AIBU to think that all mothers should have food and water on postnatal wards?

[JustineMumsnet]

Hello,

Today, we at MNHQ are launching a new campaign called Better Postnatal Care: Aftercare, not Afterthought.

Over the years, we’ve been struck by how many MNers have related pretty horrible experiences on postnatal wards. We’ve also seen lots of discussions about longer term aspects of postnatal care: help with breast or bottle feeding, mental health care for new mothers, wound care after difficult births, and physio for women who feel they need it (but rarely feel able to ask for it) - among other things.

So, towards the end of last year we decided to see if we could do something about it. We ran a big survey of Mumsnet users’ experiences of postnatal care, and some of the results were striking. (You can see more here.) Among those who stayed in hospital after giving birth - which was most new mums - many reported that it was sometimes difficult to access food, pain relief, drinking water and washing facilities. 61% had been unable to access food when they needed it; 45% had been unable to access pain relief when they needed it; 22% had been unable to access water when they needed it; and 19% had been unable to access washing facilities when they needed them.

So today, we are asking the major UK political parties to commit, in their manifestos for the general election, to making sure that women on postnatal wards always have access to the absolute basics: food, water, pain relief and washing facilities.

We’re also asking everyone (this means you!) to contribute ideas about how we can make postnatal wards ‘fit for purpose’. More midwives? A fridge full of sandwiches, fruit and water on every ward? Asking all visitors and patients to turn off noises on their phones and personal devices? Maternity support assistants? Welcome cards by every bed explaining how the ward works? Making sure that inpatients and their visitors use headphones if they’re watching TV? We’re after all your suggestions, no matter how small. We’ll also be asking for input from healthcare workers with frontline experience - so if you’re one of those, please do chip in.

This isn’t about going into battle with people who work in maternity services in the NHS. Most of you feel that overall, over the year or so post-birth, standards of postnatal care are good or OK. When asked what needs to change, many of you say you think there should be more staff. Some of you had very good experiences: if you look at the ‘Good Stuff’ heading on this page you’ll see some shout-outs to hospitals and services that MNers say are getting things right. So we know that it can be done. What we want to do is find out how these hospitals are managing to get it right, and see if the lessons can be transferred.

In the months to come, the campaign will look in more detail at things like infant feeding, traumatic births, postnatal mental health, and follow-up care for birth injuries.

Please get involved with the campaign. Here are some ways you can help.

And as ever - do let us know what you think!

Thanks

Posts that say 'be realistic' and 'think of the money' boil my piss as they are inherently soulless and inhumane, as they have no regard for what 'be realistic' means in reality for women on the receiving end of unacceptable provision of services.

If you're referring to my previous comment regarding that any changes need to realistic, this is not what I said.

I said 'Any changes need to be realistic based on the current budget and staffing level.'

I work within the profession, and have also been a service user, so have experienced being on a postnatal ward from both perspectives.

There is a shortage of midwives, and staffing levels on postnatal wards are overstretched.

More staff being recruited would help improve postnatal care, however this comes down to funding. Campaigns like this help raise awareness of the issues with the public and the government, and help the government to understand that changes to maternity services need to be made.

On admission to the ward, as part of the hand over of staff the woman should be oriented to the ward and advised where the facilities are. And a jug of water provided.

I agree it's a great idea to provide women with a 'welcome' card to ensure this basic information is given to all women.

Also ensuring that there's food available to all women at all times is a great idea.

I also think that something like a customer satisfaction card could be given to woman, so the staff are graded on the care they provided as well as the woman's experience. This could be built into the staff members development, to ensure that issues are flagged in a timely fashion.

then maybe we shouldn't provide "free" medication either, and ask the patient to pay for them in advance. Or maybe we should just scrap hospitals all together, what a huge saving that would be.

I don't want you to feel I am having a go at you, but at the way things currently are. Patients are made to feel they are a burden. How did we end up in such a situation?

Isn't that the entire point? Its about bottomlines not health and wellbeing.

^If you're referring to my previous comment regarding that any changes need to realistic, this is not what I said.

I said 'Any changes need to be realistic based on the current budget and staffing level.'^

Same difference though.

Don't say we should aim for the barest minimum because, you know, money and cuts. It feeds the same low expectation cycle. Deliver little because women will accept that because, you know, staffing.

Don't say we should aim for the barest minimum because, you know, money and cuts. It feeds the same low expectation cycle. Deliver little because women will accept that because, you know, staffing.

I haven't said that either! 🙄

Overall our attitude has to change from

"We can't afford it. There isn't enough resources"

to

"If we invest in this, it will save us MILLIONS, in this and will be better for society as a whole".

That means doing this joined up thinking on how not providing services like mental health really is costing far more than if we did.

RedTootBrush

As a nursing sister I produced a ward guide. I wrote it and dh printed and laminated 100 copies. It cost less than £50...

Water and toast cost a lot?? Really you think the NHS didn't provide this for years and years?? It's basic stuff.

Sorry but staffing levels are absolutlry no less than they were in the 80s but there were far more student nurses on the wards to help deliver this basic care. There were auxiliaries and SENs.

It's a training issue not a staffing issue.

Invest in the basic training and get that right get the basic nursing care right and that saves money preventing complications not just on the post natal ward but all wards.

*"If we invest in this, it will save us MILLIONS, in this and will be better for society as a whole".

That means doing this joined up thinking on how not providing services like mental health really is costing far more than if we did.*

Changes in people's attitudes and investment won't happen overnight. This is where campaigns such as this, help raise awareness.

We need solutions which can improve things which are within reach.

I think that all we urgently need and something that is achieveable in the short term is to simply rethink post natal ward policies and standard practices in order to make them more favourable to the women actually using the service.

It's silly to argue that toast and tea costs money. It''s part of the budget and the bare minimum to provide food. But, lots of women don't get access to that food for various reasons. So rather that saying this can't change without a budget increase, there are without doubt ways to improve service without changing the resources you actually have, just the way you use them.

Increase the timend periods for meals. Don't expecg women who have just had surgery to walk to the end of a large ward to get food. Make the information available so people know what to expect. Have water coolers or bottles available. ASK women if they have had something to eat and drink, if they need something. When you are allocating them a bed. So no extra time needed. Have non meal type food easily available between meal times for women who give birth in the middle if the night etc.

This is just using food as an example. I'm sure it could work for other aspects of post natal care as well. It's unethical and downright lazy IMO to say that none of these positive changes can be made, right now.

Of course thry can be made right now but will they?

If a poster can say 'the midwives made it quite clear that filling up water jugs was not their job' then I see huge huge problems here.

Food and water are the basics of care. Helping patients yes patients wash and walk is basic care.

What the fuck had happened to nurse training

And regarding staff numbers well get the nursing students out of the universities where they are clearly being taught what nursing isn't and back on the wards and back with nursing schools to be taught what nursing is!

Seems to me that's the problem here.

But that's what I'm saying bat.

I'm not saying it's automatically going to happen. Im just saying, giving this thread is about suggestion's to improve post natal care, that IMHO there is stuff that can, should and in some places is being done to raise standard's of care. I just hope something will come of this. Ideally before November

Separate rooms with washing facilities would give new mothers the dignity they deserve. Yes I know horrendously expensive but the wards in my experiences are humiliating and stressful places to be. I wandered off into an empty ward with my first because I couldn't cope with the noise and strangers and babies crying and bloody toilets. I don't remember even seeing a shower far less being offered one over my 48 hour stay. A nurse found me in the empty ward sitting in the dark and made me go back to my bed and I cried the whole way.

Also I wish I'd known I could have signed myself out (I think that's possible at least unless there are major concerns?)

I'd been spoiled with the midwife led unit for the birth which was blissful. The ward was horrible.

Not all women have partners, or partners who can be there all day. There are often other children to look after, and a busy post natal ward is not somewhere to bring a child say with autism who will simply have melt downs because of the over stimulation.
It does seem as if things are designed with the assumption that partners will do the caring. Which means anyone who doesn't have someone to do that, is totally neglected.

Totally agree with you cherries absolutley. All this stuff is basic I know banging on about this but it is isn't it?

Can't believe people are costing water and toast for goodness sake. Basic care.

we should work towards private rooms, or at least semi-private: 2 women per room and sharing a bathroom is unpleasant, but would already be an improvement.

Communal wards, with public toilets, also used by outpatients.. no progress since the Middle Age, this is shameful.

Anyway, in the meantime, respecting women's privacy, keeping the damn curtains closed would allow patients to have a visitor WITHOUT disrupting ^as much" the others. Not great, but what can we do.

Not allowing more than 1 visitor at a time possibly? Not allowing children? Of course little Alfie wants to meet his new brother, but the other mums need to rest. Physically need the peace and quiet. Little Alfie will meet his baby brother in a few days.

No one needs to have a party of visitors on a communal ward. Respect the others.

I know Bat it is sad that not only is our standard of care low, but also (without meaning to be offensive as I understand they are left concerns) it does somewhat make it even worse that people are willing to justify/accept as the norm that the care we receive should be like this.

And yes we do keep saying it but that is what makes it so horrifying isn't it? That the very basic needs aren't being met. I read the OP again - literally more women don't receive food when they need it compared to women who do. It's just awful :(

I think we need to be more assertive of our needs. Im hoping this time around the fact that I know what to expect will make it easier. But I was lucky enough last time to be capable of walking etc myself - I dread to think what it's like if you're bedbound or in pain, based on this thread (and many others) :(

Batsgirl I still don't understand why you keep bemoaning how adult nurse education is currently structured, when we're discussing what most here agree to be serious shortcomings in midwifery
I will reiterate the point I made a long way back in the thread - as a profession it separated itself from nursing a long time ago, and for the poorer as we have seen.
IMO it absolutely should return to being a specialist nurse conversion postgrad training, OR, staff postnatal units with midwives AND nurses.

Agreed, Michael. In fact I would say that with the increasing complexity of maternal health, midwives need more nursing skill and knowledge than ever before. Pregnancy may not be an illness, but many pregnant people are ill.

Nursing students spend exactly as much time working in clinical environments as they do in university study. Half the degree is practical (also true of midwifery).

This is niche, but still important.

If food and water must be fetched to patients by their partners (which is, depressingly, my experience), then staff must be aware that some couples will be lesbians. I've posted about it before, but my DP had our daughter five weeks ago, and I was refused entry to wards, and refused food for her, by staff who simply could not understand that I was a woman asking for food for my female partner, no matter how often I clarified that fact. DP had had a section and she has had quite a difficult recovery, partly as a result of having to do far more for herself in hospital than women with male partners.

I'm sure the same issues are faced by women whose birth partners are their mums and sisters, so it cannot be that tiny a number of us.

LRD just when I thought I couldn't be more shocked and disappointed by the issues being raised here. Appalling.

'In the same spirit, until we can afford to have decent private rooms with private bathrooms (the way they exist in other public hospitals in various countries, and some hospitals here), respect women's privacy!

keep the goddamn curtains closed,'

Brand new, huge hospital in Glasgow. Guess which unit is still a ward?

Long thread on here from, IIRC, last month about curtains. Many posters had recently been in postnatal units and ordered to keep their curtains open at all times unless a HCP was in with them and nearly all had had their curtains whipped open by HCP with no warning. There were hundreds of accounts of women being exposed without their consent.

Oh, and yes please to info cards! Especially about relatively common issues that could be serious. Off the top of my head, the things we did that we should have been told not to do include:

• DP and me feeding DD through a tube in a way we later found could have killed her. We were instructed to do this by someone with insufficient training. It went on for several days and it's only blind luck we didn't kill her.
• DP picking up and changing DD hours after a section (she was told to by a midwife who we now realise didn't know she'd had a section - she had a catheter in!).
• DP and me both walking about the ward with DD in our arms (not a big deal but it's a trip risk, and other patients were told not to, but we were just given evil looks and didn't know why!)
• Constantly having to chase pain medication as we were never found out who was responsible for it (and having to keep tabs on how much morphine she'd had as at one point they nearly gave her a repeat dose without checking how long ago she'd had the last one - imagine a morphine-high woman trying to remember when she last had medication!)

A simple leaflet about ward rules/ who's who on the ward would have solved most of these. Another leaflet about tube feeding would have solved the other - or, FFS, not requiring a new mother who was on morphine to try to tube feed a newborn!

michael - yep. I'm in the middle of trying to write a guest post for MN about it (sorry, MNHQ, I am getting to it!). It was not one of my favourite parts of the whole experience.