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

I'm only a couple of pages in but wanted to comment now. I'm absolutely appalled at what I am reading! I am a theatre based practitioner, often taking part in assisting during caesarean sections. I know patients who've had other open abdominal surgery (laparotomy, total abdominal hysterectomy etc) who receive much greater help post operatively. Things such as sitting on a commode whilst a care assistant helps them to shower and wash, the commodes are fab because there is easy access to help wash between the legs. I'm really sorry to hear that woman are having to 'help themselves'.

It would be appalling to force women's partners to leave overnight

It's appalling that vulnerable women have to sleep with strange men all around them.

Re: womens partners staying overnight (male OR female!) I think the best way to go about this would be designated bays with day beds/chairs made up. Those who want overnight partner stays are allocated to these bays, those who don't will stay on another bay. Of course now and again this might not always be feasible depending on the number of admissions but it might be a better compromise?

The hospital where I had my most recent delivery allowed partners to stay overnight but only because every room is a private ensuite room.

There were signs up everywhere with rukes on them and I joked to DH that the rules meant someone had actually done the things they were ruling against. The cleaner was in my room at the time and said that they've had nothing but bother since they started letting partners stay over.

The rules included:

• the staff are here to look after your partner and baby
• beds are for patients only, partners are to sleep on the recliner provided
• please wear appropriate clothing at all times, including when sleeping
• food trays are for patients only, there is a canteen on the ground floor open 24/7
• the ward entry/exit buzzer is quite loud, please refrain from unnecessary coming and going between the hours of 11pm and 7am
• smoking is not permitted anywhere on the premises
• showers and toilets are for patients only, partner toilet and shower facilities are available at the end of the ward opposite the day room. Please dress appropriately when travelling to/from the shower.
• please do not wander around the ward, particularly at night, your access is restricted to the patient's room and the day room

There were other rule too but I can't remember them, they were the ones I do remember though. I wouldn't stay in a hospital where I was in a communal bay with other people's partners and I don't think I'm alone in that attitude. I'd sign myself out, potentially at the detriment of my or my baby's health, in order to not have to share such a bay. Partners in shared bays doesn't work, the only way partners should be allowed to stay overnight is in private rooms.

Threelegged the solution to not wanting to be near other people's partners is the provision of private rooms for each family as happens in most other developed countries, not banning people's partners from being with them and their newborns. That would be barbaric. As a victim of sexual abuse myself there is no way I could have coped after my son's birth a few weeks ago if I had not had my husband there with me, even if the medical and nursing care had been adequate. I needed the one person I trust there with me and our baby when I was vulnerable, zoned out on drugs and unable to move my legs.

I think part of the campaign should be about partners staying over. Not necessarily that they can't stay, more that no woman should be forced to shared mixed sex accommodation on the postnatal ward if she is not comfortable with doing so.

Private rooms are indeed the only way to go about it then, One, because there are also women who have been victims of sexual abuse or assault who do not want to sleep feet away from strange blokes.

Expat I would rather not do that either, but not at a price of not having my husband there when I need him most. I think it's disgusting that private rooms aren't provided for all and that should be the focus of the campaign as it would solve so many of the issues raised on the thread and the risk of infection. In the absence of that, Stealing's idea is probably the only solution, so that each woman has the choice. To force women who need their partners there to be without them would be unacceptable, particularly for people who have just had sections so cannot make the choice to discharge themselves and leave. It's also pretty dreadful to deprive fathers of their baby's first hours of life, hence cannot be compared to the arrangements on other hospital wards.

' To force women who need their partners there to be without them would be unacceptable, particularly for people who have just had sections so cannot make the choice to discharge themselves and leave.'

It is equally unacceptable for force women to be treated in a mixed-sex unit where one half of the occupants are not patients. Plenty of women would rather also discharge themselves than be treated in an overcrowded unit where they are forced to sleep around strange men.

Ban the Bounty women - we all have cameras on our phones now. The Bounty woman in my post natal ward was pushy and intimidating.

I had a c-section and did get meals brought to me by a lovely ward orderly. I wasn't expected to get out of bed until I'd been there two nights. And loud visitors were told to be quiet or go away.

"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."

@aliphil - I completely agree with you - that really oughtn't to be beyond the capability of the staff. It could be as simple as having the drug rounds at set times, and picking up the drug chart of any woman who isn't at her bed, when the drug trolley comes round, and following up afterwards with all of those charts.

That's the thing though, it is equal. So there needs to be a different solution other than banning partners that suits both women's needs. My experience and need to have my partner is not more important than your needs, and your experience and need to have no men around is not more important than my needs.

What there needs to be is either private rooms or separate wards. The private rooms are a stretch but surely since there are usually multiple wards in hospitals there could be at least one dedictated to women who are genuinely uncomfortable having men they don't know around.

Food available 24 hours. Just some sandwiches in a fridge and a bit of fruit would do.

I arrived on the ward at 1 am after 36 hours in labour with no food as I vomited throughout. I was starving and got blank looks when I asked for some food and told next meal was 7 am. I did get a cup of tea though as there were facilities to make tea (my mum went and got me that).
Thankfully, I stashed my bag with some chocolate/energy bars so at least I had that to get me through.

I just though it odd that they didn't even supply some toast or something.

yy to banning Bounty. And if you're not going to ban them, include them on ward info cards to make it clear that they're NOT hospital staff. The ones in my PN ward wore nurse-style tunics and arrived out of visiting hours to say "I'm here to check if you've had your Bounty bag yet" - if you don't know what Bounty is, how the hell would you know they're not part of the hospital?

Realistically though, there's zero chance of existing post natal wards being converted to individual rooms for everyone. And if each ward had one or two rooms, that won't guarantee availability. In terms of what's achievable it seems better to concentrate on the basics of care.

Great campaign.

Banning partners overnight serves a purpose. For women in abusive relationships it's a period of respite which can give them the opportunity to seek help. I know someone with a jealous partner prone to paranoia, if men had been allowed on the ward when she had her last baby she'd have had the third degree for weeks. He wouldn't have been able to stay over due to other DC at home so of course, to his mind, she would have used this as an opportunity to sleep with one of them. There are women who don't want to to sleep next to unknown men, yes there are other people in the bed when you're in a shared bay but they're all women and they're all patients. Staffing issues should be a large priority of the campaign, both training and numbers, because of the staff were providing adequate care then there would be no need for partners overnight.

What about ditching the curtains between beds and having glass partitions with curtains at the front (and coverings for the partitions)?

I wonder how much it would cost in shared bays to get rid of the curtains and replace them with floor to ceiling partition walls inbetween the beds to create individual cubicles with a curtain on the front at the foot of the bed. Not amazingly private but more private than now and you wouldn't have people from the neighbouring bed practically sitting in your bed, it would also give staff/visitors somewhere to knock before entering' if your curtain is closed and it wouldn't be completely soundproof but would lessen it a little bit.

Ha! Cross post gentlemoose

@Bearfrills Too funny!

Great minds eh?

Again Bear, the need for partners to be able to stay is not just to fill gaps in the inadequate medical and nursing care. Some women need their partners there for mental health reasons regardless. As Cherries has said one set of needs should not trump the other therefore a solution needs to be found that works for all, either private rooms or separate wards. Banning the partners of those that need them there is not a solution.

Postnatal wards should operate in line with other wards in the hospital. You wouldn't have partners overnight on an orthopaedic ward or a gastrointestinal ward.

Pressed send too too.

So why should postnatal women in a vulnerable state be expected to share their patient rooms with the partners of other women? No partners overnight should be the norm in shared bays with private accommodation available on a first come, first served basis for those who do need it (with people in certain situations receiving priority). Partners overnight as standard should only be an option in hospitals where every woman has her own private room.

Actually, in exceptional circumstances, (extreme phobias or other mental health issues or physical disabilities) partners staying on general wards isn't unheard of, at the discretion of the manager.