Government Review of Maternity Services

[Marina]

You probably all read about the Department of Health allocating £100 million to improve maternity services in England and Wales. This was announced a couple of months ago and there are now widespread consultations taking place through channels such as local NCT branches etc. The aim is to find out what improvements consumers of these services would like to see.
"Giving birth in the UK" clearly demonstrates that some of us did not enjoy our time in the maternity unit. I have volunteered to collate the Mumsnet response to this call from the Department of Health.
If you would like to make your views known to the Department of Health, please post them here and I will see they reach the relevant minister, once I have found out when Yvette Cooper goes off on maternity leave, and if she is still the contact point (she was before the election).
To kick off, this is what I would like to see:

Properly cleaned lavatories, showers and baths. Newly delivered and heavily pregnant women are vulnerable to infection and there are two (or more) people's health at stake. My maternity unit was squalid beyond belief because there were no cleaners. The solution in Greenwich appeared to be to pump mums full of antibiotics instead. We have a brand new hospital in SE London and apparently the toilets are still disgusting.

More privacy. Newly delivered women should not be in six-to-a-room wards with thin curtains as their only privacy. I would like to see more units providing smaller rooms, maybe even singles where possible. Then women could often labour, give birth and recover in the same private space.

More provision for partners. Partners should be allowed to stay over - another good reason for making single rooms the norm. A proper bed, even if only a z-bed, should be provided. Partners should not be treated like perverts or trouble-makers because they want to spend as much time as possible in the hospital.

More support for breastfeeding. Most maternity units are hugely understaffed, which means that midwives and care assistants don't have enough time to spend with women who need 1-1 support to get breast-feeding established. My maternity unit had allegedly won awards for being breast-feeding-friendly. This was not my experience and mostly this was down to the staff being too overworked to put theory into practice.

What do others think? What would you like to see done differently?

My general experience of birth was quite positive (apart from the obvious) but I was in a fairly small maternity unit (Macclesfield). When I had my first, they had a breast feeding counsellor who came to visit me a number of times (at home) when I was attempting to establish bf (with all the problems of fair skin etc, plus a baby in a frog splint). Without her I would have given up after the first few days. I later received a questionnaire about this service, as they were about to discontinue it due to lack of funds.
My other gripe is that after 14 hours of labour, I could really have done with some rest myself, but there were not enough staff available to look after the baby for a few hours, it really was all left up to the mums. Whilst I don't advocate returning to my mums day (10 days in a maternity hospital, bliss) they should appreciate that some mums are going to need more support, we weren't allowed to go home with our first until 24 hours had gone (so for me that meant 2 nights stay) but we were not allowed to have anyone stay with us to help look after the baby! Needless to say, with number 2 I had her at 3:35 am and checked myself out at lunchtime.

Marina, maybe i am repeating what I've already said on the other string - I assume you want it all said here? so four main points:

1)Epsom hospital maternity wing is cosy and has a good reputation and yet they are going to close it down and move to larger hospital further away!

2)Maternity staff and health visitors quite competent, but I never saw the same ones twice.

3)like Debs said, none of the midwifes offered to look after the baby during the 4 days, even though I hadn't slept at all and was near the end of my endurance!

4)My bed was never changed in 4 days (an imperative one would think, after childbirth!) and the food was truly inedible.

thanks for making us heard!

My son's ghastly birth was at Kingston Hospital in Surrey. I shall try and be objective about my requests

1. Better post-natal support within the hospital. No-one washed my baby during our 3 day stay and we had no facilities in our room. No-one told me anything at all about what had been done to me and the effects of those actions.
2. A breast feeding advisor (or more) within the maternity unit on hand to help all new mums.
3. Facilities for fathers/partners to stay close by overnight.
4. A visitors area - so that if you and your baby have managed to snatch a few minutes sleep you are not disturbed by other people's visitors.
5. Less wards and more individual rooms.
6. Staff who are not exhausted, overworked and overstretched.
7. Bathroom facilities that are really clean and that work. The shower I finally got to use had one temperature setting: scalding hot and the water drizzled out in a trickle.
8. More general help. I had a full spinal administered at 4pm and then my husband was asked to go at midnight - he'd already stayed an extra 2 hours. I was left on my own in a single room (not private if that makes sense) with my poor sore, angry newborn baby. His head had been tugged with ventouse and forceps. For some reason he was also very hungry and my milk hadn't come in, so he was gnawing frantically on my nipples to very little avail. I had been in labour for 20 hours, so had not had any sleep at all the night before and I was in shock and exhausted. I so desperately needed a calm, friendly person to reassure me that everything was going to be OK and to help me deal with my baby. I kept buzzing for help, but it took ages for anyone to come and when they did they were just orderlies - it was so awful.

I am so angry about the treatment I received butI am very glad that there are people out there, like you Marina, to help get our points of view across.

Marina, thank you for collating this, my (slightly jumbled) contribution is as follows:

1. Derriford Hosp in Plymouth is very good (I had 2 babies there). Why not use their methods as a model of how to do things?

1. East Berkshire Health Trust does not have good procedures. For example:

-why are routine antenatal appointments at the local hospital, 2 miles out of the centre of town and difficult to get to if you haven't got a car (costs £1 for parking if you have)? Surely all routine consultations could be with doctor/midwife at the LOCAL surgery? -On the maternity ward, the staff keep your notes. I found that they lost them a few times, also I wanted to read what they had written. Why can't mothers keep their own notes as they do in other places? -Organisation on the maternity ward seemed to be a shambles. Messages were not passed between shifts, despite them all disappearing for ages for handover meetings. The results of tests done on my baby were lost. On the morning we were due to leave, the paediatricians were apparently unaware that we were leaving, and didn't come to give my baby his routine leaving checkup. We were there for 2 days, and I only found the breastfeeding room and nappy changing/clean linen room an hour before we left - no one had bothered to tell me that these facilities existed before. The general impression I got was that everybody and everything was more important than my baby.

1. The food is disgusting. There is no attempt to cater for food allergies, so the only thing you can do is avoid the bad foods, which restricts your diet. You don't really want to risk an allergic reaction just when you're trying to get breastfeeding established (and pass allergy on to baby).

1. Staff need more training in getting breastfeeding established. There is currently a huge gap in skills between staff members. Recently at Wexham Park Hospital, one midwife assured a mother that her premature baby couldn't get enough breast milk and needed formula or it would be brain damaged, and the next midwife a couple of hours later had the baby happily breastfeeding (I was there when this happened). This kind of difference in approach is hardly helpful to new mothers.

Another suggestion for improvement, make breast milk banks more widespread.

My baby was born at the Royal London - suffice to say I am currently investigating a home birth for no.2!. My list of priorities is:

1)Provision for partners to stay. The wards were horrendously understaffed and there was nobody on hand to provide any help whatsoever. My husband was shunted off 2 hours after the birth leaving me alone with a crying baby for 10 long hours and a blood soaked mattress.

2. Clean bathrooms and toilets - these were an absolute disgrace.

3. Privacy. I was in a ward with 8 other mothers & babies. Mine was the only one crying which I found incredibly stressful.

4. Help on breastfeeding. There was none available and I am sure the complete lack of assistance in those early hours led to so many of my problems in ultimately getting feeding established.

5. Edible food delivered to your bedside. Unbelievably, at the London, women are expected to walk to a nearby room, stand in line with a tray and then return to your room to eat. I never figured out how you were supposed to manage this unaided within hours of giving birth or what on earth you were supposed to do with your baby while you were doing this.

6. Better security on wards

Our two local hospitals (understandably) don't allow you to use mobile phones within the building. As the mother of a newborn,I was faced with the prospect of having to leave my baby and go outside to make personal calls. Even though I was lucky enough to be able to walk around after the birth, leaving my baby was a wildly undesirable option.

So please, can we have more public phones within the maternity unit. And some sort of token system so that all mothers can afford to use them?

When I was in our local maternity ward I well remember the queues for the two phones and how often they didn't work. And how they ate my change at an alarming rate. It caused much stress at times. And when you're coping with post baby blues, more stress is the last thing you need.

Access to a phone empowers you at a time when you're feeling vulnerable. In my case,I wanted to be the person to announce to some of our friends and family that I had given birth. I didn't want my husband to speak for me all the time. I wanted to contact certain friends for reassurance. I wanted to arrange their visits at times that suited me.

Also I would like to see access to a computer, so you can send and recieve emails and get on the internet, which leads me to my last suggestion - this is my advertising background showing itself -

A poster in every maternity ward (sandwiched in between those soft-focus pro-breastfeeding posters) outlining useful internet sites for new mothers ....like mumsnet!!

Just imagine if every mother in every maternity ward could get on mumsnet .......

Superb idea tigermoth, why should the NCT have the monopoly on leaflets?

Tigermoth, sounds like this is another advert for macclesfield. After both my babies were born the midwives wheeled the phone into the delivery room so I could ring who I wished. I still remember lying there after no 1, still covered in gore (hadn;t felt up to standing then) but ringing my mom to tell her she had a beautiful new grandaughter. I just wish everybody could do this. It does seem to be the smaller hospitals which are getting it right.

Lucky you, Debsb. I was in hospital for about two weeks with my second son (he had complications). There was no easy access to a public phone, and so my mother rang me every couple of days to see how we both were. She was worried and wanted to feel involved but she lived too far away to visit.

Also my husband and I were buying a house (or rather I was) and the estate agent had to make some urgent calls to me. Unfortunately this meant that the ward phone was getting tied up with my personal incoming calls and, understandably, I was asked to limit them.

Of course I couldn't argue with this. But over the two week period it was frustrating and depressing to feel so cut off.

I suppose in the grand scheme of things, phone access is not the most important consideration. My suggestion is way less important than some of the other suggestions posted here. It's just another idea to add to your list, Marina.

Do something about the waiting for appointments system, I seem to have sat for hours and hours - If I'm on time why can't they be?

Do some kind of major customer service training at all levels - I'm a human being not a medical condition and just because you've got MD after your name (or not) doesn't mean you can treat me like a brood mare. You may have delivered 100s of babies but this may be my first or even my second after a horrendous first. Show their female relaives videos of MDs/Consultants performance on the wards and watch them cringe!

I gave birth in the Royal Oldham Hospital last year and have few complaints.

1. I agree with Kia. The appointment system is an insult. Why do so many women have to have the same appointment time? We were herded like cattle from one area to the next hanging about for hours. Apparently this system was in place when my mother had me 30 yrs ago. Just because I was pregnant does not mean I have nothing else to do with my time.
2. They need to listen to the women, we know our bodies. Why is it that the male doctors don't believe you when you tell them that your cycle is not the text book 28 days? I got my due date correct even if they needed a scan to help them.
3. Better facilities for partners. I felt so in need of my husband and so upset that he had to go home to an empty house leaving me and his daughter behind at 2am.
4. Oldham has a very expensive private telephone & TV system, luckily I left after 2 nights so did not use them.

I do have to say they were very helpful with feeding and they had good security measures. I liked the company of other people on my ward, I would have gone mad alone.

Thanks for putting our ideas forward.

On the contrary Tigermoth, I think your suggestion is very important indeed. Not life-saving, maybe, but it was one of those change-munching daleks that caused me to have an enormous fit of baby blues hysterics in an open corridor, and I heard plenty of other mums wailing and cursing while I was there.
I was in for ten days and very ill and depressed for several of them. A decent, decently priced phone system would have cheered me up no end.
Keep the ideas coming, friends! And isn't it good to hear that some people's experiences of hospital deliveries are positive.

1. Continuity of midwives would be at the top of my personal list.
2. Not treating pregnancy and pregnant women as a problem to be controlled. Communication. What is the point of birth plans if midwives and doctors ignore everything?
3. Allowing birthpartners to stay with one even once one gets on the ward... after hours of going through the labour not only is it dangerous for someone who is physically exhausted too to have to get into a car and drive home it is a terrible wrench for all involved!
4. And yes, it is amazing how the NHS thinks one has all the time in the world to sit around waiting!

5.Adequate facilities such as birthing pools etc., I had to go to a big training hospital and was staggered by the fact that they didn't have a birthing pool!

I'll probably be adding to this list I am afraid to say...

I spent 5 days in hospital after my C section in 1995. In that time nobody cleaned the ward I was in. Chase Farm, Enfield.

When I returned in 1998 there were blood drips all over the floor of the ward, I spent one night in there after C section number 2 as apparently you have to be observed. I then paid for a private room with an ensuite shower. £138 per night. I would happily have paid £138 x 4 nights and my £600 per year annual health policy to the NHS if improvements are to be made.

The NHS food was disgusting. My mother complained to staff. I was offered a curly corned beef sandwich after no 1 was born. The food was totally inadequate for women who had just given birth.

You had to pay to park, at a hospital, !!!!

There was no advice on breastfeeding, I was told "you start and I'll come and have a look later" no one came though.

I had both my babies at the Rosie in Cambridge and had very good experiences both times. I agree with what others have said about the phones - being able to phone my mum and MIL from the delivery room was great.

My one real gripe was the food. After 13 hours in labour with my first child, I came down to the ward and, because I had missed dinner, all they could offer me was a piece of toast and a low-fat yoghurt! Luckily I had stashed a packet of chocolate biscuits in my labour bag, which rather saved the day, although I was ravenous and really needed a decent meal. My husband could have trekked all the way over to the Addenbrookes concourse and got me pizza, but how could I ask him to leave his new firstborn?

With no. 2 I left hospital immediately, and I must admit that the standard of the hospital food certainly had something to do with that decision.

Sleep that's what I need, after 20 hours of labour and a C section. I was kept in hospital to rest and because of the risk of infection, the consultant looked offended when I snorted with laughter when SHE said this.

I delivered at Trafford General a small unit. Wards had 4 beds in and I had a good laugh and enjoyed the mutual support.

Like everyone else staff were too busy to support b'feeding properly although they tried.

Marina - here's some to add regarding dads

1. Information specifically for dads - pretty much all of it is for mums at the moment, and there's a bunch of stuff dads would like to know that isn't as relevant for mums.

1. Midwives and other health professionals to say "hello" to dads and let them know what is expected of them at appointments.

1. Dads to be involved in all aspects of post-natal education - being taught alongside mums how to bathe, feed, clothe and change the baby.

1. Dads NOT to be kicked out of hospitals or treated as "visitors" (i.e. have to leave outside visiting hours) - this is unbelievably common, is an absolute insult and is as hard for mums as it is for dads. We should be able to stay with our partners and babies.

Hope dat helps.

Two things

I was induced on a very busy ante-natal ward. I was throwing up, moaning and groaning in pain aggitated, terrified, pacing up and down to the amusement of the other pregnant ladies(in for observation) and their visitors . It was a very humiliating experience.

As for cleanliness the hospital that I went to insisted that you bring in your own detergents and cloths and that you clean the toilet, bath and shower before and after use. Needless to say they were spotless -- even though cleaning a toilet/bath between contractions, as well as after the birth with the discomfort of stitches was challenging.

Crikey, Knakered, which hospital was that?? Just so we don't buy a house in that area...

Gosh, I think reading a lot of these I had a good time. During my pregnancy I was looked after by my community midwife and I saw the same wonderful woman at every appointment; it was also she who looked after us both in the 10 days immediately after going home and the continuity of care was something I greatly appreciated. I was also monitored by the hospital because of my hyperemesis and was seen on time every time and by 1 of 2 doctors whom I then saw on the ward after the birth. Ante-natal classes were run by the hospital and there was the option of just women or with partners. We chose the latter because we both wanted to be involved but interestinly the only women classes were during working hours which I couldn't have attended as I worked full-time until 35 weeks (the partner classes were at night so all the huntergatherers could attend!).

My only real complaint about my hospital experience was on being admitted with contractions (I hadn't noticed but I was having a late scan because of a leak, later decided to be a hindwater leak rather than the start of waters breaking). I was in my room (single) contracting away, getting stronger, feeling quite apprehensive, this being our first baby and my husband was advised to go home to bring my bag, eat etc. He would be away for a couple of hours and I phoned a friend who was listed as my next person to call if my husband wasn't available to come and be with me - when she arrived the nurse in charge of the admissions ward refused her entry on the grounds that she wasn't mu husband/partner. The fact that she was replacing him for a period of time didn't matter; the fact that I was on my own and feeling quite freaked didn't matter. Between us we kicked up an unholy fuss and she was allowed to stay for the time that dh was away.

When the time actually came (4 weeks later; false labour time before) it was all fine. I had midwife the whole time (all 2 hours of it!), in the very homely midwives unit and I guess it was the best of a painful situation. Having just looked at the stats for Aberdeen Maternity Hospital I guess I was very lucky (they seem to be v interventionist - but this is possibly because they are a large teaching hospital and scoop up all problem deliveries for a huge area - Grampian, Orkney and Shetland - which could distort the figures significantly). A telephone was provided once I was stitched as was tea and toast for us both. DS was placed in a lovely wooden cradle which made for nice pictures. DH had to put my venflon in but he is a doctor and there were several emergencies happening around us.

Once on the ward the staff were v supportive - no mention of going home until I asked to go home so no pressure which was nice. Food was ok. DH could visit from first thing until 10pm so v open access for partners. When they decided to transfuse me they looked after ds overnight and just brought him back to feed (best night sleep I had!). Ward was only 4 so small and sociable. All in all, really quite good. Maybe a lot to learn for other hospitals.

Tom - when the nurse came to teach us how to bath my newborn son, she insisted that my husband do it, not me. To this day bathtime is his job! Seriously though, it gave him some invaluable early confidence at handling a tiny baby, and was just great.

I have no complaints about my sons birth.The midwife who assisted me was kind ,friendly and adhered to my birthplan.Any suggestions she made were obviously tailored to suit the kind of birth I wanted and my son was born after a 10 hour labour without me needing any stitches.The care I had recieved while pregnant and the aftercare were another matter.I had been booked into the GP unit at the local hospital, which I found out was basically as way of the GP getting money for services she didn't provide.The community midwife I saw through most of pregnancy was a bitch on wheels and seemed to take pleasure in frightening me.I was admitted at 36 weeks after a bleed,and noone would tell me what was to going on.when i asked to go home they threatened me with 'you're endangering your baby's life' but no why.i was told later that i had strep b(not connected to the bleed)but when a swab had been taken at 32 weeks there was no infection.Perhaps this was a result of the internals they were so fond of doing?After ds was born they asked us to stay in for 48 hours so he could be observed as strep b can be dangerous, yet no doctor came near him until he was 4 days old and the gp popped out to check everything was ok.We had no help with breastfeeding other than someone shoving my breast in his mouth, and we were constantly disturbed, making sleep impossible.Most annoyingly, I was not allowed to carry my son on the ward.Trying to calm him by walking him was vetoed.All babies must be wheeled in their cots!!The food was abysmal and completely inadequate for newly delivered ,breastfeeding mums.I could go on.A bit of kindness and commonsense would have made some difficult and scary times much easier to handle.I'm definitely having a home birth next time!!!!!