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

Agree Oneiroi

So sorry you went through that . I think many women also feel vulnerable especially with their first baby, and given

how busy and unfamiliar midwives are, having someone who hasn't just given birth but is equally invested in the baby and your wellbeing (and even just being able to do practical stuff like fetch food) is invaluable.

And also what did strike me is apart from a routine check no one came round to actually just ask how I was doing, and give me an opportunity to express any concerns. I do strongly believe that better support when, as a first time mum terrified of my tiny newborn not getting enough milk, I asked for formula if I had just been reassured instead, I could have made a proper go of breastfeeding. Breastfeeding support in those early and hardest days is so lacking!

Absolutkry agree that midwives should be trained general nurses first as in my 80s training days.

But then I also think nursing as become far too medicalised and regret the loss of the schools of nursing and what used to be really an apprentership where you lived in a nurses home and dipped between practical ward experience and nursing school class.

Somehow the whole patient approach has been lost.

When my dil was having her baby post c section and her mouth was so dry I asked a nurse for a mouth care tray! She gawped!

Nurses need to see it's the basics that matter so a kind word, a cold cold drink, tea and toast when needed and just help.

And no bullshit about understaffing please we regularly run a 28 bed surgical ward with 5 staff and one of those would be a probationer.

The focus is all wrong now. Nursing is a practical skill not some junior doctor role.

It's obscene nurses can take blood from a patient but not realise that patient iOS dehydrated because no one filled up the water jug and put it in reach.

If partner's are to be allowed to stay on the ward overnight, then they must agree to a code of conduct that includes being quiet whilst other mums are trying to sleep, not using noisy devices on the ward, respecting the privacy of other mums etc. I suspect that, for most people these are basics that don't need saying, but the noisy, inconsiderate minority will make the post natal ward hell for everyone.

Any partner who doesn't respect these basic rules should be sent packing - by security, if necessary.

Oops - apologies for that rogue apostrophe. DYAC.

Quite agree batgirlpants. I can remember doing shifts on a high dependency medical ward with just myself and one other nurse to care for 20 patients. I don't think understaffing is a new problem. I do know it would have been unthinkable not to replace empty water jugs and that was a nurses responsibility, whether you were the ward sister or an auxillary nurse.

I worry that saying partners can stay to help the new mother is a slippery slope to further reducing staffing. There may become an expectation that you bring someone to help. And not everyone can. Someone up thread suggested volunteers for helping and that falls into the same category of facilitating the reduction in staffing.

Everything that everyone's said. I can't relate my experience, I'm can feel myself welling up just thinking about it. I try not to. I contributed to the recent thread about post natal care and I'm glad the calls on there for a Mumsnet campaign have paid off. I was just so shocked at the dismissive attitudes, the uncaring staff, rudeness, actually shouting st me from a hca while I was having a blood transfusion because I couldn't leave my bed to pick up the baby. No sleep
For five days and hallucinating that the baby was my cat. Sounds funny but really wasn't! I'm not having a second unless I can go private.

I think some of this is great, and some of it is not reasonable. I want the NHS to provide a gold standard in medical care, but some of this trips into desires, and adds to the growing health care bill.

Clearly water should be easily available on demand (& is at every hospital I've visited - I'm shocked that 22% self report it wasn't), but I think its fine for a hospital to have scheduled meal times and tea/coffee times and not offer outside those unless medically indicated - eg a simple sandwich to someone who has come out of the operating theatre and so missed a mealtime and was starving before hand, but others should wait if reasonable. Food needs to be prepared in a kitchen - and its a hospital, not a restaurant. Fridges easily get mancky and food left in them will get wasted, and create a further infection / health risk. A welcome card is a good idea, I think. Keep it simple!

I can't see requests on here that are unreasonable Alanna. All of the things asked for should be basic requirements and indeed are provided consistently in most other developed countries.

I gave birth at 4.45am. I never was asked if I wanted a drink or something to eat, even around breakfast time. My husband had to go home after s few hours after the birth and I had to wait until he came back.

I think a print out of what happens on the ward would be really useful. Often you are dumped on the ward at 3am and just left there. All wards have different rules so even if you have had 4 babies already or been in hospital several times you might not know the specific rules for that ward. You don't know where the buzzer is, aren't told where the toilet is, you don't know you have to make your way to the day room (without your baby) to get food at set times and no one tells you.
I was told off (a real rollicking) for not knowing where the food was served and also when I did find out, for bringing my baby.

I would also like to see wards where there are separate areas for those who want over night visitors and those who don't. Several wards have 4-5 bays of 6-4 beds so this could be easily done in many hospitals. I will be free birthing (my consultant won't allow me a home birth) if I cannot find away to be in a situation where visiting hours aren't similar to other areas of the hospital (I.e. 1-3pm & 6-8pm)

I would also like assault on wards to be taken seriously. I was assulted by the male partner of another patient and was pretty much told that by the staff that making a complaint (in the end the police were involved and I was shouted at by a member of hospital staff) would be creating work for them and ruining the "precious newborn" hours of the other family. I have heard of many women (not online, in real life)being assaulted or verbally abused and having their issues swept under the carpet by staff.

I would like to see nurses on the ward along with the midwifes and the care support staff. The midwives are clearly overstretched to the point they can only be delivering babies and not provide aftercare. For each of my babies our entire bay missed 2 drugs rounds in a row and several women did not have dressing or wounds seen to in a timely manner meaning they got infections and had to stay in longer. This is not just across one hospital but 3 and every woman I have spoken to (dozens) about post natal care has mentioned similar. A nurse on the ward dedicated to drugs rounds and birth injuries should be a basic right.

I would like to be treated like a patient not an inconvenience.

The NHS is on it knees if you want ton make it better vote in next election for someone who cares about the NHS IE NOT THE FUCKING TORYS.

Fridges don't get manky if they're given a two minute wipe round every day. It's only when it's nobody's responsibility to do that that it happens, it's not inevitable.

Anyway as far as I can see it's not that anyone's saying 'all wards should have a fridge full of snacks!' It's more that adequate food available when needed should be a minimum standard and in some cases, a fridge might be an easy way to achieve that.

' There may become an expectation that you bring someone to help. '

It appears this is already the case, as there was a poster on here who was given a leaflet for her 'support person'. It's not possible for everyone. The problem with partners/support people/etc overnight is that staffing is even lower and the wards were not designed to double their occupancy. Also, whilst some women feel they need their partner there, just as many others feel vulnerable and compromised by their presence in a ward setting.

The food issue, having lived in a paed onco unit, patient fridges were forever an infection control risk. Unfortunately, a lot of people just don't know how to behave, and so the patient and parent area had to be constantly closed down to people just not doing what was required on their part to keep it open and quite a few who had no qualms about taking whatever was in there, whether or not it belonged to them and/or clearing it out and leaving nothing for everyone else. It's probably not very realistic to expect an open fridge with visitor or patient access for this reason, but it'd be nice to have one that at least the staff can access.

'Fridges don't get manky if they're given a two minute wipe round every day. It's only when it's nobody's responsibility to do that that it happens, it's not inevitable.'

Actually, infection control procedures require more than that and it does need to be someone's responsibility to do this, and if there's one person who is already supposed to be doing all the bathrooms and everything else, it's not realistic.

A fridge that can be staff accessed might be a better idea when possible for this reason.

noe remember cleaning the sluice and lockers? We had cleaning trolleys and everywhere was cleaned.

Agree water jugs were everyone's responsible.

I just think a general nurse qualification first makes better midwives just as in the job training and not uni makes better nurses.

It's a skill based profession not a degree study.

I also agree that these requests are not unreasonable.

As I said in my first post, and something that has been echoed by a few other women, is that the care on the post natal ward seems so vastly different to other aspects of hospital care. Not only in the care (or lack thereof) but in the expectations of the women, who have gone through a traumatic and tiring event even if they have not had surgery. Add to that that these women now have tiny vulnerable babies to look after and it really make you realise how sad ut is that so many women seem to suffer with poor postnatal care.

The only thing that is getting me through knowing I will have to be there for my next birth is knowing that as it's not my first baby and I know what to expect, and can be prepared (mainly with a huge cool bag of food and drink, as it wasn't easy to come by last time! )

Not helping someone who has had major surgery and a section is major surgery, get out of bed, access food and water and help wash is frsnkly disgusting

I'm on the fence. But more leaning towards YABU

YABU because one of the last things maternity services probably needs is another set of stats and tick boxes. The bad parts of DDs birth and dw's experience were arguably related to compliance pressures.

YANBU Because you were clear to state postnatal care but atm postnatal is not completely separate from the rest of maternity services so it is affected by the resource pressures from other areas of the service.

Basically when 12 mums arrive at the same time staff can't tell half of them to cross their legs and think of England they have to pull resources from other areas of maternity and get on with it. One of the areas that suffers is postnatal leading to inconsistent experiences.

Maternity needs more money not another stick to be beaten with and until then we're going to get what we're not paying for.

Regardless of the reasons behind it, it is not unreasonable to expect that basic resources and essential care are available to all women who have given birth.

Also, we DO pay for the NHS.

@Batgirlspants I agree on some points but not on others.

Re:staffing, the last few times I've been in hospital (recently), the level of staffing would have had us bouncing around in joy...the 20 bedded Gen med ward (so lots of Stroke patient etc) we ran with 3 qualified Staff Nurses and 1 HCA, 2 HCA on a good day. Now runs on on 5, yes 5 qualified and 2 HCA as normal.....

But saying that there are now patients nursed on general wards that when I first qualified would have been in HDU. Cardiac Monitoring, Central Venous Lines and monitoring etc. I'm so old that when I started it was policy that a Dr have to give the first dose of IV antibiotics.
When I left this was all normal on general wards as well as training HCA to take blood and cannula. Nursing is one of those jobs that need practical and theoretical knowledge.

I was lucky enough that most of my mentors were 'old school' when I was an auxiliary so I was very strictly taught the practical side of things. And when I trained they wouldn’t accept you till you had worked as an auxiliary.
I think what a lot of people don’t realise is a swath of Nurses left when Agenda for Chance came in. I was running on low anyway, but finding out that a 3 month qualified Nurse was been paid more than me as E grade with experience in Cardio/Endocrinology & Respiratory care was the beginning of the end. As it was for many of my colleagues, very few of the people I qualified with are still in the NHS. E grades were the ones who taught the D grades how to put theory in to practice.

Sorry if it sounds/feels like me/we’re derailing the conversation but I feel this is all part of a bigger conversation that needs to be had, this bad care and neglect is happening all over the NHS, and Maternity Care is just the first to get the attention because most people can relate, after all we’ve all been babies and had Mums.

What's the issue with a fridge?

As a ward sister I would allocate jobs to staff during the quieter afternoon time and those would include locker cleaning, water jugs, bed pan cleaning etc the fridge would be just another job.

Maybe I am out of touch but when my dil was in I saw st least 7 nurses around the desk chatting or form filling.

We chatted while working and form filled during breaks.

Post CS mums being treated as well as all the other post abdominal surgery patients. Not being made to get up and do anything for the first day or so at least. I've done both and funnily enough getting up and moving doesn't improve healing for other surgery and they make sure you rest.

always yes see all your points there.

I don't want to derail either but see this lack of the basics as a lack of basic training now.

If a nurse isn't offering water and food to a patient then forget the rest.

Florence said 'the hospital should do the patient no harm' clearly there's something dreadfully wrong with basic training.

Back in the day 'sister tutor' would have had your guts for garters over all these basic things mums are saying thry lacked.

These arnt bug complicated things either just basic care