Sent home from hospital after c-section without ANY analgesia

[TeaJunky]

The title says it all.

The night before coming home I was up all night in hospital crying with pain after having taken pain relief. This was noted by the midwives.

Yet the next day I was discharged from hospital without as much as a single paracetamol. I asked several times about it, and was eventually told that as its so cheap to buy over the counter, the hospital is cutting costs.

This is St Mary's in Manchester. Otherwise, I had fantastic, round the clock care and support and the teams were excellent.

But sending a woman home, who has just given birth via major abdominal surgery, without any pain relief (at 6pm evening), with a newborn to look after is just criminal.

The community midwife that came to see me today said it has started happening only in the past few weeks, and they initially thought the hospital/staff were forgetting - but it was becoming more apparent now that it's just cost cutting. She suggested I tell the local press, which I will be doing.

I also wanted to raise awareness of this on mumsnet and ask other women to add similar experiences about such incidents.

I spent the night in pain of course - I think I must have overdosed myself with ibuprofen and a bad mixture of other odds and sods of pain killers I had in my kitchen drawer

This has to fit into an MN campaign somewhere, surely? It's just not right.

[newbielisa]

2nd c section 4 weeks ago. Pain post op seemed much worse this time. Left hospital with paracetamol and ibuprofen. I did chunter about rubbish meds but in retrospect if I'd had stronger painkillers I'd have done more and overdone it. As it was I could do f.a. for the first week other than wince and feed my baby.

Do think it was a shock for you to get sent home without meds but agree with rips suggestion to speak to the unit rather than the papers.... as your community midwife should do rather than stirring you up. If they are continuing with this practice then the patients need to be forewarned so can have their own stash of "not that effective" paracetamol

Not sure how long ago this all happened but congratulations on new arrival.

[nooka]

I had morphine for the day or so after my sections, and then I think paracetamol the day after that. Nothing to take home first time around, and then second time they wanted to give me iron so I had to wait around for hours before the doctor turned up - in the end dh took me home and came back later for the drugs. They gave me a fair few painkillers too which I don't think I used. But then as I have bad periods there is never a shortage of neurofen in our house.

I took my dd into a Welsh hospital recently when she dropped a cutting board on her toe and was really surprised when they gave us both paracetamol and ibuprofen to take home. I thought that they would have been more cost conscious. We've still not used up either pack.

However the point is that you were in pain, and probably needed something stronger in any case and that should have been assessed and advice provided at the very least (to be honest I think after a c-section you should expect some pain, it's the manageability that's the issue, which is of course an individual thing).

[sleeplessinsuburbia]

I thought this was standard procedure. I have always bought my over the counter pain relief and was only once prescribed proper pain relief as I was discharging myself early. I was pissed off when I got home and counted my tablets to see the pack prescribed only had 1.5 days of medication and the instructions were for 3 days!

To be honest I look back on all of the c sections with a feeling of annoyance wondering why they don't just prescribe a week of pain killers, I doubt too much 'abuse' can occur under the circumstances and I have a mental note for my next one to beg for more!

[sleeplessinsuburbia]

It is a good point that you are meant to feel pain so you don't overdo it.

[Want2bSupermum]

Had a CS here in the US 17 months ago. I didn't feel anything for the first day and was given a tablet to disperse any gas build up with each meal. After day three they switched me to 500mg of ibruprofin during the day and codine based pain relief for the night as it does make you drowsy.

When I was discharged it was a Sunday and I was given enough medication to see me through to the next day along with scripts for everything. CS are painful and during the first week you really need something strong to take the edge off.

FWIW DH was supposed to be relocated to Manchester while I was pregnant with DD. After our interaction with the maternity wards at the various Manchester hospitals we were left underwhelmed by the care provided and it was a factor in our decision to not move to the UK. I was impressed with the Liverpool Womans Hospital. The midwives were professional and talked me through the process rather than talking at me in a patronizing tone.

[mmmmsleep]

Had similar situation although was at least given paracetamol and ibuprofen in ttos. i refused to leave without stronger prescribed meds and pointed out i'd needed oramorph overnight so diclofenac plus co codamol was the minimum i was leaving with. got it after some huffing. Agree people do underplay pain post cs/birth trauma. Discharging a patient without adequate pain relief isn't acceptable nor is telling pt to get it from gp. I am a gp and get so frustrated and upset on my patient's behalf when my patients come to me in pain because hospital denied them meds. It's not fair on the patient, just moves the cost to other parts of the nhs and is sloppy medicine imo. Rant over and lots of hospitals do discharge with good pain relief and after care arrangements in their defence.

[mmmmsleep]

Oh and i agree with above. Speak to PALS department at your hospital who can helpyou resolve your complaint. Speaking to papers really should be a last resort if usual complaints procedures don't work and can hamper a positive resolution of the complaint for you as once papers involved legal team will be involved. It may be misunderstanding of a ruling that wasn't supposed to be applied like this and department should be given chance to change. Your midwife should have guided you to proper nhs complaints procedure and i expect has her own axe to grind if she jumps at suggesting papers.

[RedToothbrush]

You should definitely complain as much as possible.

Why? Because if they are doing it for cost cutting reasons then they need to have it rammed home to them that it costs MORE in time and effort to deal with discharged patients in pain than it does to give you pain killers.

[fufulina]

With my first c section, I was sent home with just paracetamol. I didn't query it at the time, I didn't know any better.

Second c section, I was sent home with codeine, and voltarol, which were amazing for the pain of the surgery, but the codeine really really buggered up my stomach, which at times was almost more painful than the surgery wound.

In hindsight, I was so desperate to get home after dd1, that I think I pissed them off. Hence paracetamol only!
Codeine was a double edged sword, frankly.

[fufulina]

Oh, and oramorph, which I had to have post second c section was just weird. It was horrid actually, itchy face, sooooo drowsy yet couldn't sleep. Horrid. I've come to the conclusion that paracetamol and ibuprofen are the best approach, actually!

[KvetnutsRoastingOnAnOpenFire]

didn't have a c section, but a fairly brutal forceps delivery, and was discharged with no pain relief within 20 hours. they tried to discharge me before they'd removed the catheter and one of the lines in my arm though, so think they were just massively overworked/understaffed.

I ended up crying all night then calling the GP and howling at them the next morning! and was prescribed wonderful, lovely, co-codamol!

[topsmart]

Well, this is odd.
I too was discharged from St. Mary's in manchester after my CS - 10 wks ago -but I was given strong painkillers (diclofen or something?) if I struggled though told if I needed paracetamol or ibuprofen then I should buy them myself. I actually thought this is fair enough, they cost what - 20p? Most people have them in their houses already.

Is this the only aspect of your care that you're unhappy about? Then you need to complain to the hospital first, not run to the papers.

It is rubbish being in pain but it does force you to rest your tummy.

[Nordicmom]

I have to say my experience of the EMCS on NHS 8 y ago was so bad ,other than the pain relief , specially the aftercare that I swore next time I'd go private. The resources are so few and they were so busy that I did feel completely abandoned after my section when DH wasn't there . The care before and the surgery itself were quite good. Never again!!!!

[theonewiththenoisychild]

The pain does make you rest more but i had morphine in hospital and strong painkillers to bring home with me and i was still in a lot of pain. After my second cs the stitches on the outside burst on the one side as i stupidly picked up a washing basket full of wet washing as i got fed up with calling for help while db and dp had a chat about xbox. I overdid things both times but not because i wasnt in pain i was but because if you want a job doing right in my house you just do it yourself

[TeaJunky]

Topsmart - I think if I 'ran to the papers' it would be with good reason. I have been in constant tears of pain since coming out, and without the full time support of DH I would never cope. In my particular situation, I havnt been able to make immediate contact with my gp - I don't know anyone who can to be honest. Where does that leave you in terms of strong pain relief in the short term?

As I said, the midwife did say its being brought in very recently, from around three weeks ago. That might explain why you ha a lucky escape.

[topsmart]

I'm sorry TeaJunky, I didn't mean to downplay the pain you're in. Sounds horrible. Also sounds like you need a better gp! Have you rung your surgery and told them its an emergency?

[elizaregina]

Tea Junky

You have to kick up a fuss to get the pain relief you need, how many peole have said on here - and midwives that keeping on top of pain after a section is absoluty KEY to recovery.

I am sorry but saying the pain helps you to not overdo it is absoluty rubbish.

pain is not good and does not aid recovery.

did you have an emergency section?

i had a planned one and i did alot of asking about pain relief - are they quick to respond if something isnt working to relive pain etc...

at the pre op i was given a prescription of pain relief to get then = to make sure i had paracetomol, senacot and codine at home. we brought our own ibprufen.

i then switched to diflonec as i was getting codine headaches....which the midwife prescibed for me - or got docs too and my Dh picked up. i saw the mw the day after i came home i think and she sorted out the new prescription....

if i cant get hold of my docs on the day i need, i call out of hours and get seen that night.

unfortunaly i did myself an added injury after the op which caused me tremendous pain -however if it wasnt for that i felt no pain in the wound AT ALL, and i managed to take it very very very easy for four weeks!

as for the cost cutting

i think there are MANY MANY other areas where they can cut back on costs....one idea could be on the health tourists who come here to deliberlaty abuse our nhs and those who buy their way into it - see
" panorma health tourists" the NHS in lots of hospitals doesnt have anyone to even check whether someone is entitled to free care which is costing hundred of thousands.

so for a start they could start to check people are entitled to free care.

make drunks pay for thier care in a & e on the weekends? youngsters out fighting and getting drunk....charge THEM.

IF they are cost cutting - fine but shouldnt they TELL patients and make them aware before they go in, and if she had an emergency section shouldnt she have been told this and told what to do if she needed stronger pain relief?

i agree with the other poster that said - they are passing on the problem if they leave a woman in pain like that - passing the buck back to " busy, over strected GPs".

when i was younger i always remebered our docs to be civilsed my mother was never stressed getting us appointments - our local hospitals were normal and not really anything we ever thought about - it was all running fine.

i just dont know how we have descended into this hideous bun fit to get an appointment - terrified of my local hospitals being able to take of me or my family if we need to use thier services....horror stories all the time....


dreadful.

Tea - i dont know why your MW didnt sort you out with meds - keep tyirng docs and please get yourself codeine and ibprufen or use paracetomol and diflonec....kick up a huge stink - write your MP if you have too and demand help.

shocking.

[RayanneGraff]

This happened to me too. I am also thinking about complaining to the hospital (different one). The post cs aftercare was bad overall- no advice on wound care, signs of infection, activity levels etc.

I was in a lot of pain and I think diclofenac should have been prescribed, although I didn't really mind buying my own paracetemol- it just wasn't strong enough.

[elizaregina]

tea - i would go to PALS - and papers - and MP.

[AnitaBlake]

I was discharged at 2 with paracetamol and iburophen,, called GP at 3, and had a filled script by four for paracetamol, dicolphenic and codiene. GP was horrified by the whole thing. .Ws said they couldn't give diclofenic anymore due to costs.

[RayanneGraff]

Sorry you're in so much pain Teajunky- do keep hassling the gp.

[elizaregina]

Rayanne

I thought too aftercare was ridiculous - they are making a rod for thier own backs - if they cant give proper advice on how to move - what to avoid - infection etc then instead of people healing and not coming back they are just going to get repeat visits with problems.

i was told to " get moving, get on your side" by a very rude MW the night after my op - she didnt advise me on how to move - and i did a massive twist and ruptured or pulled something, it caused tremendous pain at the time - i had to have more care assistant help moving than anyone else on the ward who had all had emergency sections - and nasty labours - they were all more mobile than me - i had to have more pain relief, i have been back to the docs with the pain - i have been back to the hospital!

utterly ridiculous. i then was handed a leaflet by the health visitor THREE WEEKS after the op - on how to move etc....with pictures!

she shoudl have at the very least been given a prescription to pay for if neccasry of stronger stuff should she need it.

all the midwives at hospital and commuity said to me = " we always tell section ladies - keep on top of the pain, dont let break through pain happen or it could be very hard to control....and beat back down...keep on top of those meds"

[Sweetiesmum]

Tea junky I agree the hospital has a duty of care that you are discharged home with pain adequately controlled. With a tiny baby needing 3 hourly feeding and a painful incision that is barely beginning to heal you have every right to expect at least 24 hours of pain relief medication to take home. (A period of grace for you to hobble to pharmacy and stock up on meds) Why dont they cut costs with cutting the managers pay that made this nasty decision to disregard the wellbeing of new mothers

[Pourquoimoi]

It's wrong isn't it. I think unfortunately that it is cost cutting throughout. I had major knee surgery on both knees at once earlier this year and they tried to send me home two hours after the op with no painkillers!!

The nurse tried to tell me to get paracetamol from the supermarket as it was cheap!! I was in agony and couldn't walk!! I really had to be strong to insist that they got me the stronger medication that the anaesthetist had prescribed. She reluctantly agreed and said grumpily that it'd take an hour as if I'd tell her that it didn't matter! I waited and got the necessary painkillers. I was really quite shocked by the treatment though.

Thankfully my c sections were years ago and the cost cutting wasn't in place then so I got plenty of painkillers.

I am all for making savings where appropriate but skimping on painkillers is just ridiculous.

[reikizen]

Firstly, some units do not prescribe codeine to breastfeeding mothers full stop, although the evidence for this is very weak, but you can buy co-codamol (at a lower dose) from a pharmacy. Secondly, I do not rate voltarol as a painkiller and I think that your standard 15p ibuprofen will work better. So, a good idea to stock up on both these before you have a baby.
Secondly, although paracetamol & ibuprofen cost 15p from your local shop, for the hospital to buy them from the pharmacy costs at least 10 times this. I'm not sure it makes sense for the NHS to spend this money on an easily bought OTC painkiller (as bissydissy says, she threw most of hers away - probably about 50 quids worth of drugs) when we are losing staff and resources hand over fist but I understand that some will disagree with this. Many women don't require anything over and above paracetamol in my experience after the first 24 hours anyway.
Thirdly, it isn't just maternity as my DH was sent home following a major operation with totally inadequate pain relief, GP was happy to prescribe something stronger.
I'm pretty sure going to the press will be pointless tbh, the NHS is getting squeezed so much ( I know midwives who share one sonicaid and one set of scales between a team of 6 people and I have had to buy my own neonatal resus equipment for homebirths) I think most people will think nothing of it. As long as St Mary's are advising people in advance (as I am doing at my antenatal classes) they can make appropriate provision. Perhaps getting GP to prescribe it if having an elective section.
I am truly sorry that people have had a shit time with their maternity provision but believe me, it is going to get much, much worse.