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

'The 1 time I didn't get infected was when a kind support worker gave me a bed bath a few hours post-delivery'

It's mad, isn't it? We've known about germs and the importance of keeping clean for hundreds of years now. What a waste of money allowing women to get perfectly avoidable infections by not enabling them to keep clean at the point when they are most vulnerable. W

Both delivery & postnatal care far from ideal. Everything everyone has said about postnatal food applied. Toilet & shower room in a flooded state. It badly needed sorting out, and by the sound of it still does. Birth itself also a nightmare - the curtains had been removed, leaving just a bush between me and the outside world for hours and hours with my nether regions on show. Then afterwards sent alone, - exhausted, confused & covered in yuck - down long corridors to the uncertain destination of the showers. The delivery arrangements also seriously needed re-thinking.

Reading the full thread now with shock, sadness and fear. Just incredible what so many have been through. I didn't have a great time of it, especially with my first (different hospital), but it was a walk in the park compared to the experiences listed on here. :(

On a more trivial note it's also inspired me to start writing my hospital bag list now (am only 13 weeks!) - so many things here that I'd have assumed were easily available on the ward but I'm not risking it.

I had 4 dc each with varying times on postnatal ward, up to 10 days. All meals were brought to bedside and u cld order earlier from a choice. Jug of water provided, tea breaks. There was sometimes a lack of communication, paediatrician telling me ds needed top ups and midwife being very unkeen left me feeling a bit like the child on naughty steps but generally looking at all these posts I appear to have been spectacularly lucky. Huge inner city hospital. They did a great job as a whole. Sure little niggles, bathroom at times needed a clean, by dc2 I'd leant to bring my dettox! No problem. Sometimes lots of relatives around a bed but live and let live and allow a bit of family celebration. Put earplugs in and chill.

I was wheeled up after stitching in evening. I'd had an epidural for the stitching, so couldn't move from waist down. Only me and baby on ward. During the night, as sensation returned, desperate to change my blood drenched pants - couldn't reach my bag. Also couldn't reach my baby! Eventually managed a pretty unsafe manoeuvre involving the blanket she was wrapped in and got her in with me, and then spent a happy night, both of us wide awake telling her all about her daddy, and me and general prattling.
Then transferred back to lovely maternity unit I'd given birth in, which was fab.

I've had some terrible postnatal experiences. With DD3 I was virtually ignored as I was the only lady in the ward not to have had a C section. I had to get my own drinks and it was assumed I was going home straight away. I delivered at 3am!They seemed surprised when I asked to stay the night!
With DD4 itwas worse. I was left alone for long periods of time during delivery then once my low weight baby was born the nurses just disappeared and left me holding the baby, with no cot to put her in, painful stitches so I couldn't move and the call button out of reach. I was there from 2am until 6am, calling for help, needing a drink and the loo and unable to sleep because I couldn't put my baby down anywhere. I cried and cried for hours. Im crying now just remembering it and she's 18 months old!
When they moved me to the ward I was ignored again and didn't get pain relief till my husband turned up at visiting hours. I had been texting him and I heard him demanding to make a complaint from the moment he arrived.
We made complaints but nothing really happened. The staff got a talking to, that was all.
Then to top it all off nobody informed the health visitors that my DD had even been born so it took me 6 weeks to track down a health visitor to come to my home and weigh her. She had missed vaccinations and heel pricks and all sorts.
I wonder if I was ignored because it was baby number 4 and they thought I didn't need helping? Or maybe they just don't have the funding. But every time I have a baby it gets worse and worse. My husband would like baby number 5 and I actually am terrified to do it again. Why do we get treated like animals?

Wow. I had my food order taken and my food brought to my bed, in a side room with just baby and I (no complications) I had a private bathroom and drinking water or tea on tap. I had midwives pop in and out all the time. I didn't want to leave!

Amazed by some of the awful stories on here, so sorry for your bad experiences. Could not fault the midwife led unit I was lucky enough to use on any detail.

I was left in a pool of my own blood and afterbirth for 3 hours. Literally no one came to check on baby or me.

That was Newcastle RVI.

I work in the nhs and am staggered how the difficult life saving stuff is done generally very well but the basics are often lacking. My suggestions (after 2 stays on postnatal wards) are

1. bathrooms: frequent cleaning, trays for shampoo etc in the shower at a sensible height so you don't have to put toiletries on the floor and try and reach them... not fun post section! toilet roll and sanitary bin within reach when you're on the toilet.
2. food and water available 24/7 and longer mealtimes. You can't be expected to get to a dining room in a 20 minute window of opportunity and wait until next meal time if you miss it.
3. caring attitude from staff and honest recording in medical/ handheld notes
4. privacy and dignity to be respected by staff and visitors. Rest times to be respected by staff and visitors
5. noise levels to be minimal especially at night - buzzer volumes reduced, quiet shoes, lowered voices as much as possible
6. better staffing numbers
7. love the idea of information about the ward

I've deliberately not included anything costly except the staffing- but all are things that would have made my stays more comfortable...

Yes I agree, I had internal surgery after giving birth and was brought back into a labour ward in the early hours. Everyone was asleep, I was drugged up, exhausted and totally out of it. My partner had to go home and I was woken up by the bright lights being switched on and generally noise of business. I was completely dehydrated but didn't have any water i could reach as I was in agony. I had to ask the cleaning lady to get me some. When it came to breakfast the food trolley cane round but as I hadn't been there the fact before to order I didn't get anything. I hadn't eaten for nearly 30 hours and was starving. Luckily my oh brought me in food and drinks.
The staff were lovely but these things would have made things so much easier and wouldn't take much more organisation to have extra meals ready for the women who were not expecting to be in the labour ward.

Can't even mention what I thought of the postnatal ward as I didn't even make it there as they were to busy, I was on the prenatal ward the whole time.
I also discharged myself as I was left alone after having my first baby alone as a single mother they would not let my dad in to being there with me. I delivered at 0.55am and at 8am I asked to be discharged as I just wanted to go home and be supported by my family. They said I needed to see various people to be checked out etc. I kept asking the tanker dah at by 4 am someone came to visit me , my blood pressure was high and they knew I was being monitored for preclampsia previously but hadn't checked on me the whole day despite me asking over and over again. They then told me that they wanted to keep me in to monitor me but I decided enough was enough and I wanted to go home with my mum who was being advised to leave as the 3-4 visiting hours were over.
I had no support from staff not knowing how to breastfeed and I couldn't walk after giving birth but was somehow expected to be able to pick the baby up and breastfed in the middle of the night after a lengthly labour that had meant I hadn't slept for 48 hours atleast.
I know everything is over populated and understaffed but my gp and hospital care has been appalling. The midwife visits were very good though. Pretty much the only thing that is positive.

I can't fault staff in the hospital where I had my children. They were all working at full capacity and brilliant at helping with my pain relief after my c section. I like the idea of the helpful hints cards and 100% agree with bringing food. Less then 24 hours after my c section I had to get my breakfast at the end of the corridor in agony and with a newborn who wouldn't settle. It was before visiting hours so I was alone. Also, I don't want to cause debates and there are often exceptional circumstances but partners should not stay over night. The lady beside me had her partner stay and he snored all night. They shut the door to our room because he was disturbing the whole ward! I was up all night exhausted and in pain. He wanted to use our shared bathroom to shower and when the nurses said no because I was there he got a bit stroppy. I felt exposed and vulnerable with breast feeding and all the other gross stuff that you experience after birth. My husband went home and he lived and hour away from the hospital. It's a tough topic but maybe there should be a visitors room for partners.

As others are speaking of snoring can I just admit I'm really nervous (and embarrassed... I've NCd for this post) about being on a big ward after the birth? I have snored for the last few years (it's not sleep apnoea, we think it may be throat related) and that wasn't an issue when I had my older kids years ago (I snored more during the actual pregnancy but it wasn't that bad). But now... I'm actually really scared about going to sleep and keeping everyone awake. But given my previous birth experiences and my other health issues it's pretty likely I'll need to stay in a night or two even if I have a normal delivery. I don't want to ruin the time for others, and more selfishly I don't want all the other mums to hate me!

People have mentioned sleeping dads snoring but what about other mums, what do they do then? Sorry for derail but it will be something that keeps other new mums awake and I hate that.

Perhaps with the instructions card a list of things they will help you with or you can ask for, like milk if you switch from breast to bottle can make it feel less intimidating to ask for help?

Hospital I was in was 'baby friendly' so they didn't supply formula and wouldn't give advice about bottle feeding. Anyone wanting to use it had to bring their own. Considering how much they were going on about breastfeeding I was surprised at how little consistent information there was about it - staff contradicting each other.

With my last delivery, 12wks ago, all they were concerned about since literally two hours after my surgery was when would I be going home. On the first night they left my call button out of reach and I ended up having to phone DH to phone the desk to tell them DD was screaming and I couldn't get to her. They let me have two doses of diclofenac overnight and then told me I wasn't allowed any more and it was paracetamol or nothing. I dug my heels in and was finally allowed "a sip of oramorph just this once". I said I wasn't going home that day and when the night MW came on duty she asked why I was still there and said this would absolutely have to be my last night (it was my second night) and I would have to "go elsewhere tomorrow".

The next morning my pain was still increasing but my bleeding had stopped. No one examined me or thought this was odd for less than 48hrs after a section. I need oramorph at 7am in order to get out of bed but at 11am they discharged me without question. I was discharged with only paracetamol and the next morning I had to ring my GP and beg for stronger pain relief (which they gave me without a quibble but said should have been supplied by the hospital).

Once home I got gradually worse and on day 5 ended up in an ambulance back to hospital. My bleeding had stopped and my pain increased due to retained tissue. If anyone had bothered to examine me they'd have found that my uterus had not contracted down at all and my abdomen was so tender it couldn't be touched. I had sepsis and was very ill. I was freezing cold, violently shaking, had severe abdominal cramps as my womb tried and tried to empty itself (the ambulance had to get me on gas and air before they could move me), vomiting bile, and was confused/hallucinating - DH had to sort out the DC and then follow behind yet I was chatting to him the entire time as I thought he was with me (I also thought I was chatting to him, he said I wasn't chatting to anybody and aside from brief periods of lucidity I was actually only semi-conscious). DD had to come too because she was badly jaundiced and had dropped in weight from 8lb15oz to 7lb4oz - because of the retained products I wasn't producing nearly enough milk so she was starving.

Like a bad joke, we were admitted back onto the postnatal ward that could have prevented things from becoming so serious had they just listened to me in the first place about my pain/bleeding instead of hounding me to get away home. The consultant treating me asked me why I'd gone home when I hadn't felt well and I told him truthfully, that I'd been pressured into it.

The care element needs to be brought back into postnatal care, staff need to listen to the women on the wards and understand that they know their bodies best - I've had four DC and I knew what to expect in terms of recovery but was still dismissed when I insisted something wasn't right. There should be a nationally agreed framework setting out the minimum standards of care and pledges from maternity departments to meet/exceed these as well as a clearer feedback route for reporting badly managed care and complaints.

I think that's a great idea! It would be very helpful and reasonably cheap to do.
After having my son, we were taken up to the ward at 6am. I slept through breakfast and missed them coming round with a tick list to order tea. Because I wasn't aware that that's what happened, I didn't notify anyone and didn't get any tea that day 😕
I also got into trouble for carrying my son around instead of moving him in his little crib thing and didn't realise that I could bring my food back to my bed instead of having to leave my son while I ate.
These things and more could easily be included on an information card and, like you say, they could have it in different languages 😊

With my first DC I had an emergency c-section and was very poorly afterwards, so they gave me a private room. Then the staff basically just forgot about me.

The room wasn't cleaned. The bedsheets were soaked in blood and not changed until my DH kicked off about massively on the 4th or maybe 5th day after asking politely multiple times.

They also forgot to take the 'nil by mouth' sign off the end of my bed for 36 hours after the op . I know it sounds stupid but I thought I really wasn't allowed to eat after the op and that was why I was never brought anything. It was only when I got so deliriously hungry that I asked DH to ask a nurse when I would be allowed food again that they realised the mistake. Apparently I could have eaten within a couple of hours of the op but survived on water and tea for all that time hill trying to nurse a newborn and recover from a major op .

The postnatal care was dreadful in many other respects. I get upset just thinking about it 12 years later. Thankfully, the care was much better in a different hospital where I had my second baby. Food was plentiful, they brought it to you, and staff were really attentive. And this was a big and busy London hospital, so good postnatal care IS possible.

@Bearfrills - I find your account utterly shocking. When I was training, back in the 80s, we all did 8 weeks obstetric allocation, and almost the first thing we were shown on the postnatal ward was the necessary observations to be carried out on a woman who has given birth - which included palpating the woman's abdomen, to ensure that the uterus was contracting down properly.

If anyone - student nurse/midwife/doctor had missed someone with your symptoms, there would have been hell to pay!

I don't have children yet but I am shocked at the way women are treated on postnatal wards. My mum had a section 34 years ago with me and she says women need more than paracetamol after a C section. I think midwives need to be more compassionate rather than dismissing them as precious princesses. Wrt drinking water, I attended a health check day a few years ago and there was a company plugging these water bottles that can be attached to the hospital bed so mums who have had c sections can hydrate themselves or for bf mums. The brand is called Hydrant but my kindle won't let me link.

I think that there does need to be more focus on the mother's wellbeing too.

More money, more staff, better training.
Information cards would help, to give an idea of the rules and schedules of the ward.
Antenatal classes were excellent at covering labour and birth but didn't mention postnatal care - maybe they could cover what to expect afterwards and what needs to happen before you can be discharged (eg. paediatric check, hearing test, stitches checked, notes processed etc) I was desperate to escape the sauna go home so I could rest, and got frustrated by all the delays.
Better bathroom cleaning - there was blood all over the toilet and floor and a cardboard bowl of urine in the sink when I went for my desperately needed shower.
Sleep - I'd been awake for over 72 hours and got less than 2 hours sleep on the ward because it was so noisy day and night. I really didn't feel safe to hold the baby as I couldn't keep my eyes open. Limits on visitors, phone calls etc and more assistance through the night - the baby in the next cubicle screamed incessantly because the mum couldn't pick her up as she'd had a section and there didn't seem to be any help available (the maternity unit was completely full and the staff were rushed off their feet and doing their best but just didn't have time to help - I only pressed my buzzer once the whole time I was there but nobody came).
Water fountain on the ward - I had to trail out and down the corridor to the breakfast room to fill up my water jug twice as DS breastfed lots and I got so thirsty. I know it's good to get out of bed but with stitches and bleeding heavily it wasn't fun.
Bounty - just NO!
I would like to say to any midwives reading this thread and feeling a bit kicked in the teeth that the staff were doing an EXCELLENT job under difficult circumstances and I felt like they genuinely cared but were just desperately under-resourced

www.homebirthsupplies.co.uk/maternity-hydrant-46-p.asp#

Also my afterbirth was chucked away/sold/who knows, after clear notes in my birthplan for me to take it home and after I reminded the midwives during the birth. Got no response to my written complaint to PALS.

My postnatal care was brilliant and I was in for 10 days after giving birth. I asked so many questions and got help with breastfeeding. Food was brought to my bed for me, I could buzz in the night if I was hungry and water was readily available at a water machine.
There were a few less friendly midwives but I got the impression that midwives are really over worked. They work so hard and long hours.
I would have liked there to have been a welcome card to explain how things work. That would definitely have been useful.