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 had adequate postnatal care, even though there clearly weren't enough staff for the number of mums. The nurses were doing a brilliant job, it is possible!

I'd fully support a campaign, great idea.

Its health visitors Id ban (read shoot here). Useless idiots. Apart from Gov box checkers deciding if my house is decent enough for a nipper after birth or if I should be reported.... They drive me bats at baby weighing as well.

They sit in the same class of jobs as the hygienist at the dentists. Go back to school and get the proper qualification so you actually have a job - a dentist rather than this idiotic half way house where you teach me to brush my teeth. Health visitors should go back and finish off to be GPs or shove off completely.

A friend had one tell her that when bottle feeding the same amount of time had to be left between feeds as the size of the bottle (or else) - i.e. 1oz, 1hr and so on. She phoned me in tears at 6oz as baby wouldn't wait any more as the ridiculous woman forgot to mention when to stop that practice!

This is the main problem; they leave you with half a piece of knowledge as they throw sentences around when you are vulnerable and piss off before you really realise what they might be talking about.

All they taught me was that if I had a question to post it here or see the GP. As you can tell I now practically hiss and spit whenever one is mentioned!!!!

my child and I are alive and well but I think my mother's generation (god rest her soul) had it better than us in terms of a week with the baby and time to bond. Now I think we are considered to be a bit like cows in milking parlour - get em in, get it out, get them out.

Yes I have a friend who is a nurse in her 50s - she says things are very different (and worse) now than when she had her first baby 28 years ago.

Women and babies were actually nursed post-natally, as in stayed in hospital for a few days to recover from the birth. Mothers were supported to eat, sleep, and keep themselves clean. They were also supported to care for and feed their baby.

The nursing element of post natal care seems to have pretty much disappeared altogether now.

If I can ask MNHQ -- between this thread and the other, I think we have a lot of stories about how dire experiences can be, and some really great ideas for practical things that can be done to improve things as well as to get more information on the real costs of sub-standard care.

What is the next step? How does MN decide whether to make something a campaign? How can we mobilise all this support and actually do something? What else can we share here that would be helpful to you in deciding how to move forward?

Thank you again for your interest thus far!

@LaCiccolina - that certainly sounds very disappointing; that said, I had good health visitors in my area, maybe it is a bit of a postcode lottery.

My bit to add to this debate is that in my postnatal ward, they clearly weren't up to coping with our numbers (as well as being let down by a ward that was 39 degrees Celsius in summer with no ventilation, and loos no bigger than a filing cabinet) but yet they also had difficulty actually getting around to discharging people, although they were polite and professional when you actually got 5s of their time. I couldn't wait to leave, as I knew my bed would be taken in a jiffy anyway. One mother next to me pretty much developed post natal depression as a result of not being able to nurse her first born and feeling she'd failed....and sitting in the noisy, chaotic, stuffy, hot and muggy for three days (after a C section) just added to it. This is probably more info than anyone needs to hear - but I didn't even bother going to the loo, as I couldn't leave baby alone either. They gave me a big jug to collect and measure the sample...did it in my ward behind the curtain! Made no mess as i had far more space to move (paper towels on the floor just in case ;-) ....as the loos were fairly clean I am kind of guessing I might not have been the only one who did this...) Not advised normally, and certainly not if you don't think you could aim straight, but you see what sort of lengths they make us go to!!!

Kateyfer and Tallblonde - yikes, I am appalled to hear what you both went through. Just absolutely no excuse that they could possibly give. Hmm - I do remember my ward had staff who brought round breakfast....surely helping oneself from the kitchen breaks hygiene and safety rules in the kitchen?! Time we had a campaign like "Jamie's School Dinners" .....this one is even more important than that. Anyone know anyone with contacts at Channel 4?

I just gave birth in the US. My child birth experience was a mixed bag as I had preeclampsia. They tried to avoid a CS by inducing me but after I didn't shift from 5cm for 12 hrs a scan showed DD was stuck in my pelvis. I thought my aftercare was amazing for the following reasons:

1 - I got my own room with ensuite bathroom. Small, basic and clean and DD was with me pretty much the whole time (sent her to nursery when on my own and falling asleep). DH had a fold out chair that he could sleep on and was allowed to stay 24/7. Everyone else considered visitors and only able to visit during visitor hours (10-2pm all week and 6pm-8pm mon-fri).

2 - Nurses were all lactation consultants and when buzzed they replied over the intercom and then someone came in to help me. Babies had their dr visits in the AM so I did have to wait a couple of times. Annoying but I could live with it.

3 - Food wasn't great and the only comment I left as feedback upon discharge was that they should have a special menu for breastfeeding mothers. They had sandwiches in the kitchen for DH to eat. These were made by the kitchens and while not what I would make they were far better than a garage sandwich.

4 - When I was hormonal on day 3 the nurses called in a doctor and had me assessed for PND. I wasn't told this and DH was a bit shocked to have two pysch guys walk in and ask him to leave the room with DD. They were wonderful (both the nurses for spotting a potential problem and pysch doctors for talking to me) and I would go so far as to say they stopped the downward spiral. If I had been sent home this would not have been caught at such an early stage.

For a CS my stay was 5 days and I could have stayed for a 6th day. Vaginal deliveries with no complications are a 2 day stay. Total cost for my prenatal, delivery and after care was a $50 copay. I thought I was going to have to pay $2500 for the hospital stay but this doesn't apply to child birth. If we didn't have health insurance the total cost would have been $8500 plus scipt costs ($4 at target) as we are 'in state'. If this hospital, which is a non-profit in a high cost area, can perform such care on a low budget I don't see why the NHS can't.

Avril, I explained a few pages back what an average day in the life of a postnatal midwife entails. Add to that list dealing with a constant stream of visitors with oversized helium balloons and it should give you some idea. A lot of the day is taken up with paperwork, many staff, me included would LOVE to spend more time actually caring for women and their babies, it's why I went into this. However sadly the trust has so many targets to meet, CNST, UNICEF, infection control to name but a few - many of which are paper pushing exercises under various guises, as well as the all important documentation (if we don't write it, it didn't happen, unless you say it did and we didn't write it then it must be true, fear of litigation in midwifery is HUGE!). I fully support this campaign but would really love for it not to become a midwife bashing exercise, most of us are doing the best we can under crap conditions (the oppressive heat? We have to work 13 hour shifts in it, no drinks at the desk as it looks unprofessional and often without breaks.) I'm all for improved postnatal care, it really is the Cinderella service of maternity and needs all the help it can get.

Ok, just trying to explain a bit. I won't become involved if is an entirely a bitching exercise though. Your poor experience was unacceptable but the majority of us are doing the best we can. I wish you all the best of luck.

MrsJRT - the thing is most women don't go into hospital with an agenda of coming out with a negative impression of midwives, or indeed their hospital ex.

sorry pressed post too soon

...hospital experience as a whole.

Not to say that the problems are the fault of midwives as a group, or that there aren't big differences in attitude and professionalism between individual midwives, but it would be a wrong to dismiss everyone's experience here as mere 'midwife bashing'.

A campaign sounds like a good idea. It doesn't sound like the UK has adequate measures in place although I don't know all the details.

The efforts in Australia seem much more comprehensive and are based on the latest research. Partly because post-natal depression is one of the larger causes of indirect maternal death - through suicide.

You can read more about it here - theconversation.edu.au/like-mother-like-child-good-maternal-mental-health-means-happier-babies-2579

Want2b your experience is exactly why my mum begged me to go back to the US to have DS. Wasn't practical obviously!

I know the US gets a bad rap for over-medicalising things but I think they do much better on the postnatal side. And while everyone is always talking about how expensive US health care is, childbirth and postnatal are covered under insurance so many people pay very little for it (unless you have really high co-pays).

That $8500 figure is interesting. It doesn't seem like a huge amount of money for what you got!

One small idea to add to all the good stuff above.

Some kind of colour code / flag on your bed to indicate whether this is your first baby? And thus you might have even less clue / need specific kinds of advice.

On discharge with DC1 (after a mixed postnatal care experience - I'd say poor but not horrendous) I was asked by discharging MW if this was my 2nd or 3rd child...

"What has started out as a campaign for better post natal care has ended (yet again) as a vitriolic rant about midwives. What a shame and what a missed opportunity. If you set up a 'them and us' mentality then you will never get what you want. Or will you? Is what you want to be looked after by nurses on a gynae ward and treated as invalids? It seems as if you have no interest in protecting normality or seeing childbirth as a normal life event.You can't stay in bed for 3 days following a section because you will get a DVT or bedsores."

As far as I can see the above quote from a midwife further up this thread perfectly illustrates the way midwives seem to view their job.
YES they are overworked, and YES it's a stressful job, but there is such a tone of..disgust at post partum women.
Why is this?
I posted some of my awful experiences at the hands of The Whittington, London on the earlier thread on this subject, and the thing that upset me the most about the whole experience (before, during, and post birth) was the way the midwives spoke to me (when they deigned to speak).
I was pretty stoic, I got on with it as best I could, but there was no need for the contempt with which the midwives behaved.

Yes, birth is natural, but when you have been pushing and pushing and the baby is stuck, for over two and a half hours because there are no doctors available to help, and when finally one come you are sliced to ribbons,and just sitting hurts like hell well, I would say that you need looking after on a ward where people treat you as a patient, not a fucking nuisance because you ask where you can change your baby.

I don't recall any midwife ever actually speaking to me at all, except to snap at me the couple of times I asked a simple question.

I support this campaign totally, and I think what is needed is to start from the training level-there are not enough jobs, so the NHS should be recruiting the brightest and best to be midwives, training them really well and paying them decent salaries.

Any worker who is downtrodden and underpaid is more likely to become a bully and take it out on their vulnerable charges.

I think a point that needs to be made, even though it falls into the category of the bleedin' obvious, is that if you have been admitted to a post natal ward it is because there was some sort of a problem during the birth and things are not 100% with you and possibly with not your baby. If everything had been "natural" (God I hate that word - what the hell does it mean anyway??) you would have been discharged to home. The fact that you are on a post natal ward means that you need assistance and care of some form or another. So, frankly, the argument that childbirth is natural and why should you be given help because you're not going to get it at home (which is wrong anyway, cos we have DH's DP's and others to help) is misplaced.