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 often tell people that I couldn't fault my care in labour & delivery but postnatal was awful! I transferred from the main hospital to the MLU 25mins away asap!

-It took 6 hours to get me from recovery to the ward after a very long labour (64 hours, back to back) & forceps delivery. This was only when one of the delivery suit MWs decided to take me up.
-By the time I got to the ward it was after 10pm (DD was born about 4.20pm) and my mum & DH had to leave straight away.
-I was still numb from the waist down so couldn't move & DD was put in a cot on the side I had a cannula in so I couldn't get her out. The buzzer was left out of my reach! I was left feeling abandoned, scared & very vulnerable!
-No one took any time at all to show me how to care/feed my newborn baby & I was left all alone in a 6 bed room until 3am when they brought another lady in, turning all the lights on in the process & waking up me & my newborn! (This was repeated 3 more times over the next 2 hours!)
-There was ONE MW on duty on the ward overnight! So it took the HCA over an hour to get me some pain relief when my epidural wore off!
-The following day it took 5 hours to get the senior MW to sign my transfer documents, there were only 3 MWs on duty on a busy (and very hot) postnatal ward & I didn't actually see one of them at all. Only the HCAs.

I am fully aware that I got off quite lightly. And there are many more people with far worse experiences than me. But why, oh why, are there so many horror stories?! It's just NOT good enough! Even an 'easy' birth is a big trauma for a women's body to go through. It's easy to just to say that more money needs to be thrown at the problem. But someone actually needs to spend some time looking at where the money needs to go. Certainly more MWs would be a start. But perhaps also some specific training & dedicated support for breastfeeding mothers, young mothers, and first time mothers might also be worthwhile.

I apologise, it should have been worded better. However it is simply untrue to say we will have hoists, we don't, yes we are taught moving and handling techniques, mainly in talking the patient through moving themselves, the more hands off the better. I am not allowed to lift you or move you myself, I can place a slide sheet under you so it is easier for you to mOve yourself but I can not sit you further up the bed. That's if there is a slide sheet to be found. Also although there are some electric beds a lot are not and require a foot pump to adjust height and a midwife to manually lift the head rest into position. We also do not have commodes or wheelchairs on the ward. I do always ask women not to get out of bed for the first time with no one else there though in case they feel faint. It's proven that having partners there does cut down on buzzers but it's impractical for partners to stay all night. We just haven't got the resources and other mothers don't like it. On our MLU, it is all private rooms and partners can stay, buzzers are rarely heard down there!

It sounds like I'm trying to defend shitty care and I'm not honestly, I just think it's important for us to know what is feasible for change and what is just not going to be implemented.

MrsJRT please don't give up - what you say "is just not going to be implemented" is the norm in other first world countries. We can afford it and we should have it. British women are worth it too.

Hi everyone, I'm not sure if this has been mentioned or not, but on the NHS choices website, you can leave comments about the care you recieved at individual hospitals for people to read. THat might be a good way to document all of the experiences/advice that people have had - if everyone did it there would be such a wealth of information, and if there were 100's of terrible reviews on show publically then it might prompt some action.

For example (this gives away my location a bit!)

www.nhs.uk/Scorecard/Pages/Results.aspx?OrgType=5&Coords=&TreatmentID=0&PageNumber=1&PageSize=0&TabId=0&SortType=2&LookupType=2&LocationType=0&SearchTerm=Worcestershire+Royal&DistanceFrom=50&SortByMetric=0&TrustCode=&TrustName=&DisambiguatedSearchTerm=&LookupTypeWasSwitched=False&MatchedOrganisationPostcode=WR5+1DD&MatchedOrganisationCoords=&ServiceIDs=&ScorecardTypeCode=&NoneEnglishCountry=&HasMultipleNames=False&OriginalLookupType=2&ServiceLaunchFrom=HomePage

I've just realised (relating to my above post) that once you've found your hospital you can then filter by service so it would be easy to find the maternity section. I really think this could be a good start for Mn'ers

I was moved from a birthing centre (where post-natal care was excellent) to a hospital post-natal ward approx 24 hours after birth as DD needed a blood test. I arrived about 10am and was shown to a bed (not actually admitted). Blood test was done about 11am and midwife reported back that all seemed fine and that I could go home soon.

I was eventually discharged at midnight having waited initially to see a doctor. He decided that DD should have another test at 1pm to make sure all was well. From that point on, I was waiting to be discharged but there was only 1 midwife on duty who didn't have time to write up my notes.

I was offered no food or pain relief (2nd degree tear). I hobbled to the reception desk a couple of times to try to find out what was going on and was told that I was not a priority and that I needed to wait.

I had had no sleep since DD's birth and she was feeding and crying constantly. I put her down at one point as I was crying myself and was told by the midwife baby's crying! what's baby trying to tell you? baby needs feeding!. I felt desperate. I eventually asked if I could write out my own notes if it meant I could go home.

I didn't press the buzzer once but the woman opposite did. The midwife responded each time with who's buzzing now?

I was made to feel like a nuisance and yet I was polite and cooperative all the time I was there.

Clearly there were staffing issues and the midwife on duty was stressed. I don't know why typing up notes and making sure patients have been offered food isn't something that an administrative asst. could do?

Afterwards, a friend who works in a hospital told me that sometimes patients are not discharged even when they can go home as they are low/no maintenance and take up a bed. If they go, then that bed is free and someone who needs a lot of attention might fill it and add to the stress on a busy/understaffed ward.

I would definitely support a campaign for cleaner, better staffed post-natal wards. My experience at The Royal Cornwall Hospital was certainly not as bad as many on here but I am still pissed off two and a half years later about the way that I and other, more vulnerable, mothers were treated.

I am not a HCP but I am a state sector teacher. To a certain extent I know what it's like to be understaffed and over stretched and I don't think it is any excuse for staff to be rude which is the main complaint that people seem to have on these pages.

My first thought when i read the title was improved postnatal care, how about having post natal care?! I had my baby 10 weeks early and i was being nagged to leave from day two. I remember quite well having to get two trains back to the hospital (i had to travel to central London and back out again) five days after birth with my husbands slippers on (feet like footballs) shuffling along(transition birth). It was plain awful; my only saving grace was that i didn't have a c-section.

PLEASE PLEASE PLEASE run a campaign. I thought I was the only one who had a godawful time.

Mrs. JRT -It sounds like your trust is not adequately assessing the generic risks on your ward. I am moving and handling specialist. I often hear stuff like "we are not allowed do X or Y." Is it simply not true, all basic training should involve use of slidesheets etc..the problem is that moving and handling is not given a priority on maternity wards so equipment is not available. Beds are a big issue as 4 section beds can be alot more comfortable and increase someones independence therefore saving on staff injuries and time assisting people. They don't cost that much either £800 per bed so management just need to be convinced about the spend to save issue. When I was in hospital a baby fell out of a high bed, pump adjustable. Also I fell asleep with my baby on the bed [through exhausting for about 5 minutes] and a horrified midwife told me off for keeping the baby in bed with me due to the risk of falling, yet some beds go very low and these could be used to minimise risks aswell.

Postnatal care needs to take in account ward ergonomics.

ohnotanotherone - yes the fact that I had to climb UP to my narrow hospital bed to breastfeed my baby seemed like a ridiculously unsafe design.

Considering women who are breastfeeding newborns are usually exhausted (I was naively horrified to discover that 'a feed every 2 hours' meant LITERALLY 'every 2 hours, including through the night' ) - how on earth does this stuff ever pass Health & Safety inspection?

Had an EMC for my first one. The surgeons were brilliant but the aftercare was awful and in some cases spiteful. There was no room on the caesarean ward so I was put in a normal ward and was spoken to appallingly by one of the nurses. I couldn't get up to pick up my baby or feed him as I was in a lot pf pain and she just spat "oh for gods sake get up". My husband was there and heard it too and was shocked. She came back an hour later to apologise and said she didn't know I'd had a caesarean so clearly couldn't move because of that. She had thought I was being a lazy cow. One night I was so thirsty I thought I was going to die but couldn't reach the buzzer to press it. The next day I made sure my husband moved the buzzer nearer me but when I pressed it no one came. One of the worst memories is of hearing my little baby posset and being terrified that he was going to suffocate on it. I kept pressing the button but no one came. Surely this is cruel and it doesn't take 2 mins for a nurse to patrol the ward. Throughout the night I could hear them chatting to eachother as if they had all the time in the world. I was absolutley starving the morning after the operation but no one offered me any food or even told me there was a toaster and kettle at the end of the corridor. There was a lovely cleaning lady who spotted me and asked if I was ok and went to get me some toast and a cup of tea. She was probably paid a pittance and had had no nurses training but was the kindest person on the ward. I had told them I'd like to breast feed but my milk didn't come down for ages maybe because of the trauma of the EMC. I was doing all the skin to skin but THERE WAS NO MILK! I was treated like some kind of criminal who had rejected her baby and was doing it on purpose. I really wanted to go home on the third day but was told I couldn't unless I proved to them that I could feed my baby. I asked for some formula, which they obviously thought of as poison, I fed it to him, he loved it and perked up no end and they let me go.

For my second baby I had an Elective caesarean which was a whole different scenario. The main change was that I was on a special ward just for caesareans. They came to pass me my baby whenever he needed feeding or changing without grumbling or looking at me as if I was a piece of crap.

I think on this card there also needs to be a list of what your rights are.

Having a midwife take my baby away to the nurse station for a cup feed - even though i was breastfeeding - and only having her bring him back when she couldn't settle him and his breathing had deteriated.

I didn't complain because i thought it would be that easy for them to take your baby. And who they believe, a midwife or an hysterical new mum?

I would like to see voluntee grandmothers/mums allowed to help/talk/bring cups of tea and lots of reassurance to new mums on the wards. I am talking of covering morning and afternoon in a rota of sorts if possible.
Have to say midwives have enough to do and my daughter couldn't wait to get home. She said no-one around for a lot of the time on the wards once you have given birth.
So what do others think.

Morning. Thanks so much for all your posts so far. Please do keep them coming!

I like Nanas idea of having volunteers. I would like them to be up to date in current advice though. My mother and Mother in law would be lovely at the tea and chat but I dread to think of the advice they could dish out.

My MIL has a good line in superstition and old wives tales- makes a lovely cuppa though.

The idea of grandmas coming in is nice, but agree with Kelly - they're not trained. It seems that most of our problems could have been sorted with tea, sympathy and common sense - most, but not all. In the current 'cuts' climate, it is probably unwise to campaign for jobs to be done by volunteers. Judging by this thread, nobody's desperate to spend money on this. We shouldn't give them any excuses, they're good at that themselves.

I'm struck by a few things reading these comments -

1. People have a hard time separating their Pre-natal, labour and post-natal experience

2. The best experiences (in general) seem to be on MLUs where traumatic births experiences are unlikely

3. MLUs seem to have much higher staff/patient ratios (which seems a bit insane).

4. Other than painkillers, most of the things people are complaining about do not require someone with a graduate degree to fix.

as an addition to my post, there were plenty of mw, but lord knows what they were doing. they seemed to be in meetings a lot, and chatting at the desk seemed to be a favourite pastime. ringing the buzzer as i was struck in bed was frowned upon, and a favourite bad tempered comment was how will you manage at home? well, dh is there, plus others.. the mw changeover was very stressful as discussed with other new mums, if the scary one was assigned to you etc, however we rarely saw the same person twice and there was no continuity of advice, so was constantly being told off and shown new ways to do things.
I didn't know people would be allowed their mobiles on the ward, and had to listen to one sided chats all day and night plus endless beeps from txt messages, plus people did have their own food bought in, unfortuately really smelly curries, fish and chips etc! and for those of us not eating it was very hard as well, tummies rumbling!
the amount of visitors was not controlled, and at one point there weer so many people round the other ladies bed, one man actually banged my newborns cot, then shoved it out of the way! There was a cleaner, who gave us the best smile, as she showed the hoover the room:) and wandered off.
a campaign would be good, but how does politeness and courtesy really cost money?

perhaps a return to one head mw who had total control, rather than lots of autonoumos mw?

I agree a campaign would be an excellent idea. Perhaps one of the things in the campaign could be Freedom of Information Act requests asking the following to every trust in the UK:

(a) how many times, in each of the last 12 months, has the trust operated shifts which have exceeded the ratio of mothers to midwives recommended by the RCM? (see http://www.bbc.co.uk/news/uk-14239022 recent BBC article)

(b) how many nights, for each of the last 12 months, agency staff have had to be used on postnatal wards?

(c) how many times, in each of the past 12 months, postnatal wards have failed cleanliness inspections?

(d) how many complaints have been recieved in the last 12 months relating to postnatal care, either directly or via PALS.

(e) how many re-admissions, for post-natal related problems (e.g. infections or other complications), they had in each 12 month period

(f) how much the trust spends per annum on treating post natal depression (medication and counselling, and training of HCP's)

I have suggested the 12 month thing on the basis that then the Coalition can't moan it wasn't in charge then! Getting the facts into the public domain would, I suspect, in itself see a lot of PCT chief execs finding themselves embarrased by what is happening in their trusts.

Until the campaign kicks off properly we can all do our bit. I would urge everyone to write to their MP to ask what they are doing to ensure that when the NHS reforms come in that funds for maternity services are protected and the service improved . I quoted the BBC article above to my MP as well as I live in an area where we are well over the recommended ratio :( My MP is conservative so I also asked when they'd honour their pledge for 3000 extra midwives!

And I would urge everyone who has had a bad experience to write to the responsible Head of Midwifery (send the letter recorded delivery) so that she then has enough ammunition to plead for more funds for more midwives/training/etc to improve the service in your area, and to hopefully offer you a debrief and apology.

My post natal care was pretty abysmal. I'd had a really tough natural delivery with no pain relief (not through choice!) and tore very badly. I also went into shock, and was shaking so badly I couldn't shower (which the staff were not happy with). They pretty much barked at me to go to the loo, and then wheeled me up to the ward (it was 10pm), kicked out my husband, showed me the light switch, and that was it. I was scared and exhausted, and didn't get one kind word. No mention of a buzzer, or that they could help. They left the sides of the bed up all night, so I couldn't get out of bed to tend to my son or to unpack any belongings. I'd also had nothing to eat for 24 hours and survived on a sole muesli bar I could reach to access in my bag. The next morning, I missed breakfast because I didn't know you had to fetch your own breakfast (and was still trapped in the bed!) and then I was ignored all day. It was only on the second morning, when a senior midwife popped her head around the curtain to see that I was crying that a midwife took the time to notice that my son wasn't latching on properly, which is why he had been so upset.

What annoys me is that if I had had a major operation, I would have been treated like a patient. Instead, because childbirth is 'natural', I was treated as if I should know what I was doing, and as if I was an inconvenience.

I'd like to add as well as an aside, that the doctor who did my son's check before I was discharged from the ward missed that he had no femural heartbeat. My son nearly died nine days later from a heart problem that this lack of heartbeat is the tell-tale sign for. Shocking 'care'.

I had an interesting experience a couple of years ago when I had DS. I got to experience postnatal care at a birth centre and hospital environment and the contrast was massive. Started in labour at the birth centre, had to transfer to hospital half way through. Delivery staff were all fine, but the postnatal ward was horrendous. I was told (after 3 nights of no sleep due to long early labour) by a bossy healthcare assistant that I wasn't allowed to shut curtains around my bed to try and have a nap in the day. I was exhausted. I wasn't shown how to operate the bed or how to get any food. The number of visitors along with 5 other babies crying in my bay prevented any sleep whatsoever. I asked for help breastfeeding and was just given a leaflet.

12 hours later I got out and back to the birth centre. It was completely different. Lovely peaceful room of my own, midwives who were happy to come and help with every breastfeed and even took my baby for a few hours overnight so I could get some sleep between feeds. Toast and horlicks was provided in the middle of the night, home cooked food brought to my bed at mealtimes, ensuite and clean bathroom, aromatherapy baths, help with showing me how to bath my baby (I wouldn't have even dared ask for this in hospital) and basically lots of genuine care and attention. Yes it was NHS and I'm lucky to have experienced it.

I'm expecting baby 2 soon and want to go back to the birth centre. Unfortunately it's looking as though it's going to be shut because it's not very well used and "women should be in their home environment after giving birth", according to the head of our PCT. Unfortunately in this area, that means just 3 short postnatal visits over 10 days and not all of those by a midwife. They really need to spend more money on postnatal care, not less.

I can't remember who put this earlier in the thread, but I agree that the GP 6 week check needs to improve too. I had a leaflet describing how the GP would check my breasts, make sure that my episiotomy was healing well and a host of other things, but what actually happened was:-

1. Being given a checklist for PND and asking if I fitted that desciption.
2. A dire warning about using contraception and a plug for the Mirena (even though I explained that we are infertile).

I had to beg for a check of my stitches and when I explained that even sitting was still painful, I was told to have lots of sex to "stretch things out". It was all done at breakneck speed and with almost no eye contact.

Compare that to www.patient.co.uk/doctor/Mother's-6-Week-Postnatal-Check.htm, which is what is supposed to happen. I don't know anyone who had a check this thorough.

blondieminx those are excellent questions, I definitely think we should do a FOIA request. Great idea!!

I also support this. I had a long and painful birth with truly awful MW care during the birth itself (ended in epidural and forceps delivery after demanding to see a consultant who rushed me to theatre immediately inspite of MWs protestations...)

I was dumped in the post-natal ward at midnight with a cannula and catheter so unable to move. DD put in a cot next to my bed with a nappy on that had only been secured on one side. cue poo and wee everywhere that I couldn't do anything about.

i wanted to breastfeed, so when DD started crying at 3am, i had to press the buzzer to get someone to lift dd out of cot and give to me. MW promptly left meaning i had to press the buzzer again to get them to help me get DD latched on as (due to canula) i only had mobility in one hand and arm. cue lots of huffing, that's not my job(!) comments etc. would take hours to receive pain medication after requested (God help you if you needed anything on a shift change!)

I got yelled at for leaving DD alone while i nipped to the loo, blood and used maternity towels everywhere. had to use sanitary gel on a tissue to wipe the loo before i felt comfortable using it. and yelled at again when i popped into the corridor to find a clean sheet for her cot (after she threw up everywhere)

a mum opposite me (ward of 6) who had twins couldn't get out of bed (CS) to pick them up from their cot to feed them, so I'd go and help when the buzzer repeatedly wouldn't bring anyone to help.

no one told me where the kitchen was to go to get food or that the bell ringing in the corridor meant that meals were being served there (found out from a fellow 'inmate' on day 2).

on the second day, i resorted to asking DH to bring food in for me...

I found the on-ward HV's/nurses much more supportive and helpful (when you could find one) but every MW i came into contact with was rude, abrupt and made it clear that I was of low priority.

it is clear that through no fault of their own they are incredibly understaffed, but that shouldn't translate to mums/babies receiving such inadequate care.

CAMPAIGN, CAMPAIGN, CAMPAIGN!