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

After a c section I was left on the recovery ward. The nurse who was meant to watch me and make regular checks ignored me in favour of her phone.

When the anaesthetist came to say goodbye after his shift he slipped. there was blood everywhere on the floor as I was heamorrhaging. After this was dealt with, I was kept for another couple of hours after which the nurse made me get up and walk to the end of the room as the bed was wedged into a corner and they couldn't get it out and a wheel chair didn't fit. So i think properly trained staff and planning would be good.

Also access to doctors after you have been discharged. My wound became infected and I was made to wait 6 weeks to see the specialist. I need a further 6 ops to put things right. This could have even avoided if I had not been written off as a nuisance by the hospital who wouldn't let me see the specialist even with a letter and phone call from my GP.

Thank you , Rowan.

STDG, that was kind of what I meant. Surgery=full nursing, vaginal birth=a bit of TLC once you're in the safe zone.

As others have said, @Radishal, proper hydration and nutrition are central to establishing breastfeeding successfully. And to recovering quickly and well from childbirth.

These aren't things that are hard to get right, but unless they are getting these absolute basics of care, how can women be expected to recover from the birth, or breastfeed successfully?

And if a post natal ward can't do the basics, how can they do a decent job of supporting breastfeeding or any of the other care women and their babies need in the post natal period.

I'm sorry if this has already been mentioned, but my only experience of being on a postnatal ward was with a baby in SCBU. I missed pretty much every meal because I was down the corridor with my baby, and it was apparently not possible to keep food back for me, let me know that food had arrived or even tell me what time food would be delivered.

When DH complained (after bringing me supplies - I was bfing as well, and was starving!) it was almost as if I was the first new mother ever to not be on the ward all the time.

I also missed the usual postnatal checks for the same reason (when I said to a midwife that no-one had checked if I was OK in the three days since delivering, she said "what do you expect us to do?")but I guess that is slightly off the subject

I haven't seen any studies to back me up, but I'd wager that turning down the heating in NHS hospitals by 2 degrees wouldn't put vulnerable patients at greater risk of hypothermia but would save many ££££s, as well as making it a much more pleasant environment for everyone

It really shouldn't be hard to order meals to SCBU for the mums whose babies are in there. Or to say to the woman, "We need to do your postnatal checks each day - when fits in best with your SCBU time?"

Cherries I see others explained why my post wasn't hyperbolic or ridiculous. Not sure if you still think you have a "legal right" to have your partner stay overnight but that's wrong, too.

Food, water, privacy, kindness - seems if the campaign focused on those four issues, we'd cover the vast majority of issues on this thread.

Wow, some of these of experiences are really awful. I think I was extremely lucky in comparison, but there were still a few things that could have been improved.

Things my hospital got right:

• a 'menu' of food options brought to your bedside where you could choose your food (including different dietary options)
• food was delivered to your bedside by the same catering assistants who brought the options around earlier
• water by the bed (although I needed to use my glass to mix up some medicine and never managed to get a spare for water)
• BF support nurse who got me an electric pump which I am sure saved BF for us when my daughter just wasn't interested
• medication came around regularly and was all packaged up ready for discharge
• shower area was clean, but there could have been more facilities

Things that could have been better:

• building work starting at half six every day right outside with builders walking past the windows (obviously this was temporary, I was just unlucky)
• I personally DIDN'T like men staying in the ward. It was noisy and I felt uncomfortable about the way some of them treated their partners who perhaps could have done with some time away from them. I respect some people would want a supporter with them and perhaps this is where we need to encourage investment in private rooms. I would have hated a private room as it would have been too lonely. Culturally this is also difficult for some patients
• I was in for a surgical repair but all the other women were in post CS and they were expected to just get up and deal with it. The midwives (until I read this thread I didn't realise they no longer have nursing training) didn't offer any support other than to tell them they'd have to get on with it at home
• too noisy. People talked all night. I was so sleep deprived I was furious and wanted out of there
• too hot. I had to wait for a woman to be discharged to send my OH over to liberate the fan she had been given
• the room was practically underground apart from the high, small windows on the other side (see wandering builders above). My DD got jaundice and one of the HVs later joked that the ward in particular made babies jaundiced because of the lack of natural light (if you were on the opposite side you got none)
• understaffed and overworked midwives. I wanted to go home asap, just to get some sleep but the midwife wouldn't even let me self discharge as she hadn't had time to write up my notes
• my option to have a shower was to "ask another mother to watch your child". They were strangers and speaking in different languages to me
• post op being left to bleed over the bed without a pad or anything and then having to desperately and repeatedly search down some clean sheets to get it changed when I could use my legs again

I like that idea Boffin but how about bays colour coded by need? So red bays for women who need extra care - CS, general anaesthetic, serious tears, etc. An amber bay for those who are bruised and battered but more or less mobile - instrumental deliveries, less serious tears, etc. A green bay for those who have had a relatively straight forward delivery. And a non-colour coded baby for those whose babies are in special care, these bays could have flexible meal times and drug rounds. Red and amber bays could have visitor numbers strictly limited to two per bed (not including partners and siblings), other bays maybe three per bed, and make sure the numbers are enforced - signing in via the ward desk would probably be the easiest way to monitor how many people are on their way to see any one patient and then whoever is on the desk could say "only xx at a time, the rest of you will have to wait until they come out and take it in turns".

I haven't seen any studies to back me up, but I'd wager that turning down the heating in NHS hospitals by 2 degrees wouldn't put vulnerable patients at greater risk of hypothermia but would save many ££££s, as well as making it a much more pleasant environment for everyone

^ This

It really doesn't need to be so hot! What benefit does it have? I don't have my central heating at home that hot, plus once you're home you tend to go out with the pram/car seat in all temperatures and - most importantly, I'd have thought - all of the literature given out on safe sleeping states that the ideal room temperature for a baby to sleep in is around 18C. In the room I had on the postnatal ward I had the window partially open for the fresh air/mild breeze and to help cool the room a little as it was pushing 26C (thermometer on the wall) - this was in February so the breeze was blissfully cold compared to the stuffy air in the room. The MW wasn't particularly pleased when she came in (private rooms) but I pointed out the above, also that DD was the opposite side of the room to the window and was wearing a vest, a sleepsuit, scratchmitts, two blankets and a hat. There was absolutely no danger of her freezing. The morning MW wasn't bothered and agreed it was stifling in the ward.

In Japan there are vending machines everywhere in the street that dispense plated hot meals, not to mention snacks of all kinds. There is no excuse in 2017 for failing to provide meals for mothers with babies in special care who are as a consequence off the ward for periods of time.

The hospital where I had DD2, for all I slated the care up thread, had the food situation right at least in theory.

Breakfast was brought to your bed, there'd be a knock on the door and then a head would pop round to ask "toast? Cereal? Porridge? All three?" and you got it brought to you in bed with little butter and jams, a plastic pot of fruit juice and a cup of tea/coffee. For lunch and dinner you ordered it via the patient TV, lunch by 11am for delivery at 1pm and dinner before 2pm for delivery at 5pm. They also had protected mealtimes. Toast and microwave meals were available 24/7, you just had to buzz and ask. The microwave meals were from the hospital canteen and were the same meals served at regular mealtimes, just frozen for reheating on the ward. It was hit and miss due to staffing, when I was recovering during our postnatal readmission, I woke up at 10pm on day two suddenly ravenous having not eaten anything at all in 48hrs. I buzzed and asked if I could try some toast. The MW was really pleased I felt like eating and promised to bring some. It was 2am when she did finally bring it because she got waylaid by other buzzers but at least it was available and did eventually arrive! With a bit of tweaking this sort of system could run really smoothly and would ensure all women had access to food at times to suit them and those that need extra (breastfeeding, appetite waking up after anaesthetic or infection, diabetic in need of a snack, etc) would have access to extra.

Haven't read the full thread. I'm a nurse and midwife in Ireland, and generally in awe of the NHS (much more efficient than our HSE).
I am genuinely shocked reading this though. Some of these accounts are appalling! My local hospital is regularly subject to bad press (historic cases mostly), but luckily our maternity services are rather good. Food is served at the bedside, hot drinks and sandwiches are available all night, tea and toast brought to those who miss meals, vending machine with snacks just outside of the ward entrance.
Visitors are asked not to take mums chairs or sit on beds, 2 visitors at a time (hard to enforce the numbers but security personnel are in hand at the end of each visiting slot), mums are asked not to use phones after 11. Women here seem to have much longer post natal stays than in the UK as there's no community midwives though... Seems we're doing ok at something. to all those with bad experiences

My postnatal experience was much better than everything before it. However, there are a few things I would change. I actually would have liked to have my OH there especially after going through a failed induction, rude consultants, and an emer c-section. Just because some people are loud doesn't mean others are nor does everyone have a ton of friends and families nearby to visit them. My son was born at 1:10am and my oh had to go home. I had never been in a hospital as a patient since I was born and being alone with a baby after a traumatic experience wasn't a great feeling. What made it worse was not being able to pick up my son once he was in the bassinet. I kept hold of him in my arms because I knew the moment he went in the bassinet I wouldn't be able to reach him without assistance due to the C-section and the boots on my feet. The midwife saw me nodding off and put him in the bassinet so I could get some sleep. I woke up to him crying and tried to reach over to him, accidentally knocking the call button off the bed and not being able to reach it. I felt helpless and not being able to reach him only made me more upset by my birth trauma since I was bullied and coerced into an induction I didn't want. I've heard other countries have bassinets that actually move over the bed (like the food tables) to make it easier for mothers who have had c-sections or have limited mobility. I think it would actually help mothers to feel more able-bodied and less need to call midwives for help picking up babies.

If direct entry courses are retained the course length should be extended by a year so some nursing principles can be instilled.

"@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."

Again, Gin, it is disingenuous and quite nasty to trivialise and dismiss some women's need to have their partners there as just a 'want' or desire, when they are just as valid as the needs of other women to have an all female environment. This has been explained by multiple posters on this thread. A way must be found for both sets of needs to be met, either through private rooms or separate wards.

Despite my poor postnatal experience, the SCBU (we were readmitted for dehydrated baby who'd lost a lot of weight) sounds much better than above. The mums all had a hospital bed next to their baby's crib so we were with them - meals were brought to us and we chose from a menu card each morning. It was much quieter because visitors were heavily restricted so we had more chance to rest. More staff around so we got support for breastfeeding (I was on a three hourly feed/pump cycle to try and make my milk come in), baby bathing demo. Staff were happy to answer questions and look after the baby whilst you had a shower.

Many of the problems on postnatal proper were caused by not enough staff, poor communication and wards/bays not being used in the way they'd been designed. Once upon a time a bay of six women would have literally been a bay of six women. Not spacious but reasonable opportunity to rest as babies were in nursery and visitors restricted. The bay rapidly descends into hell once six babies are added in, plus hordes of visitors and partners.

I had a horrendous postnatal experience with my first ("why is your baby crying so much?" fuck knows, I'd only just met her) and much better with my 2nd - two different hospitals, different areas of the country. and in fact with my first my labour got off to a difficult start when someone was actually shot in the main reception area while DH went to park the car. That was a bit scary.

YY to hydration, nutrition and peace and quiet as much as possible. but more than anything Mumsnet, PLEASE do not let this become about breast feeding only. As a PP said, a bit care, attention, kindness and food and water would probably make most women feel so much stronger.

@Oneiroi please stop accusing me of lacking compassion. That's a low shot when, if you read my previous posts I had said that women who genuinely cannot cope without their partner being there - be that previous birth trauma, mental health issues, physical disability etc should be catered for too, just not that communal wards should be full of strange men for women who just don't want it or like it, never mind women who have very good reasons for not wanting to be in a shared open space at their most vulnerable with a strange man.

I think it's the individuals who are repeatedly iterating their OWN needs who are the most lacking in compassion in a general sense.

I just happen to think - and I am most certainly not in the minority - that new mothers and babies would not need partners on hand 24/7 if the wards were run adequately and with the compassion somif you think I'm so lacking in.

I'm afraid it's my view, and many others, that for a lot of women who want their partner there, those needs could be met by better professional care.

@MiaowTheCat in a sense I agree with you, and I say that as a women who breastfed is breastfeeding and will breastfeed her third baby later this year.

The breastfeeding support in postnatal wards is woeful, in my experience. However, having said that, I was the only woman breastfeeding on my postnatal ward and there was no drama with the midwives lecturing or forcing the mothers.

However, breastfeeding is an important aspect of midwifery, the problem is there aren't the resources or time to do it properly. You are either
Lucky
Get a lactation consultant
Nearly go mad - tongue tie, PND, exhaustion, etc
Stop and start bottle feeding

Again just something else that isn't done properly.

Gin I was responding to your first post to me, in which it was you that accused me of lacking compassion towards rape survivors, despite the fact that I am one, because my needs and those of many women like me do not conform to how you have characterised them.

Many women need their partners with them to feel safe when they are so vulnerable, regardless of whether the standard of medical and nursing care is improved to an adequate standard, and should not be forced to explain their reasons for this to justify it as some kind of special case. It was bad enough that multiple members of staff I had never met before forced me to explain that I had a section due to the trauma of sexual abuse rather than simply reading my notes.

I hated being stuck in hospital after having my daughter. I was struggling to breastfeed and was bullied and told off by midwives for doing skin to skin. One took my baby off me and dressed her (she was in her nappy we were doing skin to skin on the advice of a different midwife to help my daughter calm and get ready to try and feed as she was refusing to latch) which made her start to cry, she then effectively tried to force her onto my breast and when I dared mention giving her a little formula and trying again when she was calmer she gave me a lecture that there was no reason my baby should have formula. I was a petrified new mum who was made to feel like an idiot and was humiliated several times. Why is there so little compassion on the postnatal wards?

@Oneiroi hold on a minute...I accused you of lacking compassion towards rape survivors despite you being one???

Where exactly did I write that?

Please actually read what I have written on this discussion and see if you can find those actual words.

SDTG - It really shouldn't be hard to order meals to SCBU for the mums whose babies are in there. Or to say to the woman, "We need to do your postnatal checks each day - when fits in best with your SCBU time?" You'd have thought, wouldn't you? I was very lucky that I had a very straightforward delivery and didn't need much follow up care

I agree that bf shouldn't become the focus of this campaign, not least because I would bet good money that creating an environment where women get (at least) adequate food and drink, get proper medical supervision, and are able to recuperate in a peace would be better placed to establish a successful bf routine if that is what they would like.