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MNHQ here: after your thoughts on a possible campaign on postnatal care(406 Posts)
MNHQ have commented on this thread.
As lots of you will hopefully know, we at MNHQ run campaigns every now and then on issues that really matter to MNers. Ongoing campaigns include better miscarriage care (keep an eye out for developments on that in the next month or so), support for families caring for children with disabilities and additional needs (MNHQ has signed up to a new campaigning alliance on that and we'll fill you in on what's happening soon), and rape myths.
We've been thinking for a while, though, that many of the most urgent and upsetting things our users talk about fall under the heading of - frankly - inadequate postnatal care.
MNHQ was involved in the National Maternity Review recently, and even among the senior NHS professionals there it was evident that there's a consensus that postnatal is the 'Cinderalla' of maternity services: underfunded, poorly resourced and rarely thought about - except when it goes horribly wrong.
Obviously this is a huge area and a very complex issue to address - so we'd like to hear from you:
* is this something you'd like to see MNHQ get into?
* which aspects of postnatal care need to be improved? We're already thinking about things like: breastfeeding support; perinatal mental health; staffing and conditions on postnatal wards; partners on postnatal wards (we know most of you aren't in favour ); care in the community from health visitors and community midwives; injury care for women post-birth, and longer-term care for pelvic floors; the six-week check and whether it really works for women and babies... but we're sure there are more.
* what solutions would you like to see? What's needed (up to and including money) to improve postnatal services for women and their families?
The aim of this thread is to find out whether you think this is a good idea overall, and to get a sense of which issues and which problems you think need attention - so please fire away and let us know your thoughts. When we've got something to work with we'll put together a survey for all our users so that we can get a bit of data to help us make some decisions.
Yes please do it!
(No time for anything more constructive right now)
More funding for post natal wards. More staff. Better trained staff. More empathetic staff. More private rooms. Better nutrition. The ability the sleep once on the ward. No over night partners. But then proper care from staff, as there would be enough staff.
The post natal wards have twice been the worst part of my late pregnancy/ birth and early breast feeding days. Set me up so badly for coming home with a new born. Thank you for getting involved in this
I'd like better care. I was trapped with a screaming baby (who'd pooed) & legs totally anaesthetised from 8 epidurals & 48hr labour. The other mums were swearing at the noise. Couldn't get up to reach water/cleaning things. Help didn't come. Horrendously stressful. I left after 6hrs.
Also, I failed to bond with baby. I told every health visitor/every nurse. Nothing happened, no advice no help. It was very hard. I had no idea what else to do so I just struggled on. Bonding took years sadly.
Yes, please campaign about these issues.
I know some people don't mind them, but for all the women who are harassed by bounty reps at vulnerable times, ( including one I witnessed - before a woman had even done a first wee post birth ) please get the bounty reps off our postnatal wards once and for all. It's really not the time or the place for them.
If partners can't stay overnight or at certain times then postnatal wards need more staff to help look after the newborns if a new mother has had complications / c sections / birth injuries.
Better breastfeeding support for those who want it.
Yes, please do it. I opted to go private in order to get the care that we should all get on NHS. Post natal care in London is horrendous. I agree with your list of topics - we need much better breastfeeding support, post natal wards should be calm and nuturing environments (it's not an option for everyone to leave as soon as poss after birth), there should be a lot more private rooms to allow for proper rest and partners to stay if wanted. 6 week check for mum should be more thorough, pelvic floor should be checked etc.
Yes please campaign on this on all the issues you mentioned. What happened with the Bounty campaign a few years back? Did anything change anywhere? They're still harassing new mothers and shouldn't be. Thanks for raising all these issues.
Yes, a campaign would be great.
I had fantastic care pre-pregnancy, during pregnancy (pre exciting condition) and during a (difficult) delivery and can't praise it enough, but the postnatal care was awful and had long lasting effects.
Ultimately I think it comes down to lack of resources (particularly but not limited to money and staffing). Also a lack of the different elements of postnatal care being joined up - postnatal ward, NICU, community midwives, paediatric team etc.
Yeah, the Bounty thing. I know its been done to death on MN before but I had my first baby last year and thought I was prepared to tell them to bugger off.... And then it was 24 hours after the unexpected prem birth of my first child and a brusque woman walks into my (single) room, demands loads of details and then says "well I see your baby is in NICU so you don't be able to get any lovely photos, shame" and walked back out. Completely bloody inappropriate and I won't ever accept that that should be tolerated.
yes please campaign
For all the second/third or more ( or i guess sometimes first timers too) timers then going home straight away or after a day is ok but for most first time mums they need so much more support and care.
Longer stays in a dedicated post natal unit...
More single rooms...
I might be shot down here but a night nursery staffed by proper maternity nurses available so mums who need sleep can get it .
Basically better facilitlies and a lot more staff needed to provide supportive enviroment for the first few days
I recall my own DM explaining when she had my DB 50 yrs ago she went from the hospital to the 'nursing home' which basically was a post natal unit , she stayed in ( as everyone did) for a week for a straight forward delivery...lots of good quality food , lots of rest, lots of lovely mat nurses on hand to help you learn the ropes of looking after baby...then she had twins and she was not even allowed out of bed for a week , and not home for 2 ....because the midwifes said she had a busy toddler at home and newborns and she needed to get a good period of rest first to recover herself...
Now why do we not have that now ????
ps : will add staying in bed for a week after a delivery is not a good idea because of risk of dvt but the basic idea is we seem to have completely lost the art of post natal caring
Agree - a campaign on this is much needed. Giving birth should be an ultimately joyful experience. Instead for me it was the worst 2 weeks of my life (labour, post-natal ward, stay in SCBU and frankly awful post-natal care once discharged). Ended up having PTSD and counselling around 8 months later.
Empathetic staff with time to treat me as an individual would have made the world of difference.
Birth trauma. Please campaign in some way to help mums who felt ignored and that things were taken out of their control during birth and afterwards.
Yes please do it!
I definitely feel there could be better postnatal care training ,so you get sympathy on the wards post birth, rather than feeling like a nuisance - something I encountered at CUH with all three births. But also, with the HB visits, in their profession it should be obvious and well known that the first few weeks can be difficult and I'd have loved for a HV who came, was pleasant, did her job and didn't make me question myself or hang around too long.
I have to agree with the Bounty issue too. The staff have been dire on all three occasions, not something you should be experiencing, especially as all births are different.
Most defiantly. Breastfeeding support is a big thing I had none. Gave birth at home (not planned. VVV quick delivery). Not taken into hospital as everything was fine. She was struggling to feed from the first feed midwife that attended after the birth said not to worry she would be fine. To cut a long story short after being seen by loads of midwives, none of whom stayed to help for longer than 10 mins all left saying you will be fine. Massive weight loss and a very distressed mum, baby and daddy we had to give up. Something that still really upsets me now. I'm convinced that had we had some support we would have managed.
Definitely more private rooms. When I found myself back on a 4 bed ward with my baby in special care, it was a new kind of hell. One of the other new mums was trying to be nice, but I just wanted her to shut up and go away! I still thank God for the brilliant HCA who saw I was struggling and insisted I get my own room. It made all the difference, knowing I had my own private toilet and a little bit of quiet space all of my own.
With my first child I just wanted a bit of space and privacy to get to grips with feeding. Had to keep the curtains closed 24/7 as there were too many strangers about, so no natural light and it was bloody stuffy!
Sometimes I think bf rates would be higher, if post natal care hadn't got so hurried as it is now.
Yes. A friend of mine was hospitalised with post partum psychosis. If she had slipped through the net neither she nor her baby would be here, and she would be hated by many people for something that want her fault.
Agree there are lots of important issues and it would be great for MN to be involved. Personal experience of very poor breast feeding support (staff were great but highly limited availability) - and actually very little focus from midwives before birth on whether I anticipated BF problems. Also such poor sleep on busy antenatal wards, and crap food, added to the fatigue post-birth and feeling of not being remotely "looked after". Some very unempathetic post-natal nurses.
Just reinstating the postnatal care that has been abolished in the last few years would be a good start. Here you get visits on day one and day five and that's it. Apparently it's standard even for first time mums. You can go to a postnatal clinic at about nine or ten days but if you're needing help it needs to be in your home. There's no postnatal check up for mums now either. With my first it was home visits every 1-3 days for the first 10-14 days according to need (up to 28 days after a CS) and an eight week postnatal check which is much better.
When you do the survey, is there a way/ would it be useful to confidentially capture details of those MNetters who have been lucky enough to have good experiences too, so that their health authorities can provide an example or something? My postnatal care was great both times. I sort of feel like I'm undermining the campaign by sharing a positive experience, unless there's a way it can be used.
Yes please do campaign on this. I realised recently that all the advice I give new mothers is based on post-natal care being at best perfunctory, probably non-existent and at worst misleading or uncaring. I read someone saying that after any other similarly traumatic medical process you would be looked after, but after having a baby you are on your own. I feel like we have got used to that, and it's just not ok.
The reasons are obvious: understaffing, and rotas that understandably put midwives with doubtful clinical skills on postnatal rather than delivery wards. But it should be different. It has to be different.
The postnatal care we received was so lacking. No help with breastfeeding despite me buzzing them several times to help. I got discharged the day after giving birth but when I got I just broke down as I couldn't feed her and didn't know what to do.
DH took us to a different hospital for some help but they watched me try to feed once and then just told me to bottle feed.
Biggest regret of my life that I went along with it and didn't demand more help.
Yes definitely something I'd support MN campaigning on. I'd like to see better care for women with babies in NICU. There should be greater empathy from staff and concern for the mothers' mental health when she is separated from her newborn(s) when they are in NICU. Better help with expressing breast milk for sick babies (not just "here's a DVD for you to watch on expressing but sorry we don't have a DVD player" as was my experience). Better joined up care for babies and mothers - understanding that the routines of NICU don't always match the routines of the postnatal ward e.g. being flexible about the timing of meals and drug rounds for mothers who are caring for babies in NICU (I was refused pain relief 24 hours post c-section because i was in NICU feeding my babies when the drug trolley came round). My experience was that the care for babies in NICU was outstanding, the care for women on the postnatal ward was awful, bordering on cruel.
Couple of things that come to mind:
Breastfeeding support - this is patchy at best. With DC1, I was given "advice" that was complete and utter bollocks, such as "Your baby's feeding too much. She's using you as a dummy. You should give her a dummy or you'll be making a rod for your own back" - bearing in mind said baby was less than 48 hours old. I knew this advice was bollocks based on a half-day NCT course - how can a trained midwife not know this? With DC3, I accessed La Leche League to get me through weight loss and jaundice issues - wouldn't have got there on midwife advice alone. And I only knew to do this as it was my third child and I already had the contacts and knowledge. More training, more signposting and more time to help.
Birth trauma. It's a real thing. Someone to talk through birth with new mums - extension of birth matters service maybe? I struggled for months with coming to terms with the birth of DC1. Think it was only really DC2's birth that got me over it. It's in the RCOG guidelines for assisted delivery that there should be some sort of debrief - never offered. Didn't even know I'd had an episiotomy and stitches until a midwife mentioned it in passing the next day.
Six week check - my GPs don't offer this for women. Eight week check for baby and to do vaccinations only. No chance to discuss bleeding, stitches, PND or PTSD.
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