Post natal midwife visits?

[festiemum]

Hi,

Just wondering what people's experiences of post-natal care have been like.

In brief, I had my 4th child by induction due to high bP on Saturday. I was discharged from hospital yesterday with instructions that a midwife would be visiting regularly this week to monitor my bP.

With all my other babies, routine home visits from the community midwife in the first week post-partum were the norm.

However, today we have been told that we will need to attend clinic this week in order for my bP to be monitored (a 24 mile round trip each time). We live in a rural area, with a shortage of midwives apparently.

Have you been visited at home since the birth of your child? I dread to think what women without transport/ who had sections/ whose partners aren't available or in the picture do in this area.

Many thanks for your insight and congratulations on the birth of your babies!

Where I live its pretty crap but not as bad as that! Here you get a mw visit on day one then a hca on day 5. After that you go to the clinic to be discharged. I wasn't too bothered with dc1 but after dc2 my stitches got infected and obviously hcas cant check them so I had to phone the hospital several times and practically beg for a mw to check my stitches

This is becoming normal practice to manage mw time. 4 visits in a rural area take as much time as 10-12 clinic appts. Some areas have more flexibility for those who find clinics tricky (we keep visiting twins, prems, sick mums).

I would suggest you buy/borrow a BP monitor, do it daily, and ask at what point mws would like to be informed if it is high. Phone them on clinic day with the reading that day. If you're feeling stroppy, invite them to come and discharge you and baby at their leisure. Otherwise, time your clinic visit for final mum/baby check at your own convenience.

if you think this service reduction is an issue, then write a complaint! Its the squeaky wheels that get oiled.

Thanks ladies.

I guessed it was something that is becoming more common-place, what with the birthrate going up and number of midwives down. I spoke to two midwives today and both said what you do basically mayhew. It's now policy in our area to only offer home visits to women who've had c-sections, because they simply can't cover the area otherwise. They strongly recommended that we complain to out head of midwifery services and mp. We are happy to do so; as you say, the squeaky wheel and all that...

Sorry to hear about your experience fuckbadger - it really is the last thing you need when you've got a newborn and other dc to look after. :(

Oh please complain! One of the local commissioners of our PCT was suggesting this a few years ago - I asked him whether he was happy putting the lives of mums and babies at risk.

I believe midwives save lives - and that includes in the postnatal period. A midwife going into a home sees and learns much more than she will in a clinic - women open up more emotionally, plus there are clues within a home if there are problems. Then we have those that can't get to a clinic because it's a toss up between money for the bus/taxi or money for food etc

In an ideal world - at least one visit to the home, then give women the choice - clinic/children's centre if it suits otherwise keep providing the home visits

The good thing about complaints is, it is a formal system. They have to investigate and give you a written response within a time limit. It is also formally reported at trust level.If you make a phone call, that's informal and less likely to produce accountable results.

With all service changes that staff are dubious about "the women aren't complaining" is always used to stymie dissent.

These changes to post natal visiting are often presented as "choice" but there is often no real choice.

In my area it has been really good (medium sized town) - mw visit on days 1, 5 and 10. Maternity Assistant visited a couple of times in between as she was helping me with breastfeeding.

I had a relatively uncomplicated birth although it was a long induced labour and I would not have really felt up to getting up and dressed and out to the surgery in the car. Even though I did not have a lot of tearing I did not feel ok to drive my car in the first 10 days. Not to mention the heavy bleeding, the baby blues and the tiredness which would have made me a danger behind the wheel. If home visits are stopped then people may easily slip through the net at this stage, which would seriously put lives at risk. I had it relatively easy and I would have barely managed to drag myself to an appointment so it would be even worse for women who had a harder time with tearing and recovery.

The post natal home visiting service is vital in my opinion and should not be taken away as a cost cutting measure.

This is the terrifying thing. If this is now a county wide policy in my area, how long before it is rolled out country-wide?

I live in an exceptionally rural area; we are an hour from the hospital and 20 minutes from clinic by car. There must be plenty of women who miss their vital post-natal checks because they cannot face a trip out feeling the way you described, kat. It's certainly something I could have done without on Monday, having been out of hospital less than 24 hours.

I will certainly be complaining, in writing, to the head of midwifery; local MP and paper.

This is terrible - I think it would be good for you to complain.
I had daily mw visits for 10 days after a very straightforward planned c-sec with no issues. But my area has outstanding maternity services. It's just not fair that there is such a postcode lottery.

They visit here the day after you come home from hospital, day 5 after baby is born for guthrie and to weigh if bf, and day 10 to discharge you. That's a standard vb care plan. Cs I think they do an extra visit between day 5 and 10 to check incision, but cant be certain as never had one. I live only a couple of miles from edge of town though, I can imagine it would be a nightmare for midwives if you lived very rurally.
Thing is, nightmare or not, if you need the care you need it and provision should be made.

I had no home visit at all after leaving hospital (it was someone else's fault whoever I asked...), finally rung them as found out you can't see HV (and get that red book) until the midwife has signed you off round here. So went to one appointment at the clinic to be discharged when he was 12 days old.

Good job there were no problems isn't it.

where I live the midwives visit to need. Always get a visit on first day home then day 5 for baby weigh and blood test then further weigh and visit about day 12 as the bare minimum. However extra visits are the norm for feeding problems or any history of pn depression up to day 28. Never have to visit them they always come to us and if need anti clotting injections then they visit daily to give. I feel very fortunate from what others are saying I live in merseyside and its a full NHS service from our local hospital trust.