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

Having worked on a postnatal ward as a midwife and finding it the hardest place in the maternity service to work I completely empathise with all these comments.

The long and short of this issue is staffing. Plain and simple.

If there aren't enough maternity care assistants or Midwives to go around, jobs such as filling water jugs are negelected which is inexcusable but the reality of it. We are sometimes lucky enough to have volunteers on the ward to carry out those kind of jobs but not always. It's often relied on partners or women coming to the desk and asking for it to be refilled.

The type of cases we get are becoming ever more complex - and as the number of midwives fall, the workload increased and maternity care assistants are being relied on for more complex jobs such as performing observations, cup feeding babies etc.

It makes me so sad that we can't provide the care we want.

The powers that be don't help. Those asking for 'jugs of iced water'. We aren't even allowed an ice machine where I work due to infection control.

Why would a food trolley place newborns at risk of burns (any more than a newly post c section mum shuffling down the corridor with her own tray)?

The kind I'm talking about is a rack of trays with ready plated meals on, you said what you wanted beforehand and they plated it for you and brought the trays round the bay.

I didn't find the snack cart intrusive as an inpatient either, they literally waited at the end of the bay, usually in the morning around the time beds were being changed etc (so not at a restful time) said 'snack cart?' and only approached if you asked them to.

Great campaign and not before time. I speak as an ex midwife and I know how poorly postnatal wards are staffed. New mothers are important and they need cherishing. This means adequate staffing....post natal wards should be somewhere a mother can get support and help to make those earliest days better.

And as you can see by the replies on here it's hard to win sometimes when opinions differ on certain issues.

Oh and get rid of the bloody Bounty rep.

Oh yes, definitely better cleaning schedules for the bathrooms!! I didn't have a shower for four days because I refused to go in there while it was still covered with someone else's blood. The response I got 'just give it a rinse'

"only approached if you asked them to" - but other women in your bay would not have asked them too.

The food trolleys are heated - that's the risks of burns. Postnatal wards are already full to the brim with mothers, partners, babies and belongings - it's safer to keep the trolleys out of the way in my mind. At least when women go and pick up a tray it's contents have had time to cool down and there isn't the volume of heat, or vats of hot water with it.

A card explaining rules and routines would be good, not expensive and might save the staff some time repeating themselves, especially when patients don't speak English as first language.

I was lucky enough to get a side room, the first time I left it with the baby in my arms, I was told off, I should have laid him in the cot and pushed it. First I'd heard of it.

'Cups of tea/coffee for partners would be nice. After all they are helping to look after the mothers and babies. '

Patients are not being fed or given pain relief, running a cafe for visitors is pretty low on the list of priorities.

I would absolutely support any campaign to improve post natal care - but is targeting food, water, pain relief and washing facilities not aiming a bit low? These are absolute essentials I agree but surely the focus should be on recovering from the birth and all those things including rest, and maybe some sleep? Improved staffing definitely but also stricter rules on noise, visitors, Bounty reps and help for mums whose babies are unsettled at night.

I just had a fabulous post natal experience three weeks ago and had all of those things I've mentioned BUT I got lucky and was allocated a single room and bathroom. But I don't think the main ward would have been so pleasant.

Thankfully they brought food to me but I had no help to wash. There should be assistants who provide women with food, water and help with washing, lifting their baby etc if they are unable to do it. I literally couldn't stand up without two people helping me for a couple of days and the nurses just told me off for not getting out of bed myself! Assistants to help with that kind of stuff don't need to be medically qualified, just trained in general care work, would be cheaper than additional nurses and would free up medical staff to deal with actual medical work.

Special dietary needs should be catered for as standard. I am very lactose intolerant and was unable to eat breakfast as the options were cereal with milk or toast that was already buttered. I only found out when I left that the hospital had soya milk that the breakfast lady didn't know about.

Catering should account for patients arriving on the ward 24 hours a day. The hospital I was in asked you what you wanted to eat in the morning, so if you missed the food survey you got no food for the rest of the day.

Visiting hours for everyone except for partners should be more restricted and phone use should be limited to set hours - I had a lady next to me who was on the phone all day and night making it impossible for the rest of the ward to rest.

I stayed for one night. 8 different midwives had signed off on my paperwork. I got a lot of different opinions on how to breastfeed as well. In the end I ignored them and just did as my mum had shown me which seemed to work. It also took far too long to get discharged.

Luckily I knew that it was better to bring my own pain relief so I had that covered. Then again I didn't have a c section or tearing so I don't think it's an option for lots of women to use paracetamol. They woke me up every 2 hours to ask for consent to check my baby (meconium in waters). Was that necessary? I would gladly have signed something to say that consent had been given for x, y, z and only wake me if anything else needed doing. Apart from that it was OK I guess.

I was put in a private room at the end of the maternity ward after giving birth to a very premature baby. My baby was transferred to a neo natal unit in a different city straight after birth. I had to spend all night listening to other babies not knowing whether mine was alive or dead. The midwives were very off with me and inexperienced with dealing with premature births. A lack of sensitivity and common sense prevails in the care given to women having had a premature birth. A bed in a different ward would have been more appropriate, I didn't want to see new mum's cuddling their new borns when mine was in intensive care.

I would ask for better training for midwives on premature births as a basic standard. Their lack of knowledge actually put my son and I in danger.

There should be a better organisation of the post natal, lots of staff asked similar or the same questions, not much sharing of information between staff. That makes it stressful for the mother who is trying to recuperate.

Better access to food, water and washing facilities. The hca left a jug of water on the otherside of the room without a glass so it was another hour before she brought a glass. A midwife came into my room at 6am, drew open the curtains & declared that I was to be discharged because she needed the room. I was still half asleep, I had no clothes, shoes or money as I was an emergency admission. My husband was meant to come in after breakfast with my things. I also needed to be checked and signed off by the consultant, she was most put out.

Headphones should be provided to watch TV and visitors kept to a strict minimum of 2 per bed or ideally in the visitors room.

Basic kindness and care. Breast feeding support. Tongue ties dealt with as priority for breast feeding mums. I was a single mum, no visitors, c section, HDU, incredible pain and I felt totally traumatised by how I was treated on the post natal and HDU.
Even just breast feeding in hospital beds is near impossible. Denied extra pillow for support.
Heard women in agony discharged with just paracetamol after major abdo surgery. I just don't understand the reluctance to prescribe adequate pain relief. It's bloody barbaric.

I had everything I needed in terms of food and drink.

I'd prefer more restrictions on visitors. Male partners staying for hours, loud talking, curtains open. I felt uncomfortable with that when I'd just given birth and was struggling to walk, struggling to do everything! It wasn't all the time but I feel the ward should be a quiet place.

I don't understand why other inpatients have their meals brought to their bedside but not post natal mums. Both post natal mums & inpatients have surgery or procedures where they need to rest. I could barely walk, yet was expected to walk down the ward dodging other people to get my breakfast.

• no bounty reps
• bedside card explaining how everything works in different languages as appropriate
• strict visiting hours for ALL visitors including partners
• no more than three visitors per mother at any one time
• strict noise curfew between 2230 and 0730 (no mobile phone noise, no conversations above a whisper, no loud staff conversations unless desperately necessary).
• decent air conditioning
• food delivered for those who need it (understand it's good for people to get up and moving). Snack trolley others have suggested would be a good idea
• iced water available on demand
• clean wards and particularly bathrooms
• no visitors allowed to use ward facilities (eat patients' food, use bathrooms etc.). Separate visitors' loo
• more staff to make all of this so! Would also remove the excuse that partners are needed to do what staff should be doing

The postnatal ward I was on was horrendous. Hot. Filthy. No privacy - random men barged into my cubicle several times. Crowded. The women on both sides of my cubicle had their partners there the whole time and their partners' chairs didn't quite fit meaning they were touching my bed on one side and dd's cot on the other. Rude, dismissive and clearly massively over-stretched staff. Couples arguing and shouting at each other all night. Other people watching videos and talking loudly on their phones, again all night. Visitors at all hours taking up a lot of what was already a very small space. Midwives popping in and out at random hours with conflicting advice about random bits of child rearing. Loud shouted gossipy conversations between staff through the night. We were given the same "you're leaving the hospital now" speech by three different midwives and could barely understand any of them.

I suspect the issue is lack of funding. Good luck with the campaign!

Just want to echo what others have said. Breakfast should definitely be brought to you. I had an emergency c-section, prem baby downstairs in SCBU. On my second day of staying overnight I woke up around 8.30am (no baby with me to wake me up any earlier!) and I asked a nurse about breakfast, and she said it's down the hall. Dragged and hunched and stubbled down the hall only to find almost all of it gone. They bring your lunch and dinner, so why not breakfast?

I also had to ask repeatedly about painkillers, which were supposed to be every so many hours, but due to staff shortages, I always had to chase someone down for it and then it'd be a long wait until they reappeared with the medication.

Motherhood yes. Me too. I had a crash section and the second was a planned...WHAT a difference! The emergency one was awful but at least I had privacy and proper care afterwards.

I didn't know what had hit me after my second! Straight to a depressing ward with the other Mums and nobody checked on me for two hours after I got there.

I've found the midwives and hca's on postnatal wards to be lacking in empathy, common sense and common courtesy. The NICU staff were fantastic and kind, the complete opposite of the pn staff. Basic kindness really wouldn't go amiss.

-For those of us who have had no sleep for three days (or similar!) an option to have a sleep while someone cuddles your baby. I kept getting told he was my responsibility but I was literally hallucinating from tiredness and fainted when I was forced to take him to the shower with me. So horrid and unsafe.

• maternity assistants to be better recruited. In our local hospital they are truly evil. Midwives are great but the assistants are terrible!

• for volunteer and non medical staff to be brought in. For example breastfeeding assistants who are trained but not nurses would be ideal. Listeners for those that have had traumatic births.

I'm convinced if someone had taken an hour with me to listen and tell me it was okay that I felt dreadful I had had an unusually awful time, that I wouldn't have developed PTSD. Instead I was forced to do things that made me in huge pain because I was expected to 'get on like everyone else' after birthing on gas & air a over 10lb baby over 3 days, episiotomy, third degree tear, retained placenta and surgery!!!

'They bring your lunch and dinner, so why not breakfast? '

Oh, some don't even do that! Or even tell you you're supposed to fetch. In the one where I gave birth to my 3rd, you were supposed to somehow fetch your meals but not leave your baby alone, but you were also not allowed to take your baby out of the room, even in the cot. Not sure how that was supposed to work as my h had to stay home with our other two children.

By that time I was savvy to lack of pain relief (I had afterbirth pains) and brought my own meds. And plenty of food.

If Mumsnet want to make a difference, I think setting up a review system for maternity units might have an impact (allocating between one and five stars for areas such as cleanliness, food availability, staff engagement, ward atmosphere).

How many new mums on Mumsnet? Thousands and thousands.

I was told off for various things and felt like I was getting it all wrong....I hadn't planned on being in hospital and knew nothing about hospital protocol. In a blur I'd forgotten when I'd last changed or fed dd and the nurse told me off. I didn't know who to ask for bfing help, What all the uniform colours meant etc etc I was in a totally alien environment....feeling like a non-hospital speaking foreigner.