Could we have a MN campaign for improved Postnatal care?

[AtYourCervix]

Reading the many threads on here it appears that Postnatal care is the most frequently complained about area of the maternity service.

In-patient stays in hospital - Women feel neglected, ignored and unsupported and Postnatal visits at home are rushed and women are 'lucky' to see a midwife 3 times.

I strongly suspect that with NHS cutbacks ths is only going to get worse and I think it is not good enough.

Ideas and opinions please.

I thought the after care at Lewisham Hospital 4 years ago was pretty poor, they have a birthing centre now so probably not so bad. My DD was 1 day premature, and didn't feed very well on the first night, got jaundice and we were readmitted with her having jaundice at 2 days old and was recommended that she FF to flush it out. I pumped and tried to cup feed, cue many midwives giving me lots of different advice on BF'ing and one woman telling me rather chillingly that 'jaundice starves the baby of life'. They robbed me of my confidence and made me think my baby was going to die. The food was horrendous and the general attitude of the nursing staff was cold, uncaring and judgmental.
Delivery midwives were amazing though, it's the thought of my lovely midwife that makes me tear up every time I go past that hospital, without her calm good sense I'm sure I would have ended up with a c-section - not that I would have cared at the time.

I'm shocked to hear so many negative stories! I had my first baby st st Richards in Chichester almost three weeks ago and honestly could not have been looked after better. My waters broke at 36 weeks and I had to be induced, and things weren't simple, lost a lot of blood and baby had three nights in special care, and throughout my 8 day stay I was cared for so well I cannot speak highly enough if the midwifery team there. other support staff were also great, supportive and attentive. Strangely I had a very different experience with community midwives and health visitor, who seemed uninterested in me generally, these were from royal Surrey (we live about halfway between two hospitals and choose st richards as it seemed the better hosp, glad we did!) I realise I may have been discharged by community team more quickly because of prolonged stay in hospital, but health visitor appointment lasted around 15 minutes. My mum is also a HV and was shocked that she had been so quick, especially as I hadn't had anante natal appt too!

Just to add my thoughts on this. I had DD at Leeds General Infirmary. Our MW on the PN ward was lovely but she explained how they were so short staffed they'd had to put extra beds into each bay and close other bays they didn't have enough midwives to cover.

They had asked staff to work unpaid overtime to help with the huge increase in births that winter - to which the midwives had said "no thanks".

Breastfeeding help was something we had to wait and wait for which was very distressing with a crying baby.

They'd had to close delivery suite a few times and send women to Harrogate/Huddersfield instead.

I'm currently 27 weeks pg and planning a HB. I wouldn't willingly put myself through a hospital birth experience again unless mine or the baby's health required it.

Oh bf support was dreadful, it involved a silent midwife squeezing my boob into a "burger" shape and shoving DD's head on it. It was painful and humiliating. I saw a LLL counsellor after I was discharged and she got us sorted in no time without touching or squeezing me once. Much more dignified.

Hi there,

My suggestions to our local hospital and to this campaign mainly resonate with above but a few additions:

• I found that pre-existing health problems or disabilities were not really considered during my PN stay (6 dayss after emcs and infectionm heavy bleeding etc). I am disabled and am unable to use my hands and arms well. I had problems with getting food, lifting myself out of bed, lifting baby, breastfeeding without pillows etc. These were considered part of my recovery. I was told i couldn;t go home untill I could do these myself..... I was like 'I couldn;t do these anyway...." Also told I was lazy, overweight and missed several meals. [lady opposite couldn't read as dyslexic, another was colour blind] I suggested that problems should be written on front of notes and not 'problems with arms' but "please help with meals, getting out of bed. Is able to feed herself and baby with use of pillows"

*in consistancy between care in the day ahnd during the night. During the day I had a midwife in my ward who cared for me most of the say. Helping me with rehabilitation, caring for little one. which was great but not needed as much as I had DH, my mum, other visitors etc. I dreaded 8 in the evening when DH went home... and we were more or less alone to cope and look after our babies. In terms of care needs and looking after baby the day and night were the same - in terms of care it was drastically different.

*Food and sleep are really important, not 'an extra' to be done when everything else is done. Meals should be protected time, not just in terms of visitors but even giving extra help so that all women are given good nutritious food.

*Communication. I suggested having a two bell system. Green for 'could you reach me my glasses/could you nappy change my baby' and red for 'I am fitting, painkillers, baby feeding etc'. DEFINITELY info sheet - went in to different ward few months ago and they had looooooads of information! WHo everyone was, where everything was, what you could bring in etc.

*Help from home. We were told wrongly that you couldn;t bring food in etc etc. I would suggest all are encouraged to bring nutritious snacks, qcartons of juice, dressing gown, slippers, toilet bag [I was clueless!!!], stuff for baby.

*Reduce visits from Bou ty lady, photo lady etc. And if they must come in WASH THEIR HANDS and do not give out random old wives tales advice

*feedback. During discharge a really easy to fill in 'ticky box' feedback form. Did you find wards and toilets to be a)clean all the time ......... e) really dirty etc. Then a box for any problems and another for compliments - as I am sure there is lots of fantastic care getting lost in our complaints.

It will never be possible to get private rooms for everyone [wouldn;t want one eprsonally - twas conversation that kept me going sometimes!] with own kitchen and own nanny... but thats not what is expected from this campaign.

Clean, warm care from skilled people so that we feel safe, healthy and able in our most vunerable time. Thats what i hope for with DC2..... in a few years perhaps...

Another thing for the info sheet - how to alert a cleaner if you have got blood etc all over the loo/shower. I bet a lot of women are either too embarrassed to go up to the nurses station to say they've made a right mess, or don't know there is one or aren't capable of walking 30 yards or more to it.

Mrs. JRT. It is simply not true that Staff cannot physically move patients. Every trust has compulsory manual handling training, you should have adequate moving and handling equipment for people who cannot move independently. Hoists, 4 section height adjustable beds, slidesheets etc... You should be competent at managing the moving and handling risks and be able to explain to patients how to move without them feeling like they can't manage. There should be wheeled shower chairs for wobbly patients who would be at risk of falls. There are more mothers with disabilities who do need extra help and again this should be part of good postnatal care.

Notcitrus I remember telling someone about the state of the bathroom when I was in with dd1 (blood all over floor, crap all over the toilet) and she said, 'that is what the antibac wipes are in there for'!

hear hear ohanotherone
being wobbly on my legs was the main reason I only had a shower when back home after 2 nights on the ward. I just didn't feel safe doing it. at home I had dh looking after me, helping me in and out of the bath.

Well my care after birth was OK but I think that some of the things people have written about are totally unacceptable. So my idea is to start one of these 'epetitions' things that are starting up on the directgov website - if we get 100,000 people signing then it will be debated in parliment. What do you think....worth a shot as well as other avenues.

epetitions.direct.gov.uk/index.html

Think it starts on the 4th of August.

Hi guys, I'm a medical researcher with a background in postnatal mental health. I'm happy to do a literature review from medical journals to see what is out there already about postnatal care and medical and psychological outcomes. Might take me about a month. Whoever decides to coordinate the campaign, could you let me know so I can send it to you.
Thanks.

Was just going to post same thing as Sn0wflake - very easy to set up an e-petition and the signatures get collected online; I think there's already a system for doing so (I've signed a few though never started one myself).....unless they've shut it down to change it. E-petitions are good because MNers are all online anyway.

Most postnatal care horrors (incl my own, after a labour ward experience that was close to perfect and almost luxurious) have to do with lack of funding for postnatal care - wards too crowded, loos and showers/baths not well designed, and most of all, never enough staff (staff levels often so low that they are actually third world levels).

EasyFriedRice That's really kind of you to offer! I think that would be enormously helpful going forward, once we have some set objectives. Given your experience, do you have any thoughts on practical suggestions that could be put forward?

I think the e-petition idea is also great -- I guess it would be best to have a really specific proposal?

What do we think would be the best proposal to put before parliament?

Notcitrus - not that I've ever done this myself but one could always ring the buzzer and say "I found this in the bathroom/shower/loo" -nobody is going to know!

Having worked in hospitals, I must say there is virtually a culture of misogyny in the British and Irish healthcare systems. If the loo/bathroom was in this state in a general ward with young, ablebodied, mostly male patients, they would get a staff member to clean it up quickly. But in a postnatal ward, there seems to be a culture of thinking that because a woman is coming in to give birth, she's also going to put in an hour of free housekeeping and domestic cleaning every day for the hospital while she's in too. A friend told me this long before I ever thought of starting a family and I couldn't believe my ears - having given birth now, I totally believe it.

That said, the labour ward staff were very nice about cleaning up after me when I was violently sick.....well, it was as a result of something they gave me on the way to theatre and not what I asked for ;-) (it wasn't as though I couldn't reach for a sick bowl!) ....sorry ladies, but thank you!

dreaming bohemian I've sent you a private message.

kipperandtiger when I first read your post I thought 'hmm, misogyny is quite a strong word' and then the more I thought about it.......well, even to go back to the points made by loads of people on here (including me) that you have, quite often, a long, exhausting (emotionally and physically) labour, followed by an emcs, or a forceps delivery, and you are left, frankly, in agony. Then, two hours later, its 'come on, on your feet, having a baby is natural, what do you mean he/she is too heavy to lift and you feel like your insides are going to fall out and come sliding down your legs when you stand up? pull yourself together etc' . Why is it, that as women who have just given birth, we are somehow meant to be able to cope with the most terrible pain and get on with things, yet in any other circumstances, we would be encouraged to rest. And when I say encouraged to rest, I don't mean lie in bed and we waited on hand and foot, I just mean, a bit of support for getting moving, no heavy lifting etc.

I had my gallbladder removed about six months after giving birth, and it was a much less painful and invasive surgery than a cs, yet I was encouraged by the staff to take it easy, not to lift things, to ask for help if needed. After an emcs, I was scolded for not being able to move. The treatment on the postnatal ward is barbaric in comparison.

I am 26 weeks pg and I dread the post natal ward, I think I'd rather do hard time in prison than go back there. Sadly as a high(er) risk birth, doing it all in my own living room is pretty much out of the question, so if I want this baby safely, I have no choice.

I also don't like to claim misogyny unless warranted -- but I agree, it's hard not to think this may be a factor when you compare the treatment on postnatal wards with other post-operative experiences.

I think I mentioned this upthread, but my DH was treated so much more gently and compassionately after his hernia op (which was also abdominal surgery, but just a tiny incision).

I do understand it's important to get up and moving after a section -- no one is disputing that. But it's not easy when your legs are still numb, you have a catheter in, a urine bag to carry around, you're gushing blood everywhere, you're surrounded by strangers, oh and you have to bring your baby along! There is no call for calling us lazy or spoiled or forcing us on our feet before we can manage. I suspect you don't see the same kind of shouting and humilitation directed at big strapping men.

EasyFriedRice has directed my attention toward the Birth Trauma Association:

www.birthtraumaassociation.org.uk/

Does anyone have any experience with them? It looks like they do some fantastic work, will have a nosey around their website...

(Thanks Easy!)

I think misogyny is an issue.

As is the misguided notion that as childbirth is 'natural', women need minimal or zero care to get them through it unless they or their baby are in actual and imminent danger of death.

Combine this with staff shortages and you get a minimalist, crappy service with tons of gaps for women's and babies' care to fall through.

Oh yes and talking of falling through gaps, one thing that I found really odd and stressful was that I had to breastfeed my newborn every two hours for four days on a high, narrow bed above a hard floor. If I had dozed off while breastfeeding my baby would have slipped straight out of my arms onto the floor. So I didn't really sleep for four days.

I was lucky in that I had reasonable mobility shortly after the birth, so was at least able to get down by myself and sit (on my episiotomy stitches) in the (uncomfortable) visitors chair beside my bed, so I did have one alternative. But I couldn't really have dozed off there safely with my baby either.

I had good care with both of my children but I am in Shropshire where we have access to small midwife led units where you can transfer for postnatal care. The issue I have is the lack of consistency in provision across the country. Why should I be able to stay in hosp for 6 days with every question answered and limitless help with breastfeeding and someone in the next county would have to leave hosp quicker than they would like without the support they need.

Ps I wonder if 38 degrees might be interested in making this one of their campaigns......

1. Care, care and more care.
2. Enough space around the bed that you are not embarrased to talk.
3. Good change facilities for the babies, with wipes and nappies and instructions.
4. Clean toilets and showers, near to each other and the ward.
5. Not to be told off if doing something 'wrong' - first time mothers have absolutely no idea what is going on!

I had a horrible time in Leicester - these small things would have helped, it makes me cry to remember the birth of my DD especially compared to the care I received in Adelaide, Australia, the second time round. (with similar complications...)

I totally support any campaign to improve maternity care. I had a horrendous first birth. I was in total shock afterwards. However, because I had not had a c- section, I was totally ignored on the ward afterwards. They didn't have time for me or my newborn. I didn't have a clue what I was doing and no one could help me. I am still very sad and angry about it two years on.

notcitrus 27/07- I was also told the night staff were agency. They were bloody awful. How is this meant to fit with the domino system? (same mw's antenatal, hospital & postnatal)