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

What about the provision for women for women whose babies are in NICU? Ds was born 10 weeks prem and went straight to NICU after delivery. He was in hospital for nearly 8 weeks and I was discharged after 1 night having been told that I might as well go home as there was nowhere for me to stay while he was in NICU. That meant that when he was bigger and started learning to feed I could only BF during the day and the nurses had to bottle feed him expressed milk at night. It was incredibly hard leaving him each night to go home.

I don't have any complaints at all about my post natal care. I had a pretty straight formed birth with ds1. Ventouse delivery and ds needed to be in special care for 4 days so had a 5 day overall stay. 2nd ds was not so straight forward. Emergency c section with a ruptured uterus so I was in HDU before I made it to post natal ward. If you're able to get up and about to get your own meals etc then I think you should. Ultimately the staff are there for medical reasons and have more than enough to do without operating a b&b too.

However, I do think more could be provided in the way of mental health information, breast feeding councillors on the ward etc

How about putting all women who have had c-sections together on wards and then treating them as you would treat any other patients that have just had major abdominal surgery. While getting up and about may be beneficial, expecting post c-section mothers to be able to get themselves and their babies in and out of bed and having to fetch their own meals is expecting too much. Patients that had similar operations for other reasons would be kept resting in bed for at least a few days and would not be expected to be able to look after a new born alone straight after the operation

Seriously?! It can be difficult to get food and water? That's appalling!

A card explaining what to do would really help, I didn't know how to get drinking water, who to ask for pain relief or where meals were served and when. The toilet on my ward was out of order for the whole time I was in and the nearest other one was a long corridor away. I didn't have a section, but imagine that those who did would have struggled with the walk. I didn't know if it was ok to leave my baby while I went to loo (although the crib thing wouldn't have fit in with you anyway) so kept telling the midwives at the desk when I was going to the toilet, they just looked at me like I was crazy.

I really don't think children should be allowed to visit. When I had DS2, everyone kept asking when DS1 would be coming in, but I don't think a cramped post-natal Ward is any place for a toddler. He would have been running about and carrying on as toddlers tend to do, while other women need peace and quiet. Children visiting on my ward came barging through curtains, were playing with noisy toys and messing with the lights and adjustable beds. It's just annoying. I understand that people want to introduce their other children to the new addition but it can wait.

We also had all day visiting. Great for dad's and I don't mind that, but this was whole extended families wandering around making a racket.

There needs to be privacy available too. The girl in the bed opposite me had a lot of social work involved and the baby's dad was in prison. I know more about that woman's life that some of my close friends. In situations like that I think people should be afforded a bit of privacy.

It shouldn't be assumed that all mothers are desperate to go home. A gentle "how do you feel about going home" would be welcome. Physically I was just about OK to leave but mentally I could have done with a couple more days after a traumatic birth.

They don't bring meals to you? That's horrible! I think doing things similar to the hospital I gave birth in would improve things. Meals were brought to your bed four times a day, they topped up your water glass at the same time (also a sink in each room to refill yourself), the day room had a fruit bowl, a fridge with yoghurts and juice and a freezer section with ice cream and I think there might have been crispbread too, plus a kettle for tea and coffee.
We had health checks each morning along with bloods taken for those who needed them (my anaemia was being monitored), a big sink and changing area so cleaning baby/changing nappies in each room with all the supplies and baby clothes provided for the stay. I was in for four days and DD had her paediatric check on the 2nd day and then another little check before we left.

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.*

Sadly I was also at southmead and received appalling posts natal care including being left to wander the corridors to nicki after an emcs alone at 4am perhaps it depends which ward you're on and which staff are there. I was on Percy Philips.

I’m with @MichaelSheensNextDW & @SDTGisAnEvilWolefGenius

Nursing care skills and philosophy MUST be brought back into midwifery.

As I’ve said before the ridiculousness of leaving my shift on a surgical ward where Abdo patients weren’t allowed get out of bed alone for the first 24 hours, then had to see a physio to teach them out to get out of bed so they wouldn’t pull their stitches, to seeing my sister 5hrs post emergency C-Section been told to get on with it.

They totally dismissed any of her complaints of pain. And she was sent home with an infected wound, which she had expressed concern about to several members of staff and only one of them checked it as they were leaving and went it's fine. (and pushed them out the door)

I looked at it for her about 45 minutes later and it was clearly infected we got the GP out and she was on anti-biotics for several weeks and given some heavy duty pain killers (not BF)

I appreciate that there was a time when childbirth was over medicalised but it’s gone too far the other way.

When I did my training many years ago, you had to be a qualified Nurse with experience before training to be a Midwife, and then have experience of both to be a HV.

So you had the experience of dealing with post-op patients, and ill-patients, and while people might not want to remember it, women still die from childbirth.

I honestly believe that Direct Entry Midwifery training has put women and babies at risk and devalued the role.

To be as nice as possible MN people here can make all the suggestions you want but what is needed is money, a lot of money, and better training.

These days you're only kept in if something has gone wrong so staffing levels and care need to reflect that.

I think every member of staff who thinks giving a woman 2 paracetamol every 8 or so hours after a csection needs some kind of simulation as to how much pain it causes. It's barbaric and not reflected elsewhere in terms of pain management.

It's completely unacceptable to expect women with healing wounds to toilet and shower in dirty conditions. No toilet roll or hand soap on postnatal is a joke.

Unlimited visitors do not let people recover.

The attitude of staff on post natal is appalling. Busy as they are, not being a dick costs nothing.

There were several deaths in my local trust on postnatal and as such there was a rocket put up maternity services. The only difference I saw in postnatal was the was a slight change in how meals were served (breakfast still in day room) and how drugs were brought round. I'm not filled with confidence that postnatal care is safe.

Curtains are not adequate for privacy. As a minimum there should be individual rooms for each family with their own ensuite bathroom.

Food should be edible and nutritious and brought regularly, along with painkillers and fresh water. Buzzers should be answered within a maximum of 3 minutes. Medical staff should plan their schedule so that they are not interrupting you every two hours for different reasons and you can't get any proper rest. A proper place for husbands/ partners to sleep in the room should be provided, not just an uncomfortable chair. Bounty should not be allowed at all; salespeople operating in a hospital is unacceptable and I was astonished it was going on.

I have never seen such a hellish and substandard hospital environment as the postnatal ward we were sent to and as a result we left after less than 24 hours despite me still being in significant pain. The maternity ward facilities and staff however were excellent. There is no excuse for the standard of postnatal care being so inferior.

I think visiting times shoud be limited. And I don't think men should be allowed to stay overnight. Women and their babies are at their most vunerable state in the hours/first days after giving birth. They are tired, and in pain - and having unknown men snoring loudly
wandering round wards at all hours of the night should not be allowed.

And a leaflet about how things work would be great. Clear info about where the toilets are, kitchen for tea and toast etc. Maybe a map of the ward so mums can get their bearing.

As someone who has suffered DVT post birth I realise how important awareness of this is. An important part of prevention it is that the woman is encouraged to get out of bed. So, yes to bringing mum a glass of orange juice/cup of tea and a piece of toast in the mornings but not convinced about meals in bed. It is good for a woman to get out of bed after birth. And yes, I do know how dificult that is - especially after (in my case) a gruesome Keilland's forceps delivery.

To be fair, i did have 1 bad thing after my last birth, but i feel a safety issue

1 hour after id come round in recovery, after a blood transfusion, emergency surgery etc. My mum and partner had been sent away for some reason (unsure why) i was left alone by a nursr and told to get a shower....with a new born, my bag on the floor, 1 hour after surgery and them nearly loosing me too, a tad lax i think. I could barely stand up, was covered in blood and was just left alone

Horrible experience. Post c section. Stuck in side room. No food or drink provided. Couldn't walk without holding on to something for support. Couldn't leave newborn alone in room so effectively trapped there. Room thermostat jammed at 30 degrees. Unbearable. No help from nursing staff ( didn't even bathe baby/clean him up post birth) ended up calling hospital maintenance myself and getting it sorted. 'Told off' by nurses for this. By second day I'd had enough, called cab and got myself home. Post maternity care shameful. Need a mums advocate in hospital on speed dial to ensure basic care. Opinion of nursing staff unrepeatable.

I have to say my aftercare was good in the ward. Food brought to me, visitors told to keep it down, water available etc.
I had a section so was encouraged to become mobile asap but the staff were helpful with things if needed and encouraged me to buzz for help.
I got support with breastfeeding but my dd's tongue tie was missed on her check. Having someone trained to look for this when helping with bfing would have made a huge difference to me.
Also not having the cleaning staff start at 6:30, I had not slept in 5 days so to be woken so early when baby was still asleep was upsetting.

Experience on the induction ward was a whole different story.

Nursing care skills and philosophy must be brought back into midwifery
Another vote for this. I trained as a nurse in the 80's, all student nurses had to do an 8 week block in maternity, which was lovely, and gave everyone an idea of what midwifery was like. Those who found it interesting or felt they could do the job went on to do further training as a midwife, after qualifying as a registered general nurse.
Improved staffing levels, goes without saying really.
I know this is a polarising view but I believe restricted visiting hours works best, both as a patient and a member of staff.
Food was an issue as far back as 1988. There just wasn't anywhere near enough to support breastfeeding. My husband used to bring sandwiches in for me.We did have jugs of water though (which is a basic standard of care) and I do recall a couple of lovely auxillaries making the odd extra cuppa.

For me the best things that could have happened is for the heat to be turned to a bearable level instead of being tropical and for all healthcare professionals to get on the same page about breast feeding. The amount of unhelpful and contradictory advice I was given was stressful. This was caused by lack of regular staff. In a three day stay I never saw the same person twice and lots of staff were agency or from another hospital covering and they all gave differing advice. As if breast feeding isn't hard enough to begin with!

All trainee midwives need to do an allocation on a proper surgical ward, learning how to care for post-operative patients - wound care, how to mobilise a patient properly and safely after abdominal surgery, analgesia, and how to care for and monitor patients who have had a general anaesthetic or an epidural anaesthetic.

I think we need a right to privacy.
Whether this is achieved by private rooms, banning of partners or simply adequate curtaining which is respected by staff (and I suspect the solution might be different in different settings), no woman should EVER be forced to be uncovered in front of all comers.

There were no clean sheets on my ward so had to lie in wet, bloody sheets. I even offered to change them myself but was told there weren't any clean ones available. Bed broken, no food available as I arrived at night and was asleep at breakfast.
Baby forced to bottle feed as nurse decided, no help at all and not a kind word said.
I hated it and regret ever going in to hospital am very sad about breastfeeding too as was made to feel guilty forever after

I actually think it's really important for partners to be able to stay. Especially in the state things are currently. I think better and more private facilities is the answer, rather than banning partners - yes I was the one giving birth but ithe is also his baby (not to mention I would have had nothing to eat my whole stay had he not been there!)

Other visitors on the other hand could surely wait a day or so, or at least limit stays/come in small numbers. I didn't actually see one of the partner really as they were all with bathe babies, but I did have to walk past a woman with curtains open out of necessity to accommodate her 8 or 9 visitors who stayed the whole day in my blood stained nightie to go to the toilet - it was very uncomfortable and inconsiderate of the family to stay alllll possible visitin hours, laughing and chatting loudly amongst themselves. I don't see why it's allowed.

Info card would have definitely been good. I was asked why I hadn't gone for lunch when the bell rang..? Because I had no idea what the bell meant, ditto with apparently not being able to carry my baby down the corridor..
I've no objections to following the rules but ideally I'd like to be told what they are!

My last experience of postnatal 5 months ago I was by myself with the baby after a lovely but solo birth (partner was at home with older DC) and it was horrible, I felt so alone and ended up self discharging completely miserable and sobbing snotty tears in front of my visiting DC while the staff got my paperwork ready so I could leave. It was horrendous and I hope they don't remember it.

Welcome cards explaining postnatal including visiting hours, mealtimes, Ward map and any extra facilities like breastfeeding rooms or quiet rooms would be great (in different languages as a pp said), as would a 5 minute chat (with a logged form) with your midwife when you first get there to outline any concerns you have and what you need to achieve from postnatal (ie have doctor check and then we're out of here) - and a regular check in with them to update you on achieving everything.

Personally I LOVE partners staying overnight but I know some don't, so maybe having shared rooms (depending on numbers) for women who want their partners there and shared rooms for those that don't would make a difference as at least those that don't want partners there overnight would only see other partners outside their immediate room.

My last experience of postnatal was also so ridiculously hot that my baby wouldn't wake up to feed, and they pushed formula on me (he's been fine breastfeeding since), so a lower standard temperature would be fantastic and make the temperature in an air-free window-less box room slightly less hellish.

Lastly some sort of (magnet?) fixings so you could actually close your curtains and they didn't brush open whenever anyone else walked past them?! The last thing you want on postnatal by yourself is other people's visitors and staff constantly rustling past the curtains and exposing you to everyone, and it happens so often.

Good campaign!

I would also add that as someone who has previously experienced sexual abuse it was essential for me to have my husband able to stay overnight with me. I would not have coped with being vulnerable, immobile and surrounded by strangers without him by my side. In any case it isn't practical to ask women who have had sections not to have their husbands stay because they cannot get out of bed to lift or change their babies and there are never enough staff to help, and to force fathers to leave their newborns and partners would be cruel. I do however agree that visiting times and numbers should be limited for visitors other than the father of the baby.

I had a C section due to the trauma of abuse and it was extremely insensitive that I was asked repeatedly by different members of staff the reason for my section so had to keep explaining this to people I had never seen before, because they couldn't be bothered to read my notes.