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

But you're the one arguing so dead against my POV Gin I have said throughout every post that women should be entitled to privacy, what I disagree with is the attitude some posters have toward's women expressing need to have their partners available, and the constraints that a blanket ban on say, over night visits places on women who may not give birth at the right time to have her partner help her out. I've also been appalled at some of the insinuations behind these criticisms - for example the insinuation that our experience is less important or less relevant, or the clear underlying attitude that we can all accept strangers to take care of our most intimate needs when we are vulnerable. There have been plenty of recounts on this thread about how women have been left alone for hours post birth with no help.

I am happy and have constantly said how women should in better circumstances be entitled to privacy, but all women should be entitled to that ideally. Just because I am happy for my partner to be there doesn't mean I am any more comfortable with any kind of antisocial or threatenin behaviour. There are myriad more solutions to this than just banning partners for large periods of the day. But you really do attack anyone who thinks otherwise and it's bringing an incredibly negative tone to this thread.

cherries I'll ask again. Have you given thought to rape victims?

You can't square a circle! Both sets of needs are valid, but idealistically I'd like to see us working towards more involved, caring parents and partners and fewer unpleasant/disrespectful/dangerous men breeding.

You do not know who and who is not a victim of sexual assault. There may be posters on this thread who have been victims and with the way they were left feeling so alone and vulnerable are only comfortable and capable of dealing with a newborn because their partner was there. You have no idea how every single survivor deals with and will feel about giving birth. The aftermath of labour is so traumatising for everyone but especially victims of assault. Unless you can claim to know exactly how each woman will react (which you clearly don't) then don't assume that you know what is right for every single one of them.

I have never said that women should not be entitled to feel safe. I've stated my opinion and reasoning behind it many times now. What is the point of going round and round in circles when we could be supporting women in vulnerable positions and coming up with ideas for practical solutions that allows everyone to feel safe. For a lot of women this means having their partners with them.

@Ginlinessisnexttogodliness, yes, childbirth is female due to biological fact, but care for babies and children once they are born, aside from breastfeeding, is not.

There is no biological reason why the father couldn't be there 24/7 doing all of the routine child care for babies who are formula fed, or a large percentage of it for breastfed babies. My partner did literally all the baby care aside from feeds for several days because I was too unwell and we both preferred for him to be caring for our child than asking a stranger to do it. Even if I hadn't been unwell I would have asked him to do a large share of the child care so that I could rest and recover as much as possible, and he would have wanted the opportunity to do it as well. He said the most moving and wonderful moment of bonding he had was when he was sat up for hours in the hospital holding and rocking our baby at night while I slept.

The answer should be to have private rooms or a different ward setup to allow patients flexibility about whether to have fathers present 24/7 or whether to be in an all-female space. It should be a choice, not something forced on you one way or another.

Not staying on the post natal ward does not hinder anyone's ability to bond with their child or be a good father.

Dh went home every night that ds1 and I were on the post natal ward (7 nights, because ds1 had neonatal jaundice). Ds2 and ds3 were born at home, so dh was there with me over night, every night.

I can honestly say that he bonded just as well with ds1 as he did with the younger two, and is just as good a father to them.

For most dads it will be only a couple of nights, and then their partner and baby will be at home and they will be able to be as involved as they want - and those couple of nights away from their baby will not irreparably blight the relationship.

@Fruu - there may be no biological reason why dads can't be there 24/7, but there are a number of practical reasons - the desire of other women to have privacy; the vulnerable women who don't want a strange man only feet away whilst they are sleeping/dealing with blood and lochia soaked pads and clothes/trying to establish breastfeeding; the lack of space and resources on the ward to cope with a man at most bedsides; and the extra noise that it seems to create.

And as I said in my earlier post - they are going to have years to care for their child and bond with them - spending a night or two away won't damage the bond.

No, but restricting them can hinder meeting the needs of some mothers, the emotional wellbeing of whom is vital to babies thriving.

cherries, no, I can't presume how others who went through that horror feel. But I do know how I felt. So please don't make assumptions about me either.

But that's what frustrates me on this thread, there is sympathy and understanding for vulnerable women who don't want partners around, but absolutely none for the rest of us who would find it incredibly difficult to cope alone. Every post I've been sure to say that I acknowledge that women should be entitled to privacy if they need it but every post is met with eithe insinuations that I am somehow inferior for needing to rely on my partner or an insensitive bitch and that women having privacy is so much more important than women who need that support.

They are both equally valid as I have said many many times and all I am met with is posters who haven't read the majority of my posts saying "oh but you're not thinking about the abused women" in the most derogatory tones. Of course I have, I am one too. And I am just as entitled to need my partner without being ridiculed or made to feel bad about it as you are to say you don't want anyone but women on the ward.

That's exactly why I've said that there should be private rooms or a ward setup where there is the choice of having men present OR being in an all-female space. Some women will want their partners there 24/7 and some will not. Both groups can have equally valid and important needs.

I have PTSD from my experiences on the postnatal ward the night my partner was sent home. I don't think I could emotionally cope without him or a close friend / family member there next time. Women can have physical or mental health issues that makes it hard or impossible for them to cope in hospital on their own. Equally some women need or have a preference to be in a female space at night. Both groups should be catered to.

I have no idea why I've continued to post. Some vague attempt to get my point across on the off chance it will make a difference in the campaign I suppose. I will stop now as it has gotten way too upsetting - it should be a positive thread with suggestions for what could be done to overcome problems with postnatal care, rather than argue on and on about one aspect which will obviously always be divisive and draw different opinions and points of view.

Instead of slating people for feeling differently about such a sensitive as personal issue just either move on from it or focus your energy into suggesting practical alternatives that will try and help as many people as possible.

Ideally, you would have two wards. One for women who wanted their partners with them, one as a strictly male relative free zone. More ideally of course individual rooms, but we all know that won't happen. And no phone calls on either ward beyond say 10pm. That at least could be enforced without much interruption and would make a huge difference.

The thread is about whether basic nutrition and hydration should be provided by the nhs on post natal wards.
I think a further question should have been added about basic nursing care, particularly for women who have had major abdominal surgery or suffered physical trauma requiring surgical treatment.
Mental health care should also have been included.
The pros and cons of partners staying on postnatal wards should probably be addressed after the other questions have been adequately answered. Partners are not an acceptable substitute for trained nursing and midwifery staff.
I personally think that postnatal care provision has been allowed to deteriorate dreadfully in the last few of decades.
I trained as a midwife in the 70s.
Medical knowledge has advanced a lot, but we did take our responsibilities very seriously and I think mothers really did get better post natal midwifery care back then.

I'll add my experiences. I'm in shock at so many awful experiences and behaviour. What's happening?
I had 3 c sections, the first an emergency, the other 2 planned on advice due to the first, in 3 different hospitals in S E England.
My post natal experiences were excellent. I always had food and drink, easy to ask for more, tea ladies came round at regular intervals, no hassle washing, quiet respectful considerate visitors on the wards, friendly available nurses, excellent care.
The 2nd birth felt like a rest in a hotel- (especially with a young toddler at home). ((All nhs btw))The 3rd started well but the doctors thought there was something wrong with my nb so shipped him off to a hospital in London and I must admit that was grim. Overcrowded and hot, although because I was transferred from another hospital they had to isolate me so I had a room to myself so was lucky.

Private rooms or a choice of a 'relaxed rules' ward (no restrictions on visitor numbers or visitor hours) and a 'Quiet' ward (partners only). Other people on the postnatal ward had too many noisy visitors inc toddlers screaming and I was meant to be resting after major surgery. It affected my mental health and i ended up getting myself discharged early only to end up being re-admitted later as I really wasn't well enough to go home. I would have loved the option of a quiet ward. Second time round I managed to get a private room with a bed for dh. I was extremely lucky to get that. It was absolutely amazing! A fantastic start to parenting. The feeling was the polar opposite of being on the shared ward. Despite the medical issues, i totally enjoyed my stay and felt rested, ready and able to parent my newborn when I was discharged. mentally I was in a very much more positive place after a stay in a private room with DH helping compared to how I felt after my stay on the noisy shared ward.

Would it be possible to give private rooms to those who have suffered DV so that they don't sleep on mixed wards?

I myself was offered a private room (after day 4), but I turned it down because I didn't want to feel so isolated.

Oh the other thing that I think might be really useful for new mums would be access to birth trauma support or postnatal counselling or similar - even if they just need a one-off session or talk through. At the moment it seems like we wait for something serious to develop (PND or PTSD). It would be good if postnatal mental health support was just easy to access even if u just have a niggling concern rather than a full blown issue...maybe a drop in service or a way to easily sign up for a counselling session or a parent support group you can join.

Don't really see how a night or two on the postnatal ward helps men bond with their child- we were in 8 nights and DH came in two hours every day but bonded with DD quickly and easily. Meanwhile, I was with her 24/7 and took months to bond...

It's a hospital, not a hotel. The mums and babies are the patients, not the dads. I wouldn't expect a woman having a hip replacement to have her partner there overnight.

Far rather know DH was getting decent sleep at home, plus doing all the essentials at home like the laundry (then bringing in clean clothes each day for me and the baby) than at the hospital all the time. When do the partners who are there 24/7 get the chores done? How do you get clean clothes otherwise?

In reality once you have more than one DC, then fathers staying is not possible anyway for most.

@Kpo58 - yes, it would be possible to give women who have suffered DV - or rape or other sexual violence - private rooms, but only if there is one available, and it isn't needed by another patient for another reason - isolating a patient with an infectious illness, for example, or giving somewhere private to a woman whose baby was stillborn.

Unfortunately, on many wards, there aren't more than a couple of side rooms, and when demand/need exceeds supply, someone will sadly lose out.

MNHQ should definitely add private rooms in all new-build maternity units for all post natal mothers to though it might have staffing repercussions - I am guessing you need more staff to monitor a ward full of single rooms, than to monitor women in larger bays. In larger bays, if someone collapses or needs urgent help, another patient may be able to summon help, but if everyone is in single rooms, the staff would have to make sure they checked on all the women much more regularly (which would be no bad thing, IMO).

Single rooms might make some women feel more isolated - I am still friends with someone I met on the post natal ward after having ds1 - our sons share the same birthday - and I got support from other mums on the ward.

Yes, and given that something like 1 in 4 women will have suffered rape or sexual violence, suggesting a side room that may or may not be available, just isn't enough - even if only a fraction of those women feel uncomfortable with strangers around, it will be too many.

@RoseGreen This. I think one session soon after I left hospital could possibly have prevented months of flashbacks, and helped me cope with my feelings of anger, helplessness and isolation. And maybe gone some way to tackling the anxiety I have about a hospital stay for any (thus far theoretical) DC.

From reading this thread, things seem to have deteriorated from bad to worse since my chilren where born 18 and 16 yrs ago.It is incredible to me that midwives are not properly trained to look after cs patients, who were the majority on the postnatal ward I was on. (Natural birth mothers, when I had my 2, were sent home straight away, and there was a very high rate of caesarian section.) Pain relief should be a priority, I was given diclofenac as required and very glad I was. Due to the very high cs rate they were very good at looking after cs mums!
Rather than post natal 'wards', the hotel attached to hospital, as described by some above in Spain and Norway, would be ideal. Privacy, sleep, hygene etc would be improved. You could talk to your baby all night, feed him at any hour, without fear of disturbing others. The incidence of post natal depression would, I am sure, be reduced. I wonder if that system is applied for cs mums?
However, back in the UK we are stuck with wards, so limiting the visitors should be enforced, because having visitors imho adds to the exhaustion, and disturbs others. Partners should also go home, partly so they can rest themselves. You would not expect partners to be allowed 24/7 on any other ward. Phone calls in the night should be banned, or allowed in separate room.
One thing that seems to have improved is breastfeeding training: it was just assumed that you would bottle feed 18 yrs ago. Breatfeeding training would perhaps be better done in groups rather than rushed 1 to 1 at the bed. Mums can help, encourage, and learn from each other. Midwives could save time by not having to repeat the message, and could show videos to help reinforce the training.
Water by the bed is a no-brainer. My Dad was in hospital after a stroke a few years ago, unable to get out of bed or speak. The water jug was removed for hours at a time every day for cleaning, and he became very distressed, so that is not just an issue in post natal wards.
The health service is on its knees, but with some simple changes in post natal care mothers could be supported in giving children the best start physically and mentally, which in the long run would save money by reducing post natal depression and all the knock on effects on the family,

So sad to read some of these stories. I truely hope this campaign goes someway in to improving standards.

I know the hardest place to work in maternity is the postnatal ward. The staffing ratios are simply a joke! 1 midwife to 14 patients, bearing in mind babies don't count so you've actually got 14 mums and 14 babies in the care of 1 midwife. It's hard enough just to make sure they all have appropriate observations, medications and treatment without dealing with any extra issues or feeding the baby of a post-section mother etc.

The NHS is crippled and as maternity is a loss leader (makes no money) it's usually given bottom priority. Additional postnatal care is seen as the least important in maternity as the baby is out then and most major complications have been avoided. It's the worst of the worst care and it's not good enough.

Postnatal mental health issues are on the rise, postnatal suicides are on the rise. How far does this need to go before the NHS as a whole is adequately funded and staffed?

Sadly seeing the day to day running I feel it is already too late and sadly privatisation will happen.