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

Fantastic campaign, thank you. I too was ravenous and thirsty for hours with nurses making it quite clear they weren't there to fetch water. And when the breakfast trolley finally came, it was left down the corridor, and no one told the new mums. So by the time we got there there was no milk left and barely any cereal. I couldn't walk there anyway due to losing a lot of blood and epidural. When my husband arrived at 9am I felt like I had been saved at last after 9 hours abandoned. I know it brings its own complications, but if my husband had been allowed to stay with me (I was transferred to post natal ward about 11pm so he was asked to leave me almost immediately) it would have solved so many problems and taken pressure off the staff.

Replying to suggestion above of volunteers required to free up nursing/midwifery staff: absolutely not!! Postnatal wards need more expertise, not do-gooders handing out information, even with the best of intentions.

I also like the idea of a card and I also think ALL staff should wear name badges. On the card should be pictures of uniforms with a job title and brief description of what this uniformed person can do for patients. And this can easily and cheaply be translated into other languages common in the area.

I spent a few days in hospital not realising that I was taking advice from some auxiliaries. I'd never been in hospital before so had no idea about the different roles and just assumed only qualified people could give advice. It was contradictory advice, some of which was plain wrong and caused problems with my baby not being dealt with as soon as they could have been. Not life threatening, but not pleasant for baby.

A drink of water!! Despite numerous requests over a few hours I eventually (post c section) had to get up and waddle to the nurses station to shame them into giving me water.
The Bounty Rep - a disgraceful invasion of privacy when at your most vulnerable.

sheep hospital wide it would be great to know which uniform means what! I remember somebody commenting on it being obvious and thinking, "No, no it's not if you aren't a regular in-patient!"

One hospital I went to (not for maternity) had posters in every bay with staff in the different coloured uniforms and a description of what their role is.

When I was training we were taught to never walk past an empty water jug without filling it, up no matter if it belonged to one of our patients or not. I always stuck by this until I got out of medicine because I hated the way patients were treated.

I wonder if inspections specifically of maternity units, alongside asking for patient feedback, then a published report, would help improve things.
Also a cost accounting exercise so that there is a recognition that putting money in to prevent problems like PND, by providing proper maternity care, would actually save money.

Hello all

Thanks so much for all the thoughts so far - we are reading and carefully noting.

Our aim with this is to come up with something that works for new mothers and babies, as well as for the staff. We're not expecting to solve all the issues in the first 24 hours and discussion is really welcome.

As time goes on we will ask MNers to let us know what they think about the suggestions, and we will also ask healthcare and maternity professionals to take a look too, with the aim of coming up with something that could really work.

So for now please don't be put off by thinking something seems odd or insignificant, or that you haven't got all the answers - it will all go into the mix, and one idea could spark another.

One more thing before we go: please share the campaign - on Facebook, Instagram, Twitter or wherever else you go in the odd minutes you aren't on Mumsnet . We want to get a really wide range of views.

Thanks again
MNHQ

newdaddie We do pay for our maternity services, unless you never pay taxes...

As you were.

Another vote for the information card - I didn't even know they had day rooms, two dc later. Knowing about the downright peculiar mealtimes would have helped too which isn't really a funding issue.

nurses making it quite clear they weren't there to fetch water see that's the problem.

Back in the day junior nurses were on every ward easily seen as had caps with 1/2/3 stripes to denote level of years training. Trained staff different uniforms abs hats and midwives again different uniform and badges with your name and status.

Every post natal ward would have had a junior nurse or 2 and they would be doing the jugs, serving the food, helping mums walk to leave senior staff to do more complicated stuff but if a basic task needed doing anyone would pitch in.

I don't see any complaints on here that require extra funding just basic human kindness, empathy, good ward management regarding visitors and privacy.

Seriously get the nurses out of the unis and get them back on the wards far more on all wards and stop direct entry midwife entrance.

And no to volunteers. Women are incredibly vulnerable post baby and require proper care not volunteers.

imsotired as a nurse my blood boils for you. What the fuck has become of basic care.

@Batgirlspants - I well remember the amount of cleaning that we did, as nurses - cleaning the mattteess, bed frame and locker after every discharge, before remaking the bed, for example. Or emptying, cleaning and restocking the storage trolleys that held dressings, supplies, anaesthetic equipment etc in Theatre. I remember spending a couple of days emptying every shelf and box in the supplies store room in the theatre where I was staffing, cleaning every shelf and box and checking the expiry date on every single item of sterilised equipment, then repackaging all the out of date instruments for resterilisation.

A few things from the US system that could be introduced there:

Separate wing for mothers on prenatal bed rest and postnatally if their babies are in the NICU. I could not have coped being with other mums who had their babies with them.

Patient liaison came every day to ensure I was eating enough and arranged snacks to be sent to me throughout the day to be sure. I could also tell him confidentially if I had concerns about any of my care and what I needed to help me during my stay

Volunteers who came and offered magazines etc and also provided some treats for my other DC when they came to visit

Ice machine and cold water available whenever I wanted it. Big jug size drinking cups provided, patients could bring their own to save the cost

When I was readmitted to the labour ward I'd missed dinner, but the nurse gave me a cold sandwich box with sandwich, fruit, cookie and cut vegetables. Food was always available and each mealtime window was 2hrs where I could order something's to eat from the menu and it was delivered to my bed

From 2-4 each day was quiet time. No visitors and no monitoring by nurses. I could still buzz for help if needed, but they insisted this time was for mums to rest without disturbance.

I also remember the night we went from first year to second year - where I trained that meant going from no stripes on our caps to two. We were on Nights, so as many of us as possible met at midnight in the canteen, to change over our caps.

I will stop with the misty-eyed thread derailing reminiscences now.

SDT being hissed at to get a suture from the cupboard during an op and not having a bloody clue what scrub nurse had said under that mask. lots and lots of cleaning

Still this thread is so so sad isn't it? Where have we gone so wrong that basics like water and food are withheld from patients. It's appalling

Counselling for fathers. What I remember as a beautiful experience, DH remembers as traumatic.

Are yes the stripes! Felt so clever getting 3

HerRoyal apart from the separate wings all your points would not cost really would they? Quite basic stuff.

An information card would be really useful. I gave birth at 11pm and it was a switch over for the midwives and no one told me there was a room with fruit and tea and coffee and biscuits that was open 24/7 or showed me where I could change the babies nappy, in my hazy state I was taking her into the loo and putting her change mat on the floor. No one responded to my buzzer and I didn't get any pain relief until the morning as I didn't know where the midwife station was.

'Counselling for fathers. What I remember as a beautiful experience, DH remembers as traumatic.'

He could have seen his GP for that.

Good point.

From reading these stories I would say I had a reasonably good experience on the post natal ward. A sandwich and tea was brought to me in the delivery room immediately after birth. All meals were brought to the bedside by a catering team, not nurses or midwives. When I mentioned to a midwife that expressing milk at 2am made me hungry, she offered me a sandwich straightaway. The catering team topped up/ changed water jugs throughout the day.

As my baby went straight to NICU, I was told that I'd be on a ward with other ladies that didn't have their babies with them. I didn't appreciate how important this was until the following night when this went out the window and I was on the ward with 3 breastfeeding mothers and their partners who kept barging into my curtain and table in their excitement. Not very considerate.

Visitors were strictly limited to 2 during visiting hours only so that wasn't a problem. There was a gatekeeper making note of visitors to each bed - from a patient perspective, much appreciated.

An info card would be great though, I didn't find the parents day room/ breastfeeding room which had a microwave and fridge until the day I was discharged.

HerRoyalNotness at our hospital mums without their babies get private rooms. Like you say, I can't imagine how I'd have coped on a ward. Meals were brought to me and my water jug was never empty.

However, there was a milk room which was always locked. Which meant that every time I was expressing milk (which was lots) I had to ring my bell to get someone to let me in and same if I wanted to collect it. Fine if the staff were friendly, one particular auxiliary made me feel like shit for asking so I ended up walking all the way to nicu multiple times a night instead.

I also think an introduction card to the ward would be really helpful, but I think there is a wider issue throughout maternity care where they have all these particular way of doing things which vary from Trust to Trust - you only need to look at the threads on here which are "I'm pregnant, what do I need to do" to see how much procedures vary. It's fine if you've got a friendly midwife who'll talk you through it, shit if you've got a horrible one who expects you to know the job she's done for twenty years when it's your first appointment.

I haven't experienced it myself, but in Norway, I believe you have a few hours on the ward and then you move into a hotel that is attached to the hospital, paid for by the state. A friend who had her baby here said it was wonderful.

From an ex-pat blog (link below)

In Stavanger, mothers and babies stay in the hospital for 3 nights after a normal delivery. There is a hotel within the hospital with an entire floor dedicated to maternity. Depending on room availability, fathers and other family members may also check in. The rooms are exactly like a hotel room except they include a large changing table in the washroom and a nursing station is located at the end of the hallway. Midwives and baby nurses will check on you several times daily and are a phone call away should you need anything. There was also a standard itinerary for each day including learning to bathe your baby and other health tests for the infant. The stay is cost-free for mothers but other family members pay for their stay and food.

www.fromtheretoheretheblog.com/2015/03/having-babies-in-norway.html

Yeah, Royal that sounds amazing compared to my hospital and doesn't sound like it would take an awful lot to implement.

Food is so important, we know you need extra calories to recover and for milk production, and naturally will be exhausted after labour so will need plenty of food and water.

You also can't choose what time of day you give birth, so if like me you gave birth in the early hours of the morning or miss a meal time you could be waiting a long long time before anyone even thinks of bringing you food or drink.

I've had 3 births at 3 different hospitals.

My first attempt 34 weeks was an EMCS and my baby was in scbu- I agree with others who have said it's really difficult to be on a postnatal ward with all the babies when you don't know the status of your own child, ditto to the situation of getting to scbu in the first 48 hours- I didn't see my baby for almost 3 days because there was no staff to take me and I was only escorted in the end because I was caught trying to 'escape'. The staff in scbu were amazing however, and made an effort to tell me what all the tubes were and encouraged me to be a part of my daughters care in the 6 weeks she was there.

Second birth, another emcs at another hospital. No bf support, no pain relief. I was discharged at 10am and sat in the waiting room unable to leave until almost 4pm because I was waiting on my paperwork being issued.

Third birth and third hospital (I like to mix it up, what can I say). Planned section at 36 +6. Prenatal ward was brand spanking new, post natal ward not so much- more peeling paint than anything else. Nobody listened to me for 2 days when I was sobbing in pain, I was refused anything stronger than paracetamol. When someone finally listened to me and got a Dr all hell broke loose- I was quickly diagnosed with nerve damage from the epidural but still refused any sort of pain relief despite the fact that I couldn't even have a sheet over my body is was in that much pain. They moved me to a private room as patients complained I was disturbing them with my cries of pain. Eventually I was given pain relief and lots of it. I was told I couldn't bf because of it and would have to supply the pre packed bottles and formula which I didn't have- a complete strangers husband went and got some for me because I was alone and had no visitors to get them. I averaged one meal a day in the 9 days I was in hospital because I kept getting forotten about in my little private room and then one of the midwives who hadn't bothered reading my notes decided to call children's services because I was slurring my words and drowsy due to my body adjusting to the meds.
What I will say though was that once I was moved to a private room, the hca's were told to give me as much help as I needed with looking after dd because I was struggling with pain and adjusting to the meds (as I said I was very very drowsy for the first week) and they were amazing- one of them took our clothes home to wash and brought them back on her day off as I'd not planned on a long stay. I honestly couldn't fault their care, they were amazing. All in all though it was a horrific experience and I won't be having any more children.

I think a lot of the problem is simply not enough staff and too many patients. External food was definitely allowed on the ward (the smell of domino's and Chinese had me drooling) but as I said I was missed out loads because I wasn't on the main ward and if you missed out you got nothing till the next meal if uou were lucky enough to be remembered.
Even basic stuff like providing bottles for a newborn in a situation like mine- you can't plan for that, I'd successfully bf 2 previous children and had no reason to believe I wouldn't be able to feed my new baby- to have to give my debit card to a stranger and keep my fingers crossed he'd come back with it was scary to say the least.

Anyway, dog needs walking so that's my birth experiences

I've recently worked on the postnatal ward and also am a new mum. Had a fairly good experience but I was very determined to get what I wanted and discharged myself when I wanted to go home (drs are worst patients.) midwives are great and my community one was fantastic and came and saw me after delivery on the ward to say hi, as she'd seen my name on the board, felt very happy that she had take the time. However from a dr perspective midwives (the recently trained Ines anyway) are not nurses and most certainly are not neonatal nurses, lots have told me they don't know how to measure a baby's basic observations and one ward didn't even have a working baby saturation monitor. Also worked as dr looking after mums and again basic nursing stuff missing, but they're not trained so it's not their fault. Breastfeeding and tounge tie training is terriblely bad, as dr I was supposed to check for these but I had one PowerPoint presentation on them given to read at home and that was it. I missed my own daughters for a week . This could really do with improving.