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

From my own experience (2 DCs), I would suggest the following: you shouldn't have to walk a long distance, leaving you baby alone, to fetch your breakfast. It shouldn't take 3 hours for staff to bring you 2 paracetamol when you are in pain; you shouldn't have midwives comment to you 'you are doing it wrong, that makes even me cringe ' when you are trying to breastfeed. TV s should not be allowed on wards. Visitors should be limited on wards. Staff should be on hand to let new mums sleep for at least a bit in the 12 hours following birth. It would be nice to go to the loo and not be faced with an overflowing bin of soiled sanitary pads. I know this is more about post-natal care, but I also had a hopeless midwife who kept disappearing during the birth of my first. My DH went to see where she was as i was screaming in agony as my gas and air was empty and found her crying in a side room as she couldn't cope with her new job. The midwife for DC 2 was much better.

@DeliciouslyHella is it easy to give birth at a different hospital? Are there any restrictions, or would you mind telling me how your applied?

I'm trying to think if our ward had TVs on and I can't visualise any, I think there can't have been any. Which I agree is a good thing. TBH I didn't even think of watching telly, my head was fucked with the hormone crash.

I was extremely lucky then - toast and tea immediately after giving birth and midwife even helped wash my hair! We stayed in maternity unit for 5 days PP and we're looked after. Was also back many times in the first year in children's ward I had free food as breast feeding. After that the nurses were v accommodating at looking after DS whilst I nipped out to buy supplies. It was the early days and months though in which I didn't have to leave that helped

With dc1 I rocked up to hospital in a lot of pain. Got checked in and told I was being silly and couldn't be in that much pain, still had a long way to go as was my first - examined and panic stations...baby was born less than an hour later.

Dc2 was a home birth which was fast but so much nicer

Dc3 was a home birth, very fast with two midwives too busy having tea than checking me. By time I was examined baby was right there and born after two pushes - aside from that it was fine. Had to go to hospital for stitches which was horrible...contradictory advice regarding severity (second degree verging on third), ended up with a consultant stitching me up as my newly qualified mw didn't feel confident. I remember sceaming at them as it was agony before the numbing meds and entonox kicked in DH had been asked to leave the room, baby was in cot at the other side of the room. Not a pleasant experience in the slightest, still makes me feel quite ill thinking about it.

I agree with the "how things work card" I'd never been in hospital before, I had no idea what the different coloured uniforms meant (and got shouted at more than once for asking the wrong person for pain relief/help to the toilet etc - emergency csect under GA with complications) I had no idea how the meal times worked so we missed breakfast and lunch as didn't know we had to go and get it and we had private room so nobody to copy. By the time I got food it'd been 50 hours since my last meal. Water was plentiful though.

I was expressly told not to get out of bed under any circumstance for at least 24hrs due to complications and drips and catheter etc. I was told to ring the buzzer to have my baby passed to me to feed and ring it again to have her put down, get painkillers etc. I must have waited at least half an hour after ringing the buzzer with a screaming baby waiting to feed or myself being in so much pain/falling asleep with her in my arms I then got shouted out for "endangering" her. I hadn't slept in 4 days, I was delirious and could barely remember my own name.

Constantly bothered for obs for me and for baby - why can't they do these at the same time! Do her then me in one visit not 20 mins apart every 2 hours so it's really every hour.

Cards for different procedures and drugs so you can spend a few mins informing yourself of things to expect and how to do things. E.G. I stank, I had greasy hair and was told to shower on day 3 (6 days since admission at this point and not allowed to shower before then so hardly my fault) I did, then got a bollocking for getting my wound dressing wet. Nobody told me not to - how do you shower without getting your midsection wet? When should the epidural be removed? After a catheter removed, how long do I have to wee before they threaten to put it back in?

I also had my epidural needle left cited for hours after arriving on PN. I repeatedly asked for it to be taken out and got fobbed off.

Expressly told the staff I wanted to leave the next morning, they said fine I'd be able to go by 11.30 and they'd get my papers ready. Got to 2pm when someone finally came in to ask why we were still there...erm what? Apparently we should have told them we were ready but they'd disconnected my bell.

Blow up beds for partners in private rooms. My DH spent 5 nights on the cold hard floor and was actually referred to as "useless" by one midwife when she came in to pass the baby to me (this was night two, id learned not to ask despite being told to but he was broken and needed a block of sleep to continue looking after us both) It seems him running around after me and baby, bringing me meds from home as they made me wait hours in pain and shopping for food on top of everything else wasn't enough.

Awful awful awful advice on infection complications and breastfeeding/expressing. Led to the most stressful period of my life, I honestly felt suicidal over Christmas as I was in such a mess and under so much pressure with no help, support of guidance.

Ive had a few different postnatal ward experinces in diff areas aa follows

Wexham park excellent attentive food bought to me and hot drinks

Hillingdon hospital terrible water left by bed no food was starved...

Shropshire fab hot drinks bought to me water refilled couldn't do enough
Food after
Only thing is i wish id packed snacks i seemed to be starving after birth

My postnatal care was so dangerously awful (there have been investigations / reports etc produced by the hospital) that I'm seriously considering paying to have any future baby privately:

I spent 10 nights in hospital (2 nights being unsuccessfully induced, then 7 once baby arrived by EMCS). I requested a private room as soon as I arrived and would've been more than happy to pay the £150 but was told a) they were all full and b) as a Type 1 diabetic they didn't want to leave me unsupervised in a private room (the irony of this will become apparent!)

Baby was whisked straight to NICU after being delivered and, due to me being pretty ill with HELLP Syndrome, I didn't see him for 12 hours. All this time I was on delivery suite with loads of other women coming in in labour then going off again with their newborns.

DH had been sleeping in a chair but I sent him home on the 3rd night saying I'd be fine as I was in a hospital where they were looking after me. Ha bloody ha. I was meant to be having obs every 4 hours for HELLP at the least and was still on delivery suite so they could 'keep a close eye on me'. After being given an opiate painkiller at 11pm (the first time I'd had anything stronger than codeine) and the midwife leaving me to get myself into bed, which took me over an hour and lots of sobbing, the next thing I knew I was coming round from a diabetic coma just before 8am. Nobody had checked on me all night and the painkiller had knocked me out so I didn't realise my blood sugars had dropped (I always wake up when this happens). The HCA coming to see if I wanted any breakfast found me unresponsive.

Even after suffering such negligence (which I admit was clearly due to understaffing) I was still plonked on the shared postnatal ward, minus baby who was still in NICU for another day. Finally got a private room after 8 nights when I had a complete meltdown when we were told we had to stay in another two nights as baby had lost too much weight, which I firmly blame on him being in NICU for two nights more than he needed to be because I couldn't go and feed him as the diabetic coma had wiped me (and my milk production) out for 48 hours.

Aside from them nearly killing me other issues I had with the 'care' provided were:

• Inflexibility in mealtimes for parents visiting NICU - when I had to time visits around obs / being given medication / seeing consultant finding a window when I wouldn't then have to race back for a meal was a nightmare. I couldn't afford to miss meals due to blood sugar control.

• Being repeatedly placed in wards with other mums and their newborns whilst mine was in NICU (although to their credit, the hospital has apparently now introduced specially setup ipads to Facetime so mums can watch their newborns in NICU).

• Being denied a private room initially because the staff wouldn't have been able to monitor me. If I'd been in a private room, DH would've stayed by my side and would've noticed me going into a coma

• Being told that baby should be on a 'feeding plan' with EBM top ups but nobody actually explaining this to us for two days.

The one thing that was good and better than I see many have mentioned is that there was a kitchen area with cupboards stocked with bread and cereal and a fridge full of milk so we could help ourselves to that when needed.

My whole birth and postnatal experience was a horrible shock as I'd had faultless, hugely attentive antenatal care at the same hospital.

Oops, I thought I was posting a brief version of events - sorry for the essay

Don't know where to start really as with my second child I felt Iike I was in a Rwandan hospital, at least in terms of my PN ward bathroom which was unforgivably filthy.

More staff are needed. End of, newborn babies, well lets face it it doesn't come. I hope more precious and vulnerable than them does it, ergo their mothers need support to care for them. It's ludicrous that hot drinks and decent snacks / lit meals can't be brought round but a relative can bring Starbucks and a takeaway curry in at 8pm.
Why oh why are there TVs and those awful tube lights on PN wards? There should be not any TV, the visiting hours on communal wards much more controlled and equally choice of access to paid private rooms for extra support / company / familial assistance needed. Lights should be centrally controlled apart from much dimmer lamp style ones inside cubicles. You can't sleep it's so glaring.

Much better heating control.

Much better housekeeping, ward rounds, med checks.water replenishment and just basic compassion.

Just hoping that DC decides to be born at 6am like DS and we can be home the same day unlike DD who kept me in two nights before she was born and one after. I left feeling like the victims of some sort of sleep deprivation experiment.

I cannot understand all the posts saying that visiting partners should be limited / removed. Given the availability of staffing, there is no other care alternative. I think the role of partners / other primary support vistors should be made much clearer to women on booking in. It should be absolutely clear that there is no baby support available, and that mum is on her own in terms of baby holding, cleaning, changing and general needs in the absence of any visitor. People assume that when in hospital, care will include these basic things and that's just not the case (in my experience anyway)

I'm currently on the PN ward in Worcester Royal after a c-section yesterday.

Cannot fault it one little bit.

Clean. Fresh water. Kind and attentive staff from the lady who cleaned the floors to the matron.

No withholding pain relief.

Bed changed, pads changed, obs undertaken at discretion of staff, cook and dark overnight. Helped to shower whilst another lady said she'd ready my bed for me.

Food available.

Doctors available!

Press the buzzer and they arrive, quickly, no fuss, no faces!

Gorgeous, empathetic staff who aren't afraid to give you a cuddle and take a minute to chat even though it's probably busy out there.

I actually want to stay another night!

As a nurse I completely agree with all the calls for re-thinking direct entry specialisms. When I trained, which was only the late 90's/early 2000's it was still unthinkable to go into a field without having completed 3 years adult nursing. The option to 'top up' to a specialism took all of 18mths conversion course and meant that at least you could understand the nursing principles - basic nursing care needs - that affect the individual.

Having obvs spent time on a post natal ward as an inpatient I was absolutely staggered by the massive inability of midwives to grasp this concept - that actually mothers post birth had numerous health issues which needed some assistance with. And as for drug rounds - unlike on a regular ward it was more an outpatient type philosophy of no set drug round...which made for many missed doses.

Some midwives stood out - and on talking to them they had also trained in the manner of conversion course, it was easy to tell because they had a better idea of wound care, post op recovery, basic nursing observations.

I think if you tackle the training then you tackle most of the issues - workforce training has a massive impact on ward running...as for autonomy of practice, it's a weird concept - - you have midwives who can cannulate and those that can't, most can't do an ECG yet they can happily 'birth' a baby with you.

We can afford the change, the money is there - it's just channeled into the wrong places at the moment.

This is a great campaign to push. Childbirth is hard and as much as it's natural, it's bloody painful too!!! :)

Allow some privacy. I was told I must have my curtains open at all times unless breastfeeding or being seen by a doctor. Sometimes I just wanted a bit of privacy to cry, or change, and I found it really hard to sleep with the curtains open.

Actually support breastfeeding for those who want to do it, rather than trying to persuade mothers to switch to bottlefeeding if they so much as ask a question. (That wasn't all the staff, to be fair.)

Enforce the limits on visitors.

Have the TV screens fixed so they stay off unless actually turned on, rather than the other way round. I kept having to turn off my screen, and then get up to turn off the screen in an empty bay because it was driving me up the wall.

Oh, and find some way of making sure people get the painkillers they need, rather than missing out because they're in the toilet/shower/feeding room at the moment the trolley comes round. I didn't get any the day after DD was born, having had an episiotomy and tear, until one of the staff found me crying and incoherent with pain that evening.

Frontstep inadequate staffing in hospitals is not a positive argument for allowing partners to stay in a postnatal ward. Mothers who have just given birth and are in hospital should be looked after by people who know what they're doing.

Otherwise the argument for restricting partners' visiting hours goes like this: most partners are men and new mothers deserve the privacy of an all-female ward (one woman's DP is another woman's strange man) and that however well meaning and whatever gender they are partners make extra noise, take up space and generally detract from what should be a peaceful environment. Much like any other visitor.

My personal experience was of loud snoring from one side (from a man whose chair was pushed through the curtain and was taking a good chunk of my little cubicle area) and loud arguing through the whole night from the couple on the other side.

The trouble too with 'making up' for inadequate staffing by allowing partners to stay all the time is also what happens with the women who don't have a partner, or whose partner can't be there all the time (other children to care for, distance from hospital, no other family support etc).

My DH came in for two hours a day, mainly because of the limitations of the bus timetable (he doesn't drive). Because our local maternity unit shut several years ago the next nearest one involved a three hour round trip. Because of not having a car there he was having to bring in clean clothes (for me and baby!) and nappies every day, plus extra snacks for me, so having to go shopping on foot as well. I was in 8 nights.

I also much preferred knowing DH was able get sleep at home and proper meals rather than both of us suffering the sleep deprived hell of PN. Those partners that were around weren't doing anything useful- mainly lounging on the beds and talking loudly.

I don't think DPs should be allowed to stay the night. I feel quite strongly about that. They should be allowed all through the day without restrictions but one woman's DP is another's strange man.

Don't understand what difference night makes when everyone's sense of day and night goes to pieces anyway. After being bullied by a midwife with dc1 having Dh there with the next one was the only way I felt safe. Obviously in an ideal word every family would have a private room.

Interesting article in Guardian
Despite medical advancements, childbirth is a major cause of post-traumatic stress disorder – and yet nobody talks about it. Leah McLaren tells the harrowing story of the arrival of her second child – and her fight for treatment and support
www.theguardian.com/lifeandstyle/2017/may/07/i-cant-forget-the-horror-of-my-sons-birth-post-traumatic-stress-disorder-childbirth

Some interesting comparisons with treatment around the world. In Holland and Germany the 'package' includes paid help in the essential recovery period after the birth. In Japan, the woman is cared for at her parents for 3 weeks after the birth.
www.parents.com/pregnancy/giving-birth/vaginal/birth-customs-around-the-world/

I agree Idont. If my husband was forced to abandon me and his child on the ward I would be to terrified to have another baby. It would be appalling to force women's partners to leave overnight, in some cases just after their child has been born and while their partner is still disorientated and traumatised.

I also would be worried without my partner, especially since midwives don't have time to meet ordinary needs. Without him, and being completely exhausted, I would habe really panicked about looking after a tiny newborn. I don't think it's fair to deprive women of that support at all. And surely most partners are thoroughly focused on their partner who has just given birth and their child (as it is of course their newborn as well). I really hope we don't force partners out of the wards when so many women completely rely on them at their most vulnerable :(

The actual delivery staff, student midwifes and the surgical staff that attended to me were amazing so I have nothing bad to say about them, I've kept it to postnatal.
I would have appreciated a little consistency between the local midwives and the hospital. I was told not to take any baby changing items (nappies, wipes, etc.) with me as they had approved supplies at the hospital. When my husband asked for some nappies and wipes to give our son his first change we were shouted at for not bringing our own and reluctantly given three cotton wool balls, a nappy and a small bowl of warm water. After that he went straight to the supermarket and got supplies.
The option to leave the ward to get food would be nice. At the time I was vegetarian which left me with no options for anything to eat on the ward and I was told I wasn't allowed to visit the hospital's cafe until discharged. Husband back out to the shop to get me food.
Following through with their scheduled checkups. I fully understand that the wards are busy places but after being told I needed to be monitored and checked on the hour, every hour I was left unchecked from 5:30am til 7:30pm which also meant no pain relief and no one took my canular out so I couldn't change or hold my son. (my hand had swelled up and was agony from it)
Sticking to their own rules. Visitor rules were no more than two people at a time although the woman in the bed next to me had 8, stole my chairs while my husband was out getting supplies and were spilling out of her curtained area so much they were practically sat on my bed next to me.
The postnatal care I received was far superior to the prenatal care I received where I was put in an empty ward that was half way through being deep cleaned for full day before I delivered. Didn't see a single person that day, didn't know when meal times were so ate and drank nothing as I couldn't find any staff to ask on the ward. Only people I saw were the cleaners who were loudly complaining about the midwives and how much they hated working there.
Really looking forward to going back for number 2 this week

If you'd feel terrified and vulnerable without your partner there, how much more terrified and vulnerable might you feel without your partner there and sharing the room with five blokes you don't know? Many women would be in that position, and would not feel safe or happy at all. It's one of the reasons most NHS wards are single-sex now (and why you wouldn't be able to have your partner staying with you overnight on most hospital stays for other reasons, male or female).

We desperately need to fix staffing problems, but bringing in more partners is not the way to do that. They aren't qualified, they aren't necessarily safe (I'm sure your partner is lovely but not every man who's managed to reproduce is, sadly), they increase infection risk, they take up hospital resources that are already stretched (space, toilets, showers, food, chairs), they make wards busier, noisier and hotter, and they're going to be advocating for their partner to HCPs - so women who don't have one there for whatever reason will be disadvantaged. And many many many women don't want other people's partners, who are usually male, there when they're vulnerable and recovering, and learning to breastfeed or talking to midwives about their vagina or shuffling to the toilet covered in blood.

I totally get why women who can have partners with them 24/7 would want their own ones there to make up for the awful gaps in care on postnatal. But we need to work towards a solution for the whole problem, not just something that helps me out at the expense of the woman in the next bed.

I've had two very different experiences, in two different hospitals. My first, I needed surgery but had to wait 6 hours for theatre to be free and then they couldn't find an anaesthetist - the midwife looking after me was fantastic and stayed with me despite being well over the end of her shift. She lodged a formal complaint about the delay. Post surgery I was moved to a 4 bed post natal Ward. Staff were lovely and HCAs on hand to help, but I still felt incredibly vulnerable when DP had to leave at the end of the day. But I was helped during the night, midwifes took baby as she wouldn't settle to allow me to sleep and HCA were very supportive with breast feeding. DP went to colllect my meals from out in the corridor as I couldn't walk far with a catheter etc. Plenty of pain relief and antibiotics given. Stayed in 3 nights and didn't really have problems with other ladies/babies/family making noise, so overall a good experience in the end. Second time, different hospital was awful. Long labour, lots of bleeding, and they struggled to stitch me up on the ward. I didn't feel well enough to have a shower and was ordered to by a very bossy midwife. I refused and was very upset by the way she didn't care. I also had a funny feeling in my chest which was dismissed as indigestion, massive bleeds, and generally felt really ill. No body cared how I felt and didn't listen to me. I repeatedly said I felt unwell and was told it was normal, I'd had a baby, what did I expect, etc. and that I was being overly anxious, to the point they brought the mental health team to see me (who said I didn't have an issue at all, and asked a different Dr to review me medically). I did have a private room which was nice and DP was allowed to stay. Discharged after 2 nights but they forgot to give me iron tablets. Still bleeding very heavily and feeling unwell I had several GP trips, before bring readmitted 3 weeks later to the gynaecological Ward with a massive infection. I didn't feel well enough to leave the house for another 8 weeks. The infection may have been bad luck, but the attitudes of the midwifes and the fact nobody listened to me was disgraceful. I appreciate every birth is different but I knew I was unwell. The uncaring lack of bedside manner was truly awful and such a contrast to the lovely midwifes I had with my first. I was just grateful for lovely community midwifes with my second who were horrified by the care (or lack of it) I received on the post natal Ward. I can honestly say that experience is the prime reason for me not having another.