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

'people/women need to take responsibility for themselves and whilst yes it's normal that women bleed after giving birth but it's a shared bathroom leave it clean after use. If you were home after and bled in the shower tray you'd clean up and not leave it for someone else?'

If you're physically capable of it, yes, but quite a lot of women on the postnatal ward can't bend down easily. You sound like one of the type of midwife who considers the women on the ward an inconvenience tbh.

That reminds me of when I was induced and was told to go and have a bath for the early labour pains. Was on my own because it was overnight. Anyway, the midwife came and handed me a cloth and a bottle of flash and told me to wash the bath before running it, and to wash it again once I got out. It was fun doing that in between contractions.

@UnicornMadeOfPinkGlitter just a very specific comment on one part of your comment which I generally agree with.

In almost 36 hours on a postnatal ward I can tell you ( as The only time I slept was between 3 and 4.30am - that the bathroom on my ward was not cleaned once. By the time I discharged myself the bin was overflowing, the shower full of grot, I think five cardboard urine bowls full of bloody urine, a shit smeared toilet and a sink with no soap or hand towels.

It was appalling.

I had to hobble to the top of a corridor to find a clean shower, even then the rest of the bathroom was neglected.

Disclaimer : not a bottle of Flash, but a bottle of generic hospital type cleaner. I was using Flash because that's just what any random cleaning product tends to get called in our house!

unicorn that's your hospital where you work/delivered. It's quite clear from reading the thread that while there are some hospitals getting it right, there are many hospitals who are not. You can't say "well my hospital does x, y and z" and then expand that to include all hospitals without having actually been in those hospitals.

@treaclesoda with my first they ran me a bath to see if that helped with my induced labour.
I took one look at it and pulled the plug. Totally rancid soap lines and things floating in it
I'd have loved a bottle of generic all purpose cleaner (joke)

In fairness, I would much prefer to clean the bath myself, even if it did take half an hour doing it a bit at a time between contractions, than to have a bath in a dirty bath

The wards I was on had no patient kitchens both ante and post natal. No kettle. No microwave. No sandwiches.
The Special Care units did have a little kitchen but food wasn't brought down if I was there.

The ward I was on had ready access to water and food ; there was a kitchen. The bathrooms, like the postnatal care were dreadful.
Access to water, while obviously important, does not equate great post natal care. Dirty bathrooms were just a detail in the overall crappiness and in fact dangerousness of the so-called care I received. Starting with the medical staff.

You don't need to worry about my midwifery skills as I'm no longer a midwife! Due to not enjoying the fact that I couldn't give the care that I wanted to give due to restraints placed on midwives due to lack of staff etc

However I can assure you that I did not see any woman under my care an inconvenience. I however often felt completely broken that I was unable to spare the time to sit with a woman and talk through what had happened and why or to stop and give help with breastfeeding or change a nappy etc. The basic elements of care rather than just having time to complete the bare essentials.

I left as I felt that if I could t feel happy with the care that I had given that I no longer wanted to work there. So judge me all you want. I know I was a damn good midwife and a loss to the NHS, along with several of my colleagues who left for the same reasons.

It sounds as if even the bare essentials are being ignored on some post natal wards, though, @UnicornsMadeOfPinkGlitter. Accounts on here of women who are still affected by their epidural being given no help to get to the loo, wash themselves or reach their babies. Accounts of women getting no help or nursing care after a c-section. Women not getting meals or water. All utterly unacceptable, and all things I think are basic post natal care.

I have read accounts on MN of women begging for nursing care that they actually need, on the postnatal ward, and being dismissed by midwives who say 'I'm not a ^nurse!'

The default position, on some postnatal wards, seems to be that pregnancy, labour and childbirth are perfectly natural and not illnesses, so all post natal women must be able to care for themselves and their babies with no help. And this is true, of some women - though even women who have had an entirely uneventful pregnancy, labour and delivery may still need some support, postnatally.

But there are women who have pre-existing conditions, or who develop pregnancy related conditions, or whose labour is very long, or,complicated, or requires intervention - and these women will need proper care and support - which appears to be entirely lacking on some wards where the staff don't appear to be able to move away from the pregnancy/labour are not illnesses so you don't need nursing care default position.

So is there a need for a better differentiation of patients on wards? Bays for women post C-section or needing greater observations (diabetics for eg) with a bigger staff:patient ratio, with perhaps a nurse or several nurses who can give adequate care to those who need it.

Then a bay/ward for those without complications more of a hotel style whereby they are for the most part self reliant and able to walk to get their own food from the communal area and wash/clean themselves without help, and change and feed baby independently?

I think the part I forgot to put in my long explanation was that the disparity between care given in hospitals is shocking. Rather than just using anecdotal stories about the care given and received in my local trust, I should have put I was surprised to find how inconsistent this was across the country.

Unicorn that last bit did make a difference

I'm not sure better differentiation of patients is the issue. This assumes that, at the moment, the staff have no idea what sort of labours their patients have had, or what medical or surgical needs they might have - and this baffles me.

Maybe I am just a dinosaur, but when I was training, we had a report at the beginning of each shift, where we were to,d the basics of each patient's condition, what ops and care they needed, and what they were doing for themselves - e.g.

"Bed 1, Mrs Jones, first day post c-emergency section under epidural anaesthetic, delivered at 6.30am, needs 4-hourly obs, lochia and obs normal, catheter in situ. She has had a post OP wash and breakfast, will need catheter out when the epidural wears off.

Bed 2, Miss Smith, second day following vaginal delivery, no tear or stitches. Observatio and Lothian normal, mobilising normally, self caring for her own needs and the baby's needs. She needs observations 12-hourly and the baby needs to be checked by the the paediatrician, and will probably be discharged today."

And so on.

Not to mention the Kardex - the written record of the nursing care given by each shift. Even if you don't get the report (or if it doesn't happen any more) shouldn't each member of staff check the care plan of each of their patients?

But again, Gin, your last comment ignores that having your partner with you for a such a traumatic, important life event is a very basic need that any adequate health service should be able to meet. If other healthcare systems manage to accommodate this, provide proper postnatal medical and nursing care, and provide the privacy of private rooms and individual bathrooms but the NHS model can't, then the NHS model is clearly inferior. We should be copying the healthcare models operated in other European countries that tend to provide far better care, shorter waiting lists, superior facilities, better survival rates etc.

Why is this in AIBU? Strange place to put it.

@Oneiroi I'm getting more than a little fed up of you trying to pigeonhole me as uncaring.

I have said I REPEAT if women who need their partner there for birth trauma, mental issues, Disability etc etc (which if you need it explicitly includes serious reasons that they have that are personal to them, groan) then there should be capacity to do this JUST NOT ON COMMUNAL WARDS WHERE WOMEN WHO DON'T WANT TO WANDER AROUND WITH A DRIP ON AND NEXT TO NOTHING ELSE WITH SOME STRANGE BLOKE PLONKED IN A CHAIR OR WANDERING THE WARD AT 3am.

Sorry for the caps. Actually I'm not sorry because you seem incapable of reading my views and not trying to warp them into something they are not.

And he's the NHS model of care is inferior to many. But many of those come at cost or as I say applicable in terms of systems design, scale or complexity so you are being unfair and unrealistic.

Not applicable in terms of design. Think you get my gist, I'm nursing a teething snotty baby

I wonder if some kind of Midwife Charter might be useful? Or Patient Rights lists? People cant manage their expectations if NO-ONE is telling what they should or shouldnt expect, if people know for a fact that assistance should be available for washing on the first day after the birth for example then it gives them much more certainty when asking for it.

There seems to be a lot of "I'm not a nurse", "you''ll have to do it yourself" and "what do you expect me to do" going on over things that I would have expected would be included in their job role. If they arent, who is responsible for these things? And what IS included? It surely cant be "we will be 'doing paperwork' at the desk 100% of the time, everything else is if we feel like it"?

Midwife Charter is a good idea.

Yes we always had verbal handover in handover (shift change in the coffee room midwife in charge would come in and give an overview making reference to the board we had that said how many days post etc)

Then another verbal handover reading from notes from the member of staff that you were taking over from. Then introduce yourself to each woman and give pain relief etc.

I just assumed as my family up north seemed to have similar experiences that that was how the NHS ran things. Shows how naive I am.

Gin if you had read my posts you would see that I have clearly stated that women who want/ need postnatal care in an environment free from men should have that option so I really don't understand why you keep repeating that to me when my posts have made it clear that I agree. All I have said is that all women who do want/ need their partners there should also have that option, not only as a rare exception that they have to justify to staff, whereas you have stated that you believe this should be sacrificed if the NHS finds it difficult. I don't believe that is acceptable.

It is incredibly childish to start typing capitals at somebody just because you don't like their reasoning so I think I'll leave this here.

@Oneiroi so basically we are saying the same thing.

You mistakenly thought I was lacking in compassion. I haven't actually directly accused you of a single thing, merely confined myself to generalist observations,about how individuals more bothered about their own experience could be said to be lacking in compassion for others: though that's not to say I included you in that equation. I didn't. It was aimed more specifically at someone who expressly stated she didn't care about anyone else but her baby and her partner which is lacking in compassion to me. Probably to you too. I understand and appreciate you want your partner there. You appreciate I don't and don't want other women's either, so we will have to respect one another's views.

It's up the NHS to figure out and I hope in November I have a much better PN ward experience that my last one and if you are soon to be / should ever be in one again the same for you. Only positivity.

Let's just leave it there as this thread is more important than any perceived misunderstanding of one another.

I did attempt to read the full thread but it is so long I am just going to comment on the OP. Should disclaim I am a health care professional but not in this area. This is a laudable campaign but the NHS is completely falling apart and with a likely Tory win this in all likelihood get worse. I am not sure what a campaign like this will achieve with more cuts looming. I hope I am wrong of course.

More staff, less paperwork allowing staff to do more caring and less writing. The postnatal wards in particular, as have been stated by many posters, are horrendously staffed.

Most staff do care deeply (although I'm sure other posters disagree) in my opinion but a shift on a postnatal ward is constant firefighting. This is not good for anyone.

The problem with colour coded bays is that inevitably there will be "too many" of one type of patient who will need to be accommodated in the "wrong" bay. I imagine being a high risk patient in a low risk bay could be risky, while a low risk patient who might otherwise have been able to have their partner around more (according to the proposal upthread) might not be able because she was accommodated on a high risk ward.

Besides, I think this is a level of detail that is further than this campaign needs to go: to be effective, I think we need to highlight the key components of effective postnatal care that we feel make the most difference to new mothers and new babies (and their families). Not get bogged down in detailed proposals that are then relatively easy to dismiss. (It's almost impossible to argue against having fresh drinking water always available on a postnatal ward, for example)