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

Under no other circumstances would anyone be expected to get themselves to the bathroom, fetch their own meals and drinks, and take care of a newborn baby when they have had major, invasive abdominal surgery, also known as a section, only 12 hours earlier FFS

Because a negligent nurse hadn't got a doctor to sign my script for post-op morphine, I was in agony when my spinal block wore off. I was sobbing in pain. The midwife fobbed me off with paracetamol. Yes...that's right, feckin paracetamol.

Only 12 hours after my surgery, I was left to care for DD1 in my room. Eventhough, I could barely walk and couldn't really get myself in and out of bed. Lifting her really pulled horribly on my staples. I didn't get breakfast that morning because I simply couldn't walk to collect it.

My room was grubby. My Mum took one look, and came back with Marigolds and spray bleach. The midwives laughed and suggested she cleaned the whole ward. They weren't remotely concerned/embarrassed.

Within 24 hours of DD1 being born, I felt myself sinking dangerously low mentally. I felt panicked and disorientated and very tearful (I was diagnosed with severe PND less than 3 weeks later. My HV was so concerned that she got me an emergency appointment with a GP). Turned out, I am acutely sensitive and intolerant to progesterone, and any hormonal fluctuation. No reaction or input from the midwives. One midwife barked at me 'Stop crying. Your baby needs their nappy changing.'

To be honest, I just accepted it all because I assumed it was just how things were post birth.

It was only when I compared notes with 2 friends, one gave birth in the USA and one in Spain, that I realised how truly awful and barbaric much of the NHS's post natal care is.

Spanish friend had c-section. Room immaculate, cleaned twice a day (Spanish midwives very critical of 'filthy British hospitals'. All meals brought to her on a tray. Iced water always available. Night nursery available if wanted. Maternity auxillary very much on hand, helping to care for the baby until friend was steady on her feet. Just lots of common sense, and kind care...

The midwifery degree should be longer with focus on nursing skills or go back to nuursing first then specialise into midwifery

I had a c section 8 years ago. The post natal ward was like Beirut. blood spattered bathroom area, noise like a constant drone. Horrific. Felt like I had ptsd!

Oh yes yes YES! to being brought your meals. 3 days of "meal is served at the other end of the ward, you have to go and eat it there, you need to take your baby with you but Babies Must Not Be Carried so peel that newborn from your boob, put them down in the plastic box (waaaah, wash wahhh) and stagger down to the dining room" is hardly any kind of "care".

Oh, and this is a general hospital point I suppose, but when you have had a 3rd degree tear and are terrified about The First Poo, and so (medication notwithstanding) are rightly encouraged to eat plenty of fruit and veg to help things along, it's not very helpful if no combination of menu options allows you to even achieve 5-a-day. How are we expecting hospital inpatients to get well if they aren't properly fed?!

I had an amazing experience with DS2. Gave birth late afternoon so missed supper but they had a choice of meals I could have microwaved and brought to me as 'we can't not feed someone just because they gave birth at supper time, can we?'. Made such a difference (DS1 arrived late night and I was starving post my inevitable toast and breakfast was a long time away so I ate more sweets than I would have thought possible!).

'when you have had a 3rd degree tear and are terrified about The First Poo, and so (medication notwithstanding) are rightly encouraged to eat plenty of fruit and veg to help things along, it's not very helpful if no combination of menu options allows you to even achieve 5-a-day. '

Indeed. When on the one hand they are giving you leaflets saying 'eat fibre!' and on the other, the only food available is cheese sandwich on white bread or quiche with no vegetables, it's not very efficient use of resources really.
I know it's not a big deal compared with the appalling treatment many women have had to endure but nonetheless as my first serious experience of the NHS I was surprised by how un-joined up it was.

I cans still feel distressed about my inpatient experience fifteen years later. (I was in with pre eclampsia for two weeks before my eldest was born as well as post natally.) I'm afraid the midwifery care was a disgrace. (I was an assertive pain in the arse with the second two, with hubby given firm instructions that he was going nowhere)
I was a nurse at the time. I'm really not sure that nursing training is any superior in terms of ward management and I suspect many elderly hospital inpatients would have plenty to say about the basic level of care, too, given the platform. The NHS is just full of overworked, brutalised fuckers who don't have time to care and have too little mental health training.

I found the postnatal ward ridiculously hot, which definitely contributed to me not being able to sleep. Being an anxious new mum I'd packed a room thermometer in my bag and I remember it being 28 degrees C (this wasn't even in summer!). The midwives insisted on a certain number of sheets/blankets in DDs cot when she was already in a vest and sleepsuit, and I was so paranoid that she was going to overheat.

The majority of the staff were really lovely, even if they did all give me different/confusing breastfeeding advice, but there was one old battleaxe who worked nights and was so mean to me, harrumphing around and acting like my desperate calls for help with latching on were an imposition. She was also quite rough in her handling of me. I remember pressing the call button and silently praying it wouldn't be her that turned up!

The main issue for me though, was lack of sleep. It's one thing to be in a hormonal frenzy/on a high from finally meeting your baby but coupled with the heat, the noise of other people's conversations/babies crying all night/door alarms etc and the v uncomfortable beds (not sure anything can be done about these mind you) sleep was impossible for me for 4 nights. I actually ended up being readmitted to hospital and sedated the day after I went home, because I was so ill through lack of sleep.

Finally, although skin to skin was encouraged, I felt really nervous (as did quite a few of the other mums I spoke to) having DD on my chest for too long in case I dropped off to sleep (fat chance!!) and dropped/smothered her. I'd know better second time around but perhaps things like those babywearing tops or stretchy slings could be suggested at the later prenatal appointments? If I'd have known about them before they would have made my life so much easier!

michael I find the term HCP so cold and wierd to be honest.

Nurses and doctors sufficed for decades and should still.

Dividing 50:50 between class room and ward just isn't good enough! Read the thread! It's not working.

This thread isn't about patient survival rates that should be a given in 2017 this is about empathy care basic care and what a nurse/midwife is all about?

All these posters servived

Hardly a bench mark

Thanks Mumsnet for listening and starting this campaign.
Some small things that would have made a big difference to me on the postnatal ward (background - traumatic birth and baby straight to NICU with hypoxia and seizures which we later found out were strokes):

• taking the empty cot out of my bay,
• midwives reading my notes rather than asking where the baby was EVERY time they spoke to me,
• providing a clean, dry towel for my stitches (was in hospital for 9 days using the same wet towel - yes I could have asked for another one but I had no idea who to ask and was too busy spending time with my baby/managing her care in NICU), and
• most importantly - having proper pain relief rather than being told I could only have paracetamol as I was breastfeeding (expressing at that point as I hadn't been able to hold the baby yet but I went on to breastfeed for 12 months),
• enforcing visiting times/noise/smelly food - mother in the next bay to me had at least 3 or 4 family members with her at all times bringing kebabs and being noisy at all times of day and night.

I would like to add I was shown real kindness for both my births (especially by midwives) but the above small changes would have helped me a lot.

Nothing here would cost the NHS extra money apart from better training.

I had a homebirth for my second child, for many of the reasons listed.
-food was delivered to the middle of the ward area, by the time i had finished breastfeeding it had been cleared away. I was starving.
-noone was there to mind the baby and the shower was miles away and it hurt to walk, so i felt filthy for ages until i managed to stagger to the (not very clean) shower room eventually.

Not waking everyone up at 8 for breakfast. I had been up since 6 the day before with toddler, gone into Labour 11pm, gave birth 2am, left alone on birthing bed until 5 am (too busy to move me to ward) and got to ward at 6. 2 hours of sleep. No wonder I struggled with dc so much

I took my own breakfast. Felt too weird 1st time leaving freshly born dc alone while I went to another room for breakfast.

I cannot believe they make people leave newborns alone to get food, against all safety guidelines. How is that acceptable? We had no food from them at all, I was very glad somebody warned us and we took some of our own and could leave the next day.

More support on breastfeeding. There was never enough midwife time or breastfeeding counsellors around to help me get it established.

I never left my dd as didn't think it was allowed so only used toilet or showered when dh came at visiting times.... (the shower had a Dettol cleaning spray in so you could clean it yourself before using it....) the toilet wasn't nice (lots of women still bleeding after giving birth, some unable to wipe up drips etc not hygienic) I just wanted to get out of there ASAP.
We left without a "receiving blanket" and it was sleeping so they leant us a blanket to take dd home. I felt like the WORST mother.

Sleeting not sleeping!

What everyone else has said from me too really. At 2am - 12 hours after a section, and in agony having vomited up the oral analgesia that I told the midwife I would vomit up as I was so nauseated - I had to get up to turn the lights out. Earlier in the evening I had nearly collapsed in the bathroom having been told to go for a wash and left alone. I had to ask 5 times for a bowl to brush my teeth at bedside when I physically couldn't walk but had been repeatedly sick for hours. I was given no help with my 10lb+ baby, despite being told not to lift anything heavier than 8lb; I was also told not to lift anything heavier than the baby as they just parroted standard advice. At 3am I buzzed for help to change the baby - I was told where everything was and treated to an offensive amount of eye rolling at a request for warm water before being left to my own devices having never changed a baby before and being unable to lift him safely. I was given a pot and syringe and told to hand express if the baby wouldn't latch. It was near impossible to sleep with the telephone / door buzzer / chatting from the midwive station. I had my catheter removed at 6am. I nearly missed lunch because I wasn't there within 5 minutes as I was desperately trying to establish breastfeeding and the baby was latched on when they told me to go for lunch. Babies left alone during mealtimes. My baby was swaddled in two towels as they'd run out of blankets and the ward was so ridiculously hot I felt sick. A c-section might be referred to by the midwives as major abdominal surgery but I was treated as if I had done no more than stubbed my toe. I have never felt more of an inconvenience. I felt dehumanised. I went home the next day, as did all the mums in my bay. Nobody tried to convince any of us otherwise, regardless of circumstances. I was distressed and broken.

There will be more. That's just off the top of my head.

(Antenatal and labour wards were wonderful though - except my maternity pad was put in upside down!!!)

Batsgirl I used the term HCP in my post because it's widely used on here. There are more professional groups involved in patient care than Doctors and Nurses. eg many post section women will receive recovery care from an ODP for example. I was being inclusive and realistic.

More breastfeeding support. I was lucky to have help when I needed it. It shouldn't be down to luck.

Also, Batsgirl, you have actually said that patient survival rates aren't important compared to empathy. Did you mean to say that?
The training times I described relate to nurses, who are not the profession being decried in this thread.
Please stop criticising my contributions to the thread unless you're actually going to read and understand them.

Student midwife here. Post natal is a nightmare. This is what I have observed:

1. Staffing levels. We know there aren't enough staff- staff get pulled from postnatal because they're needed on delivery suite etc and if there are not enough staff in general it tends to be postnatal that bears the brunt. 1 midwife looking after 16 women is standard where I work. Safe staff ratios are maximum 1:8 according to the RCM. We are working at twice the recommended staff ratios on a good day.

1. Postnatal is where shit midwives go to die. Older midwives who have lost all interest in the job, or ones who are being observed, who've had complaints etc tend to end up on postnatal, because they can do the least damage here. It's not that easy to fire a midwife, you need more than 'they're just a bit rubbish and don't care that much', but you definitely don't want them working on delivery suite, so they end up here.

1. Breastfeeding support is crap because a) there's just not enough time to sit with women and b) a lot of midwives are actually not very knowledgable about breastfeeding and shy away from it. Training is inadequate.

1. Communication is poor. Midwives want women to get up and about as quickly as possible, even if you have a c section, because it's beneficial for their healing, less chance of blood clots forming, encourages urinary and bowel movements returning to normal etc. The problem is that this isn't communicated to women and they feel rushed and pushed around, and like the midwives lack empathy. Our bedside manner needs to improve massively.

1. Things grind to a halt at the weekend. If you give birth on a Friday night and you need to be signed off by the diabetes team before you can be discharged, forget it. You're not going anywhere till Monday. There's also normally 1 stressed out doctor on the ward at the weekends who keeps having to dash off and help with C sections on labour ward and so nobody gets checked and they wait hours and hours to be discharged.

We need: more midwives, more doctors, better training and better communication. Easy things like having a daily breastfeeding workshop could be done on the ward with a q and a, assessments etc. We need to be more innovative and more efficient.

Jesus Christ daemons wind your neck in. Have you actually read The Code?!

Thank god they haven't qualified you yet if you have such an unpleasant view of your colleagues.

Definitely food being brought round to you. I had two sections and was in for a week with my first and two days with my second. I didn't eat for a whole day after each because I'd been put in a bay the other end to where the food was served. I just couldn't get there myself and when I asked if someone could bring some to me I was told that they don't do that. In no other ward in the hospital would someone who has just had major abdominal surgery be expected to walk the length of the ward to get food.

Welcome cards would be good. With my first I had no idea that food was served elsewhere, that there were certain quiet periods, or where the toilets were located.

I'd also like to see visiting restricted for those other than the dads. Having to discuss latching, nipples, bleeding and bowel movements while the entire families and friends of the other women were present. It was embarrassing. It also meant that the collective din made it impossible to get any rest.