x-post.

Yes, how to identify staff, and who you should ask for what.

A general sense of 'what happens now' -- for example, If You Have Had a C Section: a list of the things that need to happen, and roughly when, before you are discharged (obviously it will vary by patient but things like you will have your catheter removed at this point, you will need to have your wee checked, obs will be taken every hour or whatever, the doctor will examine the baby, hearing test, etc.)

An explanation of the food service (when it comes, how to order if you must do so, if you have to go to another room)

What to do if you need help with breastfeeding
What to do if you need formula

Visitor policies and rules

If the toilets are soiled, who you should tell
Does the ward provide maternity pads?

Perhaps something explaining why it might take some time to receive meds, be discharged -- set realistic expectations for things

That's just off the top of my head, will think some more...

I think it could all be framed as: How to Take Care of Your Baby in Our Postnatal Ward

I think they do provide a good amount of information on how to take care of yourself whilst pregnant, and then how to take care of your infant at home. What's missing is this link -- how to take care of the baby whilst you are in this strange environment, and recovering yourself.

I think it might also have the benefit of standardising postnatal advice (to the extent it can be) -- for instance, I had one person tell me it was fine DS went X hours without feeding, another one tell me I was completely irresponsible for letting it go on so long. Maybe the process of putting a sheet together will encourage staff to get on the same page.

kenobi Thu 28-Jul-11 11:19:24

Absolutely to previous posts, and:

Where to get drinking water (I was soooo thirsty and ended up drinking directly out of sink tap).

When to worry if your baby is sleeping too much/not eating.

And yes to a patient's code of conduct. It is a two-way street.

Deffo full list of what to expect with c-section, plus a list of things you should and shouldn't expect, ie that you should expect help with your baby as aren't supposed to get out of bed (no matter how much the MW grumps at you for asking for help with your 10lb baby).

Sorry, got a bit diverted there!

Oh yes, when to worry is a good one

I was really unsure when to ask if something might be wrong

gallicgirl Thu 28-Jul-11 11:27:33

In regard to Mrs JRT's comments about discharge and what can go wrong if you just walk out - is it worth looking at what happens with HBs?

I had a HB and everything managed to fall into place for checks and things (apart from GP not contacting me for 8 week check!). I think the CMW took my notes away to be entered onto the system and baby records came back a few days later. I forget exactly what happened but it must mean that it's possible to do some of those discharge duties at a later date maybe? There are fairly efficient lines of communication between hospital, CMWs and GPs so maybe these can be utilised more.

marriedinwhite Thu 28-Jul-11 11:34:18

What sticks in my craw is the insenstivity about one's most personal parts and the inability to treat women (me) with a little delicacy. I shall never forget the first midwife who visited my home. She asked about sex, when I was going to have it again and instructed me to start pelvic floor exercises straight away. I ventured that sex was at present the last thing on my mind. She then raised her arm in the air held her elbow with the other hand and waggled the arm in the air at the same time as saying "well if you don't do them your husband he going to say this is how it feels when you do". Sorry but would a midwife like to come on here and tell me why I should respect a profession that employs people who treat women in that manner.

Overall attitude and respect for women. Respect has to be earned.

I found that the advice and babycare side was fine but basic stuff like access to food was really difficult. With such a high turnover of patients, the 'fill a slip in for the next patient' system really didn't work. With ds1 I got one cheese salad in 28 hours, wasn't allowed to bring more than basic snacks in, would have had to discharge us in order to go to the cafe downstairs and was relying on crisps and choclate. Needless to say, with no proper food, the early days of bf'ing were even harder sad.

With ds2 I watched for those paper slips like a hawk and he was born at a more convenient time, so I got to eat.

RozziPringle Thu 28-Jul-11 11:54:27

I support this campaign 100%, Judging by the responses to the thread i started a hell of a lot more obviously needs to be done. The fact that this is so widespread is something that surely cannot be ignored any longer, Women and children are been put at risk by chronic understaffing and in modern day britain this should not be happening.
Women in vunerable states should be supported shown the upmost respect and not treated like an inconvenience and in some cases abused.

happywheezer Thu 28-Jul-11 11:57:56

I really support this campain.
For the reasons outlined in the previous post. It's amazing poor post natal care has been able to go on so poorly for so long.
My experience was recent- 10 weeks ago, but some are 15 years ago.
It seems post c section care is especially patchy and neglectful.
Basically I was told that 24 hrs after section that I would get no food unless I walked 400 metres for it. That's not good enough. And nobody checked.

There was a report recently about old folks who are poorly treated in hospitals. What about new mothers?
It just makes me mad.
How many mothers never have children again due to the poor care they have received?

happywheezer Thu 28-Jul-11 11:59:23

It's campaign and in the end my husband brought me in food, he wasn't allowed to get me food because it was "women only".
How stupid is that?

VivaLeBeaver Thu 28-Jul-11 12:38:22

I fully support and agree with the comments about a lot of things on the postnatal ward being unacceptable. There is no need for rudeness from staff, women should be treated with compassion and get support, food, medical/personal care, food.

I do have to say though with regards to people not waiting for discharge and getting up and leaving........it really bloody annoys me. As jrt said previously it's not our fault we,re waiting for a dr, a paed, meds, etc. It's the one area that I get the most abuse over and believe me people can be very aggressive and nasty about it. My mum was shocked when I told her, she said when she was in hospital you wouldn't even ask when you could go home never mind be ringing the buzzer every twenty mins getting arsier and arsier. I think people's expectations have changed sadly. There is only one paed and one obs sho and I am sorry if they can't come but the chances are someone needs them more than the person wanting to go home. If we upped everyone's ni contributions to 20% maybe we could afford more drs - do you want to do that? No, didn't think so.

If you leave, someone fills your bed within twenty minutes. So I still have just as many women to look after, plus all the paperwork from a woman who is no longer there. It can cause problems for the woman as she has no postnatal notes to take home. I also have to fill out an incident form which takes another twenty/thirty minutes. I have literally chased women through the car park begging them to come back and being ignored or told to fuck off.

MrsChemist Thu 28-Jul-11 12:46:17

Maybe a leaflet put on the beds when they are changed between patients would be the way forward. The MW/porter/HCA escorting you to the PN could then say, "here is all the info about the ward that you might need to know."

That way women would receive the information at least, and wouldn't have to hunt for it.

notcitrus Thu 28-Jul-11 12:50:10

Thank you for your insights from the MW point of view MrsJRT.

At my hospital, all follow-up MW visits had to be organised yourself - you had to phone a different hospital. Ditto hearing checks, GP 6 week check, the lot. No discharge meds either, just told to buy painkillers from the chemis. No continuity of care anyway, so it couldn't get worse.

It would be useful for patients to know that the pharmacy only deliver once a day, which means if there's a cockup in giving you prescribed meds just after birth, it's going to take 24 hours to sort out even after a doc has been tracked down to prescribe them, unless it's a life-threatening emergency.

This was explained to me eventually, but having gone from 60mg codiene 4x daily before birth and then not had any during 2 days of labour, and then it turned out no-one had told the post-natal staff to give me any - to be fair, someone did come and tell me some had been prescribed within two hours of being aware of the situation, but it was nearly 36 hours later when someone turned up with half my usual dose on the grounds that 'the doc said 30-60 so we thought we'd give you just 30' !!

Actually, that's another question - is it really necessary for MWs/nurses to walk round when they have a spare moment with little cups of two paracetamol and supervise you swallowing them? Given that it got to well over 6 hours between promised 4-hourly visits, and pregnant women have been coping taking the stuff for ages, does it have to be doled out and supervised simply because you're in a hospital?
Especially if you're fine and not really a patient but just having to stay in because the baby is there?

VivaLeBeaver Thu 28-Jul-11 13:22:29

Yes it is necessary to supervise patients having paracetamol as its part of the rules and regs surrounding prescribing that the medcine is given and observed to have been taken. There have been cases where people have stockpiled paracetamol/codeine, either because they felt they didn't need it at the time so saved it for later and then unintentionally had too much too close together, other people have attempted suicide and how would a m/w know that its not left unattended and then swallowed by a visiting toddler?

I must admit when its really busy I just tell the woman she must take it now and leave it with her but I'm risking my registration doing that.

hildathebuilder Thu 28-Jul-11 13:49:07

Please please don't frame anything as how to take care of your baby in a postnatal ward. There are usually a number of women who are in the postnatal wards where their babies are in NICU/SCBU. Postnatal is not just about the baby and for those of us who do not have the baby with us it is hard enough being ignored when the staff of necessity concentrate on those who have babies with them. And its worse when you do not know if your baby will live and you are surrounded by mums who have their babies with them.

I support the campaign wholeheatedly, but I thought when I was in hospital than prem mums get a raw deal, and I still do.

If there is to be information on a laminate or similar there needs to be one for babies who have babies in nicu/scbu. And ideally these women should be together whenever resources and space allow away from other mothers.
And bounty people should be banned from coming anywhere near. In fact if it was up to me Bounty people would only visit if you ask them to.

hildathebuilder Thu 28-Jul-11 13:51:36

And if you are in NICU when the mw come round with the paracetomol (which I was every day for 4 days) it is not helpful to have a snotty member of staff moaning at you. Chances are you are more stressed than them.

The system where they left a card and told me where and when to go and get the paracetomol when i wasn't about worked very well however.

Oh gosh Hilda, I'm sorry, that's a really good point.

What do you think about having two information sheets: one for Taking care of yourself, which everyone would get, and one for Taking care of baby, which would only be given to women who clearly have babies with them.

Llanarth Thu 28-Jul-11 14:21:52

notcitrus Thu 28-Jul-11 09:12:42
"Anything that is only going to cost say £200/year to maintain (copies of info will go missing), but means half the women on the ward use their buzzer say twice less than otherwise, because they don't need to ask 'When is lunch and how do I get it', must be value for money."

I think this is a really important point - value for money will need to be demonstrated to get the info sheet scheme adopted at the Trust level, sadly I don't think lofty aims about empowering/enhancing the mother's experience will cut it.

We would need a small scale study (one postnatal ward, 24 hour period) and get all buzzer-answering staff to log how many buzz's (and how many questions asked at the desk/on the ward rounds) are ones that could be avoided if a comprehensive information sheet was available. From this it should be possible to monetize the benefit of the sheets, i.e. reduce buzzer calls by xx %, each buzzer call taking x mins to deal with, means x more MW-hours available for clinical duties.

Could any midwifes here comment as to how much time they think might be freed up by an info sheet? Or are we barking up the wrong tree?

voodoomunkee Thu 28-Jul-11 14:55:21

I would really support this campaign, not because I have had a terrible experience with PN care with either 2 of my children or that I expect to receive bad pn care with my 3rd due in Nov but simply because I have read, with mounting horror, how badly other people feel their care has been and how much it appears to have contributed to decisions not to have more children or to PND. In todays society I really do not think that is at all acceptable. I think the idea of information sheets that are available in a variety of formats (I work with people who are visually impaired so am always championing the need for accessible formats!) and languages is a great idea. It is often the little questions that are actually the ones that you need answering the most!

WillbeanChariot Thu 28-Jul-11 14:55:27

This is really interesting. I am involved in local neonatal networks and there have been changes made in NNUs because they are encouraging parents to be involved and really listening. In fact my local networks now have the opposite problem of information overload and are looking to reduce the amount of info given out to new parents on the unit. There is plenty of will and some funding available, why the difference from postnatal care? Is it because it is usually a short term experience and people leave and never look back? Or is it to do with different commissioning arrangements? I don't know.

I think the info sheets would work well. And the idea of a 'what to bring' list is a good one too.

Hildathebuilder I think we are on the same page re NICU mums and the dreaded Bounty lady.

kenobi Thu 28-Jul-11 15:16:00

Is the Bounty lady the one who takes pics? What's she for?

MrsJRT Thu 28-Jul-11 15:16:56

Our bounty lady is normally very good and always asks which mums she should avoid.

hildathebuilder Thu 28-Jul-11 15:17:06

Willbean I agree that the NICU had lots of info, And it was brilliant and listened. But it was all about the baby nothing about the mother and the postnatal care. I could have been in two different hosptials for the difference it made

Llanarth, that's a really good point.

How can we find a postnatal ward somewhere that would be willing to help us get that information?

And I agree about emphasising the practical benefits. I mean, it's never going to be really pleasant being in hospital. I don't think any of us are asking for super luxury treatment. Really, we are asking for just a bare minimum of care: to be fed, monitored, clean environment, treated with dignity. This bare minimum is what is missing for so many women right now. So in that sense, the information sheets are simply a measure to bring the standard of care up to a minimum standard, it's not asking the NHS to do anything beyond what they should be doing anyway.

lottieloulou Thu 28-Jul-11 16:36:15

it's not just about the care on the ward though is it. I was home within 6 hours with DD1 and then didn't see anyone apart from DH for 2 1/2 days - I was beside myself by the time a MW finally turned up. I had never held a baby before let alone cared for one. We live in a society now where many families are huges distances apart and there just isn't the help around. We saw a different MW then at 10 day post birth. That was it. I was in a terrible state emotionally by this point and felt completely let down. My tear healed badly as it wasn't regularly checked. DD2, independent care and I saw MW every day for 10 days and then once a week for 6 weeks. perhaps a bit excessive but gave me huge reassurance and confidence.

A campaign to improve postnatal care needs to consider the postnatal period as a whole and not just the time in hospital.

Lisatheonewhoeatsdrytoast Thu 28-Jul-11 16:38:27

I agree i'd like a campaign on improving post-natal care, and letting women know situations like mine and many others should NOT be tolerated.

wearenotinkansas Thu 28-Jul-11 16:41:34

I appreciate that Trusts have budgets - so cost is relevant - but I can't help feeling that part of the solution must be to spend some more money on pn care. Mvs and nurses - no matter how good - only have one pair of hands - and unless there are more people, the level of care is always going to be stretched. I know this might mean diverting resources from elsewhere, but a lot of pn women had had major surgery or procedures - and deserve to be looked after properly. And some things - like regular cleaning of bathrooms should be relatively cheap to implement.

My mum trained as a nurse many years ago and she always said that the Ward Sister regime worked well - as everyone was terrified of them and they kept standards high. I don't think we have the same system any more - I wonder if they should reintroduce it? <expecting that all the mvs and nurses will now correct me!>

VivaLeBeaver Thu 28-Jul-11 17:03:12

I think you're right about the ward sister. We have ward sisters still but where I work you rarely see them on the ward. They have an office near the entrance to the ward so they come on the ward, go in their office, sit in the office all day doing paperwork and leave at 5:00pm. They can go weeks without been seen on the ward.

MrsJRT Thu 28-Jul-11 17:30:17

We have ward sisters and they are reasonably visible, although they do spend a ot of time in their offices coming up woth more time wasting rules to follow or paperwork to complete. So much of our day is taken up with paperwork, a lot of it we have to do ourself, such as documentation, but discharges etc could possibly be delegated to a ward clerk type person. We do have a ward clerk who works until half 3 but she is busy all day every day and doesn't work weekends. Delivery suite on the other hand have someone on a 12 hour shift during the day, including weekends. I'm sure it does help.

Was it on this thread that someone was asking about hospital volunteers? Yes we do have them within the hospital but never in the maternity department as it is too much of a security risk, we are a locked ward (another time waste, dealing with the constant ring of the door buzzer, and woe betide if you don't answer it immediately despite their being polite notices explaining we might be busy dealing with YOUR baby or wife or sister or whatever) and although you are right volunteers could help so much it is a matter of what we are actually trying to achieve I suppose. Relying on unpaid help to run a busy hospital ward is not on, many midwives already feel their job is being eroded to the point of being paperwork machines, many of us came into the profession to help women and babies, we like doing the breastfeeding support, the sitting up through the night holding your hand whilst you have the baby blues and showing excited new mums how to bath their baby but we just rarely get the time to do it, that kind of stuff is more and more being delegated to healthcare assistants or support workers who don't have the training we do to assist you adequately, but they're cheap and that is why there are more and more of them and less qualified staff. That is not in any way to be disparaging to support workers, a good one is worth their weight in gold but they are not midwives, they don't go to uni for 3 years (or 18 months if nurses first) to learn the stuff we do and we find it so frustrating that we can't do the parts of our job that we love because we're so bogged down doing other stuff.

Mrsxstitch Thu 28-Jul-11 17:48:58

I think one thing that would help is tell patients that something will take a while eg for a Dr to be free. Personally I would feel more comfortable with that than being told they will be a few minutes then still noone hours later IYSWIM.

duffybeatmetoit Thu 28-Jul-11 17:51:13

The idea of an information sheet was one I suggested to Princess Anne in Southampton for all the reasons everyone has said. I got told in no uncertain terms that it was a complete non-starter as they would have to translate it into umpteen languages and therefore they wouldn't even contemplate it.

kenobi Thu 28-Jul-11 18:21:07

duffy - Translation is expensive, but again, it's something that could be paid for by sponsorship.

Duffy oh that's interesting.

That kind of sounds like a made-up excuse though. Does anyone know if they would in fact be legally required to do this?

I certainly got loads of pamphlets just in English.

Also, not to get all 'big society', but translation is something that you can get volunteers to do, especially as it would just be a short thing. Just thinking of friends of mine who would be willing to do that, I could get you French, Italian, Turkish, Russian, Polish, Bengali, Persian...

AtYourCervix Thu 28-Jul-11 19:24:09

OOh looky - we got a sticky <<preen>>
This is brilliant.

I'll have a thorough read through later but so much good useful suggetions and information.

A few thoughts.

I think every postnatal ward needs information cards/sheets specific to that particular area (standardising maternity care nationwide might be too big a jump) but maybe from all the info MN could do a 'recommendations' list. So things like mealtimes, drinks, visiting, maps, discharges, drugs etc. (other languages also v important). .

I heard today about an area just the other side of here (so we have women from that area in this hosp, but over the health authority border) where midwives do NO postnatal home visits AT ALL. Women are expected to get to the clinic friom the day after they are discharged (whether they have sore perineums, stitches, wounds etc or not). I also heard on the grapevine that there is a proposal to discharge women from community midwife on day 5. The implications make my mind boggle. It cannot go on.

I didn't have a CS but I couldn't help but compare the treatment of the cs women and the care I received post-ectopic (on gynae ward). The point about women who have had a cs being seen as 'post natal' rather than 'post operative' is an important one. The cs women just seemed to be left to fend in the same way as the women who had a normal delivery.

AtYourCervix you should be very proud! Thank you for starting this!! smile

It would indeed have to be specific to every hospital but I imagine we could put together a template, that just has to be filled in?

Fun that was indeed very mind-boggling for me, after my CS, there seemed to be no allowance made for it at all. It was night and day compared to how my DH was treated after a hernia op (also abdominal surgery).

Bonsoir Thu 28-Jul-11 20:26:17

I had absolutely fantastic post-natal care on the NHS and, IMO, post-natal care in the UK is among the very best in the world...

Bonsoir, do you mean postnatal care generally or the postnatal wards?

I think a lot of the things we are talking about are focused on the wards.

strandednomore Thu 28-Jul-11 21:03:52

Sorry haven't had time to read the whole thread so this might have already been suggested but this would have a lot more impact if done in conjunction with eg the NCT.

I think it's a great thing to campaign on though. I had a similar experience to many here - great care antenatally and during my CS's but terrible post-natal care. The first time in particular was shocking. We weren't allowed to take our babies to the place where the food was, but if your partner wasn't around you had no-one to leave your baby with. They weren't going to bring you food so I just went without sometimes. Great way to recover! Couldn't wait to get out of there, when in fact I should have been using that time to recover and learn about things like breastfeeding.

CMOTdibbler Thu 28-Jul-11 21:24:03

My PN care was awful. I appreciate that they were very busy, but I'd had a prem labour,a PPH, and a baby in SCBU and just the teeniest bit of care would have been nice (clean sheets not covered in my blood and food might have been a start). And the Bounty lady would charge in through drawn curtains where I was hand expressing and ask where my baby was.

There were outright lies in my notes too, and if I'd planned to ever go back to that hospital I would have complained - but having done a formal complaint about my mc 'care' and not got anywhere, I didn't expect anything

Dnomaid Thu 28-Jul-11 21:31:30

I fully support your campaign even though I feel priveledged to have received the most excellent care during labour and delivery, and brilliant postnatal care at Worthing Hospital. Even with 2 babies in SCBU the staff couldn't have been more helpful, caring and exemplary (for me at least).
This hospital already produces a laminated information card/ folder that is kept with each bed and has posters asking you to check ID if you're unsure and one midwife told me they were in the process of reorganising the uniforms to make it clearer who everyone is. Maybe examples of " best practice " should be collated to show that what women are asking for is not unattainable - if it can happen in some hospitals for some women it can happen in all hospitals for all women!

mousymouse Thu 28-Jul-11 21:39:57

reg meals, I was also left without. first time because I was transfered from the labour to post natal ward just after dinner. and then another time during my 2 day stay because I was bf baby and by the time we were finished the dinner trolley was gone...
also discharge was late as the paed who was doing his round was called to an emergency just before it was my turn. which resulted in me staying a second night.

it is just so unneccessary

to be fair the lady on the ward who prepared the empty beds etc. was lovely and kept my jug of water filled up all the time.

tigana Thu 28-Jul-11 21:58:11

Fairly certain there is an obligation to provide info in whatever format is requested.
What trusts usually do is print lots in english and several in the other frequently occurring/commonly understood languages in their area (which they should know) and then have a page on the back with the words "please ask if you need this information translating" repeated in every other language.

Any info re BF support can link into the (I think) national target around bfing - about numbers who start and numbers who continue as 6-8 weeks.

Dnomaid that's very interesting! (Where is Worthing Hospital?)

How can we steal borrow from what they're doing?

duffybeatmetoit Thu 28-Jul-11 22:06:33

I thought the response was just an easy way of getting out of doing it. Think Tigana is right.

The basic format should be something that could be done nationally/regionally and then a lot of the translation costs could be shared reducing the cost dramatically. As we've all said, producing that kind of information would save so much staff time wasted on answering questions which aren't specifically medical but are procedural/practical.

tigana Thu 28-Jul-11 22:17:32

There are (or were a year or so ago...pre-Lansley <<spits>>)...national ratios around the number of midwives to patients. I seem to recall they aren't exactly generous, but I wonder how many Trusts are hitting them?

We def need to frame this around outcomes and evidence. It's all about evidence based practice and patient outcomes (and underlying it all...and probably what is the actual selling point for Trusts - productivity).

More info that would be useful to add to list (really basic stuff, but it' s the stuff that went through my mind when I was on PN ward as an inexperienced and self-conscious new mum):

Can I leave my baby alone in order to get food/have pee/change mat pad?
Can I close my curtains/ask for them to be closed?
Reassuring words about it being ok if your baby cries at 2am ( and 3am and 3.30 am etc) even though yes it probably does disturb the other mothers, they are all in same boat.

Dnomaid Thu 28-Jul-11 22:19:51
BagofHolly Thu 28-Jul-11 22:24:54

Funtimewincies you've just put your finger on it - cs women not being treated as a post operative patient! I wonder could RCOG make a comment about that?

BagofHolly Thu 28-Jul-11 22:29:18

Strandednomore, I think we should stay a million miles away from Nct. they have had years and ample to exert their influence in acute maternity care but have failed, miserably. Their agenda isn't about postnatal care either.

twinklegreen Thu 28-Jul-11 22:43:26

I personally feel that it should be essential for midwives and health visitors to have an 'expert' level of training on breastfeeding, it is unacceptable that new mothers trust them and they quite often give very bad, unhelpful information. sad

marriedinwhite Thu 28-Jul-11 22:45:39

Here here BagofHolly - well said.

aseriouslyblondemoment Thu 28-Jul-11 22:56:02

atyourcervix great campaign and well overduesmile
ok ,my experiences are slightly different as my pfb was born at a cottage hospital with v few births a year.cannot fault the mw's in their care or professionalism but lack of food was a huge factor (not their doing the nhs catering co's),sarnies at 5 don't help a new mum, albeit a bf one!
my gripe was serious hunger!
my other dcs were homebirths.
however friends have had their and subsequent babies in hospital and their comments have related to the lack of privacy and inflexibility of how the wards are run.one of these had her baby in scbu

happywheezer Thu 28-Jul-11 23:47:49

Can somebody please forward this to mr Lansley?
I don't think the NCT speak for me either.
I wonder whether SamCam had the same for her post natal section in Truro hospital?

aseriouslyblondemoment Fri 29-Jul-11 00:01:32

agree totally with you hw!
sadly i don't think mr l gives a toss....it's left as usual to the dedication and good will of the nhs who are all in the profession because they care about people unlike him and his croniesangry

MrsJRT Fri 29-Jul-11 00:06:57

Oh bugger i knew I had something else to post! I suspect it wasn't entirely accidental that SamCam happened to be on holiday when she 'went into labour'. Perhaps I'm being far too cynical but there was no way Cameron could have gone private, which I'm sure they'd have preferred but I bet equally they didn't wish to be subjected to the NHS 'service' in a busy understaffed overworked London hospital.

Oooooooh, do you reckon MrsJRT? Scandalous!

I believe it grin

BagofHolly Fri 29-Jul-11 00:27:17

I reckon SamCam really did labour early, and could have done what Cherie Blair did, and get a private room at St.mary's paddington.

MrsJRT Fri 29-Jul-11 09:27:57

Pffft why let the truth get in the way of a good conspiracy theory! I am genuinely quite dubious about the SamCam thing though. All seemed a little too perfect to me. I mean, who goes on holiday that close to their due date?

spout Fri 29-Jul-11 09:39:32

just wanted to add my support to the campaign.

All I'd ask for is for postnatal staff to be encouraged to show a little kindness and empathy. I was treated like the shit on their shoe and I truly believe that their disparaging attitude was the trigger for my PND. It still makes me very sad to think of how cruel they were sad

VivaLeBeaver Fri 29-Jul-11 10:29:35

There's no way that Sam cam would have been subjected to normal standards in a busy London hospital. She would have had one to one care even if the head of midwifery had Medes to be brought in to look after her. Shame really, it would have been good for them to realise how dire things can be at times.

BagofHolly Fri 29-Jul-11 10:39:34

I have to say, if Mr Holly were PM, I'd have wanted him to sort a helicopter or something!

legalalien Fri 29-Jul-11 11:02:56

just noting a couple of posts re community midwives etc: what's the story /expectation there? when I had DS I had one visit from a midwife, I think about three days after the birth - very quick five minute visit and some form signing. Was there supposed to have been more? I could have done with some support as it happened, as didn't have any friends / family nearby and willing to visit / help and DH was away with work for most of the first month. Maybe the info sheet could include some info about expectations in that regard?

strandednomore Fri 29-Jul-11 11:15:35

bagofholly - it's a shame you think that and it sounds like you have not had a good experience of the NCT. However, it is the largest UK charity for parents (bigger than MN) and does campaign on issues including postnatal care - from their website:

Our charitable purpose

We offer information and support in pregnancy, birth and early parenthood

We campaign to improve maternity care and ensure better services and facilities for new parents

We aim to give every parent the chance to make informed choices

This is a very big topic, not something MN can really do on their own and I would think that the NCT would be a good campaigning partner. But perhaps I am a lone voice on this!

Mrsxstitch Fri 29-Jul-11 11:53:27

I have worked in a hospital so no how long discharge can take. When I was being discharged I was asked to sit in the day room as they were desperate for beds. DH wasn't allowed to wait as men weren't allowed in the day room. As I had given up my bed I no longer had the crib for dd. After 4 hrs I asked one of the staff to hold dd while I went to the toilet, I just got shouted at. It was another 2 hrs before I could go to the toilet, it was very painful.

MrsJRT Fri 29-Jul-11 12:22:26

Hmmm, perhaps I'm just a bit cynical, see above posts! But I think that the NCT often have their own agenda and I'm not sure how it fits with what we are trying to achieve.

My experiences of the NCT would also lead me to the same conclusion bagofholly.

Mrsxstitch Fri 29-Jul-11 12:52:10

I too have had a bad experience with the NCT. The only contact I have had with members has involved them making me feel bad for having an EMCS.

I am also not impressed with the NCT.

BagofHolly Fri 29-Jul-11 15:54:15

Stranded, my experience of NCT can be summed up in one phrase - missed opportunities. They have unprecedented access to the young middle classes of the UK and appear to fail influence on real policy change. If they pitched themselves as a parenthood partner then perhaps my experienced wouldn't be the same as everyone else I know - antenatal classes and a magazine with natural births and big bras.

My local Nct teacher is a perfectly pleasant woman but utterly advocates natural birth and fails, repeatedly, to empathise with those for whom a medicalised birth is the right option for them as individuals. "Yes we cover c section and other things that go wrong" is her take on birth. Her closest colleague, broadly recognised as being a jolly good egg, sits on the local maternity liason committee, and is openly vociferous in her belief that maternal choice is a mistake, and people wouldn't chose cs/epidural if only they knew what she knew. It appals me. And her views are absolutely in line with that of NCT. Nct used to be called the Natural Childbirth Campaign and that ethos clearly lingers.

The women we are taking about here, who have had a rotten time with post natal care are disproportionately cs/intervention birth mums and/or SCBU and NICU mums. They're not women who were able to do it the Nct way. And whilst I'm sure that plenty of Nct teachers and representatives would say the organisation is there to support all women in all births, I think for many, the experience is of feeling that if you didn't do it on tens and gas alone, you'd failed in some way.

I'm sure Nct do lots of good work, but not in this area of maternal care. I'd love to be corrected.

BagofHolly Fri 29-Jul-11 15:57:02

Sorry to derail, btw.

strandednomore Fri 29-Jul-11 16:36:24

Ok it's sad that people have that view of the NCT and it sounds like the NCT does need to do more to show women that that ISN'T what it's all about. For me, the NCT is about showing women that they have CHOICES - whatever that choice should be, and not that they have to to what they are told by the medical system. I realise, from reading other threads, that this is a very contentious issue but from my point of view the NCT is exactly about this sort of campaign.

And if it is of any interest, I am training with the NCT to be an antenatal teacher and had two elective cs's (very happily) so it's not all about natural birth. (hope I haven't outed myself there!).

notcitrus Fri 29-Jul-11 17:06:09

My impression of the NCT is they are a very small organisation with lots of almost-uncontrolled local teachers and other local volunteers, who vary hugely. I was lucky in that my local teacher was excellent and did go into detail about caesarians and other intervention - and warned us not to expect anything from postnatal care.
Other people I know had very different experiences. And the local and national magazines really are just trying to sell overpriced crap for them and advertising 'treatments' that are a waste of money.

However, they are an influential group so it would be very helpful if they even just produced a statement saying "The NCT supports the Mumsnet campaign to improve postnatal hospital care for women", with a bit of detail.

reikizen Fri 29-Jul-11 19:42:30

Do you know what ladies, I am seriously concerned about the mindset of mn these days. What has started out as a campaign for better post natal care has ended (yet again) as a vitriolic rant about midwives. What a shame and what a missed opportunity. If you set up a 'them and us' mentality then you will never get what you want. Or will you? Is what you want to be looked after by nurses on a gynae ward and treated as invalids? It seems as if you have no interest in protecting normality or seeing childbirth as a normal life event.You can't stay in bed for 3 days following a section because you will get a DVT or bedsores. With a section rate of nearly 30% how can a midwife caring for 10 women bring you all your dinners, change your sheets, spend an hour helping you to hand express, bath your baby, get your painkillers, carry out daily checks on mum & baby, empty your catheters etc times 10. I routinely have to look after women in early labour as well as post natal women (some of whom, despite what you may think, are capable women who can care for themselves and their babies). It's not possible is it? I would love to know what jobs you all do that give you such a position of authority on how a midwife spends her time.
I wholeheartedly agree with you that postnatal care is the cinderella service as this is where there is less likelihood of serious harm (compared to delivery) but I cannot and will not support a thinly veiled anti-midwives campaign, bourne of ignorance and malice. Do you know what the worst part of my job is? Not the 10 hour shifts without a break, or food, limited access to the toilet, terrifying obstetric emergencies, giving myself a back injury from the hours helping women to breastfeed, having to care for women on the ward because there is no space on delivery, sorting domestic disputes, caring for victims of sexual abuse in an appropriate way, counselling women about poor antenatal results or a poor prognosis for their baby, dressing a dead baby to be cuddled by it's mum for the last time? None of those, they go with the £10 per hour a newly qualified midwife starts on. No, it's mumsnet's attitude to midwives. Have a look at America and see how that medical model of childbirth suits.

mousymouse Fri 29-Jul-11 20:16:08

that's just the point, reikizen, it is not about midwifes, it is about the post natal care that is just not happening at a humane level.
beeing left without food has nothing to do with the midwifes on the ward, neither have clean facilities.
I shudder when I think about the women who don't speak the language well or have no one visiting on the ward bringing in extra food and pads...

HomemadeCommunistRussia Fri 29-Jul-11 20:54:09

reikzen, I can understand why you are upset.

I for one am only interested in helping midwives to focus on the valuable work that they do and to free them up from calls about 'where's the toilet' 'how do I get breakfast' 'where can I get formula/sanitary towels' and so on.

Just a little practical help for bewildered new Mums.

BagofHolly Fri 29-Jul-11 21:16:35

Reikzen, you've missed the point. It's not an anti midwives campaign and despite your obvious distress I'd urge you to go back and read the thread again. We need MORE midwives, better communication and im

BagofHolly Fri 29-Jul-11 21:19:14

improved post natal care and communication. I take my hat off to any midwife who can work in today's NHS. Having spoken to many private midwives, they almost unanimously say that they moved into the private sector so they could have the chance to do the job in the way they believe it should be done.

Stay and let us pump you for info!

So because you are overworked Reikzen, we should lump it and thank our lucky stars hmm? I understand that it must be frustrating when you're pulled in all directions by requests for information which may not be your job, but new mums really are not doing to deliberately increase your workload and make your life more difficult.

As bagofholly says, you've missed the point. We want better resources, training and information. It is perhaps a separate issue that many of us have felt that some midwives (pre- and post-natal) have let us down, including me who was left to deliver my own baby in pain, fear and in danger to myself and my baby, who I failed to catch and who landed head first onto the very hard floor sad.

Mrsxstitch Fri 29-Jul-11 22:15:22

AFAIC no amount of heavy workload excuses rudeness and swearing at patients which many of have experienced. As funtime said new mums are not deliberately trying to increase MW's workload. For instance the young mum who was in at the same time as me who fainted, fell off the toilet and banged her head. We all saw the MW drag her back through the ward for having the audacity to faint and interupt her day. I am as sure as I can be that that new mum would rather not have fainted, surely the treatment she received is inexcusable.

If these systems and information sheets being suggested can free up a MW's time to get on with other stuff.

I have thought of something. A lot of us became very dehydrated on the ward due to the eat and trying (often unsuccessfully) to establish breast feeding). Water jugs were only replenished every second day if you were lucky due to time restraints. However the taps with drinking water were in a staff only area so we could not get water ourselves. A simple solution would be to have a tap with drinking water in an accessible area so mum's can top up their jugs themselves and are less likely to annoy the busy MW's when really longing for something to drink.

happywheezer Fri 29-Jul-11 22:59:47

I don't think in anyway any of us think this way about Midwives reikzen.
You are being shortchanged aswell as a midwife. You need more help.
My care was poor because of the lack of midwives, too many births not because of the midwives that were there. I only complained about the care that I had not the midwives. It's your managers that should be ashamed.

I spoke to my husband about my care and he said "they know" meaning that midwives know that they aren't giving good enough care to the ladies that they look after. You would want to do more for post natal care because you can't because there is not enough of you- that's not your fault.

Mrsxstich I'm not sure I agree with the way your response "no amount of heavy workload excuses rudeness and swearing at patients ...[tale of appalling treatment] surely the treatment she received is inexcusable." puts the blame squarely on the front line service providers. In my experience in other sectors, when things are this bad it is really because of management priority, practice and supervision. When so many women across the board experience dire treatment that is because of systematic failings in the service, not simply individuals being incapable of performing a reasonable role.

reikizen it is lamentable when professionals who have the opportunity to hear first hand the experience of people they serve and find it uncomplimentary take that as a personal affront. Whether midwives are working hard or not, whether the practices are intended to (or do) generally improve people's lives or not, your imperious dismissal of the experiences of the women who are on the receiving end of this treatment is abhorrent.

Mrsxstitch Fri 29-Jul-11 23:12:44

That was not the only thing I witnessed prospects and I was shouted at and sworn at myself. I agree the systems is failing both staff and patients. IME however there were some MW who used this as an excuse for poor treatment of patients. Please note I said some not all. That was the point I was trying to make. There should be ways to either bring these MWs up to the standards of the other MW or to get rid of them tbh.

I agree there must be a few MWs out there who would be poor even in unstressful conditions. I don't think it's reasonable to expect any job to never have a bad apple. But given the extent of the problem demonstrated on these threads I don't think it is the crux of the problem, it's just far too widespread. Developing a work environment in which the resources are sufficient, the attitude is respectful and the few truly bad apples are removed is a leadership role that rests with management (and in theory the The Nursing and Midwifery Council). It isn't something that can come about through a focus on simply trying to persuade MWs as a group not to bully patients.

hazeyjane Sat 30-Jul-11 05:57:42

I think a lot of it must come down to the culture of the working environment. At Wexham park, I was stunned that so many of the hcp were neglectful and bordering on abusive. But because it seemed acceptable to treat women as if they were a constant royal pain in the arse, it continued.

I saw the same thing at Charing Cross (not post natal). I felt truly sorry for the nurses(and MWs at wexham)who were trying hard to do their jobs well and with compassion, because they were working in such awful environments.

I don't know how we change that culture.

Reikizen, so many of the experiences described on this and the other thread, can't just be put down to being overworked, poorly paid etc. Would that make it right to be laughing with a colleague about a woman, covered in her own shit, sobbing, having had no sleep or pain relief, surely that sort of behaviour has to be deemed completely unacceptable.

mumwithdice Sat 30-Jul-11 11:39:10

I think MrsJRT mentioned volunteers doing things like water, etc, but is there any way volunteers could help with the paperwork? That seems to be the biggest time-eater from what I've heard.

Reikizen: 'Is what you want to be looked after by nurses on a gynae ward and treated as invalids? It seems as if you have no interest in protecting normality or seeing childbirth as a normal life event.'

I'm sorry but having abdominal surgery is not a normal life event. If that is how midwives see section patients then yes, I would rather be treated by nurses on a gynae ward.

And no I don't have any interest in protecting normality, I don't even know what that means.

I think all the suggestions here are totally in the spirit of helping midwives do the most important bits of their job, which would hopefully make life easier for them. I think the campaign really needs to emphasise that above all.

SnoozleDoozle Sat 30-Jul-11 18:52:33

Childbirth might be a normal life event, but it hurts, and a lot of women are left in considerable pain after the event. Why should they be treated with less care than a hospital patient who is in pain for any other reason? The postnatal care after my emergency CS was horrendous - like many others have mentioned, I was left numbed from the spinal block, and yet scolded for being unable to get out of bed. I hadn't slept for about three days, nor was I allowed to eat (I was actually light headed and faint with hunger) due to having been in pain with contractions, yet when I asked for help with my baby, I was told 'and what are you going to do when you get home? We won't be here to help you then!'. Er, at home I have a husband. The postnatal experience was the worst of my life.

On the other hand, the after care in my own home from the community midwives and health visitor was excellent.

And also, my local hospital does not allow you to bring any of your own food or drink into the hospital, so heaven help you if you end up missing a mealtime or whatever.

I understand hospital policy in some areas makes it almost impossible but if mums were encouraged by the antenatal teams to include (sealed) snacks in their hospital bags, because food might not be available after labour, this would help for when you're flagging, back on the ward at 3am, ravenous and tired.

I was tipped off by an experienced mum and took bags of peanuts and raisins, choccie bars, flapjacks, juice and all sorts in my hospital bag, the hospital didn't seem to mind anyway so I could graze across the 24/48 hours I was in second/first time, it was so lovely to just stick my hand in my bag and get something to eat out, especially as they were the things I liked to eat. If I had to wait for the set meals I'd have fainted with exhaustion and the one time I had to do the john wayne shuffle to collect it it wasn't worth the trip.

If and when there was another I'd get more inventive and have a tupperware of pasta, a flask of tea... Only hope hospital policy wouldn't confiscate them.

I want to add that I have found all the gazillion midwives I have seen (fleetingly) along the way to be absolutely fabulous and where I've had gripes it has been the systems or procedures, not the individuals.

eurochick Sat 30-Jul-11 20:28:41

I haven't read the whole thread but I did read the thread about experiences of post-natal care. I don't have my own experience to draw on (am still ttc) but it seems to me that what is needed is not medical help but old-fashioned "sicknursing". Basically someone to get you a drink when you are thirsty, pass you your baby if you can't sit up after a section, help you get to the toilet, etc. From the sounds of it, people don't need more medical care in most cases, they just need more care. Hospitals seem to have forgotten this most basic part of their role. I guess it has got lost in staff shortages and too much paperwork.

cocoachannel Sat 30-Jul-11 20:46:41

What struck me after having DD1 5 months ago was the bizarre allocation of funds. I experienced poor postnatal care in the 24 hour hospital stay post-partum, and then a week later was offered a five week baby massage course on the NHS, for no particular reason (baby didn't have colic or such like...). hmm

I realise that there are different pots of funding, so it is not as simple as saying that by cancelling the massage, more funds could be directed to hospital care, but I do wonder whether a full review is needed which includes these additional services.

DontCallMePeanut Sat 30-Jul-11 20:53:35

Reikizen: 'Is what you want to be looked after by nurses on a gynae ward and treated as invalids? It seems as if you have no interest in protecting normality or seeing childbirth as a normal life event.'

But it's not really a "normal" life event, is it? At least 50 % of the population never experience it, and everyone's pregnancy (and post natal needs) are different. This should be reflected in the way the patients are treated.

tiredmidwife Sat 30-Jul-11 21:07:35

Where I work there is a big push for one to one care in labour which will be wonderful, making births safer for women and hopefully will improve normal birth rates and birth experiences for women. However it all comes at a cost and all women who deliver normally without complications will be expected to go straight home regardless of how they are feeling and what support they will need with feeding. They will not be offered extra post natal visiting by midwives but will be expected to access breastfeeding groups run by childrens centres and hv's if they need further bf support. All the midwives here find this difficult to accept but have no choice but to send women home early.

As an aside I have seen overworked midwives being rude to women and there is no excuse whatsoever for rudeness. We need to remember that it is a huge scary thing having a baby and a smile and friendly face can go along way even if the person is extremely busy. It is a minority of midwives and support workers that do this but sadly when a woman is very emotional after having a baby it can do great harm at what should be an extremely happy time in her life.

Another thing is that many women have complained that they didn't have help with general babycare, getting their dinners, going to the shower and toilet. It doesn't have to be a midwife who does this sort of thing and I feel that if there were more maternity support workers well trained to work in maternity this would help immensely.

I was shock shocked and horrified that someone posted that their hospital don't allow people to bring in their own food. That seems totally wrong, especially if they are not going to provide a decent feed for a woman who has just given birth.

SurprisEs Sat 30-Jul-11 21:23:41

I had never held a newborn and the only thing I asked for was that I was shown how to hold a baby when giving my daughter a bath. Got sent home 8 hours after giving birth to my first baby still not having been shown how to do it.

HalleLouja Sat 30-Jul-11 21:29:00

I spent a lot of time in hospital before and after delivery and on the whole they were amazing. There were a few mws who were miserable but most did their best to help. My main concern is they are shutting down the ward so everyone will need to travel much further and if you spent as much time as I did that would be a real headache.

With regards to scbu mums it would be good if they could bf put on a ward without babies as this helped me. Would have been inconsolable on a post natal ward with screaming babies.

The day room had a fridge with left over yogurt etc we could help ourselves to and biscuits.

One of the worst things was everyone had their curtains shut and didn't talk in the room but more chatty in the day room. Mws with little post degree experience were expected to do far more than their pay grade and were overstretched.

As someone said something needs to be communicated about pharmacy times and the fact that drs take a long long time to come round. Would make the wait easier.

SnoozleDoozle Sat 30-Jul-11 22:08:24

It was me who posted about not being allowed to bring food into the hospital - my hospital has big posters up all around it saying that visitors etc are not allowed to bring food, flowers etc and says it is for patient safety as an 'infection control measure'. hmm I had just assumed that it was a nationwide NHS policy, it wasn't until reading this thread today that I discovered it was unusual.

I was in hospital for 8 days when DD was born and had no food at all for three of those days. It was brutal.

SurprisEs Sat 30-Jul-11 22:14:06

eurochick I couldn't have said it any better.

tiggersreturn Sat 30-Jul-11 22:43:25

1. Make it possible to have food at all times not just providing you're on post-natal by 9.30am. Some hospitals do picnic packs at any time of day or date. An idea that should be copied.
2. Don't delegate important things such as pain relief to HCAs who can't read charts. Make mws or medical professionals responsible for these items. It is not acceptable to have to go 24 hours after a major surgery with no pain relief.
3. Get more staff! There's no way 2 mws can adequately look after 40 women.

foreverondiet Sat 30-Jul-11 22:48:17

My personal view is that women need their partners with them for the first 12 hours after the birth, and perhaps the trade off would be that more of those with straightforward births would be encouraged to leave within this 12 hour period. Yes this would mean a need for more private rooms. I do take the point about school runs within 24 hours but thats nothing to do with the NHS...

I also think that there needs to be more breastfeeding support and a number to call for the hospitals BFing counsellor, that you could pop in and visit even if you'd been discharged. Doesn't have to necessarily be 24 hour but would need to be available 7 days a week.

The after care when I had DC1 was not good; DH had to leave at 8pm, the ward was noisy all night (midwife had loud discussion with a non english speaking mother about a) why her baby needed vit k and b) that the hospital couldn't supply nappies) plus crying babies etc. TBH I can't even remember the food, as it somehow didn't seem relevant. They then lost my notes so couldn't discharge me but we decided to leave anyway as i was so tired i was sobbing after 2 nights of no sleep (one in labour and one on post natal ward), and other than lost notes no other reason to stay.

Both DC2 and DC3 born in birth centres and could stay in labour room until we left (and DH could stay) - what a different experience.

molepom Sat 30-Jul-11 22:52:07

Haven't read the whole thread but the title did force one thing to my mind.

Can midwives/healthvisitors not be so quick to diagnose you as PND and that it is actually just tiredness?

Also, if you are going to advise family members to help, please do so in a way without the words "Watch her like a hawk".

I refused to see any health visitor after that because she made me feel so crap. I did complain but heard nothing from it.

deliakate Sat 30-Jul-11 22:58:51

My post natal care with no. 1 was fab and I was apparently well looked after. I think it must have been because it was a very complicated delivery, with magnesium sulphate infusions for severe pre-eclampsia, and 2 nights in HDU for me afterwards. Then DH paid hundreds for a private room for the following 2 nights.

No. 2 was not so great. This was because although it was the same hospital as before, they had changed their post-natal notes format. Nothing was recorded on the notes about the problems I'd had last time. I was pressurised encouraged to be getting home after 6 hours to a 22 month old toddler and no family, which I resisted. However, I was sent home the next day, with a perfunctory obs performed - where the nurse noticed my raised bp, but didn't comment, because she didn't know the previous history.

Result was that the community midwives sent me back into hospital twice as it kept on shooting up, so I was yo-yoing back and forth with my newborn in a blimmin car seat, and had two extra nights in hosp while they sorted out my medication.

So I think there just needs to be more attention paid to the patients' history. I felt like it was down to me all the time to remind people of my bp problems and promt them to check it, rather than it being visible when they opened up my notes. I was treated like a first time mother in many regards.

foreverondiet Sat 30-Jul-11 22:58:53

In response to some of the other comments:

1. We took loads of food in to hospital. I do think its a bit unrealistic for the hospital to be able to provide proper food if you can't have dinner at the right time as you are in advanced labour and are starving at 10pm. It might be nice if there was a bread and a toaster and some jam though.

2. I don't think its the hospitals job to show you how to bath your baby on a post natal ward.

3. re: school run within 24 hours comments - in the community in which i live this just doesn't happen. someone organises a meal rota for 2 or more weeks, others bring the older children home from school or do playdates for them. i don't think thats up to the nhs though, other perhaps a mumsnet campaign on that would be good - when DC3 was born both DC1&2's school PTA and our synagogue called to ask if we wanted meal rotas, and I didn't do a school run for weeks.

BagofHolly Sat 30-Jul-11 23:09:22

I think a lot could be learned from The Rosie at Addenbrookes. I was there as an inpatient antenatally and both ante and postnatal women had access to a day room, breastfeeding room and a canteen where the food was served. If you couldn't get out of bed they brought it to you, and if you'd put a slip in saying you would be around for meals, and then missed it, they saved it for you.
The canteen was open 24/7 and had tea and coffee making facilities, cereal and biscuits and water, so if you got the munchies in the middle of the night there was somewhere to go.
There were a selection of vending machines just outside the door of the ward so again there was somewhere to get things at all times without having to go to the main hospital shop.
There was a small kitchen with fridge and microwave, and I sent my husband to Waitrose nearby for a stash of nice ready meals.
The bathrooms were spotless. The staff worked mega hard and yet were always pleasant and wanted to help. I transferred to deliver elsewhere so I never got to see what it was like post delivery but as the post delivery girls were down the end of the same ward I can't imagine it was hugely different.
Jolly well done to The Rosie, IMO!

tiggersreturn Sat 30-Jul-11 23:13:04

foreveronadiet I'm not suggesting you should be fed a hot meal any time of day or night but it's not reasonable to get onto PN at 10am having been in labour for over 24 hours with no food and be told you can't have lunch or supper because you didn't order it at 9.30.

SurprisEs Sat 30-Jul-11 23:25:46

foreveronadiet should we then say it's not their job to help you breastfeed? All aspects of babycare should be adressed as soon as a new mother shows insecurity.

foreverondiet Sun 31-Jul-11 00:13:40

I can see that there are limited resources and so these have to be used wisely. I still think the most important thing is that your partner can stay for the first 12 hours.

re: food. As I said I took with, because I expected the hospital food not to be nice. I recall being offered toast (made by the midwifes) after I'd given birth, but I didn't need it as I had smoked salmon bagels in my bag. It might just be very expensive to organise meals outside the normal schedule, and if there are limited resources I am not convinced that this should be a priority. Clearly if you are there at mealtimes, but didn't order in advance etc they should try to accommodate. I remember with DD (DC1) arriving on the ward and them asking what I wanted to eat the next day and me saying, don't order me anything I don't plan to be here tomorrow, and then having discussion that it was too late to order for that day. In the event a breakfast did appear and I left at 1pm so didn't need lunch (although thats other whole story because we left without a discharge as they lost my notes, I had wanted to go home straight from labour ward but DD was a bit distressed at birth so we had to stay in for 24 hours).

re: bathing, I stand by what I said before. Again of course if there was infinite amounts of money they'd be able to accommodate but I don't think this should be a priority. Of course they should show you how to breastfeed for obvious reasons, but learning to bath a baby can be picked up from a book, from youtube etc etc not rocket science. Also babies don't need bathed immediately and the midwifes visit at home the next day so maybe this would be more appropriate? No one showed us, I'd also never really held a baby, or changed a nappy we just worked it out, looking at a book, never occurred to ask the hospital staff. Ideally the hospital would run ante-natal classes showing how to bath a baby, breastfeed, etc etc so that this wouldn't need to be covered on the busy post natal ward.

Qualisegg Sun 31-Jul-11 00:58:55

BagofHolly When were you in the Rosie? I was pleasantly surprised to read your experiences, as I've been reading this thread nodding along to SO many of the comments and horrid experiences. I had DC1 at the Rosie and my experience of the postnatal 'care' there was one of the main reasons DCs2 & 3 were born elsewhere. I missed meals because I didn't know how to access them, the toilets and showers were not clean (blood). I was left not knowing when my epidural would wear off and the support for breastfeeding was frankly shit. Discharge took hour upon hour. I could go on. But, this was 6 years ago and I would be delighted to hear things have improved smile.

pickgo Sun 31-Jul-11 01:48:54

I think the single most important thing that could be done to improve pn care would be to have compulsory feedback forms for every mother to fill in before discharge and the the results were collated and made public every quarter.

Wormshuffler Sun 31-Jul-11 07:18:13

I am currently 17 weeks and the anxiety of post natal care is ruining my pregnancy. I will have a ELCS for medical need, so already know I face at least 2 sleepless and stressfull nights in hospital. With DC1 I had a post operative heamatota (sp) because I had done too much moving around apparently. I just did as I was told!

I am currently googling if I can claim anything on Bupa for example a private room, but not having much luck.

It just seems so wrong what they expect post CS ladies to be able to do, they wouldn't expect a post hysterectomy patient to pick up a 7 pound plus weight up to ten times in a day, nore would they tell you to get up the next morning and fetch your own toast.

SurprisEs Sun 31-Jul-11 07:29:21

foreveronadiet breastfeeding can be read about in books too. What I really meant by my post was not that every mother should be shown every aspect of caring for a baby but that there appears to be a huge pressure to send you home as quickly as possible and let the insecurities be delt with by someone else but me because I'm busy. It's not the right attitude. A 2 minute chat about it and a smile would have done it for me.

hildathebuilder Sun 31-Jul-11 07:34:17

Bagofholly. IME the Rosie is very good at somethings but my postnatal care was there and my comments about the bounty lady, keeping nicu/scbu mums together and away frm crying babies, not being able to get drugs because I was on the NICU with ds were in respect of that hospital last year.

One other comment I would add which could improve thigns is that at no point should I have been made to keep the curtain around my bed open when I was in floods of tears (not just because of DS, but also because my FIL died while I was still in hospital and my DH was trying to deal with that and arranging a funeral as well as caring for me and DS) to be faced with another mother, her baby and countless visitors in the next bed. As I said before I didn't know that my ds would live. I was mobile and had no catherter/drugs etc so although I was in hospital I didn't need careful observation.

I just wish they could have kept the sara ward open. the staff tried their best, many were lovely, all were overworked and some were rude. The staff on NICU and SCBU were so much more helpful. The scbu staff encouraged me to complain as my comments were comments they heard time and time again in scbu and nicu.

I would however say that getting one to one care for babies on NICU is still a long way off despite NICU being an intensive care ward and that is I believe a higher priority.

I also spent a night on a gynae ward the same year. the care there was much much better than postnatal care, despite the fact I was there after an early pregnancy problem.

cardamomginger Sun 31-Jul-11 08:38:57

Haven't had time to read the whole thread, and I'm sure this has been said somewhere already, but I think it is completely unacceptable for there to be (a) too few toilet and bathroom facilities on PN wards and (b) dirty toilets and bathrooms. It is shocking that anyone in an NHS hospital should be forced to negotiate puddles of other people's blood and urine in order to use the toilet or have a shower. This is just basic common sense and hygeine. When I was on the antenatal ward in my hospital, the toilets were too few, some were broken and they were dirty (although there was no blood to contend with) so I went downstairs to use the spotless toilets in the main bit of the hospital. The chart in these toilets indicated a cleaning schedule of once per hour. Why can't the PN toilets be cleaned just as diligently? Lack of resources is no excuse for putting women and their newborns at risk of infection in this way.

ohanotherone Sun 31-Jul-11 08:57:11

This is what I would do to improve postnatal care:

Continuity of care from the same staff as much as possible - not different staff every single shift. I saw 80 different staff in 9 days at the Chelsea & Westminster. Paeds, HCA, midwife, Doctors etc... yet the same staff were on the ward so it would have been possible.

Staff that are less noisy and bullying and consistency of advice across staff about breatfeeding and hospital routines.

Quietness - TV's, phones, Other people having 4 or 5 adults about the bed, I didn't sleep for the whole 9 days and am traumatised by it, okay if you are in for one or two nights, really distressing not getting any sleep for that length of time with staff that don't realise how tired you actually are and tell you things like "you'll have to feed your own baby" when you can't actually physically pick them up through tiredness. Seeing my notes with "ONO is a little tired" was the understatement of the centuary.

Cleanliness - The toilets were soiled with faeces and blood and blocked for 3 days. There was broken glass under my bed for two days. The cleaning supervisior spent ages trying to get a cleaner to clean properly. The cleaner was arguing with her. If I hadn't had high BP I would joined in and told him he would lose his job if he carried on. It was unacceptable.

Food - Staff who care that someone gets fed and can communicate in English so don't take away food before it's eaten. Good food not one baked potato without butter and rotten carrots.

There's probably more but that's enough for now......

lovemysleep Sun 31-Jul-11 11:17:51

I would definately support this campaign - one of the reasons that I am going for a HB this time round is that I couldn't bear the postnatal care at my local hospital.
It would seem that a lack of staffing was the main problem where I was - no doctor available to discharge me, needing the loo but unable to get up as I was still numb from the epidural - when I buzzed someone to help me, she was rude and I was made to feel like I was being a pain.
I was confident enought to do the feeding/changing etc, so didn't bother them much at all. Overall, the staff were nearly all rude and abrupt.
So, my experience wasn't so bad in comparison to some, but I would definately agree that they need to prioritise the patients who are ready to discharge, as this would ease the load and make it much easier all on staffing levels. Better information available at your bedside in the form of laminated cards would be great too.

KitKat84 Sun 31-Jul-11 11:20:09

I discharged myself after a dire hospital stay with my first. They barely spoke to me the entire time I was there despite the difficult birth I had. It wasn't until I demanded to be discharged right that minute as I couldn't take another night of staying there that they suddenly seemed to realise I was actually there. This was nearly 9 years ago and the trauma of it still lives with me. I think it severely effected my bond with my daughter, I had PND and flashbacks to the PN "care" I received. It traumatised me so much that i had my second baby at home 5 years ago.
I wasn't offered food, I wish I had known I could have got my partner to bring some in. I had no appetite anyway but I could have done with some energy. I remember one HCP (no idea who she was) telling me to "pull yourself together".

I think a list of who is who would be incredibly useful. And perhaps some info before you have your baby about hospital guidelines, food, toilets, nappy changing, what you need to bring in with you etc ... would be really good too. I had no idea, I didn't even have a hospital tour before I went in.

KitKat84 Sun 31-Jul-11 11:22:26

Tbh I have no idea what the PN wards are like now, as I said my stay was 9 years ago almost. I do know that staffing wasn't an issue, there were loads of staff milling around the reception area talking.

Jcee Sun 31-Jul-11 12:30:29

I would support this campaign, my post natal care after an emcs was appalling. I'd been booked into the hospital's midwife led unit but DD was an undiagnosed breech in distress so I ended up with an emcs and 2 days in the post natal ward. The key things for me were food and getting information.

I arrived on the ward just after 12 after being in delivery for 12 hours and as lunch had been served, I didn't get offered a meal until 6pm. Availability of a kitchen with basic supplies - drinks, toaster, bread, jam, cereal etc -would have been so helpful. Ironically the midwife led unit upstairs from the post natal ward had one!

Meals were prepared and collected from a kitchen area and had to be carried back to your bed on a tray, but no-one told you this. So I missed 1 meal because I was alone and unable to get out of bed to get food, so I didn't have anything until DP came in later and went to the hospital shop.

When I'd figured out where to go as I still had a drain in my groin which was attached to some bottle of gunk, the only way I could carry it all was to put the drain bottle next to my meal on the tray...very dignified!

If food wasn't collected in the 10 minute availability window you didn't get a meal. There were no checks to see if you'd eaten or offers of help to get food. Other women in my section of the ward missed meals because they were breast feeding or in the toilet/shower!

An info sheet with key facts about the ward would have been useful - food comes from here, at this time, you need to get it yourself, visting times, lights will go out at 8.30pm for the evening etc. If I'd known some of this in advance I would have been prepared and might have packed better.

I look back now and think it was madness, but at the time I was disorientated, in a hormonal fug, emotional and just went along with it.

As mother to a 10wo DD who is suffering from her second infection follinwg her birth (induced 5 days after waters broke, she's been riddled with infection since) this campaign has my complete and utter support. Lets not just focus it on the hospital though - my postnatal check at the GP was a sham. And something should be noted that just because I have another child, doesn't mean I 'know what I'm doing' and its not 'like teaching your grandmother to suck eggs'. i need help, advice and support. And I'm only really getting it from you lot here.

Thanks, btw.

TooImmature2BDumbledore Sun 31-Jul-11 14:00:40

I'd be v glad to support this campaign too. I haven't anything similar to relate (DD was stillborn, so I had a private room with en-suite and DH was allowed to stay in a camp bed and all the MWs etc were really nice to me), but I work in organisational change and the system as a whole shocks me.

One key thing (already mentioned upthread): It is the system that is at fault, not the individual people.

The staff involved already know what needs to be changed, what they need is a bit of help to get it started. I would suggest to any midwives or other HCP out there that they try a bit of simple demand analysis. Basically, keep a record of everything you are asked to do for a whole day, and preferably encourage others to do the same.

Eg:

Demand: I want to know where/how I get food.
Who: Patient
Is this the first time they have asked this (of anyone, not just of you)?: Yes

You build up a picture of the top few demands, and the ones that patients most consistently have to ask repeatedly. Take your top demand and see if there is anything you can do to stop patients having to ask it (in this example, info leaflets would help to reduce the number of patients asking about food). It gives you some very powerful stats to show managers, and it takes very little time to do it. Obviously, some demands (eg I want to know when I can be discharged) may be without your power to change without extra staff/funding, but at least you can show your managers what the biggest demands on your time are.

gateacre1 Sun 31-Jul-11 14:44:40

sorry i have not read all of thread yet.
I wanted to add that while I was researching hospitals for my second birth I found on an nhs complaint website that a lady had complained about her terrible post natal care, The hospital St Thomas's London in response to the complaint said that the post natal staff would undergo customer service type training to learn how to be politer to patients and more understanding.

I will see if I can find the link

I have to say that the post natal ward was not as bad as I had expected at the hospital although the night staff were very hostile when you buzzed in the evening to ask for help to pass a nappy/cotton wool

One hilarious moment was when I asked a HCA if I could have dry pads under me as I was covered and the bed covered in blood. ( I had just had a C section couldnt move my legs and had a catheter- she told me to move myself so she could change the bed ..... I was incredulous I informed her I couldnt move and she told me it was not her job to move me)

however the obgyn who did my op was so kind she came to see me on her day off and signed my discharge papers as she knew I was desperate to get home!

gateacre1 Sun 31-Jul-11 14:45:54

ok I am really sorry I dont know how to do the linky thing but here is the url with the response from the hospital

http://www.patientopinion.org.uk/opinions/33818

MrsJRT Sun 31-Jul-11 15:04:29

I can see what St Thomas's are trying to do there but quite honestly stuff like that makes my blood pressure rise, rather than admitting that their staff are overworked and put under too much pressure to meet unattainable targets it must be because they don't understand how to talk to people. I'd bet an extra midwife every shift would have a much greater effect on politeness levels than some customer service course!

MrsJRT Sun 31-Jul-11 15:27:16

Just as an aside we (and HCA's) are not "allowed" to move you. We may assist in talking you through moving or support you whilst you move yourself but we are not able to lift you or move you up the bed etc. If we hurt ourselves doing something like that our careers could be over and the trust would not support us in any way. Of course that is not explained to women.

hazeyjane Sun 31-Jul-11 15:34:44

Mrs JRT, some of the attitude and behaviour of staff is not just down to being overworked etc. I'm sorry but some of the nurse and MWs I came across were just bloody rude and abusive. In these circumstances I think there should be a straightforward way of passing on a complaint, and a visible sign that something is being done to address the problem.

Mrsxstitch Sun 31-Jul-11 16:37:53

Whilst I agree that staff are over worked and understaffed it is no excuse for the rudeness that I and many other women have experienced. I work in the NHS and have been under pressure like this, have been threatened and even assaulted by patients. Yet every time I have gone on to treat the next patient with respect, politeness and empathy. Admitedly I will sometimes think to myself that the patient is overreacting or whatever but that is my problem not there's I may see it all the time but they don't and deserve civility at the very least which incidently costs nothing.

kippersandjam Sun 31-Jul-11 17:05:08

mine was dreadful from the moment I stepped into the maternity unit. mw at docs was awful as well, but common knowledge, so just saw my doc, who said"completely understood, she was always getting complained about"
on arrival
-ignored by mw gossiping round desk-we could hear and see them all chatting about last night out even though we were right in front of them at the desk. ignored with impassivity of a head waiter my dh said.
-told that i should go home as they were busy, even though told by consultant to do in as needed immediate c section. admitted with v bad grace after consultant got angry.
-was deceided to do cs, mw in labour unit FAB. she was as she disagreed with new consultant on my care, lucky for me as he was suspended on full pay after wanting to do illegal procedure on me that would, the new consultant said, have killed me.
- surgery, apart from already posted below, cut baby, student stitching, massive loss of blood which FAB MW dealt with also with army of efficient mw never to be seen again.
-ward- mw came when buzzed to hand me ds as i was stuck in bed with catheter. she picked up ds, said, be back soon and went off with screaming baby for 30 mins. in end another mum went to get her as i was hysterical as hadn't seen her before, it was dead of night and thought she had taken my baby.
-refused to take out catheter as wasn't her job. told it was by irate other mw, still wouldn't.
-they forgot to read my notes, forced me to take shower alone. i said i felt v weak after loss of blood. they said it would be ok. collapsed in filthy shower blood everywhere. another doc came and said i now needed blood transfusion. refused as now sure they were out to get me. (nutty i know, but understandable)
-mw said i should just leave if not having bt as they needed the bed, despite still being on catheter. rang dh in tears, he called head mw who told horrible mw to stay away after my complaint being the last straw.
- mw wrongly calculated weigt of ds, i did it myself, turned out she had no idea how to do %. left hospital asap

-food- dismal, pre wrapped garage sandwiches and toast. no wonder milk takes so long to come down. and you had to get it yourself in from fridge in waiting room with all the visitors.

nightmare. surprised anyone has more than one baby.


i did complain in writing but of course go nowhere, letter unanswered and just a long form letter about how they were always working to improve themselves and how they liked getting feedback. The independent org that handles complaints said they they have this all the time and often it is more distressing to complain as often the response is ignored and handled badly, causing the new mother more stress when she should be enjoying her baby and recovering

lilystar Sun 31-Jul-11 17:05:28

MrsJRT - who would a patient need to speak to, to get help moving? Where is this explained to them?

seoladair Sun 31-Jul-11 17:35:01

I'm so shocked by this thread. I had daily home visits from midwives for 10 days, and four home visits and three phone calls from breastfeeding counsellors in 10 days. As soon I was discharchged by the midwives, the health visitor arrived. We get home visits from the same health visitor for 5 years, weekly for the first year, bimonthly for the next four. PN care in hospital was fab as well. It's terrible that women in other parts of the UK are treated so badly. There should definitely be a mumsnet campaign to improve pn care.

notcitrus Sun 31-Jul-11 18:34:50

MrsJRT - so how do immobile patients in other wards get their sheets changed and bed baths etc? Is there really a hoist for moving all of them?

When I gave birth I couldn't move myself up or down the bed or sit up by myself - had been in a wheelchair for a few months. The staff through labour were fab at hauling me about with the help of my birth partners, and by themselves postnatally in their team of two.

I think inconsistency of both policies and how reality lives up to policy is a problem - for example I just had my booking appt and in my notes it has the hospitals breastfeeding policy. Allegedy 'all staff are trained to help you breastfeed' - now I would bet that the people who come and change your water, or the ones who clean you up after getting excretions all over your bed, haven't been.
And 'breastfeeding help is always available on the postnatal ward' - there was a specialist breastfeeding woman last time, who was great - and works 9-5.
And 'staff will pass you your baby if you can't pick them up yourself' - implies there's staff who will come within a few minutes and be happy to pick the baby up for you. And the staff just don't exist.
Then there's how every book on birth tells you about that wonderful tea and toast on the postnatal ward. Which doesn't exist in my hospital because for some reason they think it's OK for 'vulnerable' women to handle a kettle but a toaster is too dangerous! (I have this in writing)

Clearly every hospital is different but could the Royal College of Midwives (being the ones who get the stick, even though half the staff on the postnatal wards probably aren't midwives!) possibly coordinate policies and pre-birth info about postnatal care?

umf Sun 31-Jul-11 19:31:47

Desperately needed campaign.

Nearly 5 years later I still can't sleep if I start thinking about the postnatal ward at the hospital where I had DS1 (Royal Free Hampstead).

marzipananimal Sun 31-Jul-11 20:01:21

I think info about how things worked on the ward was provided where I was (hard to remember) but in my severely sleep deprived state I struggled to take it on board. I think this needs to be taken into account when preparing info sheets - make them as idiot proof as possible because noones brain is working well when they've just given birth.

I hated the attitude of some midwives that 'we're not going to help you change your baby's nappy (in the middle of the night when you've had no sleep and your leg in still dead from epidural) because how would you manage at home when we're not there?' IF I WAS AT HOME MY HUSBAND WOULD DO IT BUT HE'S NOT ALLOWED TO BE HERE AND I'M NOT IN A FIT STATE TO DO IT MYSELF. ARGH!

linziluv Sun 31-Jul-11 20:01:44

I nearly died from a PPH after DD...post natal care was appauling. They also suspected eclampsia but I was left all day with no monitoring. Nobody told me where to make a cup of coffee...I only knew things had been serious when I read my notes...nobody told me anything.
Mmmm...lunch...spinach flan if I remember correctly!
The night I had her on delivery I was left in a side room strapped up to every monitor, catheterised, drips in each arm, sorry if TMI but I was left in my own shit as the drugs used to contract my uterus went straight through. My baby was crying in the night, I couldn't get to her and nobody came.
I got shouted at for accidently pulling out a cannula in my sleep!
Midwives forgot my antibiotics both days for chest infection, I had to ask for a box to self administer. Also no pain relief offered.
I'm fecking disgusted by post natal care and reading this thread makes me realise it's not a one off.

so,so agree with you hildathebuilder - I had care after DD2 in Sara Ward and they were (generally) brilliant. There was one particular mw who added a few catty comments to my record, but she did seem to mellow in the two weeks that I was in.
So glad that my baby days are over now though. smile

wearenotinkansas Sun 31-Jul-11 21:04:27

How do Mumsnet campaigns work? - Obviously it's a topic that lots of people think needs to be addressed - me included. Is there a next step to be taken?

chelmsfordbirths Sun 31-Jul-11 22:34:15

My experiences of complaining about post natal care was similar to kippersandjam. This was despite some extremely serious complaints such as my child being given formula without my knowledge and despite my having said I was solely breastfeeding. I also complained about the insistence on re testing blood sugars after a feed even if the levels were fine before each feed to cause unecessary upset to the baby.

My experiences in Chelmsford were absolutely horrendous each time and for the 3rd I seriously considered going private but didnt want to be so far from my other children. No option for home birth as they were all c-sections but I stayed less than 24 hours each time and that was far too long. Still find it hard even now to think of my after care in hospital without getting angry.

Very happy to help with a campaign.

Murtette Sun 31-Jul-11 22:49:59

I had good post natal care at Stoke Mandeville and they do (or did before I had DD) have some useful info on their website. However, I would still strongly support an info card as then I would have asked many fewer questions and those that I did ask would have been directed at the right person. One section which should be included is "What needs to be done before you can be discharged". At SM, it included things like DD being seen by a paed, having her hearing test & me doing 3 x 500ml pees in a pot, the pot having to be collected from a special shelf, labelled with your name using the biro attached to the shelf by string and then returned to the adjoining shelf. Personally, I would appreciate it if it said that you should write your name on the pot before you've peed in it! I would extend the "Uniforms" section to a more general "Who's Who" section too which would include doctor "ranks" (eg difference between a registrar & an SHO & the minimum number of years a person would typically work to get to that level - what I'm trying to get at is I would have liked to know if the doctor confidently telling me something had been working in this area for years, had seen a case like mine umpteen times before and therefore I could have confidence in his judgment that it was entirely normal or whether, as appeared from his youthful looks and the fact he kept disappearing to check things and ask someone else a question, he had just qualified and wasn't entirely certain of his diagnosis).

Other things I could have been informed of and so wouldn't have had to use my buzzer/experience for include:
- when food was served and, as I was on a catheter, that it would be brought to me;
- a map showing that there were two blocks of toilets (one of which was just next to the ward) and so wouldn't have keep going to the one which was on the other side of the unit;
- what time shifts changed and that it was much better to wait 20 mins and ask someone a question 10 mins into their shift than to have asked someone who was supposed to finish in 10 mins and already had a million and one things to do; I would have known that the doctor's rounds at the weekend were at a different time to weekdays and so wouldn't have chosen that time to go and have a shower;
- that the people in red tops were the breast feeding advisers; and
- someone came around mid-morning & afternoon and filled up your water jug.

I appreciate that some people may have felt overwhelmed with leaflets when they were in hospital but, even if only, say, 50% of the patients read it, that would still reduce the number of "buzzes" and therefore free the midwives and other staff up to be able to do more important things that deal with someone's questions about logistics.

I thought the after care at Lewisham Hospital 4 years ago was pretty poor, they have a birthing centre now so probably not so bad. My DD was 1 day premature, and didn't feed very well on the first night, got jaundice and we were readmitted with her having jaundice at 2 days old and was recommended that she FF to flush it out. I pumped and tried to cup feed, cue many midwives giving me lots of different advice on BF'ing and one woman telling me rather chillingly that 'jaundice starves the baby of life'. They robbed me of my confidence and made me think my baby was going to die. The food was horrendous and the general attitude of the nursing staff was cold, uncaring and judgmental.
Delivery midwives were amazing though, it's the thought of my lovely midwife that makes me tear up every time I go past that hospital, without her calm good sense I'm sure I would have ended up with a c-section - not that I would have cared at the time.

mrsred Mon 01-Aug-11 05:45:00

I'm shocked to hear so many negative stories! I had my first baby st st Richards in Chichester almost three weeks ago and honestly could not have been looked after better. My waters broke at 36 weeks and I had to be induced, and things weren't simple, lost a lot of blood and baby had three nights in special care, and throughout my 8 day stay I was cared for so well I cannot speak highly enough if the midwifery team there. other support staff were also great, supportive and attentive. Strangely I had a very different experience with community midwives and health visitor, who seemed uninterested in me generally, these were from royal Surrey (we live about halfway between two hospitals and choose st richards as it seemed the better hosp, glad we did!) I realise I may have been discharged by community team more quickly because of prolonged stay in hospital, but health visitor appointment lasted around 15 minutes. My mum is also a HV and was shocked that she had been so quick, especially as I hadn't had anante natal appt too!

KellyKettle Mon 01-Aug-11 08:39:03

Just to add my thoughts on this. I had DD at Leeds General Infirmary. Our MW on the PN ward was lovely but she explained how they were so short staffed they'd had to put extra beds into each bay and close other bays they didn't have enough midwives to cover.

They had asked staff to work unpaid overtime to help with the huge increase in births that winter - to which the midwives had said "no thanks".

Breastfeeding help was something we had to wait and wait for which was very distressing with a crying baby.

They'd had to close delivery suite a few times and send women to Harrogate/Huddersfield instead.

I'm currently 27 weeks pg and planning a HB. I wouldn't willingly put myself through a hospital birth experience again unless mine or the baby's health required it.

KellyKettle Mon 01-Aug-11 08:42:10

Oh bf support was dreadful, it involved a silent midwife squeezing my boob into a "burger" shape and shoving DD's head on it. It was painful and humiliating. I saw a LLL counsellor after I was discharged and she got us sorted in no time without touching or squeezing me once. Much more dignified.

Hi there,

My suggestions to our local hospital and to this campaign mainly resonate with above but a few additions:

* I found that pre-existing health problems or disabilities were not really considered during my PN stay (6 dayss after emcs and infectionm heavy bleeding etc). I am disabled and am unable to use my hands and arms well. I had problems with getting food, lifting myself out of bed, lifting baby, breastfeeding without pillows etc. These were considered part of my recovery. I was told i couldn;t go home untill I could do these myself..... I was like 'I couldn;t do these anyway...." Also told I was lazy, overweight and missed several meals. [lady opposite couldn't read as dyslexic, another was colour blind] I suggested that problems should be written on front of notes and not 'problems with arms' but "please help with meals, getting out of bed. Is able to feed herself and baby with use of pillows"

*in consistancy between care in the day ahnd during the night. During the day I had a midwife in my ward who cared for me most of the say. Helping me with rehabilitation, caring for little one. which was great but not needed as much as I had DH, my mum, other visitors etc. I dreaded 8 in the evening when DH went home... and we were more or less alone to cope and look after our babies. In terms of care needs and looking after baby the day and night were the same - in terms of care it was drastically different.

*Food and sleep are really important, not 'an extra' to be done when everything else is done. Meals should be protected time, not just in terms of visitors but even giving extra help so that all women are given good nutritious food.

*Communication. I suggested having a two bell system. Green for 'could you reach me my glasses/could you nappy change my baby' and red for 'I am fitting, painkillers, baby feeding etc'. DEFINITELY info sheet - went in to different ward few months ago and they had looooooads of information! WHo everyone was, where everything was, what you could bring in etc.

*Help from home. We were told wrongly that you couldn;t bring food in etc etc. I would suggest all are encouraged to bring nutritious snacks, qcartons of juice, dressing gown, slippers, toilet bag [I was clueless!!!], stuff for baby.

*Reduce visits from Bou ty lady, photo lady etc. And if they must come in WASH THEIR HANDS and do not give out random old wives tales advice

*feedback. During discharge a really easy to fill in 'ticky box' feedback form. Did you find wards and toilets to be a)clean all the time ......... e) really dirty etc. Then a box for any problems and another for compliments - as I am sure there is lots of fantastic care getting lost in our complaints.

It will never be possible to get private rooms for everyone [wouldn;t want one eprsonally - twas conversation that kept me going sometimes!] with own kitchen and own nanny... but thats not what is expected from this campaign.

Clean, warm care from skilled people so that we feel safe, healthy and able in our most vunerable time. Thats what i hope for with DC2..... in a few years perhaps...

notcitrus Mon 01-Aug-11 09:49:35

Another thing for the info sheet - how to alert a cleaner if you have got blood etc all over the loo/shower. I bet a lot of women are either too embarrassed to go up to the nurses station to say they've made a right mess, or don't know there is one or aren't capable of walking 30 yards or more to it.

ohanotherone Mon 01-Aug-11 12:15:35

Mrs. JRT. It is simply not true that Staff cannot physically move patients. Every trust has compulsory manual handling training, you should have adequate moving and handling equipment for people who cannot move independently. Hoists, 4 section height adjustable beds, slidesheets etc... You should be competent at managing the moving and handling risks and be able to explain to patients how to move without them feeling like they can't manage. There should be wheeled shower chairs for wobbly patients who would be at risk of falls. There are more mothers with disabilities who do need extra help and again this should be part of good postnatal care.

hazeyjane Mon 01-Aug-11 12:21:27

Notcitrus I remember telling someone about the state of the bathroom when I was in with dd1 (blood all over floor, crap all over the toilet) and she said, 'that is what the antibac wipes are in there for'!

mousymouse Mon 01-Aug-11 13:05:34

hear hear ohanotherone
being wobbly on my legs was the main reason I only had a shower when back home after 2 nights on the ward. I just didn't feel safe doing it. at home I had dh looking after me, helping me in and out of the bath.

Sn0wflake Mon 01-Aug-11 14:19:56

Well my care after birth was OK but I think that some of the things people have written about are totally unacceptable. So my idea is to start one of these 'epetitions' things that are starting up on the directgov website - if we get 100,000 people signing then it will be debated in parliment. What do you think....worth a shot as well as other avenues.

epetitions.direct.gov.uk/index.html

Think it starts on the 4th of August.

Hi guys, I'm a medical researcher with a background in postnatal mental health. I'm happy to do a literature review from medical journals to see what is out there already about postnatal care and medical and psychological outcomes. Might take me about a month. Whoever decides to coordinate the campaign, could you let me know so I can send it to you.
Thanks.

kipperandtiger Mon 01-Aug-11 14:27:53

Was just going to post same thing as Sn0wflake - very easy to set up an e-petition and the signatures get collected online; I think there's already a system for doing so (I've signed a few though never started one myself).....unless they've shut it down to change it. E-petitions are good because MNers are all online anyway.

Most postnatal care horrors (incl my own, after a labour ward experience that was close to perfect and almost luxurious) have to do with lack of funding for postnatal care - wards too crowded, loos and showers/baths not well designed, and most of all, never enough staff (staff levels often so low that they are actually third world levels).

EasyFriedRice That's really kind of you to offer! I think that would be enormously helpful going forward, once we have some set objectives. Given your experience, do you have any thoughts on practical suggestions that could be put forward?

I think the e-petition idea is also great -- I guess it would be best to have a really specific proposal?

What do we think would be the best proposal to put before parliament?

kipperandtiger Mon 01-Aug-11 14:36:07

Notcitrus - not that I've ever done this myself but one could always ring the buzzer and say "I found this in the bathroom/shower/loo" -nobody is going to know!

Having worked in hospitals, I must say there is virtually a culture of misogyny in the British and Irish healthcare systems. If the loo/bathroom was in this state in a general ward with young, ablebodied, mostly male patients, they would get a staff member to clean it up quickly. But in a postnatal ward, there seems to be a culture of thinking that because a woman is coming in to give birth, she's also going to put in an hour of free housekeeping and domestic cleaning every day for the hospital while she's in too. A friend told me this long before I ever thought of starting a family and I couldn't believe my ears - having given birth now, I totally believe it.

That said, the labour ward staff were very nice about cleaning up after me when I was violently sick.....well, it was as a result of something they gave me on the way to theatre and not what I asked for ;-) (it wasn't as though I couldn't reach for a sick bowl!) ....sorry ladies, but thank you!

dreaming bohemian I've sent you a private message.

SnoozleDoozle Mon 01-Aug-11 15:26:59

kipperandtiger when I first read your post I thought 'hmm, misogyny is quite a strong word' and then the more I thought about it.......well, even to go back to the points made by loads of people on here (including me) that you have, quite often, a long, exhausting (emotionally and physically) labour, followed by an emcs, or a forceps delivery, and you are left, frankly, in agony. Then, two hours later, its 'come on, on your feet, having a baby is natural, what do you mean he/she is too heavy to lift and you feel like your insides are going to fall out and come sliding down your legs when you stand up? pull yourself together etc' . Why is it, that as women who have just given birth, we are somehow meant to be able to cope with the most terrible pain and get on with things, yet in any other circumstances, we would be encouraged to rest. And when I say encouraged to rest, I don't mean lie in bed and we waited on hand and foot, I just mean, a bit of support for getting moving, no heavy lifting etc.

I had my gallbladder removed about six months after giving birth, and it was a much less painful and invasive surgery than a cs, yet I was encouraged by the staff to take it easy, not to lift things, to ask for help if needed. After an emcs, I was scolded for not being able to move. The treatment on the postnatal ward is barbaric in comparison.

I am 26 weeks pg and I dread the post natal ward, I think I'd rather do hard time in prison than go back there. Sadly as a high(er) risk birth, doing it all in my own living room is pretty much out of the question, so if I want this baby safely, I have no choice.

I also don't like to claim misogyny unless warranted -- but I agree, it's hard not to think this may be a factor when you compare the treatment on postnatal wards with other post-operative experiences.

I think I mentioned this upthread, but my DH was treated so much more gently and compassionately after his hernia op (which was also abdominal surgery, but just a tiny incision).

I do understand it's important to get up and moving after a section -- no one is disputing that. But it's not easy when your legs are still numb, you have a catheter in, a urine bag to carry around, you're gushing blood everywhere, you're surrounded by strangers, oh and you have to bring your baby along! There is no call for calling us lazy or spoiled or forcing us on our feet before we can manage. I suspect you don't see the same kind of shouting and humilitation directed at big strapping men.

EasyFriedRice has directed my attention toward the Birth Trauma Association:

www.birthtraumaassociation.org.uk/

Does anyone have any experience with them? It looks like they do some fantastic work, will have a nosey around their website...

(Thanks Easy!) smile

MistyValley Mon 01-Aug-11 16:10:12

I think misogyny is an issue.

As is the misguided notion that as childbirth is 'natural', women need minimal or zero care to get them through it unless they or their baby are in actual and imminent danger of death.

Combine this with staff shortages and you get a minimalist, crappy service with tons of gaps for women's and babies' care to fall through.

MistyValley Mon 01-Aug-11 16:25:01

Oh yes and talking of falling through gaps, one thing that I found really odd and stressful was that I had to breastfeed my newborn every two hours for four days on a high, narrow bed above a hard floor. If I had dozed off while breastfeeding my baby would have slipped straight out of my arms onto the floor. So I didn't really sleep for four days.

I was lucky in that I had reasonable mobility shortly after the birth, so was at least able to get down by myself and sit (on my episiotomy stitches) in the (uncomfortable) visitors chair beside my bed, so I did have one alternative. But I couldn't really have dozed off there safely with my baby either.

sazlocks Mon 01-Aug-11 16:26:34

I had good care with both of my children but I am in Shropshire where we have access to small midwife led units where you can transfer for postnatal care. The issue I have is the lack of consistency in provision across the country. Why should I be able to stay in hosp for 6 days with every question answered and limitless help with breastfeeding and someone in the next county would have to leave hosp quicker than they would like without the support they need.

sazlocks Mon 01-Aug-11 16:28:00

Ps I wonder if 38 degrees might be interested in making this one of their campaigns......

leroymerlin Mon 01-Aug-11 16:40:51

1. Care, care and more care.
2. Enough space around the bed that you are not embarrased to talk.
3. Good change facilities for the babies, with wipes and nappies and instructions.
4. Clean toilets and showers, near to each other and the ward.
5. Not to be told off if doing something 'wrong' - first time mothers have absolutely no idea what is going on!

I had a horrible time in Leicester - these small things would have helped, it makes me cry to remember the birth of my DD especially compared to the care I received in Adelaide, Australia, the second time round. (with similar complications...)

longbay Mon 01-Aug-11 16:44:21

I totally support any campaign to improve maternity care. I had a horrendous first birth. I was in total shock afterwards. However, because I had not had a c- section, I was totally ignored on the ward afterwards. They didn't have time for me or my newborn. I didn't have a clue what I was doing and no one could help me. I am still very sad and angry about it two years on.

aliceliddell Mon 01-Aug-11 17:26:47

notcitrus 27/07- I was also told the night staff were agency. They were bloody awful. How is this meant to fit with the domino system? (same mw's antenatal, hospital & postnatal)

bebejones Mon 01-Aug-11 18:18:28

I often tell people that I couldn't fault my care in labour & delivery but postnatal was awful! I transferred from the main hospital to the MLU 25mins away asap!

-It took 6 hours to get me from recovery to the ward after a very long labour (64 hours, back to back) & forceps delivery. This was only when one of the delivery suit MWs decided to take me up.
-By the time I got to the ward it was after 10pm (DD was born about 4.20pm) and my mum & DH had to leave straight away.
-I was still numb from the waist down so couldn't move & DD was put in a cot on the side I had a cannula in so I couldn't get her out. The buzzer was left out of my reach! I was left feeling abandoned, scared & very vulnerable!
-No one took any time at all to show me how to care/feed my newborn baby & I was left all alone in a 6 bed room until 3am when they brought another lady in, turning all the lights on in the process & waking up me & my newborn! (This was repeated 3 more times over the next 2 hours!)
-There was ONE MW on duty on the ward overnight! So it took the HCA over an hour to get me some pain relief when my epidural wore off!
-The following day it took 5 hours to get the senior MW to sign my transfer documents, there were only 3 MWs on duty on a busy (and very hot) postnatal ward & I didn't actually see one of them at all. Only the HCAs.

I am fully aware that I got off quite lightly. And there are many more people with far worse experiences than me. But why, oh why, are there so many horror stories?! It's just NOT good enough! Even an 'easy' birth is a big trauma for a women's body to go through. It's easy to just to say that more money needs to be thrown at the problem. But someone actually needs to spend some time looking at where the money needs to go. Certainly more MWs would be a start. But perhaps also some specific training & dedicated support for breastfeeding mothers, young mothers, and first time mothers might also be worthwhile.

MrsJRT Mon 01-Aug-11 18:48:03

I apologise, it should have been worded better. However it is simply untrue to say we will have hoists, we don't, yes we are taught moving and handling techniques, mainly in talking the patient through moving themselves, the more hands off the better. I am not allowed to lift you or move you myself, I can place a slide sheet under you so it is easier for you to mOve yourself but I can not sit you further up the bed. That's if there is a slide sheet to be found. Also although there are some electric beds a lot are not and require a foot pump to adjust height and a midwife to manually lift the head rest into position. We also do not have commodes or wheelchairs on the ward. I do always ask women not to get out of bed for the first time with no one else there though in case they feel faint. It's proven that having partners there does cut down on buzzers but it's impractical for partners to stay all night. We just haven't got the resources and other mothers don't like it. On our MLU, it is all private rooms and partners can stay, buzzers are rarely heard down there!

It sounds like I'm trying to defend shitty care and I'm not honestly, I just think it's important for us to know what is feasible for change and what is just not going to be implemented.

umf Mon 01-Aug-11 18:59:49

MrsJRT please don't give up - what you say "is just not going to be implemented" is the norm in other first world countries. We can afford it and we should have it. British women are worth it too.

MrsCog Mon 01-Aug-11 19:05:24

Hi everyone, I'm not sure if this has been mentioned or not, but on the NHS choices website, you can leave comments about the care you recieved at individual hospitals for people to read. THat might be a good way to document all of the experiences/advice that people have had - if everyone did it there would be such a wealth of information, and if there were 100's of terrible reviews on show publically then it might prompt some action.

For example (this gives away my location a bit!)

www.nhs.uk/Scorecard/Pages/Results.aspx?OrgType=5&Coords=&TreatmentID=0&PageNumber=1&PageSize=0&TabId=0&SortType=2&LookupType=2&LocationType=0&SearchTerm=Worcestershire+Royal&DistanceFrom=50&SortByMetric=0&TrustCode=&TrustName=&DisambiguatedSearchTerm=&LookupTypeWasSwitched=False&MatchedOrganisationPostcode=WR5+1DD&MatchedOrganisationCoords=&ServiceIDs=&ScorecardTypeCode=&NoneEnglishCountry=&HasMultipleNames=False&OriginalLookupType=2&ServiceLaunchFrom=HomePage

MrsCog Mon 01-Aug-11 19:07:21

I've just realised (relating to my above post) that once you've found your hospital you can then filter by service so it would be easy to find the maternity section. I really think this could be a good start for Mn'ers

MixedClassBaby Mon 01-Aug-11 19:44:24

I was moved from a birthing centre (where post-natal care was excellent) to a hospital post-natal ward approx 24 hours after birth as DD needed a blood test. I arrived about 10am and was shown to a bed (not actually admitted). Blood test was done about 11am and midwife reported back that all seemed fine and that I could go home soon.

I was eventually discharged at midnight having waited initially to see a doctor. He decided that DD should have another test at 1pm to make sure all was well. From that point on, I was waiting to be discharged but there was only 1 midwife on duty who didn't have time to write up my notes.

I was offered no food or pain relief (2nd degree tear). I hobbled to the reception desk a couple of times to try to find out what was going on and was told that I was not a priority and that I needed to wait.

I had had no sleep since DD's birth and she was feeding and crying constantly. I put her down at one point as I was crying myself and was told by the midwife baby's crying! what's baby trying to tell you? baby needs feeding!. I felt desperate. I eventually asked if I could write out my own notes if it meant I could go home.

I didn't press the buzzer once but the woman opposite did. The midwife responded each time with who's buzzing now?

I was made to feel like a nuisance and yet I was polite and cooperative all the time I was there.

Clearly there were staffing issues and the midwife on duty was stressed. I don't know why typing up notes and making sure patients have been offered food isn't something that an administrative asst. could do?

Afterwards, a friend who works in a hospital told me that sometimes patients are not discharged even when they can go home as they are low/no maintenance and take up a bed. If they go, then that bed is free and someone who needs a lot of attention might fill it and add to the stress on a busy/understaffed ward.

feralgirl Mon 01-Aug-11 20:38:48

I would definitely support a campaign for cleaner, better staffed post-natal wards. My experience at The Royal Cornwall Hospital was certainly not as bad as many on here but I am still pissed off two and a half years later about the way that I and other, more vulnerable, mothers were treated.

I am not a HCP but I am a state sector teacher. To a certain extent I know what it's like to be understaffed and over stretched and I don't think it is any excuse for staff to be rude which is the main complaint that people seem to have on these pages.

mrspear Mon 01-Aug-11 20:46:43

My first thought when i read the title was improved postnatal care, how about having post natal care?! I had my baby 10 weeks early and i was being nagged to leave from day two. I remember quite well having to get two trains back to the hospital (i had to travel to central London and back out again) five days after birth with my husbands slippers on (feet like footballs) shuffling along(transition birth). It was plain awful; my only saving grace was that i didn't have a c-section.

anothabubbla Mon 01-Aug-11 21:07:44

PLEASE PLEASE PLEASE run a campaign. I thought I was the only one who had a godawful time.

ohanotherone Mon 01-Aug-11 21:29:08

Mrs. JRT -It sounds like your trust is not adequately assessing the generic risks on your ward. I am moving and handling specialist. I often hear stuff like "we are not allowed do X or Y." Is it simply not true, all basic training should involve use of slidesheets etc..the problem is that moving and handling is not given a priority on maternity wards so equipment is not available. Beds are a big issue as 4 section beds can be alot more comfortable and increase someones independence therefore saving on staff injuries and time assisting people. They don't cost that much either £800 per bed so management just need to be convinced about the spend to save issue. When I was in hospital a baby fell out of a high bed, pump adjustable. Also I fell asleep with my baby on the bed [through exhausting for about 5 minutes] and a horrified midwife told me off for keeping the baby in bed with me due to the risk of falling, yet some beds go very low and these could be used to minimise risks aswell.

Postnatal care needs to take in account ward ergonomics.

MistyValley Mon 01-Aug-11 22:09:06

ohnotanotherone - yes the fact that I had to climb UP to my narrow hospital bed to breastfeed my baby seemed like a ridiculously unsafe design.

Considering women who are breastfeeding newborns are usually exhausted (I was naively horrified to discover that 'a feed every 2 hours' meant LITERALLY 'every 2 hours, including through the night' grin ) - how on earth does this stuff ever pass Health & Safety inspection?

Stay123 Mon 01-Aug-11 22:19:52

Had an EMC for my first one. The surgeons were brilliant but the aftercare was awful and in some cases spiteful. There was no room on the caesarean ward so I was put in a normal ward and was spoken to appallingly by one of the nurses. I couldn't get up to pick up my baby or feed him as I was in a lot pf pain and she just spat "oh for gods sake get up". My husband was there and heard it too and was shocked. She came back an hour later to apologise and said she didn't know I'd had a caesarean so clearly couldn't move because of that. She had thought I was being a lazy cow. One night I was so thirsty I thought I was going to die but couldn't reach the buzzer to press it. The next day I made sure my husband moved the buzzer nearer me but when I pressed it no one came. One of the worst memories is of hearing my little baby posset and being terrified that he was going to suffocate on it. I kept pressing the button but no one came. Surely this is cruel and it doesn't take 2 mins for a nurse to patrol the ward. Throughout the night I could hear them chatting to eachother as if they had all the time in the world. I was absolutley starving the morning after the operation but no one offered me any food or even told me there was a toaster and kettle at the end of the corridor. There was a lovely cleaning lady who spotted me and asked if I was ok and went to get me some toast and a cup of tea. She was probably paid a pittance and had had no nurses training but was the kindest person on the ward. I had told them I'd like to breast feed but my milk didn't come down for ages maybe because of the trauma of the EMC. I was doing all the skin to skin but THERE WAS NO MILK! I was treated like some kind of criminal who had rejected her baby and was doing it on purpose. I really wanted to go home on the third day but was told I couldn't unless I proved to them that I could feed my baby. I asked for some formula, which they obviously thought of as poison, I fed it to him, he loved it and perked up no end and they let me go.

For my second baby I had an Elective caesarean which was a whole different scenario. The main change was that I was on a special ward just for caesareans. They came to pass me my baby whenever he needed feeding or changing without grumbling or looking at me as if I was a piece of crap.

LithaR Mon 01-Aug-11 23:41:11

I think on this card there also needs to be a list of what your rights are.

Having a midwife take my baby away to the nurse station for a cup feed - even though i was breastfeeding - and only having her bring him back when she couldn't settle him and his breathing had deteriated.

I didn't complain because i thought it would be that easy for them to take your baby. And who they believe, a midwife or an hysterical new mum?

nanatothree Tue 02-Aug-11 08:41:09

I would like to see voluntee grandmothers/mums allowed to help/talk/bring cups of tea and lots of reassurance to new mums on the wards. I am talking of covering morning and afternoon in a rota of sorts if possible.
Have to say midwives have enough to do and my daughter couldn't wait to get home. She said no-one around for a lot of the time on the wards once you have given birth.
So what do others think.

HelenMumsnet (MNHQ) Tue 02-Aug-11 10:28:05

Morning. Thanks so much for all your posts so far. Please do keep them coming!

KellyKettle Tue 02-Aug-11 10:33:27

I like Nanas idea of having volunteers. I would like them to be up to date in current advice though. My mother and Mother in law would be lovely at the tea and chat but I dread to think of the advice they could dish out.

My MIL has a good line in superstition and old wives tales- makes a lovely cuppa though.

aliceliddell Tue 02-Aug-11 11:00:15

The idea of grandmas coming in is nice, but agree with Kelly - they're not trained. It seems that most of our problems could have been sorted with tea, sympathy and common sense - most, but not all. In the current 'cuts' climate, it is probably unwise to campaign for jobs to be done by volunteers. Judging by this thread, nobody's desperate to spend money on this. We shouldn't give them any excuses, they're good at that themselves.

I'm struck by a few things reading these comments -

1) People have a hard time separating their Pre-natal, labour and post-natal experience

2) The best experiences (in general) seem to be on MLUs where traumatic births experiences are unlikely

3) MLUs seem to have much higher staff/patient ratios (which seems a bit insane).

4) Other than painkillers, most of the things people are complaining about do not require someone with a graduate degree to fix.

kippersandjam Tue 02-Aug-11 11:48:46

as an addition to my post, there were plenty of mw, but lord knows what they were doing. they seemed to be in meetings a lot, and chatting at the desk seemed to be a favourite pastime. ringing the buzzer as i was struck in bed was frowned upon, and a favourite bad tempered comment was how will you manage at home? well, dh is there, plus others.. the mw changeover was very stressful as discussed with other new mums, if the scary one was assigned to you etc, however we rarely saw the same person twice and there was no continuity of advice, so was constantly being told off and shown new ways to do things.
I didn't know people would be allowed their mobiles on the ward, and had to listen to one sided chats all day and night plus endless beeps from txt messages, plus people did have their own food bought in, unfortuately really smelly curries, fish and chips etc! and for those of us not eating it was very hard as well, tummies rumbling!
the amount of visitors was not controlled, and at one point there weer so many people round the other ladies bed, one man actually banged my newborns cot, then shoved it out of the way! There was a cleaner, who gave us the best smile, as she showed the hoover the roomsmile and wandered off.
a campaign would be good, but how does politeness and courtesy really cost money?

perhaps a return to one head mw who had total control, rather than lots of autonoumos mw?

blondieminx Tue 02-Aug-11 13:21:03

I agree a campaign would be an excellent idea. Perhaps one of the things in the campaign could be Freedom of Information Act requests asking the following to every trust in the UK:

(a) how many times, in each of the last 12 months, has the trust operated shifts which have exceeded the ratio of mothers to midwives recommended by the RCM? (see [[ http://www.bbc.co.uk/news/uk-14239022 recent BBC article]])

(b) how many nights, for each of the last 12 months, agency staff have had to be used on postnatal wards?

(c) how many times, in each of the past 12 months, postnatal wards have failed cleanliness inspections?

(d) how many complaints have been recieved in the last 12 months relating to postnatal care, either directly or via PALS.

(e) how many re-admissions, for post-natal related problems (e.g. infections or other complications), they had in each 12 month period

(f) how much the trust spends per annum on treating post natal depression (medication and counselling, and training of HCP's)

I have suggested the 12 month thing on the basis that then the Coalition can't moan it wasn't in charge then! Getting the facts into the public domain would, I suspect, in itself see a lot of PCT chief execs finding themselves embarrased by what is happening in their trusts.

Until the campaign kicks off properly we can all do our bit. I would urge everyone to write to their MP to ask what they are doing to ensure that when the NHS reforms come in that funds for maternity services are protected and the service improved . I quoted the BBC article above to my MP as well as I live in an area where we are well over the recommended ratio sad My MP is conservative so I also asked when they'd honour their pledge for 3000 extra midwives!

And I would urge everyone who has had a bad experience to write to the responsible Head of Midwifery (send the letter recorded delivery) so that she then has enough ammunition to plead for more funds for more midwives/training/etc to improve the service in your area, and to hopefully offer you a debrief and apology.

tallblonde Tue 02-Aug-11 14:06:31

My post natal care was pretty abysmal. I'd had a really tough natural delivery with no pain relief (not through choice!) and tore very badly. I also went into shock, and was shaking so badly I couldn't shower (which the staff were not happy with). They pretty much barked at me to go to the loo, and then wheeled me up to the ward (it was 10pm), kicked out my husband, showed me the light switch, and that was it. I was scared and exhausted, and didn't get one kind word. No mention of a buzzer, or that they could help. They left the sides of the bed up all night, so I couldn't get out of bed to tend to my son or to unpack any belongings. I'd also had nothing to eat for 24 hours and survived on a sole muesli bar I could reach to access in my bag. The next morning, I missed breakfast because I didn't know you had to fetch your own breakfast (and was still trapped in the bed!) and then I was ignored all day. It was only on the second morning, when a senior midwife popped her head around the curtain to see that I was crying that a midwife took the time to notice that my son wasn't latching on properly, which is why he had been so upset.

What annoys me is that if I had had a major operation, I would have been treated like a patient. Instead, because childbirth is 'natural', I was treated as if I should know what I was doing, and as if I was an inconvenience.

I'd like to add as well as an aside, that the doctor who did my son's check before I was discharged from the ward missed that he had no femural heartbeat. My son nearly died nine days later from a heart problem that this lack of heartbeat is the tell-tale sign for. Shocking 'care'.

marylou242 Tue 02-Aug-11 14:18:14

I had an interesting experience a couple of years ago when I had DS. I got to experience postnatal care at a birth centre and hospital environment and the contrast was massive. Started in labour at the birth centre, had to transfer to hospital half way through. Delivery staff were all fine, but the postnatal ward was horrendous. I was told (after 3 nights of no sleep due to long early labour) by a bossy healthcare assistant that I wasn't allowed to shut curtains around my bed to try and have a nap in the day. I was exhausted. I wasn't shown how to operate the bed or how to get any food. The number of visitors along with 5 other babies crying in my bay prevented any sleep whatsoever. I asked for help breastfeeding and was just given a leaflet.

12 hours later I got out and back to the birth centre. It was completely different. Lovely peaceful room of my own, midwives who were happy to come and help with every breastfeed and even took my baby for a few hours overnight so I could get some sleep between feeds. Toast and horlicks was provided in the middle of the night, home cooked food brought to my bed at mealtimes, ensuite and clean bathroom, aromatherapy baths, help with showing me how to bath my baby (I wouldn't have even dared ask for this in hospital) and basically lots of genuine care and attention. Yes it was NHS and I'm lucky to have experienced it.

I'm expecting baby 2 soon and want to go back to the birth centre. Unfortunately it's looking as though it's going to be shut because it's not very well used and "women should be in their home environment after giving birth", according to the head of our PCT. Unfortunately in this area, that means just 3 short postnatal visits over 10 days and not all of those by a midwife. They really need to spend more money on postnatal care, not less.

MrsTittleMouse Tue 02-Aug-11 14:41:30

I can't remember who put this earlier in the thread, but I agree that the GP 6 week check needs to improve too. I had a leaflet describing how the GP would check my breasts, make sure that my episiotomy was healing well and a host of other things, but what actually happened was:-

1) Being given a checklist for PND and asking if I fitted that desciption.
2) A dire warning about using contraception and a plug for the Mirena (even though I explained that we are infertile).

I had to beg for a check of my stitches and when I explained that even sitting was still painful, I was told to have lots of sex to "stretch things out". hmm It was all done at breakneck speed and with almost no eye contact.

Compare that to www.patient.co.uk/doctor/Mother's-6-Week-Postnatal-Check.htm, which is what is supposed to happen. I don't know anyone who had a check this thorough.

blondieminx those are excellent questions, I definitely think we should do a FOIA request. Great idea!!

kateyfer Wed 03-Aug-11 14:03:49

I also support this. I had a long and painful birth with truly awful MW care during the birth itself (ended in epidural and forceps delivery after demanding to see a consultant who rushed me to theatre immediately inspite of MWs protestations...)

I was dumped in the post-natal ward at midnight with a cannula and catheter so unable to move. DD put in a cot next to my bed with a nappy on that had only been secured on one side. cue poo and wee everywhere that I couldn't do anything about.

i wanted to breastfeed, so when DD started crying at 3am, i had to press the buzzer to get someone to lift dd out of cot and give to me. MW promptly left meaning i had to press the buzzer again to get them to help me get DD latched on as (due to canula) i only had mobility in one hand and arm. cue lots of huffing, that's not my job(!) comments etc. would take hours to receive pain medication after requested (God help you if you needed anything on a shift change!)

I got yelled at for leaving DD alone while i nipped to the loo, blood and used maternity towels everywhere. had to use sanitary gel on a tissue to wipe the loo before i felt comfortable using it. and yelled at again when i popped into the corridor to find a clean sheet for her cot (after she threw up everywhere)

a mum opposite me (ward of 6) who had twins couldn't get out of bed (CS) to pick them up from their cot to feed them, so I'd go and help when the buzzer repeatedly wouldn't bring anyone to help.

no one told me where the kitchen was to go to get food or that the bell ringing in the corridor meant that meals were being served there (found out from a fellow 'inmate' on day 2).

on the second day, i resorted to asking DH to bring food in for me...

I found the on-ward HV's/nurses much more supportive and helpful (when you could find one) but every MW i came into contact with was rude, abrupt and made it clear that I was of low priority.

it is clear that through no fault of their own they are incredibly understaffed, but that shouldn't translate to mums/babies receiving such inadequate care.

CAMPAIGN, CAMPAIGN, CAMPAIGN!

fotheringhay Wed 03-Aug-11 14:42:28

I had adequate postnatal care, even though there clearly weren't enough staff for the number of mums. The nurses were doing a brilliant job, it is possible!

I'd fully support a campaign, great idea.

LaCiccolina Wed 03-Aug-11 14:56:03

Its health visitors Id ban (read shoot here). Useless idiots. Apart from Gov box checkers deciding if my house is decent enough for a nipper after birth or if I should be reported.... They drive me bats at baby weighing as well.

They sit in the same class of jobs as the hygienist at the dentists. Go back to school and get the proper qualification so you actually have a job - a dentist rather than this idiotic half way house where you teach me to brush my teeth. Health visitors should go back and finish off to be GPs or shove off completely.

A friend had one tell her that when bottle feeding the same amount of time had to be left between feeds as the size of the bottle (or else) - i.e. 1oz, 1hr and so on. She phoned me in tears at 6oz as baby wouldn't wait any more as the ridiculous woman forgot to mention when to stop that practice!

This is the main problem; they leave you with half a piece of knowledge as they throw sentences around when you are vulnerable and piss off before you really realise what they might be talking about.

All they taught me was that if I had a question to post it here or see the GP. As you can tell I now practically hiss and spit whenever one is mentioned!!!!

flickor Wed 03-Aug-11 16:48:53

my child and I are alive and well but I think my mother's generation (god rest her soul) had it better than us in terms of a week with the baby and time to bond. Now I think we are considered to be a bit like cows in milking parlour - get em in, get it out, get them out.

HouseOfBamboo Wed 03-Aug-11 19:19:49

Yes I have a friend who is a nurse in her 50s - she says things are very different (and worse) now than when she had her first baby 28 years ago.

Women and babies were actually nursed post-natally, as in stayed in hospital for a few days to recover from the birth. Mothers were supported to eat, sleep, and keep themselves clean. They were also supported to care for and feed their baby.

The nursing element of post natal care seems to have pretty much disappeared altogether now.

If I can ask MNHQ -- between this thread and the other, I think we have a lot of stories about how dire experiences can be, and some really great ideas for practical things that can be done to improve things as well as to get more information on the real costs of sub-standard care.

What is the next step? How does MN decide whether to make something a campaign? How can we mobilise all this support and actually do something? What else can we share here that would be helpful to you in deciding how to move forward?

Thank you again for your interest thus far! smile

kipperandtiger Wed 03-Aug-11 20:43:02

@LaCiccolina - that certainly sounds very disappointing; that said, I had good health visitors in my area, maybe it is a bit of a postcode lottery.

My bit to add to this debate is that in my postnatal ward, they clearly weren't up to coping with our numbers (as well as being let down by a ward that was 39 degrees Celsius in summer with no ventilation, and loos no bigger than a filing cabinet) but yet they also had difficulty actually getting around to discharging people, although they were polite and professional when you actually got 5s of their time. I couldn't wait to leave, as I knew my bed would be taken in a jiffy anyway. One mother next to me pretty much developed post natal depression as a result of not being able to nurse her first born and feeling she'd failed....and sitting in the noisy, chaotic, stuffy, hot and muggy for three days (after a C section) just added to it. This is probably more info than anyone needs to hear - but I didn't even bother going to the loo, as I couldn't leave baby alone either. They gave me a big jug to collect and measure the sample...did it in my ward behind the curtain! Made no mess as i had far more space to move (paper towels on the floor just in case ;-) ....as the loos were fairly clean I am kind of guessing I might not have been the only one who did this...) Not advised normally, and certainly not if you don't think you could aim straight, but you see what sort of lengths they make us go to!!!

Kateyfer and Tallblonde - yikes, I am appalled to hear what you both went through. Just absolutely no excuse that they could possibly give. Hmm - I do remember my ward had staff who brought round breakfast....surely helping oneself from the kitchen breaks hygiene and safety rules in the kitchen?! Time we had a campaign like "Jamie's School Dinners" .....this one is even more important than that. Anyone know anyone with contacts at Channel 4?

Want2bSupermum Wed 03-Aug-11 21:19:53

I just gave birth in the US. My child birth experience was a mixed bag as I had preeclampsia. They tried to avoid a CS by inducing me but after I didn't shift from 5cm for 12 hrs a scan showed DD was stuck in my pelvis. I thought my aftercare was amazing for the following reasons:

1 - I got my own room with ensuite bathroom. Small, basic and clean and DD was with me pretty much the whole time (sent her to nursery when on my own and falling asleep). DH had a fold out chair that he could sleep on and was allowed to stay 24/7. Everyone else considered visitors and only able to visit during visitor hours (10-2pm all week and 6pm-8pm mon-fri).

2 - Nurses were all lactation consultants and when buzzed they replied over the intercom and then someone came in to help me. Babies had their dr visits in the AM so I did have to wait a couple of times. Annoying but I could live with it.

3 - Food wasn't great and the only comment I left as feedback upon discharge was that they should have a special menu for breastfeeding mothers. They had sandwiches in the kitchen for DH to eat. These were made by the kitchens and while not what I would make they were far better than a garage sandwich.

4 - When I was hormonal on day 3 the nurses called in a doctor and had me assessed for PND. I wasn't told this and DH was a bit shocked to have two pysch guys walk in and ask him to leave the room with DD. They were wonderful (both the nurses for spotting a potential problem and pysch doctors for talking to me) and I would go so far as to say they stopped the downward spiral. If I had been sent home this would not have been caught at such an early stage.

For a CS my stay was 5 days and I could have stayed for a 6th day. Vaginal deliveries with no complications are a 2 day stay. Total cost for my prenatal, delivery and after care was a $50 copay. I thought I was going to have to pay $2500 for the hospital stay but this doesn't apply to child birth. If we didn't have health insurance the total cost would have been $8500 plus scipt costs ($4 at target) as we are 'in state'. If this hospital, which is a non-profit in a high cost area, can perform such care on a low budget I don't see why the NHS can't.

AvrilHeytch Wed 03-Aug-11 21:24:33

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AvrilHeytch Wed 03-Aug-11 21:28:49

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AvrilHeytch Wed 03-Aug-11 21:54:54

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MrsJRT Wed 03-Aug-11 22:35:49

Avril, I explained a few pages back what an average day in the life of a postnatal midwife entails. Add to that list dealing with a constant stream of visitors with oversized helium balloons and it should give you some idea. A lot of the day is taken up with paperwork, many staff, me included would LOVE to spend more time actually caring for women and their babies, it's why I went into this. However sadly the trust has so many targets to meet, CNST, UNICEF, infection control to name but a few - many of which are paper pushing exercises under various guises, as well as the all important documentation (if we don't write it, it didn't happen, unless you say it did and we didn't write it then it must be true, fear of litigation in midwifery is HUGE!). I fully support this campaign but would really love for it not to become a midwife bashing exercise, most of us are doing the best we can under crap conditions (the oppressive heat? We have to work 13 hour shifts in it, no drinks at the desk as it looks unprofessional and often without breaks.) I'm all for improved postnatal care, it really is the Cinderella service of maternity and needs all the help it can get.

AvrilHeytch Wed 03-Aug-11 22:47:03

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MrsJRT Wed 03-Aug-11 22:57:14

Ok, just trying to explain a bit. I won't become involved if is an entirely a bitching exercise though. Your poor experience was unacceptable but the majority of us are doing the best we can. I wish you all the best of luck.

MistyValley Wed 03-Aug-11 23:01:40

MrsJRT - the thing is most women don't go into hospital with an agenda of coming out with a negative impression of midwives, or indeed their hospital ex.

MistyValley Wed 03-Aug-11 23:02:08

sorry pressed post too soon

...hospital experience as a whole.

MistyValley Wed 03-Aug-11 23:04:35

Not to say that the problems are the fault of midwives as a group, or that there aren't big differences in attitude and professionalism between individual midwives, but it would be a wrong to dismiss everyone's experience here as mere 'midwife bashing'.

AvrilHeytch Wed 03-Aug-11 23:05:45

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AvrilHeytch Wed 03-Aug-11 23:31:59

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reemarattan Thu 04-Aug-11 08:20:59

A campaign sounds like a good idea. It doesn't sound like the UK has adequate measures in place although I don't know all the details.

The efforts in Australia seem much more comprehensive and are based on the latest research. Partly because post-natal depression is one of the larger causes of indirect maternal death - through suicide.

You can read more about it here - theconversation.edu.au/like-mother-like-child-good-maternal-mental-health-means-happier-babies-2579

AvrilHeytch Thu 04-Aug-11 08:31:41

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Want2b your experience is exactly why my mum begged me to go back to the US to have DS. Wasn't practical obviously!

I know the US gets a bad rap for over-medicalising things but I think they do much better on the postnatal side. And while everyone is always talking about how expensive US health care is, childbirth and postnatal are covered under insurance so many people pay very little for it (unless you have really high co-pays).

That $8500 figure is interesting. It doesn't seem like a huge amount of money for what you got!

stirlingstar Thu 04-Aug-11 11:28:50

One small idea to add to all the good stuff above.

Some kind of colour code / flag on your bed to indicate whether this is your first baby? And thus you might have even less clue / need specific kinds of advice.

On discharge with DC1 (after a mixed postnatal care experience - I'd say poor but not horrendous) I was asked by discharging MW if this was my 2nd or 3rd child...

northernrock Thu 04-Aug-11 11:58:22

"What has started out as a campaign for better post natal care has ended (yet again) as a vitriolic rant about midwives. What a shame and what a missed opportunity. If you set up a 'them and us' mentality then you will never get what you want. Or will you? Is what you want to be looked after by nurses on a gynae ward and treated as invalids? It seems as if you have no interest in protecting normality or seeing childbirth as a normal life event.You can't stay in bed for 3 days following a section because you will get a DVT or bedsores."

As far as I can see the above quote from a midwife further up this thread perfectly illustrates the way midwives seem to view their job.
YES they are overworked, and YES it's a stressful job, but there is such a tone of..disgust at post partum women.
Why is this?
I posted some of my awful experiences at the hands of The Whittington, London on the earlier thread on this subject, and the thing that upset me the most about the whole experience (before, during, and post birth) was the way the midwives spoke to me (when they deigned to speak).
I was pretty stoic, I got on with it as best I could, but there was no need for the contempt with which the midwives behaved.

Yes, birth is natural, but when you have been pushing and pushing and the baby is stuck, for over two and a half hours because there are no doctors available to help, and when finally one come you are sliced to ribbons,and just sitting hurts like hell well, I would say that you need looking after on a ward where people treat you as a patient, not a fucking nuisance because you ask where you can change your baby.

I don't recall any midwife ever actually speaking to me at all, except to snap at me the couple of times I asked a simple question.

I support this campaign totally, and I think what is needed is to start from the training level-there are not enough jobs, so the NHS should be recruiting the brightest and best to be midwives, training them really well and paying them decent salaries.

Any worker who is downtrodden and underpaid is more likely to become a bully and take it out on their vulnerable charges.

cardamomginger Thu 04-Aug-11 12:21:29

I think a point that needs to be made, even though it falls into the category of the bleedin' obvious, is that if you have been admitted to a post natal ward it is because there was some sort of a problem during the birth and things are not 100% with you and possibly with not your baby. If everything had been "natural" (God I hate that word - what the hell does it mean anyway??) you would have been discharged to home. The fact that you are on a post natal ward means that you need assistance and care of some form or another. So, frankly, the argument that childbirth is natural and why should you be given help because you're not going to get it at home (which is wrong anyway, cos we have DH's DP's and others to help) is misplaced.

AvrilHeytch Thu 04-Aug-11 12:49:39

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mousymouse Thu 04-Aug-11 12:54:56

applauds cardamom

cardamomginger Thu 04-Aug-11 13:28:12

Thank you mousy smile. Another point - MWs and other HCPS cannot simultaneously claim that CS is major abdominal surgery that necessitates a longer recovery time (used as argument to try to get women wanting CS to consider VB) and claim that nursing on a PN ward should not involve nursing as this detracts from making child birth a normal part of life and that to give assistance to a woman post-CS is unreasonable as she would not get this kind of help at home. If a baby has been cut out of your uterus, you have had a major operation and nursing care, with all that that should imply, is appropriate. Further, I would argue that women who have had tears that include the muscle layers, and particularly those that have extended into the anal sphincter, should also be considered as if they have had surgery. Sure the rip came from a baby forcing its way through rather than it being a cut from a scalpel. But surely this results in more trauma to the area, not less, and, again, a need for nursing care. To reiterate: if you have been admitted to a PN ward you are a patient and are entitled to receive care that is appropriate to your needs, just as any other patient is.

allhailtheaubergine Thu 04-Aug-11 13:41:29

Some excellent points being made here.

also applauding cardamom

This idea that childbirth, even when there are complications, is just a natural, normal thing and women should not be coddled too much postnatally sometimes seems to me to have become an ideology. It's an attitude or party line that seems to be adhered to even when obviously contradicted by reality.

Smileymoo Thu 04-Aug-11 13:51:32

Agree that something needs to be done but in current times, it's unlikely there any funds available to address it. Also, as dreamingbohemian pointed out, a lot of the care required is not strictly medical and volunteers/a charity would help the situation. Is this not something for a charity to take on? I'm thinking of the NCT in particular. It's a charity that already has strong links with the NHS maternity services and is well-respected. However, I've absolutely no idea how to get such a charity involved!

cardamomginger Thu 04-Aug-11 13:52:19

Thanks dreaming [blushes a bit]

MistyValley Thu 04-Aug-11 14:13:53

Dreamingbohemian - yes it really does seem to have become an ideology.

The trouble is the 'least intervention' ideology has morphed into 'least care'.

The dogma that women should be leaping around self-sufficiently both just before and just after giving birth fits in conveniently with NHS cuts as well.

MistyValley Thu 04-Aug-11 14:18:45

Oh yes and I wholeheartedly agree with the earlier poster who said that giving birth was certainly NOT a normal everyday activity for her.

Even when everything goes smoothly, pregnancy and childbirth is a HUGE physical and emotional upheaval, especially if you haven't done it before.

ohanotherone Thu 04-Aug-11 14:54:58

I would be very wary of saying that volunteers would be useful. I had enough people bothering me and the idea of another person doing so but probably even more badly would just make things worse. The point really is that if some hospitals can give good care so can others. I have worked in different hospitals and the culture varies between them. Really it is about good management and organisation rather than money spent on the service. Some hospitals think it is efficient to have a different midwife see a person every shift however actually it isn't because time is wasted reading notes and trying to process information before and during each interaction. This means the midwives make a view of a woman before they even reach the bedside and get burnt out and then are bitchy and vile rather than looking at individual mums and the difficulties that they having.

MrsJRT Thu 04-Aug-11 15:07:29

"doctors don't get this defensive" I can't recall who said this, no doctors don't get defensive, mainly because if most people have a poor experience with a doctor then they accept it is that doctor who is at fault and has undesirable traits. It seems to me that if someone has a poor experience at the hands of a midwife it is because midwives as a whole are a shit profession. Midwives as a collective are nasty lazy vile bullies. I'm sick of it. I've been supportive of this from the start, accepting there are major failings in the area of postnatal care, I will no longer continue though because it's just become an exercise for people to complain about midwives as a collective yet again. Yes there are some shit midwives, I don't doubt some of you have met them but we aren't all like that. No doubt someone will be along soon to tell neck shouldn't take this so personally, guess that is easier said than done.

fargate Thu 04-Aug-11 15:54:10

I've been thinking about this problem for a few days now.

MW are already a scarce and precious professional resource and there is no money to increase their numbers. The birthrate is rising and the majority of cuts have yet to be made. Should MW be providing in-patient postnatal care, at all?

The role of MW in a postnatal setting seems to be staggeringly large and rather diffuse and doesn't utilise the majority of their core skills. I imagine these things would be a source of stress and disatisfaction without the ever present pressures caused by under-staffing.

Much of the paperwork, answering the phone, opening the door etc could and should be done by ward-clerks who could be charity/voluntary workers. Nursing staff are responsible for infection control not for the cleanliness of toilets & bathrooms - a dedicated cleaner making frequent checks should be able to do this without supervision.

BF support should be available 24/7 and could also be provided by commited volunteers or MW assistants. They could also help with personal care

Post op care after CS or surgical repair [20-25% of mothers] should be of the same quality and standard as in any other surgical wards/units in a hospital. And maybe should be cared for separately by nurses with surgical rather than midwifery expereince.

Rather long and rambling.

cardamomginger Thu 04-Aug-11 16:22:43

MrsJT - I am truly sorry you are feeling that you and your entire profession are being got at. I don't think anyone here has said "all MWs are rubbish". Some may have said that all the MWs they encountered on the PN ward provided a level of service they perceive to be substandard. If that is their experience, then they should be able to express that and complain about it, either here, or more formally. I'm sure you must have come across colleagues who you felt have been rude to someone or who have not provided the care to a woman or her baby that you felt was appropriate. I don't think anyone here is expecting you to apologise for poor care provided in PN wards to which you are unconnected. Your defense that MWs are overworked and overstretched in working conditions that are far from ideal and sometimes downright uncomfortable may be an explanation for the poor level of care some women here have reported. Be that as it may, it is not an excuse and mothers either individually or collectively should not have to accept substandard care with these poor working conditions given as justification. A lot of the posts here have pointed out the difference between care provided on other wards and care provided on PN wards, with further comparisons being made between care and conditions in MW led birthing units and in PN wards. This is not MW bashing. You raised similar points about PN services being the poor relative in the NHS. Once people have brought forward their experiences and we have a list of reasonable complaints and ways in which PN services tend to be lacking, we have two questions. 1. How to get these issues addressed at the PCT (or whatever it is it's called these days - I lose track) level such that PN care won't be the Cinderella service any more; 2. Within an overstretched system, what small, low cost measures can be implemented to improve care? (and hopefully make MWs' jobs less stressful and more rewarding).

KristinaM Thu 04-Aug-11 16:27:35

Good post northern rock

Inspirachion Thu 04-Aug-11 16:47:30

I'm sorry some of you have had such awful experiences.

There were some bad examples of individual midwife behaviour in my postnatal stay. 'Terse' and sometimes seemingly neglectful I suppose would be the least emotive ways to describe them. In these cases at the time I assumed (was made to feel?) someone else needed them more or was worse off than me - though I was in a pretty bad way.

I can think of many fabulous midwives I met too and some fabulous examples of care.

However

The over riding negative (a year on looking back) would be the seeming lack of time most midwives had to 'help/assist/care'

by the time I left after 8 days I was convinced this was due to the
their responsibility for keeping a detailed handwritten transcription/record of conversations in my notes rather than what I had previously assumed to be too many patients per midwife

I was staggered about the note keeping.

The midwife who was responsible for me in labour (induction/failed epidural/mal presentation/episiotomy/forceps) spent an incredible amount of time writing notes. Fairly early on I said something like gosh you seem to be writing an essay .... She said something along the lines of 'well yes we have to write everything down so if afterwards a woman says you didn't keep her clean or something you can proove you did and at what time etc'

Has there been a trial anywhere of minimal or alternative forms of recordkeeping (if this is really so essential) therefore freeing midwives to do more midwifery?

What training is there on notes surely facts would be more useful than the things I found eg notes say 'Inspirachion complained she had not seen a midwife today' - actually I went to the desk early afternoon to say 'who was my midwife for today (different most days) as I needed to see her as hadn't had any painrelief yet and should I just continue to wait on my bed'

northernrock Thu 04-Aug-11 16:59:32

I don't think anyone is going out of their way to go after midwives as a whole Mrs JRT.
Personally I am recounting my own experience, in The Whittington Hospital which was that the labour and post natal midwives were variously:
Disinterested
Sloppy
Rude
Callous
Absent
Bitchy.
Not just to me, but to everyone they came in contact with, that I could hear/see.
I only saw one doctor on the ward, and although he was an idiot (he discharged my bright orange baby as being Not Jaundiced) he was at least polite, and actually it was the unpleasantness of the midwive I encountered that most offends me.

The visiting midwives who came to see me after I got home were wonderful and thank God for them.

We can only say what our own experiences are, and if I sound angry and hostile towards the maternity staff I had, thats because I am, for bloody good reasons.

SnoozleDoozle Thu 04-Aug-11 18:32:25

I have been thinking this over for a few days, and the more I thought about it, the more it annoyed me. I think that the post by Reikizen back on page 7 of this thread pretty much sums up how a lot of people feel about their postnatal care. Although I'm assuming her intention was to point out her frustration at how overworked they are on postnatal wards, in actual fact it came across as ' I know many of you have had surgery, and many others have had interventions that have left you in pain, but frankly, I think you are making too much of a fuss. I can't change everyone's dressings/catheters/soiled sheets, so most of you will just have to wait, and to hell with the consequences.'

So, in actual fact, in trying to explain the midwives situation, she has really just left me feeling that 'yes, it is attitudes like yours that sum up why so many people on here rate their postnatal experience as the worst of their lives'. If you consider postnatal patients to be such an unpleasant, whining, unreasonably demanding group of people, why on earth have you chosen a career which is meant to involve looking after them? Its a shame too, as the other midwives who have contributed have all had such positive contributions to make.

And for the record, I had some wonderful midwives, but individual wonderful midwives are not the same thing as getting good overall care.

And my health visitor was outstanding.

Oneof4 Thu 04-Aug-11 19:24:46

I would completely support a campaign to improve maternal care from start to finish, but particularly post-natal. For a large proportion of women in post-labour wards (those who haven't had cs or major complications) it's not actually difficult to improve their experience at a relatively low cost.

AvrilHeytch Thu 04-Aug-11 19:50:36

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AvrilHeytch Thu 04-Aug-11 20:08:16

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MistyValley Thu 04-Aug-11 20:13:17

Agree with SnoozleDoozle.

And for individual midwives to take umbrage on behalf of midwives everywhere just smacks spectacularly of Not Getting It, sorry.

MistyValley Thu 04-Aug-11 20:14:50

"Then perhaps midwives could visit their patients and spend time with them in hospital, as they do in the community."

Avril - that makes sense to me. And sorry to hear about your experiences, they sound horrendous.

fargate Thu 04-Aug-11 21:03:52

Midwives, like all NHS clinicians, have a legal responsibility to keep clear, complete and contemporaneous clinical records in line with agreed standards.

They should, by neccessity, also be concise. Writing unneccessarily detailed essays protects no-one from litigation but can be a powerful psychological defence against the anxiety of making an error or the fear of being sued .

Then there are all the care plans,risk assessments etc etc which run in parallel/replicate the clinical records wh nursing staff are obliged to complete - there's got to be a way of reducing this unproductive make-work.

Even recently qualified MW seem to be 'burning out' when they should be at their most enthusiastic. sad

monkeypuzzeltree Thu 04-Aug-11 23:06:36

OP, an excellent post, I can so relate to much of this. Just TTC DC no.2 and already I have a list of things that I am certain of...

- I want the number of a private bf expert who can be there when i need her. I'm afraid that the fact that the bf expert when dd1 was on holiday didn't really cut it and those first few days of getting it so painfully wrong set us on a tricky path. I'm lucky that is an option for me but it shouldn't have to be and they wonder why so many people end up giving up. Experienced midwifes were understandably busy and well meaning young trainees were supportive but not actively helpful

-I was lucky enough to be given one of the private rooms at the hospital, not sure why, I just got lucky and should that happen again, I'll be taking my own DO NOT DISTURB sign - medical staff excluded but is it really necessary when I have only been in the room for the first 3 hours with my baby and I'm half naked and trying to sleep that about 3 different men come in to empty the different bins!

-Food - nothing special, just food that looks like you would want to eat it and yes, my husband does also need to eat when there are no shops at the hospital!

To be honest, having had one experience it has made me more determined to do as much myself and not have to rely on getting the care i will need, I might get great care but you can't rely on it sadly.

AvrilHeytch Fri 05-Aug-11 09:14:09

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MistyValley Fri 05-Aug-11 09:32:12

Yes, I don't understand why a busy maternity ward wouldn't have a receptionist/administrator to deal with the door and visitors. Could they not also deal with admin tasks like requesting cleaning staff to attend if there is a big mess in the bathrooms or wards, and help with some of the mountain of paperwork?

It seems mad that midwives are also acting as receptionists and administrators if it is stopping them from looking after women and babies.