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

Sorry, how exactly will this be damaging? It's not a law that they have to stay, it's a choice, surely?

As someone else's DP staying in a bay ward would/could negatively impact on other women patients - for the reasons raised throughout this thread.

As facilities are what they are its balancing all patients’ rights/needs to privacy/quiet while recovering at night in dark wards with less staff against some women wanting/needing their DP and who actually have a DP who could stop all night.

I'm really glad i'm done with having kids if this sort of thing is going to happen.. lovely, the most vulnerable time in your life, bleeding, stitches, tits hanging out trying to get to grips with breastfeeding and you have random men about, being loud, stinking the toilets out.

No, just no!

and what will be next? Bringing the kids as well because there's nobody else to look after then and it would be discrimination or something to allow some dads and not others.

Silly, stupid idea.

One of the most striking things about this thread, for me, is that it shows really clearly that the shit experience I had after having my twins - really dreadful post-natal care - is not remotely unusual.

What's going wrong here? It's not just under-staffing. Some of the midwives I came into contact with were unhelpful & seemingly uncaring too. If women are routinely being left without assistance after having surgery, as I was, it's no wonder some would want their partner - or anyone who could act as an advocate for them - present.

I still think the arguments for this being a bad idea are stronger. But there's obviously a real issue here.

No I haven't read the whole 800+ messages!

If the men sleep in a chair then no, there's no laundry expense. If they change curtains to walls then you eliminate that problem. This is down routinely in other countries, why should the uk be different?

Loon - there is definitely a real issue here (about postnatal care) but it isn't solved by allowing dads to stay to pick up the slack. What if you're allowed to have dads stay but your partner can't/won't/isn't around/is abusive - then you still don't get adequate care.

I do think understaffing leads to midwives being unhelpful or uncaring - if you are in a stressful situation, know you are unable to give good enough care, aren't getting breaks etc then people often stop "caring" as a defence mechanism.

My postnatal experience wasn't as bad as many of those described in this thread, but I was aware that there was only actually one midwife on duty on my ward, so although a lot of the caring was done by HCAs and students, it was pretty difficult to actually speak to the midwife if you needed too. And that's a pretty stressful situation for the midwife to be in.

So allisgood, you are arguing that everyone should get a private room for them to stay in with their partner rather than being on a ward? Presumably they would build extra toilet facilities too?

What's going wrong here? It's not just under-staffing. Some of the midwives I came into contact with were unhelpful & seemingly uncaring too

I wonder that as I was on ward on an exceptionally quiet night and that was my experience as well.

Perhaps it was a result of long term understaff impacting on moral -? I don't know it was a relief to go home and deal with the community MW - who were also understaffed and short on time but always pleasant and helpful even at odd hours and with next pg middle of the night.

I wonder if we actually need midwives on postnatal wards? It's actually nursing care most women need post-csection/epidural/difficult birth, and specialist breastfeeding help that most midwives don't seem to be that hot on anyway. A lot of the non-medical care you need with a first baby is babycare and handholding. Maybe nurses, nursery nurses and breastfeeding consultants would be better.

Why not fleder? You can easily have 3 rooms sharing a bathroom like in my local hospital.

I agree the issue here is a little lost. Likely due to the fact that employment laws in this country make it virtually impossible to lose your job especially when you work for a government department such as the NHS. So a midwife can treat you just as she wants with no consequence other than maybe a slap on the wrist. If you want to get to the bottom of this "real issue" then 1) get rid of the crap midwives who hate their job 2) train (properly) and employ more midwives so there is a high midwife to patient ratio (1:3 ideal). And probably pay them better.

As usual though the government will do anything to "cut costs" so I really can't see the above happening. And if we can't allow an option of partners staying to provide extra support then essentially you are screwed unless you get lucky and end up with a good mw in hospital.

The cynic in me is wondering if this is just a way of making totally privatising the NHS completely more attractive or something.

allisgood - campaigning for private rooms for all is quite different from campaigning for partners to stay overnight on wards. Even if we do allow an option of partners staying, you are still screwed unless you have a supportive partner who is able to stay.

Fleder- I would only advocate for private rooms because so many people have issues with men staying on the ward.

If they change curtains to walls then you eliminate that problem.

Blind spots and monitoring seem to be issues - plus other faculties like MW time and toileting, food being taken are still problems.

Plus putting walls up over a big number of hospitals is going to cost some money at some point - plus PPI hospitals might/do find they can't actually change their layouts.

Good design in new buildings putting in private rooms that can be mointored easily with no blind spots where anything could happen - would get round those problems but that isn't going to help existing buildings with bay wards.

Call me cynical but I would be very concerned that its a short step from partners allowed to stay to staff from necessity on busy wards coming to rely on most women having a family carer with them to do basic care and observation and care/ staff being reduced even further. What is initially a luxury quickly readjusts to be basic standard and necessity. It may become very difficult and less safe for a woman who can't have someone with her.

Point two- reading 800 plus comments, it becomes apparent that many women in the UK have had appalling experience in NHS birth units through lack of basic medical care and attention. Surely that should be the priority to address, this is rather Titanic deckchair Feng Sui.

What is initially a luxury quickly readjusts to be basic standard and necessity.

I had to fight for a HB with my third. However when they were trying to force a hospital birth - for no medical reason - they wouldn't have it that I would be there by myself as I'd find someone to come with me.

There was no-one as we had no childcare for our DC as no family or friends could/would help - apparently that was wrong . The MW told me that without an advocate and a birth partner support I was less likely to be listen to and as MW had several people to look after I'd be by myself. It was apparently out of there experience for a woman to give birth by herself - which I though bloody odd TBH.

All of wish made me more determined for a HB and wonder why the MW were so against it.

Plus it will be legally quite a short step from 'fathers may stay overnight to bond with child' to court enforced 'father will be present at birth and with his battered ex overnight unsupervised because the right of a child to its father is paramount'

Five minutes on the legal or relationships or lone parents boards and you'll find many abusive men who would be gleeful about this idea.

Even if legally they didn't get that right rumbleinthrjungle I wonder how many would cause distress by threatening they had the right.

God know my MIL wound me up by insisting she'd be at the birth - I don't think she ever had any real thought out intention of being there but it did cause me worry. MW had to reassure me if she did turn up she wouldn't be let in and in the end we didn't tell them till after the birth.

To be honest I don't really get why the need for at hand support by family is any greater than it is if somebody has cancer or extensive surgery. We don't see family members sleeping in when their frail parents are in hospital, adjusting after a fall etc.

Yes having a baby is hard, it can be intimidating and we are led to believe that unless we all sit there skin to skin, playing whale music in a room with lovely wallpaper, our children will be in therapy eighteen years later because we have fallen at the first bonding hurdle. If we have adequate staffing levels with the appropriate skill mix then new mothers will gain more confidence in their ability to adjust and learn how to mother and won't feel they have to have a partner or friend there to do the job the staff should be doing.

Are we in danger of allowing the services to offset their inadequacies by roping in supernumerary family carers? I guarantee that allowing partners or advocates onto the wards overnight will NOT result in improvements to medical and nursing care. It will NOT free staff up to do more of the job they are doing. Speaking personally I spend more time checking on security, head counting and watching the door during visiting times and times when patients have their relatives nearby than I do at other times.

And it will cost a LOT more then supporters of this idea think. What about fire drills and evacuation alerts? Nurses, Midwives and all other staff will be responsible for evacuating the babies, mothers AND their accompanying person. At night, this will be a nightmare with some of them in the cafe, some outside having a cig, some at the nearby pub (Yes happens all the time), some at the nearby shop, some popping back and forth between work, home and ward. We will have to implement a system of in/out that costs money to develop and we will need to have extra security too.

The days of tiny cottage hospitals where these things were easier and relied on everybody knowing each other well are gone.

I think an important point that has got rather lost is how this proposal sits with the right of patients, medical need permitting, to be nursed in a single sex ward. Why are patients on post natal wards to be denied this right?

Another important point is why the vulnerability, distress etc of post natal patients is seen by birthrights as best being addressed by the constant presence of family members, whereas the same vulnerability etc in patients from other groups is seen as being best addressed by better/more care from hcps?

I think this proposal sends the dangerous message that post natal patients are not really 'proper' patients. I'm all for the non-medicalisation of birth, where appropriate, but if you are on a post natal ward, you have medical need and are a patient and should be afforded the care and rights due to any other.

People with illness rarely have the mental space to just lie there being ill anymore. Go to any ward and you will see people working when they should be resting, still commanding the reins of their households, of children, elderly parents etc all from their beds.

And I would argue that being old, sick and alone or worried that your illness will screw up your job, life or existence on the planet is far more stressful than being a young, healthy new parent albeit one with a sutured abdo or perineum.

Yes having to look after a baby is tiring, especially when you are recovering from birth but it is at least something we have actively chosen to do- we have planned for it, prepared for it. Nobody prepares for illness generally which often strikes at a time when you have no contingency plans in place.

The sick role is one which maternity activitists have tried to resist- they fought the medicalisation of birth and the treatment of women as passive, helpless ill people and it seems to me that the lack of NHS resources coupled with the encouragement of familial carers is pushing pregnant and newly delivered woman back into this. We are not helpless resourceless creatures requiring defending by our (often) male partners. We are national insurance and tax paying members of society who EXPECT appropriate and resourced medical treatment and MWs capable of doing the job they trained to do.

In Italy post-natal care is abysmal (at least it is in my area). Women usually have their mother stay with them (no men allowed) and the mother is expected to help with breastfeeding, help to clean the mother 'down below', providing meals etc. Not that meals are an issue as women aren't allowed any food after a C-section (and the father is not allowed to remain during the C-section either). I didn't travel to Italy after 20 weeks when I was pregnant for fear of anything going wrong and being forced to give birth out there. Basically the nurses (they don't really have midwives as such) don't do anything for the new mother as they leave it to the relative. I could see a system evolve where midwives would leave the care to the partners if this was allowed.