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

'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.'

That is absolutely disgusting that a hospital refused to a feed a patient, a newborn infant, no less, who could not be fed any other way. I really hope you complain about this.

I'm nearly 37 weeks pregnant and am terrified reading these stories. The level of care in so many different hospitals across the country seems appalling and I'm dreading it now

I wondered after my experience on a post natal ward if all I required was someone to be nice to me. While I was induced the birth wasn't complicated so I didn't "need" much medical help. But I'd still given birth, had stitches, had to bfeed a new baby etc. Only lasted 10hours on the post natal ward because it was so unwelcoming. Midwifes came & did OBs but the scolded me for not feeding my baby every 2 hours, (we were asleep) for not changing his nappy quickly enough, (he'd just done the first poo and I was about to and the midwife tutted at me) I didn't have any water or food either as I'd missed the lunch order.

The nicest person was the Bounty Lady. I just wanted someone to say "oh, you're new! Congratulations! Are you ok? Have you had lunch yet? If not, the lunch order has gone but if you text your DP he can pick you up a sarnie or there's toast in the end room, give me 10mins and I can get you some. How's the baby? If you need help getting to the loo I can help" Etc etc.

I would like to ask for a non medical volunteer programme on post natal wards. Just a friendly face to help out practically.

Trained nurses on ward. Midwives aren't nurses no nursing skills. Either that or train midwives in basic nursing

LostSight
We have a similar thing in Spain. I thought it was great. My friends who have given birth in UK and Spain say the postnatal care here is infinitely better.
You move from the ward to a hotel attached to the hospital, funded by social security. Typically, you stay for two nights after a standard delivery. Longer for multiple births and other situations.
At my hospital the post natal hotel was a whole floor of the building. Everyone has a private room so visitors can come and the dad or other family or friends can stay with you. There is literally a nurse at the press of a button, 24/7. They also have specialists e.g. to help with breast-feeding. Being Spain, the food is excellent, plentiful and regular. The Spanish healthcare system or even maternity system isn't perfect but this aspect was great for me and everyone I've spoken to. It's a shame that many mothers and parents aren't treated well in British hospitals. Let's hope this initiative leads to improvements.

See again all basic stuff here.

As a staff nurse I was in charge of the info cards. Wrote it in one night and my dh printed copies and laminated them. This isn't rocket science.

See again this is not about throwing cash at the NHS it's about getting the real basics right and the rest follows.

Mumsnet this is basic stuff.

However still think direct midwife qualification is stupid. Still think nurse training in uni is stupid.

You don't need a degree to care. If I had to have had s degree and not just A levels I wouldn't have nursed. We might be attracting career applicants and not bed side nurses.

lost that sounds amazing

There should be quiet time after 10pm with no mobile phones being used. After 10pm you should only be able to watch the television through headphones.
The women next to me was on her phone all night and one had the telly on full blast. It was awful.
Ther also needs to be access to much more pain relief and also women should not be forced to keep the their curtains open. Vsitors should be kept to 3 and only at strict visiting times.
Partners should have to leave by nine at night if on a shared bay (of course in a perfect would every women should have their own room and the partner able to stay the night).
Single mothers should also be able to nominate someone who can come and visit them during the extended partner visiting hours

Lost that sounds fab

Raggy again all basic ward management

Expat I did and got an apology from the hospital with a promise that they would revisit policy- whether they did or not I have no idea.

Sorry to harp on but the more I read the luckier I feel. The TVs on the whole ward, also down in the rooms in neonatal so possibly the whole hospital, went on mute at 9pm. You could still watch them with headphones but no sound came back on until 8am - now surely it's possible to implement this very very easily in other hospitals as I think they all use the same TVs and provider?

I think that the campaign perhaps should find a way towards increasing staffing. The hospital I delivered at seemed to have virtually no-one available on the Postnatal ward. I was in a bay full of women with no staff (at all/ever). The only time I saw someone was when she burst into my cubicle to tell me something...except I think she was looking for someone else! I felt well enough to leave that day. I went to the empty desk to say goodbye. Still no one there!

I had no idea until after I'd given birth that midwives aren't specialist nurses as I had thought. As others have said this is probably a big part of the problem. The dehumanising way that women are treated is appalling.

It's disgraceful that MN has to campaign for basics for post-natal mothers. Of course they should have access to food, water, and adequate medical care.

The wards need to be treated the same as others. Most crucially, no 24 hour visiting (babies' fathers included). It's just not acceptable on shared wards and men would never, ever, have to put up with it. Sensible visiting hours, such as 9am-8pm, with visitors removed if they're aggressive/noisy/inconsiderate.

Yes, Raggy!

I would like to add 'rest' to the list of basic needs we often aren't getting. I had two nights on PN ward with close to no sleep, because my baby fed all night (and I'm sure lots of others do!) and the place was so so loud and busy during the day. Noisy partners, noisier visiting groups, unattended children stampeding through the bays, staff yanking open curtains all the time, bloody Bounty reps - and then all the necessary care/checks/crying babies stuff on top of that.

There's no perfect fix I'm sure (apart from giving everyone single rooms!). But at least TRY. It seems like priorities are the wrong way round so often - "well, sorry you've had days of labour/major surgery/massive blood loss and you desperately need to rest, but the visitors of that other woman want to have 3 hours of loud shouty conversations between 15 people crammed in a single bay, so they come first."

Don't put new mothers on ante-natal wards particularly after a difficult birth. It was one of the longest nights of my life. I felt abandoned.

Restrictions on noise and visitors and staff actually policing these rules.

Access to food when you need it outside of a planned mealtime is important, but the most difficult thing for me was that the ward wasn't adequately enough staffed so when my baby cried no-one could bring him to me when I couldn't leave the bed myself. I had to watch him cry for ages which was devastating in the hours after a traumatic birth. One time the staff refused to bring him to me at all because I was so tired she thought I might drop him but she didn't have time to sit with me while I tried to feed.

So many problems would be helped enormously if there was enough space to lift visiting restrictions so women could have some one with them through the night. It is mad expecting a woman post-surgery, to look after a newborn and establish a feeding routine by herself, when she can't sit up, roll over, or lift the baby herself, and to argue that this is in the cause of 'getting a good night's rest'.

I suspect that many women leave the post natal ward doubting themselves as new mothers because of poor care at a vulnerable time.

Honestly? The post natal 'care' I've experienced was so horrific I would simply shut down that unit, and tell women that they'd, on average, have better odds of getting through birth intact by squatting down in the woods with bears as midwives. The midwives I encountered were horrible. Unkind, unfeeling, unfair. Not a one of them should have been in caring professions, they were nasty women who enjoyed the power they had. If I saw one of them on fire I wouldn't piss on them.

I disagree with limiting visitors and partners - the only thing that saved my life (literally) was one of my visitors noticing I was haemorrhaging again. I hadn't seen a midwife in nine hours, after a 3.5 litre PPH. If I'd not had someone there beyond visiting hours, I would be dead. Fucking midwives would probably have noticed when the blood got on their fucking gossip rags, but until then they would have been oblivious. I'm sure being walked in on is unpleasant but until the shit midwives have been fired, visitors are vital.

Wow that's crazy. I'm coeliac and after 22hr labour I'd still not had anything to eat or drink offered to me after a further 12hrs . Thankfully I had packed some snacks gf flapjack and some banana chips and my oh had left a bottle of lucozade so I had them but I'd have starved otherwise. I did ask and they said they would see what they could do still waiting lol. I genuinely thought it was just me and I'd been unlucky.

Yes info cards! You know when you're in a hotel and they have an info folder? Like that. I didn't know if i could leave my baby to shower- I was still covered in blood. I was expressing colostrum for a baby who couldn't feed and no one helped me with where the sterile pots and syringes were. I didn't even know there was a breastfeeding room for 3 days. Where do you get clean sheets for example.

I didn't know if I could leave the ward with the baby to go to the coffee shop when food didn't materialise.

Oh and the heat! Why are is the guidance to keep your bedroom quite cool but the hospital is 1000 degrees? Can they keep it at a comfy temperature? It would save a fortune.

The unit I'm planning to use for this pregnancy has a little kitchen area that patients and their partners can use as and when they need. It's only a few feet away from the delivery suites with a kettle, fridge, freezer, microwave, toaster etc which patients/family are encouraged to use if they wish. (This doesn't replace the meal service, it's an additional facility) I thought this was a brilliant idea - reduced pressure on staff and budgets, patients and family can eat and drink at any time... I can even bring in ice lollies to have during my summer labour!

with dc1 I missed mealtime but did get the obligatory (amazing) tea and toast. But two small slices of toast and a tiny cup of tea hardly touched the sides, and dh (quite rightly) wasn't offered any which left him the option of leaving the hospital and driving into town for food, going without, or sharing mine. The facility to make our own would have been really appreciated!

I agree with Spikey - better bedside manner. I had a prem baby by emergency C section. She was very poorly when born and so was I, so I didn't see her or touch her before she was whisked away. When I got to the ward I asked for a wheelchair and help to go to see her (literally just out of recovery) and the answer I got was "Why don't you walk", followed by a 2 hour wait for a wheelchair (NICU was a significant distance from the ward).

I don't think this should turn into a criticism of graduate qualified HCPs.
Certainly in nursing, there is robust evidence to show that patient survival rates are distinctly better when graduate nurses are part of the healthcare team.
Currently nurses complete a 46 week academic year, so much longer than 'regular' degrees, and that time is divided 50/50 between classroom and ward/A&E/all kinds of care settings.
I do strongly believe that midwifery as a profession and women needing their service have lost out phenomenally from the rejection of its nursing origins.
Just as you wouldn't achieve success if a physio, podiatrist or cardiac physiologist was left to run a ward, the same has happened with midwifery. Ward management and maintenance of a particular culture is a longheld nursing responsibility and a fundamental part of that role.