What did you want from midwives on postnatal wards?

[Studentmidwife247]

Hi ladies, I am a first year student midwife heading out on my first placement next week. I will be spending a fortnight on a postnatal ward and was just wondering what you most wanted from the staff during your time on postnatal wards? I'm mainly hoping to be a supportive, consistent friendly face who can get to know the women (due to the high risk nature of the ward, ladies are likely to be spending long periods of time on it). I know that staff on these wards are normally incredibly busy, so from your experiences, what would you have wanted from a student midwife to make your stay more comfortable/pleasant? Was it just someone to chat to? Someone to assist with practical skills such as breast feeding? I want to make myself as useful as possible during my time there! Thanks

Yes to painkillers- I was in a lot of pain but also just wanted to go home so didn't complain. Only once I crawled out of the car when home did I realise how stupid I had been. Luckily midwife visit the following day sorted.

I think the midwives were great but so short staffed- saying they wanted to see breastfeed on both sides but ended up seeing neither because of time. I think most important thing is to manage expectations- I was told could leave by 2 so when still there at 5 without being seen/medical need you can imagine my frustration. Felt I had to push to be discharged but just wantes to be home with dh...(and a comfy bed!)

I remember wishing someone would just respond to the buzzer and help the post c section ladies. On more than one occasion I was tempted to go and help them myself.

Someone to have read my notes especially the bit highlighting that I was already suffering from depression and the staff were continually placing my meds out of reach/ saying that I couldn't have them because a Dr on the ward hadn't ok'd them so sitting there in floods of tears and shaking might have been good.

A call bell within reach. A light that worked!

Realising that I had had a GA and was completely out of it when being brought to the ward so actually explaining where the toilets/showers/call bell was. I was disorientated for the 3 days I was in with no natural light in the ward at all (see point below)

To follow the ward policy of having the curtains drawn back.

To spend some time on the ward.

Not to shout at me when my baby was obviously hungry but I had been desparatly trying to bf but unsuccessfully yet asking for help and no one ever coming. And then hearing the woman opposite who was able to get out of bed get 2 hours of 2 on 1 support to bf in the middle of the night.

Not to shout at me when they had placed baby miles away (post emcs) and he was muscousy and sick and coughing and I called for help as I still didn't have any feeling in my legs due to anaesthesia problems.

Communicate and don't just leave you in limbo about what is happening. And communicate with other staff. I was on oxygen and the consultant wanted me off it as my O2 sats were fine and to start moving round. But the mw wouldn't let me move out of bed until I had been disconnected from the oxygen.

The day time hcp on the other hand was fantastic. I'm due for an elcs in a month or so and I'm already worrying about the postnatal care element.

What everyone else said - provide basic care especially for women who can't move, eg on a catheter. Ensure no-one is left in diarrhoea or blood puddles. That they can reach water etc. How to get food at mealtimes or ensure its fetched for them. Give them a list of what forms, checks and tests should be done before you can get discharged, so faffing about at least is less of a shock.

My first postnatal experience was terrible because there were no night staff - when the cleaning team got to me they were great but five hours of lying in shit trying to feed a baby who had been in SCBU was terrifying. The MW response was only that bf for under 20 min a side didn't count so I should try harder.

Second time I needed psych support during pregnancy in order to face labour there again. Lots of paperwork to try and get me to avoid the postnatal ward. Ended up needing a night there, but the staff were great - when they said ring every time you need your baby passed to you, they really did do so within a couple minutes, got water and cleaners, etc. Didn't get any sleep what with 7 babies screaming until 6am, at which point staff started nursing rounds, but not sure how to improve that. Though communication could improve - the first nurses to visit hadn't been told I was deaf so not being up to lipreading, I thought she'd left a urine sample on the side until next nurse asked why I hadn't drunk my lactulose. Made her sip a bit first!

Also establish what meds someone was on before labour and ensure they get them! You get told that hospital will supply all meds - but took 2 days to get mine sorted out, leading to extra problems. Second time I had them with me - just as well as no-one brought any.

I agree about setting women up to fail. It's only now facing the birth of ds2 that I realise how much the odds were stacked against me when I was trying to breastfeed ds1, drugs that I had, my nipples being very flat etc etc. All the help I got in hospital was various women squeezing my nipples, scraping them with syringes (they were red raw before baby got anywhere near them) and lecturing me because I hadn't fed him for hours. Um no I can't feed him I'm waiting for someone to help me!

I thought the general level of post natal care was appalling and I will do anything to avoid an overnight stay this time round. I was made to feel like an irritating inconvenience and told off constantly. I needed a rubella jab before I was discharged because I had lost my immunity and the midwife was so nasty to me. Presumably she thought I had never bothered to be immunised and didn't care about the harm it could have done to my unborn child. Not that I'd had the jab several times, and that despite having fertility treatment and seeing doctors constantly none of them gave me a blood test until well into my pregnancy. She also gave me a lecture about how I was not to get pregnant in the next 3 months, was she having a laugh?! It had taken me 3 years to conceive my son with fertility treatment!

Empathy without patronising. Some sort of routine for pain relief. Checking for tongue tie and real support for breastfeeding. You sound lovely....you'll be wonderful!

I agree, you will be great if you are sensitive enough to ask here. Good luck.

I felt I had enough bf-ing support but I was grateful for it. I would have appreciated someone bringing my meals over - I missed three as we had to go and collect them and dd was helpfully bf-ing at mealtimes! The third time I tried to take her with me to get the meal and got shouted at. I was starving which when starting bf is not very helpful.

My nighttime midwifery assistant (is that the right term?) is the one I remember. She always looked me in the eye and smiled rather than looking straight at my notes and addressing a question in my vague direction (I appeciate staff are hugely busy but a smile takes a second). She also made positive comments - I remember snuggling with dd in bed in the early hours and she said how lovely it was to see. As a first time mum worrying about doing it all wrong I appreciated that. Also she used my name rather than 'mum' - again I know staff are busy but I hate being referred to as mum by medical staff holding my notes in their hands.

Agree with the previous point about vulnerable new mothers feeling unable to tell the Bounty lady to come back later/leave them alone. Mine wasn't too bad but she was very focused about taking a photo of dd I had no intention of buying and after a three-day labour and an emcs I didn't really have the energy to deal with her.

great that you are asking! I had a horrid time with my first 12 yrs ago. with my latest - 4 weeks ago - was ok, but am experienced mum with straightforward labour. the poor woman opposite me though....she was 1st time mum, csec, and was just weeping. couldn't reach her baby; missed her husband; in pain; trying to bf - and no one to help her. I was shocked. in the end i went over to her (only us on ward) and tried to give her a bf pillow and get her a drink etc. she was embarrassed and begged me to shut curtains, which i did of course. then took my baby to see if i could find mw, they were all reading mags and having cuppas in staff room!!!! went back to bed...lasted 20 mins and asked for discharge as i just couldn't bear poor woman's distress. really hope she was alright.

Echoing what others have said about not making women feel like a nuisance! Also food please! I was in labour through breakfast time so obviously missed that and then lunch was served as I was being handed over to postnatal ward so I missed that too. I was told I could go home in the evening so I didn't order dinner then after lots of faffing with paperwork it was too late to discharge us and we ended up staying in overnight - with no food! I don't know about anyone else but labour and breastfeeding made me ravenous and being denied meals seemed so cruel. I didn't find out until the following morning that there was a little kitchen I could have used to make toast but no one told me.

I had a difficult induction but felt extremely well cared for during the birth. Postnatal care was the worst part of my birth experience. All staff seemed overworked and here seems to be no communicated between staff and patients or staff with each other. I got a lot of breastfeeding support as we really struggled but it was so inconsistent and rushed. I was told by one midwife to try something and then the next shift would 'tell me off' for doing it 'wrong'. My baby was jaundiced but I want allowed to move to a bed near the window. I spent 5 days in hospital with no natural light at all.

Haven't had the chance to read the whole thread so apologies if someone else has said this, but in response to your comment about bf support always being 'hands off' I'd just say be aware, empathetic and get informed consent for whatever you do, but sometimes the only real way to help is to be 'hands on' and a desperate mother may be more than happy to have that assistance if it helps to get food into her hungry newborn or ease her pain!

BF support

Just asking how I was doing, and offering five minutes to listen to the reply

Aromatherapy knowledge (I still love this midwife, made the post butchering suturing healing so much more bearable!

Liaison with the neonatal doc doing the newborn checks so you know which patients are on the list and when they will be seen, to try and avoid feeding/showers/MW check ups at the same time. Less time wasted for everyone

It's really sad to read how many negative experiences women have had. Makes me realise how lucky I was.

The post-natal (NHS) care I received was reassuring, caring, attentive and regular. Perhaps partly because I'd had a c-section (so was having regular visits from MWs for blood pressure checks anyway) and I was lucky enough to have a private room.
They patiently helped me with latching, showed me how to use a breastpump so I could pump my colostrum, handed me my baby, changed nappies for me outside visiting hours, let me co-sleep etc. They also noticed my dd was very hungry and my milk hadn't come through yet so (sensibly) gave dd a bit of formula and even offered to take her for an hour or two so I could rest.

Everyone's experience should be like this. Physically and mentally it can be an ordeal, women need support. And midwives need more resources and funding. At night time particularly they are literally rushed off their feet.

I wanted to co-sleep - I didn't want to have my baby in a fishtank cot next to my bed (that I couldn't reach into from my bed) - I got really told off by midwives for sleeping with her on my chest, for putting her on my bed (even though I'd taken two V pillows in to make a 'next' for her to sleep in). I'm a 40 year old grown woman, I'm not an idiot.

My biggest issue was that I was bullied out of the ward. I had a doctor, midwife and a transitional care nurse stood at the end of my bed telling me there was no medical reason for baby or I to be there despite the fact I was certain that neither of us were in a state to go home, and given that they were the professionals and I was just a new mum who had delivered almost a month earlier than expected I didn't have a leg to stand on. This time I will insist on staying an extra night if i think I or bump needs it.

I could barely sit upright not alone walk due to the blood loss, they claimed that my iron was fine but wouldn't show me the test results, and i have no recollection of them ever taking blood for said test... over a week later I went to the docs to get tested because I was still suffering and was told my iron levels were so low they couldn't possibly have been anything resembling fine when I was discharged.

I was worried that DD wasn't feeding from the breast properly but no one listened. I was feeding DD with a syringe because I couldn't get her to latch on but the transitional care woman insisted we were fine because she'd come and helped us a few times the day before... yes, she had taught me how to hand express but I still couldn't get DD on the boob. When DD was dragged back in on day three we were told there was 'no way' we would had been allowed to leave syringe feeding, and we certainly wouldn't be allowed to leave the room off NICU until she was seen to be getting enough milk from a bottle and had gained back all of her lost weight. we ended up in there for 5 days with her on and out of the lights for jaundice treatment because she'd been allowed to get so unwell.

I will be doing a mixture of days and nights, I'm definitely taking all of this on board. Although as a first year I know there's not much I can do to make a difference, if I can just help one woman feel more positive about her experience, it will be so worth it xx

You CAN make a difference - you can hand people's babies to them when they need it, and put them back in the cot for them when they need a sleep. You don't need any training to do that (beyond knowing to support the head!) and for someone who is struggling to move at all yet needs to care for their child, you could be a real blessing.

I had amazing treatment on the ward and I especially appreciated all the help with breastfeeding.
I would have liked more water though as breastfeeding on a boiling hot ward was thirsty work. I know that isn't a midwife's job but it would be worth keeping an eye on.
I am also extremely grateful to the lovely midwife who sat with me when the doctor had said a lot of things I didn't understand about my baby's treatment and left me in tears. She explained everything and calmed me down, she was really brilliant.

Not getting the hump with a lady because her catheter disconnected and wet the bed :( I felt bad enough for it as well without feeling like a burden.

Unfortunately I can only echo a lot of the negative experiences on here.

What I would have wanted:

1. Somebody to have had the courtesy to tell me that no, my delivery hadn't been straightforward, my BP was dangerously high and I wouldn't be going home anytime soon. Not just tell me that the following day only when I asked when I was going to be discharged.

1. To have remembered to have given me the meds I needed the first night - obviously I didn't know I needed them at that point.

1. To have chased up a cleaner to deal with my sheets and other women's on the ward. After 3 days of lying in blood me and the girl next to me just changed our own. I'll never forget it, she was having a blood transfusion at the time.

1. To have been given some real, proper BFing support. Not just come into the cubicle, push DD's head onto my breast and walk straight back out again. I was desperate to establish BFing and I asked for help so many times. I got the distinct impression in the end that I was a complete nuisance to them.

1. To have been treated with a bit of human kindness. One particular MW was so vile, she had several women in tears.

I was kept in for a week afterwards and it was a horrific experience, thanks to the MWs really. I don't know what the problem was but I suspect a real understaffing issue.

Oh and just adding to the BFing point - if a woman obviously is very keen to BF, support her in doing that, don't whisk her baby off on day 2 to give it formula instead when there's no medical reason to do so but it's quicker and easier

WD41 that reminds me of PSB birth, two hours after birth they came in and insisted, wouldn't take no for an answer, that he had formula

In the small hours I asked for paracetamol following an episiotomy - never got them, the midwives were busy chatting in the office and forgot.
As pp's have said - empathy, midwives witness childbirth everyday, most women don't.
This is really basic stuff isn't it?