postnatal ward survival tips

[elliejjtiny]

I'm 22 weeks pregnant with DC4 who has a cleft lip (not sure about palate). DS1 was home birth and DS2 and DS3 were hospital births with a 3 hour discharge so never been on the postnatal ward. The cleft team want me to stay on the postnatal ward "for a day or 2" to establish feeding. The thought of that makes me panic (hyperventilating type of panic). I had a miscarriage at that hospital which was managed badly and a fairly traumatic pregnancy and birth with DS2 which hasn't helped matters.

Any survival tips for the postnatal ward? I'm going to talk to my midwife at my next appointment to see if transferring from the delivery suite to the childrens ward instead of postnatal but don't think that would be allowed (I think I asked for that with DS3). At least on childrens ward it's all side rooms, open visiting (on the postnatal ward visiting time clashes with school run and bedtime so DH and the DC's could only come for 20 mins after school) and most importantly no bounty photographer!

Do they have private rooms on offer? At my hospital you could pay for your own room if there was one available. Although there were none available when I gave birth second time, I got one first time around as I was kept in for 7 days and it was great.
Second time I was on a ward with 2 other women, which was a bit annoying as it meant there was a constant flow of people in and out of the ward doing monitoring etc, but as I kept the curtains around my cubicle shut most of the time it still felt pretty private.

Earplugs.

A fan, fone charger, iPod. But would second discussing your anxieties.

Nothing like your own pillow. I stayed for 3 nights after dd1, couldn't sleep a wink til dp bought me a decent pillow in.

Firstly, congratulations! Hope it all goes smoothly!

Sorry to reinforce what you're thinking but... Birth was ok compared to post natal care... (3 nights) next time, I would...

• pack as much food as you can. The fibre content of my meals was dismal; I basically lived off chocolate buttons and dried mangoes & apricots.
• pack post birth bags really carefully: probably a days clothes at a time, so you can send them home as you're done with them, also if you can, organise your stuff at home similarly so it can be brought in if you're in longer than you hope
• don't forget cotton wool and something to hold water in to clean baby's bottom, I didn't have either and it was really hard to get some on the ward
• work out the names of the staff you like; I also wish I'd asked to see a different midwife to the one who really hacked me off on day one
• My hospital didn't have bounty women, but by the time the night staff clocked off, the food orders came round, the drug round came round, the day staff came on...
• bring towels, bedding etc. that make you feel good
• make an effort for 'day' and 'night' clothes.
• use all the confidence that you have having done it three times before to get what you want!
• if you can't get a side room, at least get the best bed you can (by a window, with a chair, near the sink in my example). Keep being awkward
• don't let them take your water jug away
• remember its not forever!
• transfer somewhere not as hospital-ly if I could (I went to the local MLU on day 4, which was so good n comparison!)

My milk came in and I was so engorged there was no way my not-interested-in-feeding-anyway baby would be able to latch on, and I didn't know what to do to hand express, and I waited 12 hours before I got a pump. For this reason, next time if I end up there, I'm going in with my own Milton and pump... But that's a very personal experience.

Good luck!

Sorry, retreading that was overly negative. The care for my baby was excellent and we both survived, and I'm sure a lot of it would be different if it wasn't my first baby. (Ie id know how to hand express, what is normal to dress a baby in, etc.)

My other thing was to ask visitors to bring in calippos or ice lollies as it was very hot!

Thanks for the replies. I'll talk to the midwife about my anxieties when I next see her (got an appointment at 25 weeks) and ask about a side room too. Got a breast pump so I'll pack that in my back, along with food, pillow, kitchen sink etc . Hadn't thought about the MLU. I'm not allowed to give birth there (bmi over 30) but hadn't thought about going there afterwards.

The annoying thing is that I think feeding will be easier at home. After the cleft nurse explained that I'll probably be able to breastfeed but feeds will take longer and he/she will probably need top ups of ebm, via syringe at first and then via a special squeezy bottle so he/she doesn't have to suck as hard, I thought I can do this no problem. I thought it would be a lot harder than that. Also at home I won't have to ask how to work the sterilizer or ask for my ebm out of the locked milk kitchen.

I'm also worried about my baby screaming unless cuddled all night while all the other babies sleep through the first 24 hours like the pregnancy books say they will. Fine at home when I can just cuddle him/her and watch tv but hellish on a ward when there are other mums trying to sleep. I'd prefer to be at home when I bleed through my pj trousers and onto the bed sheets too which I always do a couple of times on the first day or 2.

I think being prepared would help. You mentioned a couple of specific things you were worried about, I've put some tips below, but is there anything else?

Worried about bleeding? Wear tenalady pants as well as pads, take some pampers bed mats.
Take food, lots of!
Same for clothes. Remember it will be boiling in there.
Have you got a tablet/laptop you can load with tv/DVDs/games and use with headphones during the night?

Can you ask what they are going to do for your baby after the birth... then ask why hospital is the best (or only) place that can happen. I guess what I'm trying to get at is- do you have to be there overnight, could you go back in the day for a timed appt with the paed, could a community MW visit 2x a day at home. I'm wondering how much help you would get on an hourly basis vs the stress to you being stuck in there.

If you think feeding is going to be easier at home, then I'd decline a PN stay and go home.

Lots of PN wards profess to be able to give support for BF women, but sadly this usually boils down to an understaffed ward full of women having a MW pop in when the buzzer goes off, shoves baby and boob together, then the MW having to run off to the next woman who needs her. I agree it will be more faff having to request your EBM is found, or you're shown where the steriliser and equipment are and have to sort it all yourself, whereas at home you'd have dedicated support on hand all of the time.

If you struggle, you can always be readmitted, but you'll also have MWs visiting you at home - or as Arith says, you could go in for an appointment with the cleft team or paed.

Can they show you how to use the bottles and syringes before the baby is born, rather than after?

I would be inclined to push for community care at home too. Especially if the cleft nurse is encouraging about you being able to manage. You are not exactly on your first baby!

I spent 5 days on a postnatal ward after having my first baby. That experience made me so unenthusiastic about hospitals I paid for a private midwife for the second one, with her main remit being to get me out of hospital asap! I ended up discharging myself after 10 hours in. (Baby was never admitted, as he was born at home. I needed transferring in afterwards.)

Do your funds stretch to paying for a postnatal package with a private MW? They will visit you at home daily for as long as you need, and help you establish feeding. You are still able to use any NHS facilities you might need.