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

Justine - this is a great campaign and one that is sorely needed in my view but I agree with pp... if the Tories get in and the NHS suffers even more cuts I wonder what we can achieve. Here's hoping though and nothing ever gets done if we don't try...

My own experience was that all prenatal and delivery care was first class, however I felt as soon as I'd delivered (csection) and was delivered back to the ward it was almost like I'd been sent to a war zone. The post natal ward was so severely understaffed that one night there were 2 midwives to 20 women, I'm sure that must breach safety guidelines. Even during the day they were so severely understaffed, and the fact is, if they are unable to provide basic care they need to let husbands/birthing partners stay all night as it is physically impossible to drag yourself up, pick up your baby to feed, collect meals while pulling your baby along etc just hours after what would be called major abdominal surgery if a man were to have the procedure!! I agree with others, it is as if because you have had a baby the medical aspects are not as important or as painful. I've had several other operations and never been treated as though I were making such a fuss about nothing (and I made no fuss at all). Also, paracetamol only for pain relief post surgery... seriously??

I was at one end of the ward and not told about dinner post giving birth, my husband had to go out and find somewhere to buy me food. My catheter wasn't emptied and burst all over the floor, while mopping up took place I was told "oooo you've made a lot of mess!" Errrr actually no, whoever was responsible for my care has made a lot of mess. I don't actually blame them as they were run completely ragged. Bounty woman should be banned as well. In what world is it ok to come round to vulnerable people post surgery and try to sell them things while they are still medicated?? The whole post natal experience was a lesson to me in just how badly women are still treated in our society - yes we have moved on from the dark days of high maternal morbidity such as is still seen in developing countries but if men were in there giving birth there is no bloody way it would be as dreadful as it is!

This all reads like a horror story to me. My god! this has to change. Midwives snarling at people,( new mothers) denying them basic care, denying food and drink, failing to provide a clean safe calm environment for mothers to recover from the greatest ordeal in life. If I was about to have a baby now I would insist on having a home delivery.
Yes, I do understand the reservations attached to that, but wild horses wouldn't drag me into one of these hell holes.

@Leinlondon - I can promise you that surgery like a c-section is considered major when it happens to women too - outside of obstetrics. It really isn't a case of men getting better treatment than women - it seems to be that some midwives genuinely don't understand that a c-section is major abdominal surgery, and a woman who has had one, will need proper post-surgical nursing care.

When I was a student nurse, back in the Dark Ages 1980s, there was a standard for post-op care. Everyone who came back from Theatre had their pulse, respirations, blood pressure and operation site/dressing checked as soon as they came back on the ward. Depending on how serious their operation had been, and how well they were when they came back to the ward, they would then be placed on regular obs - as frequently as every 15 minutes, if they were really poorly. Once their condition had stabilised, and they were more awake, they had a post-op wash, where a nurse would help them wash their face and hands, to freshen up, and to clean up any dried blood, if that could be done without getting the wound dressing wet, and they would be helped back into their own night clothes, and helped to sit up, and made comfortable.

Wound drains were checked regularly, as were catheters. It would have been considered a serious failure of care, if a patient's catheter bag got so full it burst or leaked everywhere.

It baffles and horrifies me that this standard of nursing care has been allowed to slip, in some areas. It doesn't even make financial sense. Having enough staff on the ward to deliver proper care, and monitor patients properly must be less expensive than dealing with post-op wound infections that could have been avoided with proper care, or hospital readmissions because someone has been discharged too early when their condition was not properly stable (but no-one knew, because they hadn't been properly monitored), or treating new mums for PND or even PTSD that could have been avoided, or been much less serious, if they had had proper post natal care - or even settling wrongful death suits or compensation claims when a woman suffers death or injury due to poor post natal care.

I remembered something else from my time on the postnatal ward. My catheter was removed at around 9pm but no one came to help me out for bed until gone 9am. It's a good job I didn't need a wee in that time because I wouldn't have been able to go for one!

Caesarean mothers need extra care because they can't move immediately, obstacles including getting baby in and out of bassinet, being attached to a catheter and having their muscles cut through with a new six inch wound. This seems to often be overlooked.

After a 24 hour labour and having had only a 2 hour doze in 30 hours, my baby was born by emcs late afternoon. That night the early hours the post natal ward was like a train station. At 1am the mw came and stripped my baby for some skin to skin contact and arranged him on my chest. She didn't come back despite to re-dress the baby and put him back in the bassinet despite my pressing on the buzzer and the risk if my falling asleep with the baby on my chest. I still had little feeling in my legs from the spinal and was attached to the catheter, but after waiting with no response for a long time, and at that point having been awake for nearly 48 hours, I had to get up by myself, put baby down safely (awkward handling a new born as a new mum when your stomach muscles are shot), lay baby on the bed, dress him awkwardly and put him back in the bassinet awkwardly. It was awful.

After my first csection they kicked dh out about 20 mins after I got back on the ward as it was end of visiting hours. I then was sick everywhere including on baby despite my numerous attempts to get some help to clean up I was left with me and my baby covered in sick untill the next morning. I managed to put baby back in the basket thing. I also had no water and was not offered anything to eat. I wish now that dh stood up for me a bit and sorted me out some food before he left. I ended up in a pool of blood and vomit that night littrally a small pool and got a bedsore the size of a mango on my bum! When I showed the nurse the next day she shrugged it off. I was then told it was okay to go home the next day after having major abdominal surgery. Really baffles me how your expected to somehow snap back on form the next day after having your insides cut open.

Aw velvet I know - if we are having any other operation that involved cutting right through to your womb and leaving a six inch scar, I can't help feel you'd receive better care.

But because you've got a baby out of it, a caesarean just seems to be treated as no more than a cut finger.

@velvetcandy - I doubt I would have kept my job if any of my patients had been left in the state you were left in - I would certainly have been given absolute hell by any of the Ward Sisters who trained me.

Did you make a formal complaint at the time, or would you consider doing so?

It was all such a blur at the time and I never even knew that bed sores were considered really bad I just wasn't well informed. I did complain to my midwife a few days after I got home and again to my GP at my next visit but nothing was done about it. My GP even suggested that the bedsore was a stretch mark! My wound also got really infected. I definitely believe that maternity wards (I've had four kids so I know what I'm saying) are run to meet targets rather than for the care of patients. I've always felt more like a statistic than a person who's just given birth. As long as everything looks good on their paperwork they don't care.

I would just like to be treated like a human being! I had an awful experience and experienced some very rude staff after a traumatic birth which ended in an EMCS. Just treat people how you would like to be treated.

I'm six months pregnant with number three and I'm so scared of going to hospital. I know I'll be having my third section.

your be fine!

I've had two pretty horrendous experiences. I'm actually waking up in the night at the thought of having to go back in.

I'm due 19 July and bricking it!

I went in when my waters broke, missed tea, and there was no food but there was water. A midwife gave me her cheese and biscuits!

I then went into labour and my daughter was born at 8 the following night. Cue the same problem. Once I had recovered a bit I was starving. There was a room with toast and butter, tea and coffee.

Our hospital wasn't particularly close to town and my.husband was tired too. I just gave in and ate what felt like a loaf of toasted bread.

The following day I had normal meals and as far as I recall they were fine. You just had to be there to order them and that had been my previous problem.

Then mates arrived with allsorts of goodies so I was very well.supplied.

This was 21 years ago!

Watching, please contact PALS now and get some support for how you're feeling. It can only get better!

I love the video idea. Pretty sure there were no TVs on the ward when I had DS but I really like the thought of watching a tour of the wards before I go into hospital. I'm nervous about staying in hospital, this is my third pregnancy so the new baby bit I'm not so worried about, but I have no idea if the ward has changed in the 8 years gap. I'm worried anyway as my health is pretty poor now compared to previous pregnancies, I am technically disabled now and I have concerns about postnatal care and how I'll cope with the extra pain etc.

I'm also autistic - obviously I have always been so, but I wasn't diagnosed until 2015 so I am now more aware of the things that will help me, such as knowing what to expect rather than letting it all be new and unfamiliar. I'll be talking to my MW to see if there's some way I can find out as much as possible in advance.

I found it was hard to get a complaint recognised. I filled in a feedback card on the PN ward but no idea if it did anything. It nagged at me for months and I eventually wrote a letter when DD was 11 months (and I actually had time to write a letter!). Sent it to the maternity feedback email but got no response. Sent it again and asked for acknowledgement which I got that it had been received and passed on, but nothing else. I eventually sent a copy to the hospital Chief Exec (by this time DD was about 15 months!) and suddenly I started getting apologetic phone calls from senior midwives. My complaint was eventually dealt with and I am happy about that, but it took a lot of persistence to get a response and how many women dealing with a newborn actually have the time to follow through with a complaint?

In both cases I was unable to visit the labour or post natal wards before giving birth (different hospitals) - the first because of swine flu and the second because they had stopped doing it (it said on their website they did, only to be turned away when I turned up at the appointed time).

This would have really helped with understanding the running of the ward and where things were.

Do you know what @idontmeanto , I'm going to contact PALs today. I really shouldn't be this anxious. Thank you.

I can't believe what I'm reading here. I'm now in NZ and honestly didn't realise things had got so bad.

Missouri - to put it in perspective, everyone is sharing their bad stories here. Although I didn't get the help I needed for one cs, at a different hospital it was a very good experience (mainly because they had had the brainwave to put caesarean patients together and were able to treat them according to needs.)

*mislou

I had two C-secs in a small Scottish country hospital 12 and 10 years ago.
The food was outstanding. Kitchen on site. 3 cooked meals a day of good quality and size, plus homebaking (scones, flapjack) and fruit, midmorning, midafternoon and sandwiches and baking for supper. I am a big eater and I couldn't manage it. When H came in with toddler for 2nd Csec stay nurses rustled up extra for both toddler and H!!!

BUT... I was left without access to washing. When I finally could walk to shower (day 3, covered in dried blood) the ceiling tiles were green and black with mould and so sodden actual tiles were dripping strings of mould onto floor. It was absolutely stinking and I was worried about my wound getting infected.

There was no breastfeeding guidance or support at all. My ds had a tongue tie and couldn't latch. I was told I was 'not trying'. He was taken to the 'nursery' as he wouldn't stop crying, against my wishes. I was told 'you are keeping all the other mothers awake because you are not feeding him properly'. When I woke in the night and walked down to the nursery I moved towards the wrong baby (in my sleep addled state) and got a bollocking from the nurse. The other nurse laughed at me 'dont you know your own baby?' and I went back to my cubicle alone and in tears.

A Dr came to look at ds' mouth and said: 'he will never speak'. I was in floods. H arrived and another Dr was called and said: 'nothing wrong with his mouth you just aren't feeding him properly'. His tongue tie was finally operated on when he was two. We were back in within a fortnight as he was jaundiced and he was on the 3rd centile.

Disposable nappies were not allowed on the ward as there was a Scottish Govt push for real nappies. But there were no liners or outers so the baby pee poured through the sodden towelling. We got told off and nurses refused to provide fresh. H's were sneaking in Pampers!

No help was given lifting baby in/out Bassinet and Mothers and babies left to cry for hours if they were not coping. It was cruel.