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 think that food arrangements for PN mothers should be different during the day, as it'd be Sod's law, baby was up all night and then falls asleep just before lunch. Most canteens are open from morning onwards, when I've been in hospital there's been a person in charge of food and managing housekeeping.

So an extra responsibility for such a person or HCA, have a menu of food available, make lunch and dinner flexible, advise though that closer to closing of the canteen less choice may be there.

Breakfast should be 7am till 10am, Lunch should be 11:30am till 2pm
Dinner should be 4:30pm till 8pm

If they don't have a head house keeper, then a HCA can order the food that's available. It's bought by someone every 30 minutes. With access to sandwiches, crisps, fruit, anything that can be stored for a snack instead of a hot meal.

Depending on Ward capacity, there should be 1 lavatory/sink/shower with fold down seat, per 4/5 people. Then separate toilets so during busy bathing times, people can still get to the lavatory, including visitors.

Post birth extended visiting times for Dad / Carer, so if Mum has had CS, someone is on hand to help with baby instead of needing to press the buzzer constantly. In private rooms 8am till 12am. In communal wards something similar, but curtains to be closed for bed with Dad/Carer outside of open visiting hours for guests for privacy.

If space allows, they should have a set number of private rooms with lavatory/sink, available to book in advance for mothers who want privacy, available to NHS patients if empty, with an addendum that they may be moved should a paying patient need it.

The charge for the room can go towards various items to help mothers/fathers/siblings. Examples:

Having a trained MW in pre-post natal mental health. Mental health issues to be discussed as standard with community MW, to highlight possible problems. Then a visit post birth, with a postpartum friendly questionnaire, so it's highlighted if there are any issues, so trauma during birth, concerns about baby. Extra support if needed, or a watchful eye by MW/HV so it's reviewed as standard, over Mum having to get the guts to admit there's a problem.

Access to leaflets about birthing interventions, so people know what is to be expected. Every woman receiving a leaflet on how to measure their mental health. What to expect at home PVB, PCS, possible issues postpartum with Mum. Leaflets on common breast feeding issues (tongue tie, mastitis, blocked duct, baby feeding during growth spurts, baby comforting on breast, dummies, oral thrush, positions, warnings about co-sleeping etc) & bottle feeding issues. General health of a newborn, how many wet nappies to expect, how many dirty nappies to expect, safe home remedies for suspected constipation, warning signs for certain issues like that commonish bowel problem. Vulnerability pre-jabs, chicken pox, temperatures, norovirus, reflux, milk allergy, weight loss / gain.

Making the Day Room more patient friendly. Having a Day Room for pre-natal & post-natal patients, although either can ask to go into the other room if the patient doesn't mind. Thinking high risk pregnancies, where Mum to be is stressed, she may get anxious near a post-natal Mum.

If not standard, then possibly run classes too, for first time Mums.

Emergency supplies of necessities.

I'll keep thinking.

I honestly think the meal idea is needed so there's flexibility. Sandwiches etc available at all times. Hot food such as jacket potatoes or whatever's available, accessible for a 2 hour period.

I also think mental health checks before / after birth are important, as from experience, it's hard admitting there's an issue. Extra support maybe required if AND was an issue. Checking for markers of PPP. Checks maybe every week or fortnight by MW & HV after discharge till 8 weeks PP. Then every month till 9 months. Just a simple questionnaire, but aimed at pre-post partum mothers. So unlike normal ones which look at appetite, fatigue, most Mums would fail the standard generic questionnaire.

I had to stagger from the postnatal ward to nicu (a five minute walk for a fit person) pushing my baby in a cot,with a catheter still in, hours after a crash section, at 4am through unlit deserted corridors. I could hardly stand and if I'd fallen over I have no idea what would have happened. I have never felt so alone and vulnerable in my life and even though my child is nearly 2 now, just typing this out is making me want to cry

I agree with pretty much everything said already, although personally I really wanted my partner there, in part because I was made to feel like an inconvenience every time I rang the bell for help in his absence. Staff shortages and attitudes need sorting before partners are restricted, I think, otherwise many women would be left every more stranded and helpless.

I was on an open ward for five days. I had about five hours sleep total in that time. I had a non-latching baby and support for bf was utterly useless and conflicting and given with clear impatience by staff. There were two electric pumps for a ward of about 70 women. I switched to formula on day 3 because I genuinely had no other choice.

It was hellish. I've never felt so vulnerable, alone and miserable. After the great standards of care in delivery it was a huge, horrible shock.

I was placed on a high dependency unit after DC3 (purely down to bed availability) had an emergency section.
The room had a designated care assistant who refused to help me with anything as 'you're not one of mine'
She also sat, behind my curtain at a table feeding every single baby in the room overnight to give the mums a rest.
This involved lots of noisy package opening and rustling - fine to keep me and my baby awake though.
The mums in question were fully mobile, up and down for ciggies and I was 2 hours post op.
The only thing that changed her was one of the doctors coming in to see me socially mid shift - she was completely up my arse when she realised what I was but it shouldn't matter who or what I am. We need equity in care.

Regarding the fruit filled fridge - telling you now it would be emptied into Asda bags by a scuzzy visitor and vanish.
I do feel that there should be some warning prenatally that you need quite a bit of money for the experience.
I also think that after the initial period after birth, where possible we should be relying on friends and family more to provide extras.
The NHS is dying on its arse. If a few more people could help themselves (in the nicest possible way!) it will free up the few remaining staff to provide pain relief, personal care etc. Forewarned is forearmed!
to everyone who has had shitty experiences.

YY to a "How things work" card.
It would be helpful for hospital staff to have a tick list of what you've been told/should know. I was taken up to the postnatal ward during "quiet time" which means I missed out on the "where everything is" talk they apparently normally give everyone. So when I needed someone I was faced with tracking down a member of staff (who was then annoyed with me for not knowing where it was), or muddling through.

You should be offered food/water after you give birth even if it doesn't coincide with meal times.

I gave birth just before 9am (so missed breakfast) and wasn't moved up to the postnatal ward until 2pm. Which meant in terms of hospital food I didn't get offered anything until 5.30pm (dinner).

My own experience was fine, I had to have surgery after the birth but recovered very quickly and I had a very supportive partner who brought breakfast, lunch and dinner for me every day and made sure I always had drinks. I also got lucky the first proper night I was in and had a midwife come to check when she heard both me and baby crying. She took the baby "for an hour" and I woke up at 7am the next morning to find they had kept her with them so I could sleep. However, a girl over the way from me had an awful time. She had had a c section so much harder recovery. Partner was rubbish so no food or drinks supplied and believe me expecting anyone to survive on the stuff they call food in hospital is a joke. Her first night baby wouldn't stop crying and she couldn't even move her own bed to sit up. Asked a midwife for help and was told she had to get on with it herself, it was her baby! Major abdominal surgery and she "had to get on with it" ffs. No other patients would be treated that way!

From a mumsnet aspect - could we maybe have a Maternity Hospitals subsection. Each thread could be about individual hospitals where people can search for advice/ask other mums things?

Does anyone know the parking costs?
Is there a restaurant?
Shall I take an extra pillow?

Posters could leave tips too - like 'the ward is hotter than an oven, take a little hand fan if you're in over the summer.

Breast pads aren't supplied.
BAMBIS are contactable on the ward for BFing advice.

Postnatal wards are on the first floor.
No children except siblings are permitted to visit.

That kind of shizz...

2 patients die die of thirst and hunger on NHS wards every day
We need to fund the NHS properly.

www.independent.co.uk/news/uk/politics/two-patients-die-starvation-thirst-each-day-nhs-hospitals-uk-care-homes-statistics-office-national-a7517171.html

I had my first baby in late 2015 and I was surprised at the way post natal ward work, it seemed a world away from the rest of the hospital.

I was lucky enough to only have to stay for a day (baby born at 5am, discharged at 11pm), but the majority of this stay was actually due to there being no one available to discharge me, all day.

I was so uncomfortable and disturbed on the labour ward, but by all the wrong people! The only time I was approached was to have someone remove my catheter. I just wanted to go home as I thought the point of staying on the labour ward was to get support as a new mum, but found it very lacking. The midwives I did talk to were nice though, just clearly understaffed.

My breastfeeding support was also a bug shock. An hour or so after I had given birth, a woman just came into my room and reeled off a list, very quickly, of a load of different things about breastfeeding. Bearing in mind I had just given birth and hadn't slept in at least 24 hours. She shoved my boon into baby's mouth and left, despite it being very obvious that the position she had got me to hold DD in was uncomfortable for me.

I know it's not what you asked about but I can't really talk about my post natal care without mentioning the awful treatment I received from the midwife while giving birth. I actually had quite a straightforward birth, what made it traumatic was the absolute lack of sympathy and support from the midwife. I was so disappointed and felt like I was just a burden to her, and annoyed her. She wouldnt let me have pain relief until I screamed at her, even gas and air, despite being 6 centimetres. The whole thing was a shambles and I honestly felt like it would have been easier to stay at home.

So in comparison to that, the post natal care was okay, but I agree with previous posters about food and drink not being readily available, although I did hear one midwife being very nice to a lady who had just had a c section for twins. Which shows they obviously want to provide this care for all women, but simply can't.

My hospital actually has a reputation for poor maternity care. I am due with my second child in early November and am frankly dreading going back to that hospital :(

It would be nice if young mums were not patronised so much.

I had my children at 20&22 and I was spoken to and treated like a complete idiot on the postnatal ward with my second child. I was stopped from carrying my baby into the day room for the group discharge meeting because I "might trip and drop him" and was ordered to go back and wheel him down in his cot. Out of 20 women I was the only one who been made to do this and all the others where holding and cuddling their babies. The only apparent difference between them and me was our ages. Everyone else was late 20's early 30's. I had a normal birth and was in no pain etc and was walking around and lifting things quite normally so there was no reason to doubt my ability to carry him. Halfway through the meeting the lady asked if anyone already had kids and I was actually the only person in there who did. funnily enough the patronising comments to me and nodding in my direction when discussing things that are common sense, such as supporting the babies head and changing regularly to avoid nappy rash, all stopped once that was established.

I also had a nurse come over to see how breastfeeding was going. Before I could stand up to pick him up. She talked at me whilst picking him up and putting him in my arms. I hadn't even pulled my top up yet and she was trying to position him for me and grabbing at my arms telling what to do. She went into a massive spiel about the different positions I can feed in once I've built up a bit of experience and how often I should feed etc. Every time I tried to speak she just spoke over me before I could get the second word out so I gave up and sat there quietly feeding whilst she went on and on about her superior knowledge of breastfeeding positions. She told me that she would be back later on to check his latch again and if I'm confident to feed him without her 'Help' I can go home. I told her that I had breastfed my first child until he was 18months old and I was more than confident. She visibly blushed, apologised and quickly shuffled out of the door.

I don't think I could have felt more patronised on that ward if the staff had started patting me on the head.

It's just a couple.pletely different world to the rest of healthcare. Yesterday I was in for an outpatients procedure. I was shown around the ward, asked if I was comfortable. I was wheeled on a trolley down to the room i had the procedure despite saying I could easily walk and following the procedure I was offered sandwiches and drinks and snacks regularly, all brought to my bed. I was also discharged with a prescription for codeine even though it was a relatively minor procedure.

Contrast this with my stay in the maternity ward 10 months ago where I would have starved had it not being for my DP since my DS decided he needed to feed whenever meal times came so I never got anything from the trolley that was at the other end of the ward. I had horrific after pain and was offered nothing more than paracetamol that barely touched it. I was just left really

Both of these were in the same hospital.

It needs to stop being treat like we should just put up with it. I think the prevailing sentiments seems to be "women have given birth for thousands of years and somehow managed" I don't know what the answer is though since it seems to be so ingrained in the culture of post natal care.

I was recently an inpatient, both pre and postnatally at Southmead Maternity in Bristol. I received amazing care, including most of the things mums are asking for here. They all bent over backwards to help, including wheeling me down to Nicu in the middle of the night. I highly recommend them to anyone having a baby in Bristol.

Being as the wards are usually well understaffed I wonder if there'd be a way that they could have volunteers that have an advanced DBS check that could visit the wards a couple of times a day?

I know it's something I would have been happy to do and I bet there's alot of other women out there who have the experience,would have passed the needed checks and would be happy to help out new mums on the wards.

That way a new Mum wouldn't have to wait for a nurse to become available so they could be given things like food/drinks,someone to report any worries to ie other people's visitors being very loud,tv or radio's blaring whilst other new Mums and newborns are trying to rest.

Help with feeding the baby,they could apply for some volunteers that have helped women with breast feeding counselling before.

That way the Nurses are given a helping hand because there would be someone else you could get help/advice from that you needed that wasn't of a medical nature.

Freeing up the Nursing staff to be able to deal with making sure women and babys got any medical checks and medication on time,the time saved for the nurses should mean that there'd be less chance of anything healthwise weather of the Mothers or the babys being missed before they're allowed to go home.

The use of volunteers would also mean our Governement wouldn't be able to complain about the added cost of extra staff and the cost of any training should be re-couped hopefully over the years as we'd hope that there would be less women being diagnoised with PND(specifically that's been accredited to the lack of help and support whilst in hospital)and hopefully less health problems being missed of post natal Mums and they're newborn baby's.

I was lucky in the respect that water and hot food was offered and brought to each patient regularly - a miserable woman came round 3 x day with a menu card, you selected what you wanted and it appeared an hour or two later. Just as on a regular ward - this was at Winchester.

What I found distressing was being placed on a post natal ward immediately after an emergency section, surrounded by other people's loud visitors and babies crying. Mine was in respiratory distress in SCBU, I was in total shock and pain, and all alone. It was honestly the darkest day of my life to date and I believe it contributed to some (mild) PND. I was eventually transferred to a private room, but only after having a bit of a breakdown. I still get quite emotional when I think of those first 48 hours.

I agree a card on how things worked would be brilliant, I was extremely anxious in that first week and on some drugs that were affecting me quite badly (hand tremors), and I wasn't sure what I could ask for and what would be deemed 'pestering' - as this was the attitude I got from the care assistants and midwives. An example: No one came to empty my (nearly bursting!) urine bag, I rang 3 times in 3 hours and risked falling over on wobbly epidural legs to empty it myself, and then got a telling off for doing so as she "was just coming, if you'd have given me a chance!".

I did have some lovely student midwives who I can't fault - one came and sat with me while I cried my eyes out and told me all about her son's traumatic birth 18 years ago and how she still found it hard to talk about. That really touched me. She also was the one who saw I was struggling and made it her mission to get me a private room. I also had a few students who had been there during my labour come back on their next shift to say hello, give me a hug and tell me I did well. they made me feel human again and not just a 'case' in a hospital bed.

Agree totally that things need to improve.

The daily wail won't pick this up will they?

The side rooms on the ward. After my baby was born he was taken to NICU and i was put in a side room, broken heating blinds didnt shut no privacy and not one person came to check on my well being. They forgot to tell me breakfast had arrived. I was left and forgot! In the night nurses wouldnt shut doors quietly. Several times my baby was woken by a slammed door. Makin him jump. It was truly awful.

Tea and toast after giving birth! A nurse made this for me and it was wonderful.

Staffing is key as is understanding that all maternity care is 24/7 rather than regular hours like surgical wards.
One of the points that I don't think has been made is about Special Care. I was on a PN ward with no baby. My baby was in SCBU. I had had a section so I had to be accompanied by a member of staff from the PN ward if I wanted to visit My baby for the first 24 or 48 hours (can't remember which it was). This meant every visit to my baby had to be negotiated and limited. And left the ward with fewer staff.
Fortunately my baby was OK and I don't know whether there are different options for very ill babies. I hope there's a way of accommodating women immediately post section if their baby has only a few previous hours.

I was in 4 days after a long labour, EMCS and complications that meant 36 hours in HDU. I was also struggling significantly with (undiagnosed) SPD* that meant I hadn't left the house independently in weeks so was in a pretty poor state before the birth. I certainly hadn't walked the equivalent distance from the bed to the day room for a long time.

The hospital was heaving at the time of the birth. I'd had to wait an hour in agony to get a room on the labour ward. I was changed from HDU to the postnatal ward abruptly at midnight to get the MW on to the ward. I was basically dumped there to fend for myself. I hadn't stood up without support for well over 48 hours and had been struggling to stand without the major abdominal wound. There was no point in using the buzzer as no one came. At one point I dropped DS on his head as my strength gave out as I tried to reach to put him back in the crib.

The staffing ratio was 1:14. When it came down to 1:8 on the last day it made such a difference. The same staff suddenly had time to care rather than be perfunctory.

I think there is a culture of "you've had a baby, get on with it" fed significantly by a lack of time to support and listen to the additional barriers that patients may have. On discharge we asked if we could borrow a wheelchair to help us get to the car because I hadn't walked that far in months. I was told that if I couldn't walk to the car then I wasn't fit to go home. I was desperate to go home for some quiet, rest and sleep so inched my way painfully out. It was a few weeks before I walked that far again.

My second stay was better, partly because I was in much better condition "only" a third degree tear which meant that I retained much more strength. Crutches were definitely helpful in making the point that I was struggling with mobility.

Access to food needs improvement. 1500 calories provided in meals is half of what a recovering new mum needs. No wonder my milk took its time to come in leaving me battling with a baby struggling with low blood sugars. I had a false labour and was kept in for 24 hours as a precaution as a VBAC. I went in just after breakfast, was denied lunch "just in case" even though the contractions were fading and now irregular. I had to ask for tea pointing out that birth clearly wasn't happening in a hurry and got a barely edible sandwich as lunch was the hot meal of the day. No access to food until 8am. DH brought food in to the postnatal ward- other people don't have the luxury of visitors. They need access to an adequate quantity of food. 5pm to 8am is torturous to not have access to food when you're awake most of that time trying to start breastfeeding.

More staffing would address much of it. I like the information cards idea, it would help with issues like having no idea what to do with baby while you shower/ toilet. Access to an appropriate quantity of food and outside of meal times.

• just pregnancy aches and pains according to the GP when I went to him at 34 weeks in constant agony and unable to do things like getting around the supermarket.

With my last baby I gave birth in the midwifery led unit, it was shiny and new and places where like gold dust or so I was informed. Labour was quick and straight forward( because I did all the work.) It was the aftercare that wasn't up to scratch.
They wanted me to leave two hours after baby arrived, I opted to stay for the night.
I did not see a midwife or any hcp for hours and my dh had to leave so there I was stuck and isolated. Later that evening I went to find a midwife to ask for pain relief and I was asked why I hadn't brought my own with me I wasn't given any. I also really needed a drink of water but after the reception I had earlier I didn't dare ask. So I was parched all evening and throughout the night. You are probably thinking the midwives where busy with mothers in labour but I was the only one on the ward. This is not a midwife bashing post I come from a family of them and have great respect for the profession, just giving my personal experience of that time.

Yes it would be great if water was provided throughout the stay.

Yes to food (any food of any description)
My lunch came whilst I was in labour and really wasn't keen on eating it as I was pushing a tiny human out of my fanjo, dh enjoyed it though. I was offered nothing else. Nothing!
Yes to pain relief after birth if you need it. I had a tear so I needed something.
Yes to a little more checking in with the mother and baby. As I said I had to go looking for a hcp.

I never understood why patients on post natal wards are made to get up and get their own breakfast when on every other ward patients are brought their breakfast. I remember being told about it but completely missing when the breakfast was put out as I was dealing with my baby and having to scrabble around for some cereal whilst dealing with a third degree tear.
Seriously I don't understand the attitude of not looking after new mothers. I remember trying to get onto the high bed holding my baby and struggling and asking the nurse could she hold him while I got up. She said " no I won't be here when you are at home". I mean come on. I had had a third degree tear less than 12 hours ago, lost a Lot of blood. When I get home I will have my husband to look after me which will be a lot better than you.

Our hospital brought breakfast and meals/snacks to your bed. It must depend where you are whether they make you get it yourself. No harm in encouraging mobility but should be offered at bed space too.

In my hospital it is a general maternity ward. I was induced in a 6 bed bay with 2 postnatal women and the rest in for observation. It was horrible trying to be quiet whilst I was contracting. Afterwards i was taken to a bay with mostly postnatal women and 1 being induced. She was clearly in agony and was moaning so loudly for hours. Obviously I don't blame her but everyone was clearly knackered and she was making more noise than the babies. Whoever thought mixing up the ward was a good idea needs to spend some time as a patient.

I wish all the lights hadn't been switched on and the curtains opened suddenly at about 7am, I'd just had 2 hours sleep (the longest in 3 days) :( Don't see the need to wake everyone up when a lot of us had barely slept. It's not like they needed the light to bring us food/drinks

I did mention this on a previous thread but will do so again.
My baby was moved from special care to transitional care fairly quickly and I was moved there too. Whilst there I was discharged from PN care. I was therefore no longer a hospital patient and expected to care for my baby ready to go home. Having had a section I was doing well but obviously in discomfort. As I wasn't a patient I couldn't be given any medicine, not even paracetamol. I couldn't leave the ward. I had a problem that I wanted some medical advice on. I tried to get my GP on the phone but was told they'd need to see me. So I was in a hospital, unable to get paracetamol or routine medical advice. I was threatened with Social Services if I left the ward with or without my baby. Totally Kafkaesque.
DH fortunately was able to bring paracetamol.
So as before, accepting women with newborns in SCBU may have recently given birth would be good!