Midwife support on hospital ward

[CJ2010]

As i'm now pregnant with DC2 my mind has started going back over my pregnancy and birth experience with DC1.

I was treated really kindly by most midwifes in hospital, apart from one who had a bit of go at me for daring to ask for some cotton wool in order to change DC1's nappy. 'It isn't our responsibility to provide cotton wool' I was told quite abruptly. I had remembered everything else btw, but im straying off my point.

Before I went into hospital to have DC1, I was asking my mum for advice on what to expect as I nervous about going into hospital. My Mum recalled her hospital birth experience with really fond memories. The babies all slept together in a nursery at night so the Mum's could catch up on their sleep. This was the early 80's and I knew from talking to my friends that the babies now sleep beside their Mum's bed. Whilst I don't think I would have liked to have my baby down the corridor away from me, I was expecting some support from the midwifes in the few hours after giving birth in order to help me care for the baby. I had a difficlut birth and got rushed into theatre for surgery afterwards so when I got transferred up onto the ward, I was battered, knackered and had a catheter attached to me. However, I had to get up and change DC1, feed her and change her clothes, whilst holding onto my bag of wee. Is this normal?

As I say, the midwifes were very kind and were more than helpful when it came to assiting me with breastfeeding, but I really could have done with some help in those few hours after the birth when I was in a bit of a state.

Should midwifes offer this support to all new mums as standard or is it normal to let everyone just get on with it? Is the onus on the mum to ask for help? How do Mum's who have had a C- section get on?

Just curious really.

Yes that's normal.

I've had c-sections with mine & had no help caring for the baby at all. I make sure I get a clip on cot so I can change, lift, feed baby more easily on the first day & night. Apart from that I just got on with it, it wasn't that bad. DH cared for the baby during the day (apart from feeding) so I could have a shower & sleep. Best thing to do is get up asap so you can go home - I was in for two nights both previous times but I'm hoping for one night this time around.

In fact the only time I really saw a midwife at all was for medical stuff - checking dressing/lochia, drugs rounds & discharge, even the obs were done by a health care assistant. The HCAs were nice though & refilled my water, changed bedding etc.

Breastfeeding support was non-existent, luckily my mum is a midwife so I had all the help I needed from her but obviously few people are that lucky.

It should be the norm that midwives and mca's help you in the first hours post delivery, but unless the midwife can always see you, you have to press the bell beside your bed for assistance and someone will come as soon as they can.

If they can't see you (ward lay out/curtains) you really do have to ask and most are willing to help (I say most because as we all know some midwives are dragons who should have retired long ago!)

If you don't ask, you don't necessarily get, because the midwife doesn't know precisely when nappies need changing etc. I hear so many women complain that they had no help, yet they didn't ask for it.

Your catheter should have been attached to a stand so you don't have to hold it all the time, it can hang on the bed/stand on the floor. It's bad if you didn't have a stand.

iyswim

I think it is normal unfortunately.

I was lucky this time and had an ELCS with DD so DH was around all day to take care of her. They would come and help her latch on and bring me pain relief but that was it. My hospital has just closed 1 of the 2 maternity wards they had so they are very very busy and it is a bit of a nightmare up there at the moment.

It was the same when I had DS 3 years ago, and that was with 2 wards. Although they did take him for me for a bit both nights but that was because I have M.E. and the MW on the night duty was very sympathetic to that. This time they did ensure I got my own room because of it which was fantastic but as for the stuff you mention in your OP, yes I am afraid that is standard. It shouldn't be, but it is.

I also didn't have a catheter stand for nearly a day, they didn't have one available!

I was really lucky with DD as I was in a small midwife-led unit and the first night I was there (stayed two nights in a private room) I was the only person there, so got loads of midwife help.

They changed DD's first nappy for me (I was clueless and DH had gone home for the night), dealt with the meconium and gave me loads of BF support, including trying a pump to get my milk going and providing a bottle of formula and a small cup to try to feed her when my milk wasn't coming (milk came with a vengeance on day three!).

The second night they had one or two other ladies in, in labour, so I didn't see them as much, but that was okay by then. TBH, I think I just got lucky.

I'm pregnant with DC2 and we have now moved area so I don't seem to be able to find the small/MLU experience locally. Which is a real shame, I think.

Strange, my sister had a c section and I know for a fact she didn't change her baby until a day or two afterwards because I was there the first time she did it and I think I went the day after (could have been 2 as I live quite far away) The hospital had changed her before that. This was 11 years ago now though so I can imagine staffing levels have dropped since then.

Totally normal, even with a c-section. I remember going without breakfast one morning because I didn't want to stand and queue from the trolley in the hall for 10-15 minutes whilst DC2 screamed her head off back in her cot. And they wouldn't let me carry her (another crazy rule) so that was that.

I am absolutely dreading it this time round - the above anecdote was pretty much the least annoying of my postnatal ward "fun times". It's a joke - and 95% of it is down to lack of resources and the other 5% is, as another poster said, because a very small minority of midwives are dragons who should really be parking wardens or something where yelling at vulnerable women in tears is "acceptable" instead.

Would you consider a homebirth so that your DP would be there to help you?

I got sod all help at my last hospital birth - the MW in labour room said the MW on the postnatal room would catheterise me (had epidural and ventouse) The MW on the postnatal ward refused "you don't need to" I pointed out this was 5 hours after the last time, I couldn't walk ... still no. So I ended up staggering around the hospital, clutching onto walls, trying to find a fucking toilet, having left my hours-old baby by himself. I don't think that is an abnormal experience.

After my first homebirth, the MW dried me with a towel as I got out of the shower

I was taken back up to the postnatal ward at midnight and DP was sent home. I really didn't have a clue what I was doing with a screaming brand new DD.

The midwives told me to press the buzzer if I needed any help, but didn't specify what kind of help they meant. Every time I went down to the nappy-changing room, they were all huddled round the reception desk, gossiping, scoffing and drinking tea.

I do think they could have spent more time just checking that the first-time mums were ok.

Other than that, my hospital experience was very good, and I cannot fault the midwives on labour ward in any way at all - just amazing. Caring, nurturing and respectful the whole time.

I am at this thread!

I had a section with DS, and I had loads of help from the midwives during the nights when DH wasn't with me. I had to press the buzzer, but they were really lovely.
Food was brought to me by the porters or whatever they are called these days, didn't have to go and get it.

The midwives took DS off for a cuddle at one stage so that I could get an hour's sleep, and helped me with changing etc until my catheter was out and they had checked I could stand up on my own for long enough to have a shower.
They even brought me more pads, nappies and cotton wool without me having to ask.

Realising that despite having awful care in labour, I had very good postnatal support....

My catheter was removed once I could get out of bed with help, 12 hours post op. It occurred to me a couple of hours later that no-one had changed his nappy since his first was put on, so I did it. I had to ask for cotton wool, it was brought to me, but no offer of help (to be fair I didnt ask either I wanted to "take ownership" of my baby by caring for him).

That evening (20 hours after op) I was told off for wearing my own pants (no hospital ones provided) and not taking pain meds (none had been brought to me). The next evening the same MW told me off for changing him myself. Morning of day 2, no-one brought me breakfast - there was a kitchen down the hall which I was supposed to be using as I was "up", but I was in agony after a rough night and couldn't face pushing the crib and walking that far. I kept expecting someone to come by when they weren't busy, like the day before, then it got to 12 and DH arrived. I was given a baby bath on request on day 3, but not an offer to fill it or help.

I only got help with BF when I asked, it wasn't until the second night that I was shown how to feed lying down, although a MW had seen me struggling to feed "sat up", and told me I couldnt raise my bed any further to help.

I should make it clear I'm not complaining (except maybe about the pants telling off), that's just how it was, the midwives and assistants were professional and never refused me help when asked.

Ultimately I think it's a case of the squeaking wheel getting the oil. I am sure if I had asked regularly, the help was there, it was just not offered. I noticed as I left that some mums had clocks outside their rooms saying "please help me to nurse at this time" which I thought was nice. I didn't know that service was available. I think they assumed I was fine.

I think you have to not be afraid to call them if you need help, even if it's just a second pair of hands, it's too easy to push yourself too hard. I felt like I was imposing if I called, but if they are busy with someone more needy, they will tell you and pop back when they can.

I also wish I had made it clear to DH I needed him there all day. I was sensitive to his dislike of hospitals (after recently watching both his parents die), so I didnt challenge him breezing in at lunchtime after a late night xbox session (insomnia) and a lie in, but I had no-one else and I should have made it clear that my need was greater.

Ultimately, ask for help, from HCPs, friends, family, breastfriends supporters, a doula. You deserve to be taken care of, and if they really can't, they can say no.

Have you got a birth centre you could go to instead of a hospital? If you need to be in hospital for the birth, you may be able to transfer to one for postnatal care? It's worth looking into.

I planned to give birth at a birth centre but had to transfer to hospital mid-way through labour. I gave birth and unfortunately had to stay in hospital for 12 hours to wait for an anti-D injection - have no clue why it took so long. I experienced the same problems as you I'm afraid, nobody showed me where to get breakfast or how to order lunch and the midwives were run off their feet so I felt bad about asking how to change a nappy etc. I "wasn't allowed" to close my curtains to try and get a bit of sleep, it was like trying to sleep in a train station or something, all the people rushing past.

I then got out of the hospital and back to the birth centre where there was all the help I needed. I stayed for three nights and they came to help with every feed, showed me what to do with the nappy changes and bathing, explained that nappy changes should be done before a feed (I seriously had no clue about anything). Best of all, after a 3 day long early labour and no sleep for 3 nights, they took my baby off into the office for a few hours overnight so I could get some sleep, bringing him back when he wanted feeding.

Goodness me. Some of these stories are dreadful.

I had to have a trip to theatre to be patched up after having ds1 so ended up having a spinal anaesthetic. Because of this I was catheterised aswell. I was taken to the High Dependancy Unit straight from theatre (about 8am) where I was the only patient until about lunchtime so I had 1:1 care. The mw's were so supportive with changing and dressing ds, showing DH how to do it and helping me to express my colostrum to feed to ds via a syringe as he was sleepy. After that the unit gradually filled up until it was full. I was moved to the normal ward about 10pm as my legs were then working and everything had stabilised.

DS fed, fed and fed some more through the night. I felt like death warmed up the next morning (and must have looked it too!) as I wsa moved to a single cubicle until I was discharged 2 days later. The midwives respected my privacy but were quick to respond to my pleas for help, especially the bf advisor. One mw even took ds for short periods through the night to help me get some rest (only short periods as he was still feeding very frequently!).

Food was brought to me, and plenty of hot drinks were offered too.

I really couldn't fault the care that I had, and I feel very that I seem to be in such a minority.

I find it amazing that in a world of beds, catheter stands are always hard to find- one reason is that staff forget that the stand is there and then lower the bed, making it into an interesting shape, but useless as a stand. I sometimes think it would be quicker to buy one....
My personal philosophy of postnatal care is that its purpose is to ease the transition from individual to parent, from couple to family. Most women on a postnatal ward aren't ill, they are there so that they can become confident as parents, and to be spoiled a bit before they go home. We are there to help you learn how to change your baby, bath your baby, dress it, pick it up, learn that it isn't really made of spun sugar and can be handled without breaking.
Therefore, if you want me to make you a mug (not a cup- mums need proper mugs!) of tea in the night, I will. If you need the baby changed, I will help you to do it, or even do it for you. If your baby has slept all day, and wants to spend the night partying, I might take it for a while, so it can help me with the project I'm working on, and you can sleep. I might sit with you for a while and discuss all the worries that have filled your brain through the day, and are now, at midnight filling you with horror. I might also spend a bit of time telling you why a certain well known baby book is full of rot, and written by an author who talks through her hat. (that might be why the baby isn't doing what the book says, not you failing as a parent).In an ideal world, that is what midwives would do, because we are 'with woman' and that is part of our job (at least it should be).
Sadly, I cant do that all the time- I might have a high risk lady to look after who needs one to one care, or we might be short of staff, and having to spread ourselves thinly. Somebody might need some drugs that have to be carefully prepared and given by two midwives, and so we are distracted for a while. It might take a while to answer your buzzer, but I will get to you when I can.
However, I can do this because I work in a small unit on a small island that is relatively well staffed. Women here have the luxury of being able to stay for up to 6 days post section, and don't get sent home after 2 days (and readmitted with a gaping wound after 3 days....) I no longer work in a busy high risk unit where 25 beds were looked after by 2 midwives and an HCA along with a student on a very steep learning curve. In among the sections, inductions, medical cases, babies on antibiotics, etc, low risk, normal delivery women who want a bit of breastfeeding support get pushed to the back of the queue. None of us like that, and none of us are proud of our care in that situation.
Something I truly hate though are 'tough guy' midwives, the sort who say 'what are you making tea for, tell her to do it herself.' I'm sorry, to me it's what midwives do- we care for women. A cup of tea and a handful of chocolates from the tin in the office are as good as any medicine, and at two in the morning they are far better.

Wish all MW were like you Midwifendy

Some of these stories are terrible, no wonder people don't want to stay in hospital. I had a Csection and the first night, when I still had catheter and hadn't been helped out of bed (happened the next morning), I rang the bell every time DD needed feeding and midwife came and changed her nappy and gave her to me to feed, then I rang for someone to put her back. In the morning someone brought me breakfast. After that, once I was able to get up, it was down to me and DH but that was what I expected and I didn't need help at that point. Then after 4 days DD had dropped weight and I had to top her up with formula and express after every feed - I rang the bell every time and someone brought me the pump (as it had to be taken away for the next person each time) and then in the night when no DH there, someone helped cup feed DD as I was distraught and not really in a state to do it.

I was desperately miserable on the postnatal ward and longed for more help.
I had emergency section with sepsis and massive PPH. 1 night ITU admission, next night on delivery for close monitoring - both these nights baby was on SCBU as also unwell. Next night back to postnatal ward. Baby awake ALL the time - literally. Crying unless feeding - every time I put her down she'd start to cry again. I remember sitting up in bed pinching and slapping myself because I was so scared I'd fall asleep and smother her. In hindsight, obviously poor babe was starving as I (fairly predictably after above) didn't have much milk - when weighed at 10 days she'd gone from 6lb 13 to 5lb 11 (still struggled on with exclusive breast feeding for another fortnight before giving formula top ups to disapproval from MW and HV). Anyway, whilst on postnatal ward - zero help. I wish somebody had helped me and let me get a little rest - might have made the whole newborn period less of a nightmare.