Postnatal care cancelled ‘due to covid’ (c-section)

[sarah13xx]

Has anyone else experienced very little post natal care since leaving the hospital after their c-section? Everything seems to be cancelled with the excuse that it’s due to covid. The midwife was supposed to come every day at first but came twice and phoned once instead of coming. When you’re a new mum, don’t have a clue what you’re doing and have an incision that you have no way of telling whether it’s infected or not, how is a phone call any use? 🤷🏼‍♀️ I was told to take the dressing off it myself because they don’t have time to do it. The health visitor then came after day 10 and comes once a week. She’s lovely and very helpful but hasn’t checked me at all, it’s just for the baby really. My car insurance says I need to have a doctor check me at 6 weeks and say I’m fit to drive. I phoned the doctors to book my 6 week check-up and was told they won’t be doing postnatal checks just now ‘due to covid’. I questioned this and asked if this was even if you’d had a c-section but was told they won’t be doing it. If I really want to speak to a doctor at 6 weeks I can phone and get a telephone appointment 🤦🏼‍♀️ How am I medically trained to assess whether or not my wound is infected, my uterus has gone back down, my ab muscles haven’t split etc? It just seems complete madness!

Its shit isn't it? Can't comment on the Mw situation, but health visitor is not medically trained and can't examine you for anything. I'm glad you have a good one though, they can be really useful, ours was rubbish!

That doesn't sound right at all and must be really tough as a first time mum. I would push for a face to face visit with a GP. Do you have contact details for a post natal clinic in your trust? Hope you manage to see someone. You will know if your c sec incision is infected though as it will be hot/red/itchy, or possibly leaking fluid. If you have any concerns about it do call your GP as they will need to check that out for you. Good luck!

It's Shit.

DS (15 months) has seen a HV twice, in his first 6 weeks, nothing since.

His 12 month check was a telephone call where I could have said anything really.

Sad to see they've not moved any further forward.

You get a lot more care than some women.

Here it's one home visit then seen day 5 and day 10 in clinic, discharged if possible but a few seen weekly until day 28 if clinically needed.

Yes you take your dressing off yourself- it is literally a big plaster so don't see the problem in that?? MW usually discuss wound care, signs of infection so you can monitor and then they will check at appointments.

Again if uterus wasn't contracting then there would be signs such as heavy loss, which again MW should havebl discussed when to contact them/GP if concerned.

To pp who said HV aren't medically trained- they are. They are either nurses or midwives who have done extra training. Never known a HV to visit weekly though.

But yes MW would love to see women more but there honestly isn't the capacity- without Covid coming in to play. some days clinics are so full and overbooked that we don't get lunch breaks and have to do visits when we've officially finished for the day. It sucks

You’re expecting too much I think because all the midwifes do anyway is it give it a coursery glance. I had my first baby in 2017- GP not doing post natal checks as doctor was on sick leave, one visit from the midwife, one visit from a horrible health visitor and that was it. I had my second in Feb- 2 midwife appointments at the clinic, 1 brief phone call from HV and 1 call from GP. So it’s not new that you don’t get a lot! Honestly you’ll know if it’s infected and if it is call your GP as you’ll probably need antibiotics. You can feel for your own ab muscles (google it). I also had private post natal check ups with my consultant as I had private births and even they didn’t check my abdominal muscles. It’s great you have a good HV, that is really quite rare! And whilst it is primarily for baby, they are trained nurses or midwives so they should be able to answer basic questions about wound care etc.

I’m 15 weeks post C Section and my GP has been ok but I’m getting absolutely nothing from my Health Visitor. I complained about the first one to be told that they were very stressed because of Covid. The second has seen my baby once, weighed her and sent me on my way. It’s a total lottery as the mums in my antenatal group are in a different borough and getting seen properly. Also the midwives didn’t bother checking my C Section wound and lo and behold it was infected.

I wonder why covid is causing substandard service. I'm not aware that many midwives were moved to ICU or covid wards. There could be some sickness leave but apart from that covid seems to just be an excuse. Hope you are well and healing.

I’ve been a midwife for years and never known daily visits (unless a problem) even for lscs women so it sounds like your trust were going above and beyond the National standard. Which tends to be day after discharge, day 3 if bf, day 5 and then day 10 for discharge. That’s routine (pre covid), obviously if there is a concern extra visits will be added.

I don’t work clinically apart from the odd hospital bank shift so not sure what’s happening now. I know initially locally some visits were changed to phone appts but I did think they were back f2f. Dressings are easiest taken off in the shower so we’ve told women for years to take their own dressing off.

20 years ago when my dc were born I only saw the HV 2 or 3 times. Never known a HV come weekly so it sounds good you’re getting that.

I suppose for the gp appt there is quite a bit they can do over the phone to assess you….ask questions about lochia, is the wound red, any offensive discharge,…..so that would rule out infection and also if your uterus had involuted just by questions. Your stomach muscles are different…..I think I saw a guide for self assessment recently…..will try and find it and link. A lot of GPs refuse to sign people as fit for driving now, they won’t take responsibility….they say if you feel you can do an emergency stop it’s up to you.

I’m sorry you feel let down though. I do think MN is a good source of support and advice if you’re not sure if anything is right though.

If it helps, my 6w section check up focused exclusively on mental health (no particular reason, there were thankfully no issues with that). They checked my scar, but only because i asked if they wanted to and they said they could if I liked.

This was before Covid.

www.parents.com/pregnancy/my-body/postpartum/diastasis-recti-the-postpartum-body-problem-no-one-talks-about/

Here, how to check for diastasis recti.

I’m not saying this to gloat but I am genuinely horrified by this, especially for a first time mum. I’m not in the UK and in a country where all healthcare is privatised, but to give you some comparison, the standard post partum care here is:

• Obstetrician who delivered baby will come and check on you in your (private) room before you are discharged (usually 48 hours after a routine vaginal delivery)
• Obstetrician will see you again around 5 days later in their clinic to check any stitches, check on your bleeding etc
• Obstetrician will answer WhatsApp’s, emails etc to discuss any concerns before doing a final 6 week check at which point they will do things like an ultrasound to check your womb is clear and then also write you a referral to a Women’s Health Physio who will check you for diastasis recti, pelvic floor function, general aches and pains etc
• Baby will have a check up with pediatrician before discharge from hospital
• Baby will be seen as much as you want in the baby clinic for the first 18 months (I quite literally went daily for the first week with DS1) and they will do things like clean the cord stump, weigh and measure the baby, administer vaccinations, provide breastfeeding support, provide emotional support etc
• The midwives that run the baby clinic will also do home visits if requested and will happily provide support via phone, email and WhatsApp

Even with all this support, I found having my first baby totally overwhelming so am horrified at what you are describing

Hello

This does sound bad service. When I had my son I had the midwives descend upon me for a long time every day. I struggled to bf, my son was jaundiced and slept so didn't feed and we got readmitted to hospital on day 4. This was all down to the midwives helping us. I'm so sorry you have been failed like this and if I were in your shoes, I'd write a letter of complaint.

Obstetrician who delivered baby will come and check on you in your (private) room before you are discharged (usually 48 hours after a routine vaginal delivery)

You can oay for a private room, so I had one both times. The first time i got a visit from my surgeon, both times i was checked by a doctor before discharge

- Obstetrician will see you again around 5 days later in their clinic to check any stitches, check on your bleeding etc

We don't get this, but we get several visits from a midwife to check these. Some are now by phone due to covid.

- Obstetrician will answer WhatsApp’s, emails etc to discuss any concerns before doing a final 6 week check at which point they will do things like an ultrasound to check your womb is clear and then also write you a referral to a Women’s Health Physio who will check you for diastasis recti, pelvic floor function, general aches and pains etc

We can phone up the midwife/postnatal care at any point in the first 10 days or so until officially discharged from their care. GP appointment 6 weeks later which can be a bit hit and miss tbh. They don't scan women routinely, but would i guess if there is a problem evident.

- Baby will have a check up with pediatrician before discharge from hospital

We have this.

- Baby will be seen as much as you want in the baby clinic for the first 18 months (I quite literally went daily for the first week with DS1) and they will do things like clean the cord stump, weigh and measure the baby, administer vaccinations, provide breastfeeding support, provide emotional support etc

There are local clinics several times a week for the things you mention, and in my area daily bf support groups. All of these are drop in. Many haven't been running because of covid

- The midwives that run the baby clinic will also do home visits if requested and will happily provide support via phone, email and WhatsApp

So will our health visitors if requested or they think its necessary. Again, things haven't been normal because of covid.

I had a c-section last April. Was kept in for 5 nights afterwards due to feeding issues. But once we were discharged we had literally nothing. No midwives, no health visitors. Absolutely zero. Women and children are really being left down.

Sounds pretty standard to me and I had my babies is 2016 and 2020. Both were c sections and I had severe pre eclampsia with my first and both babies were premature.
Once I left hospital, I was visited once every 2 days for a week but then hardly saw anyone after that.
I agree with pp that you are expecting way too much

I had ds3 last April and care was different compared to non covid times. Ds3 was born at 35weeks and I was told ds3 would get a letter via the post for a final check up by the nicu team. He was there for two days and three days with me at postnatal ward because it makes breastfeeding more likely to succeed. I loved this pathway as it meant I wasn't away from baby for long and I didn't need travel back and forth. Ds2 who was also a nicu baby I had to leave him behind and it wasn't a nice feeling.

This time, my postnatal 6 week check up was done via the phone. However, my womb did get infected but I went back to labour ward and they checked and gave me antibiotics. I was still on the antibiotics when my 6 weeks check up happened. It was healing nicely so I told gp that and we discussed contraception. You might find that useful.

One thing I'm not sure was missed is the weekly weigh in for baby until ds3 reached term. Only because with ds2 a midwife came weekly and weighed him. Ds2 was born earlier at 33weeks maybe it is covid or there is a cut off point between 33weeks and 35weeks that stops weekly weighing. My aunt had a daughter at 35weeks and she took her dd for a weekly weighing 8years ago so things might have changed.

FTM here, now 4 months after csection. Had my 6 week appointment during my little ones 8 week check up.

I was told by mw that as long as I can do an emergency stop without discomfort I'm good to drive. It was way before the 6 weeks for me. All depends how you heal.

With the wound, ad long as it doesn't weep, open up, or is hot to touch you should be OK. No-one looked at my wound, even at the 6 week appointment.

If you are concerned about anything, get in touch with gp

Obstetrician will answer WhatsApp’s, emails etc to discuss any concerns before doing a final 6 week check at which point they will do things like an ultrasound to check your womb is clear and then also write you a referral to a Women’s Health Physio who will check you for diastasis recti, pelvic floor function, general aches and pains etc

We can phone up the midwife/postnatal care at any point in the first 10 days or so until officially discharged from their care. GP appointment 6 weeks later which can be a bit hit and miss tbh. They don't scan women routinely, but would i guess if there is a problem evident.

Yes but the second point all the onus is on the new mother, and the scan will show any problems earlier, not just those that are evident. Likewise all women should be getting checked by a women's health physio.

It's sad that people are saying OP is expecting too much, and that others get even less care, it shouldn't be a race to the bottom and certainly what OP expects is not extravagant.
Patients should not have to Google how to check their own abdominal muscles.
Patients cannot always identify signs of infection until it has really taken hold.
Checkups should not be by phone. At least a video call would be a bit better if they are determined not to do visits.

I’ve had 2 c sections. The midwife who did visit only asked if I had any problems with my scar. I went to the doc at my 6 week check up and asked them to check to make sure all was good tho I did feel well in myself anyway, the only on going thing I had to do after both was the daily injections to reduce blood clotting. If your worried about how your healing is contact the doctor or ask a nurse to check

@Unicornflakegirl I wouldn’t have thought I was expecting much to have a medical professional physically check me once after major surgery but it seems a lot of people haven’t had much after care at all 🤦🏼‍♀️

@squee123 that’s really sad 😔

Not just UK I’m afraid. I had zero postnatal care last November here in Italy with spiking cases. I was left to recover from a c-section with a jaundiced baby and no family close by after being released from hospital just 48 hours after birth, and two weeks pp my dad was admitted to the Covid unit in the Uk with double pneumonia. I honestly think it was the most stressful thing I have ever gone through and am honestly quite bitter at having pregnancy and post partum ruined by the pandemic.

Nope I had mine in 2014 and 2011, not much has changed I see

You seem to have more visits than standard. They want to discharge you asap

Sou DD poor but I'm not sure it's necessarily down to Covid. I had a C-section ten years ago and the midwife came out once. Health visitor also only came once. Everything else was done over the phone.