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 genuinely shocked by some of these stories 😔. I had both sons in an NHS hospital in Scotland, and although it was busy (and by no means luxurious) it was clean, functional and our care was excellent and compassionate.

We were also brought meals three times a day and given jugs of water to keep by our beds at all time - I cannot believe some people don't get fed!

That said, the wards were noisy, crowded and chaotic at visiting time and the midwives with DS1 (9 years ago) were rushed off their feet, much better with DS2 (4 years ago).

CatchingBabies it is really interesting that you say it's the mother's who are counted as the patients and not the babies. So much of what we see here and what I've heard from friends who had bad experiences seems to come down to feeling like you as the mother are not the patient, you're just there to look after the baby, and whatever you need from staff for your own care is an added inconvenience. Baby's out, job done, sort out your own shower/drugs/whatever.

I had a good experience of care on postnatal after EMCS (ward itself was far too noisy and busy to rest but staff were great), but that seems to be in the minority among people I know

Sorry not had time to read the previous 27 pages but just popped on to say that my experiences were not horrific but not brilliant either.

I definitely didn't feel very cared for as the staff were too busy/ stretched. I was made to feel a bit of a nuisance first time round for asking for help with breastfeeding as it just wasn't happening and I didn't have a clue - the classes I had been to previously made it all sound so natural, which certainly wasn't my experience.

My other issue was the noise. Hard to rest or sleep due to noisy visitors, phones etc. Second time round I asked to be discharged after listening constantly to the loud house music ring tones of the entire family who were camped out in the bed opposite me.

Maybe some basic info on expectations of behaviour visits etc. given out on arrival would be helpful?

"Can't you empathise with women who have had past trauma like domestic violence and rape and don't want to be bleeding and barely able to walk on a ward with five strange men?
*
Have some compassion.*"

I have a huge amount of empathy for such women because, as stated earlier in the thread, I am one of those women. And I needed my husband with me in this situation, even if that meant having other men around too. I don't presume all men are dangerous predators because one man raped me. The medical staff are strangers to me just as much as other people's visitors and I needed the one person I trust by my side when I was at my most vulnerable and scared and unable to move out of bed, let alone care for my newborn.

My posts and those of Cherries recognised that the needs of women vary and all of these needs must be met. Some vulnerable women will need an all female environment, but some will need their partner, who may be male, with them at all times to feel safe. One set of needs cannot be allowed override the other and reading back the number of people who appear to think they speak on behalf of all vulnerable women and can tell us all what's best for us even if some of us have explicitly stated the opposite is not very nice. Your posts appear to be the ones lacking compassion.

Sad to read things haven't really improved since I gave birth in 1993. It us still really clear yo this day. I was torn badly so sore and my son had jaundice as early, so was under a 'light box' for 24 hrs after birth. Food not bought to bed, told to go in day room, battle axe senior nurses saying 'do you eat your food on your bed at home?' Always remember that, unable to breast feed ( really tried)made to feel a failure, but I was so tense. We were sent home on a Sunday without any back up bottles of milk until shops opened Monday. In those days, stores not open on Sundays - husband had to go back to hospital to beg for milk. Have things changed?

I asked for help repeatedly with breastfeeding but all the staff would do is literally grab my tit and shove it in my babies mouth then walk away again. The issue I had was with my son changing position after latching, not getting started but they didn't listen to me!

I had a traumatic delivery and I had to be monitored every 10 minutes for 5 hours post labour. So no sleep. Then moves into a ward but my bags didn't come with me until nearly 2 hours later so I had no phone to call anyone or nappies even for my baby as they didn't supply them, a mother on the ward had to lend me one of hers.

I had a nasty tear with stitches and a catheter and I was so swollen I couldnt close my legs so i couldn't get to the breakfast trolley. Partner bought me some cereal bars so I wouldn't starve. I work on NHS wards and have done for 8 years and this is the only ward that does it! Even on wards for 'medically fit' patients their breakfast is brought to them! It makes no sense.

[Sorry everyone for massively long post!] Although I received very good treatment during the birth of my first child (long, complicated, ending in emergency CS), the postnatal ward was a hideous environment and I'm sure my stay there was largely responsible for the depression I experienced afterwards.

The change of tone was apparent even as I was being moved from ICU to the recovery ward and asked for a drink of water and whether I could sleep for a bit (for the first time in 48 hrs) and was told 'Ha! You'll be lucky - no water for at least two more hours. And your baby needs feeding and changing, so no sleep for you ...'. As per many of the pp's comments, it was hot, noisy, dirty and chaotic, and patients seemed to be treated as an irritating inconvenience by the staff.

The hospital was a relatively new, modern, no-expense-spared type in central London, and I remember feeling bitterly aggrieved that they'd spent so much on the public spaces - a huge glass atrium with coffee shop, sculptures and paintings - and yet the women on my ward were expected to slosh around in each other's blood and shit and used sanitary pads in a filthy bathroom that nobody ever cleaned. The catering staff were aggressively rude and unpleasant, there was no concept of privacy (curtains wrenched open any time of the day or night and you or your baby woken without ceremony for whatever reason, regardless of whether you'd only just managed to snatch a moment's sleep), the nurses allowed coachloads of people to swarm into the ward at visiting times (completely against the hospital policy), but seemed to delight in summarily ejecting husbands/partners who might be quietly sitting with their babies because 'visiting time is over, you have to leave, hospital rules' ... I remember crying and begging them to let my husband stay as I was so exhausted and having him there was my only chance to get the rest they claimed to want me to have, but no ... I even had a phone next to my bed which would ring randomly every few hours, night and day (never anyone there), and when I mentioned it to a nurse was told 'what do you want me to do about it?'.

The worst thing was hearing the woman in the next bed crying softly for hours because she couldn't breastfeed properly, and listening to the way they spoke to her and the distress of her baby - it felt like there wasn't a grain of kindness in the whole place. All I wanted to do was comfort her but I was weak and exhausted and couldn't stop crying myself, so we both just lay there behind our own curtains, not even speaking ... honestly one of the worst experiences of my life; the whole environment seemed calculated to make you feel helpless, disorientated, sleep-deprived, frightened and insignificant - closer to a military boot camp than a maternity ward. I ended up discharging myself against medical advice for the sake of my own sanity, which sent an administrator scurrying immediately to my bedside with a 'satisfaction survey', and it says something about my mental state that at the time I didn't even find it funny ...

The truly worrying thing is that all this happened 15 years ago, and at the time the London Evening Standard was running a campaign to improve postnatal hospital care (with specific naming and shaming of the hospital I gave birth at, which pledged to address these issues) ... and here we are now, all these years later, with new mothers apparently still having similarly terrible experiences all over the UK.

[NB: My DD was born five years later in a Kent hospital, also by section, and the aftercare could not have been more different - the ward was equally busy but the place was calm, clean and organised, and all the staff managed be both efficient AND unfailingly kind. It was a happy experience for me and for the women I shared the ward with, and proves that it's possible to deliver hugely positive and beneficial postnatal care within the NHS.]

First ever post after lurking for years, so apologies for wanging on, but this is an issue close to my heart. I really hope this campaign can make a difference.

I had lovely porridge and plenty of water and absolutely shit post natal care.
I don't give a feck about water which a relative could bring in or fetch for me if it genuinely wasn't available. I do care about being treated like a failure when I struggled to bf and being turfed out with a hospital born infection that triggered and MS relapse. And then more shit about bf when I had to come back into hospital even though they didn't have enough staff to help me pick up my baby .
Stop wasting time on trivial shit and keep your focus on the important stuff. Please.

My post natal experience was terrible for me. I had a terrible birth experience and ended up being left from around 2:30 am till 8:30 am, alone with my baby, when I had only come around from a General anaesthetic at around 2am. So in that period when you wouldn't be allowed to take yourself home after any other kind of operation, I was left alone to care for a newborn baby.

I was both physically and mentally disoriented, the physical from the pain, the painkillers, the loss of blood from a post partum haemorrhage and the after effects of the anaesthetic, and mentally from the previous 24 hours of something that approximated well to torture due to inadequate pain relief.

There needs to be fantastically better communication between labour teams and post natal. Some women have had positive birth experiences and are not physically depleted to the point of exhaustion. Others have lost blood and had terrible and traumatic experiences. The post natal care for these groups CANNOT be one size fits all.

My post natal care team had no idea what I had been through or what I was experiencing. They seemed to have had no idea that I had had a GA, or that I had ended up hoping not to wake up at all after what I had experienced.

I honestly still cannot imagine how or why I was left alone to look after a baby while still woozy from a G.A.

Becoming severely dehydrated while breastfeeding a newborn because you don't have a relative or partner on hand 24/7 to fetch you water is trivial shit?

Not an exaggeration - it's happened to some of the posters on this thread.

All issues are important.. water is pretty essential to wellbeing. Being dehydrated, especially after an operation or birth, will makes it so much harder. Many people don't have visitors or partners coming in... There should be a water supply in the wards.

Fair enough, not trivial shit. I apologise. But water was the least of the shortcomings in my post natal care.

I completely think yanbu!
I had my second baby a couple of weeks early (bag not completely packed) and quite fast so no time to remind dh to pack food too! Dc2 was born at 3.30am, so no shops open for food, I was allowed a drink, but apparently health and safety had removed the toaster. I was ravenous. I think it's forgotten that most people can't eat whilst in labour or if they do they tend to be sick, so it can be days that they've not had food. A fridge full of sandwiches etc would be a good start!

Having read all of this I am seriously of the opinion now that CS mothers should be on a different postnatal ward from those people who have not have a CS - a ward that is clean, calm, quiet and has better food and bathroom facilities. To have major abdominal surgery and perhaps a general anaesthetic and then be expected to stagger around 30 minutes later bleeding and trying to look after a newborn is certainly not what people are expected to do in any other circumstance in life. I don't know where midwives have got the idea from that this is acceptable professional practice, because it quite patently isn't. New mothers who have had operations need the same post-operative care as anyone else who has just had an operation. And this nonsense about 'childbirth not being an illness'. It bloody is if you would have died without surgery, FFS. These people need extra TLC. It sounds like most people would be better off absconding to a Travelodge in a hospital gown.

I know postnatal wards are understaffed. But keeping noise levels down would definitely help and wouldn't cost anything. Allow fewer visitors, for shorter periods. Only allow visits from close family. No dads staying over. Definitely no sales reps (e.g. bounty).
Also privacy: allow mums to keep their curtains closed except when being seen by a healthcare professional.
Turn the lights down as low as possible at night and staff talk as quietly as possible.

I agree Boffin and would like to see some additional thought around women with babies in Special Care such as grouping them together where possible and taking account of the fact they may be off ward at meal times, drug rounds etc and getting lectures about cleanliness from the paediatric team down there.

Boffin I totally agree with your general sentiment, but please don't assume those giving birth vaginally don't also need the same kind of support. Not all will, but some, like me, are also recovering from General Anaesthetic, and have had huge blood loss.

@Radishal - access to water is an absolutely basic NEED, and if someone can't get it for themselves (because they have had an epidural or a section), and don't have someone to fetch it for them - because not every woman has someone with them at all times, ffs - then it is basic nursing care to provide it.

I am a qualified nurse, and every patient (except those who are nil by mouth) should,have water available! It is utterly ridiculous to state that hydration is trivial - possibly the daftest thing I have seen written here.

@BoffinMum - every patient in hospital deserves a quiet clean ward, and decent nutrition. Are you really saying that a woman who has given birth vaginally can slum it in blood and filth? Torn, cut or abraded perineums can get infected too.

That said, I would agree that women who have had c-sections should be on a ward with staff who have proper nurse training and know how to look after a post-OP patient - since the midwives don't seem to have that bloody basic skill in their training.

SDT, I apologised for using the word trivial.
I am frustrated that a powerful voice like MN is not going big on the matter of inadequate bf support. It's a tricky subject and it seems like ducking it to focus first on nutrition and hydration.

Difficult to get going on bf when you're dehydrated, staving, so tired you can't hold the baby and have no privacy though.

@Radishal hydration and nutrition are pretty essential for breastfeeding......

Hydration and nutrition was the only thing my hospital got right. The rest was downright dangerous.

@Oneiroi I think you're mistaking lack of compassion for an ability to see that with care free at the point of need some tough decisions about what one person wants and what the majority need have to be made.

I have no issue with partners being there a lot of the time but I strongly object to it overnight and it being used as a notion that their being there is a panacea for activity bordering on clinical negligence.

The vast majority of women would be fine with reduced partner visiting or no overnight stays if they were bring treated properly as a patient and a new mother in a clean, peaceful, safe and dignified environment: what the campaign is really about.

@Radishal

SDT, I apologised for using the word trivial. I am frustrated that a powerful voice like MN is not going big on the matter of inadequate bf support. It's a tricky subject and it seems like ducking it to focus first on nutrition and hydration.

Hello - we are going to focus on breastfeeding support and issues around feeding as the campaign goes on (as well as birth trauma, long-term care for birth injuries and pelvic floor injuries, and mental health).

The focus on the nuts and bolts of good care on the postnatal wards is what we've kicked off with because so many of you have said your experiences were lacking, and because it's not an issue we've seen tackled systematically before. But we are absolutely going to campaign on other aspects too. Watch this space - this is only the beginning!