What do you think about spouses/partners staying overnight on postnatal wards?

[RowanMumsnet]

Hello

The organisation Birthrights (with whom we've done some stuff in the past) are planning a new campaign called First Night, and wanted to know whether it's something MN could support - so we said we'd ask you lot!

Here's Birthrights' description of the campaign:

'Birthrights is a human rights in childbirth charity, and we will be launching a campaign later this year to ensure women aren't left alone on often over-staffed postnatal wards, but instead can choose to have their partner remain with them overnight. We will be researching what's important to women, partners and staff, the barriers and benefits, and working with units who've implemented this policy to draw up best practice guidelines to use as they lobby for change.'

So please let us know what you think. Is this something you'd like us to swing behind?

Thanks
MNHQ

Surely, as hospitals come to the end of their lives and require refurbishment or re-building the planners should be thinking about moving to entirely private en suite rooms.

I'd agree with that - though fairly new city one didn't do this when they had the chance and I do wonder why.

The free-standing birthing centres are all very well but should a straightforward pregnancy/birth become a not-so straightforward one, how close is the nearest neonatal unit etc? I had an textbook pregnancy, went to a birthing centre much like this one and several hours into labour had to be blue-lighted to another hospital. It was the most traumatising experience.

But this is deviating from the topic of conversation.

higgle, my understanding is those sorts of facilities are midwife-led, and so not appropriate (or desirable - I'm with you havant, I want to be where the serious drugs are!) for all women. If you are consultant-led then you are in a hospital, if you have interventions which leave you less capable of looking after yourself and your baby then you are in a hospital. And hospitals have wards.

I might have completely got the wrong end of the stick here, but my limited understanding was that wards were safer than private rooms, as it allows nurses to monitor multiple patients? And that they ideally need patients to be relatively seeable by nurses? So picking up on your point, charley, while all private rooms would be lovely, my understanding was that you would need private hospital levels of staffing in order to monitor all those patients?

@mignonette

Mumsnet- how many of your staff have ever worked as HCPs'? My BPis rising at the thought of having to police such policies. I feel dreadfully sorry for my friends working in OB/GYN who now have the possibility of this to contend with too.

Stick to encouraging units to decision make on an individual basis please- plenty do allow high risk patients or those with extra needs to have enhanced family presence.

I am so fucking furious that you appear to have made up your minds already. Please leave this be and stop piling on yet more pressure onto my VERY over worked colleagues.

Think you've misunderstood, mignonette.

This isn't MNHQ's campaign.

We wanted to know what MNers thought - and you've told us, very clearly.

I understand entirely Rowan and I know it isn't your campaign. :)

HCP's feel under attack from all quarters and this is yet another potential stick to beat us with. I would hope that MN has the sense to not engage in it and instead campaign for better funding.

We had a few private rooms available for those in need. My first few nights were spent on the main ward, but as soon as we heard our dd needed a lumbar puncture and she was admitted to special care, I was moved straight away into a private room and advised that my DH was allowed to stay overnight. I genuinely couldn't have done anything without him being there with me.

I think these rooms are also ideal for ladies who give birth late at night but who are moved almost immediately to the postnatal ward, my SIL and BIL had an hour together before he was sent home at 11pm so that she could be moved to make room on the labour ward; this was their first born and made her feel very isolated, scared and unsupported - and IMO was very likely to be the trigger for her PND.

Having women in wards makes the nursing care more efficient/less time consuming though, it think. IF you can just pop your head into one room and check everyone is OK (hence their insistence at keeping the curtains open) that's less time consuming than knocking and going into 6 private rooms. Plus, if you do have someone who's partner might want to force them into sex at 8 hours post birth, being in a private room is more dangerous than having her on a ward with five other mums.

When you decide upon another campaign that is. The BOUNTY one is a good one, for example.

From my personal experience I would have wanted my partner to stay overnight. He wasnt allowed to even in the private room.

@mignonette

I understand entirely Rowan and I know it isn't your campaign. :)

HCP's feel under attack from all quarters and this is yet another potential stick to beat us with. I would hope that MN has the sense to not engage in it and instead campaign for better funding.

Ah right, apologies. Your asking us whether we had worked as HCPs made us think you thought this was our initiative, and your line 'I am so fucking furious that you appear to have made up your minds already' did rather look as though it was aimed at us.

As we've already said, the weight of opinion on here make it look pretty certain that we won't be signing up, unless something changes very dramatically.

The real issue is lack of staffing and incredibly poor and often inhumane care..

This is what MN should be campaigning about because women wouldn't need their partners with them if post-natal care was not so awful.

My experience with DS 2 mirrors a lot of women's experiences on this thread. I'd had an instrumental delivery (in pretty much the worst hospital in the country) so they insisted that I had to stay overnight. Apparently this was so DS could be seen by a paed in the morning. This, I was told, was Absolutely Essential.

So they packed me off to the postnatal ward, where they put me in a room at the furthest end of the ward from anything and everything, including the room where they 'served' food. They were supposed to give me painkillers, but I never got them. I dread to think what would have happened if the drugs I'd been prescribed were more vital than painkillers, especially as asking for them did nothing.

Because I was exhausted, in pain and struggling with DS2 I couldn't go and serve myself some food, or get a drink, so I had nothing to eat or drink until DH was allowed in for visiting hours (many, many hours later and a long, long time since I'd eaten due to a 36 hour labour). I got no sleep that night either because the ward was noisy.

DS never got to see a paed and by 6pm I was really fed up and desperate to go home. Eventually the midwife in charge of breast feeding support came round to help me and I broke down in tears, so she arranged for them to let me go home. DS saw the GP the next morning, a full 24 hours later than if they'd let me go home when I wanted to. It's not like either of us were under any meaningful medical supervision in there (in fact, the support provided by the community midwives was orders of magnitude better than what the post-natal ward could provide).

In that situation, having my DH stay with me would have made things much, much better for me because he'd have nagged about painkillers and fetched me food, etc. But that would only be a way of compensating for the thoroughly inadequate care I (and everyone else) received on that ward. So the thing that needs to change is the standard of care on post-natal wards so that women don't feel alone and abandoned and terrified as they struggle, exhausted and in pain, with their tiny new babies.

We wanted to know what MNers thought - and you've told us, very clearly.

My last word on single rooms.

As a RMN I found the onset of single rooms VERY stressful because they are harder to check upon effectively. I didn't mind the time nature- not an issue morally but I was all too aware of how hidden patients are in them.

Using PFI designers to design meant that despite the 'consultation process' (HA!) we ended up with rooms that HCP staff did not consider safe, offered too many blind points and meant we had to actively disturb patients inside at night to ensure we got a good look at them- shining torches, going inside and looking around and a total of 42 bathrooms to potentially have to check should a patient not be in bed instead of ten.

I can see the same thing happening on post natal wards with single rooms and let us not forget that a MW is responsible for TWO people- Mother and child.

RFFU - yes I do.

My daughter wanted me with her when she had her 3. It was her choice, she wanted her mum with her. Second and third time around she asked again and when I said, if you are sure, she said, I wouldn't have anyone else. I didn't know how I had done the first time or if she felt ok with it afterwards so I left it to her to ask because I didn't want to put her in the position where she might have to say -actually mum if you dont mind blah blah blah.

My first DIL also wanted me with her when her baby was born. She's from an Eastern European country where mums/female relative/friend are your birthing partner and as she moved countries to be with my son it was me who helped her instead of her mum. My son was also with us.

The same applies to my DIL who had the baby last week, she also comes form the same country as my other DIL. Her mum couldn't be here either, so it was me and my eldest daughter who helped her.

After the babies have been born they come and stay at home with me for as long as they want, though traditionally its 40 days. Most modern young woman however do about 3 weeks before going home, but if its not a first baby they do about a week, the entire family moves to the grannies house, and when they move back home they are then looked after in their own house.

As it happens, my eldest DIL went home when her baby was 3 weeks old and her mum and dad arrived the next day for a two month visit. And next week my youngest DIL's mum is coming to stay with her and my son for 2 months.

The being looked after aspect of it all is very similar to what I can remember growing up in Scotland except the mum was in her own home and other women looked in daily and did all that needed doing.

It was the most beautiful of experiences, all of the births. To see your 5 grandchildren come into the world is amazing and scary in equal measures, and I could never find the words to describe seeing the most beautiful and loved young women in your world doing their best to bring their baby into the world. And seeing your son become a dad, handing him is baby, is pretty special as well.

Ive no idea why you would think any of my daughters would want to do an AIBU.

Partners should only be allowed to stay on the ward after being tested for snoring levels.

It's a no from me too.

I would much rather see the NHS putting more staff on their wards to be honest.

I was lucky enough to have a room at the local maternity home before it was closed down to 'rationalise' maternity care.

It was a lovely environment -totally man free and the new mums could relax with their baby along with other new mums and capable maternity nurses who kept a close eye on everyone.

If a woman had had a difficult birth they offered -but didnt insist - to take the baby for the night to the nursing station where the staff all sat cuddling babies when they werent busy with other things. There was a lounge where everyone could go and sit and watch TV,smoke - yes smoke, it was a while ago , or mainly just chat.

The experience of talking freely with others in exactly the same situation is such a great thing and helped many through the first confusing days. Old hands passed on nuggets of wisdom at the right time and new mums werent scared to ask questions and talk openy about their concerns.

Visiting hours were very strictly adhered to. Only 2 at any time and any extras were shooed into the waiting room. There was a quiet time in the afternoon when nothing was expected to happen - no doctors rounds, no meals ,no visitors. Peace and quiet (and baby snuggling) reigned.

This is the sort of maternity service that should be provided rather than trying to rope in partners to provide free aftercare under the guise of improvements.

It's a no if you are in a ward.
A definite yes if you are in a private room.
The wards are way too small to start with. It's already too noisy in there when dads are visiting in day time and even madder when it's visiting times. I have had a good dose of chavs

I absolutely agree that partners/supporters should be allowed to stay at the staff's discretion in special cases (e.g. particular physical/mental/emotional needs, stillbirths and so on), in private rooms.

I would also agree (hypothetically and with a few reservations) with one partner/supporter being able to stay in other cases, IF there was a private room and private bathroom facilities available, and IF there was adequate security to ensure they wouldn't be able to stray into other rooms/wards (particularly as other women still might not have partners around). But in most places that's not the case currently.

Outside of those two cases, NO NO for all the reasons given above:

• Noise/disturbance and lack of sleep
• Privacy and decency/dignity issues
• Safety issues - particularly if the other care issues mentioned above have not been addressed. Read some of the examples above where women have been left alone and immobile after epidurals etc. and can't reach the buzzer or even their baby. Or simply exhausted women (and babies, of course...) finally getting some sleep. Then throw in random strangers wandering around when the unit is dark and quiet at night and there's huge potential for trouble (or just for women to feel unsafe, which is bad enough). And more minor things like thefts would also be more likely.
• Issues for women with particular religious or cultural sensitivities
• Risk of HCPs assuming partners will help to take the slack - which would just give more problems for women with no partner, with previous children who need their partner at home, or whose partner is there but too useless to help.
• Based on what I've read a few times on MN (NOT only on this thread) - risk of (a few) partners pressuring the mothers into s*x too soon after birth...
• Women in abusive relationships being stuck with their abusers 24/7 and unable to ask for help or at least get a break.

Of course those last 3 would also potentially apply in the private-rooms scenario, which is why I think that would also need to be used with a little caution, even where the facilities are available.

Nomdemere - you dont have to take someone if you dont want to but I can't recall that every happening to anyone Ive known or anyone Ive come across in hospital. But if you really didn't want to - there are nurses and nurses aids.

I think cultural practices come into play here - most of the people where I live wouldnt want a stranger helping them. Its considered a 'family' thing. You look after your own. On a personal level I wouldnt mind who looked after me but then I wasn't born into this culture and Ive brought my funny ways with me. ;)

If a post partum woman suffers a massive hemorrhage in a private room, how long could she be lying there on her own before anyone notices? In a ward at least there are more people to notice. I'm not advocating making patients look after each other, but if someone collapses on the floor it's easier for midwives to see if its in a ward.

I had DC2 at Kings where, as someone said up thread, they already do this on the postnatal ward. I didn't feel especially vulnerable, but the noise was pretty much constant all night, with whispering and moving around.

I do have friends who are very supportive of the whole idea though, mainly as they would have loved to have their partners there the first night for many of the reasons people are for it - they felt very overwhelmed and wanted their partner's support.

CalamitouslyWrong's last paragraph, nail on the head. My hospital experience was one of the absolute worst things that has happened to me in my life. I have never felt so patronised, dismissed and belittled as I did on the postnatal ward.

And it was only DH being my advocate that helped me. I think if I had felt that the staff were actually on my side and listening to me then maybe I wouldn't have needed DH.

Am hiding thread now as it brings back too many raw memories.