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

The fact that other patients in the hospital were elderly or had cancer didn't change the fact that I was severely anaemic on the verge of a blood transfusion, still with very high blood pressure after being induced for the starting of pre-eclampsia, and by all accounts quite ill - and having to look after a baby on my own. It's all well and good saying you planned and were prepared for it, I had no idea how to look after a baby because I hadn't planned on doing it for another five years at least.

"I wasn't being observed at all, DD was."

Could the solution to this be that your DD needed to be on a ward more focused on babies or children where either parent could stay rather than keep both of you on the postnatal ward where husbands or partners could stay? Don't some children's wards allow parents of young babies to stay if possible?

"In fact I didn't even get the normal post natal checks that midwives do, despite having stayed 5 nights."

Which highlights the need to have more staff on hand to do these necessary checks, rather than have various partners sleeping over who may or may not be helpful with the baby but who wouldn't be able to do things like this.

"I needed the sleep then because babies cried most of the night in hospital and other patients and partners talked loudly all day."

And nothing to say these other patients and partners wouldn't carry on talking loudly all night as well. At least without partners to chat to, the patients might actually get some sleep.

"It was ok for other people as they were only their for one night and could cope with one nights sleep deprivation, but try coping with five nights after a long labour."

The campaign is First Night so is wanting Father's to stay over on the ward for that one first night only. Which wouldn't have helped you, wouldn't have helped me as DS was born at 2am and we only got to the ward at about 5am. DH was allowed back from 8am anyway, so we would have benefited from this for at most three hours and then would have still had a full night alone but with other women's partners there all night with them.

I'm not meaning to pick your post apart but everything you have said seems to back up why this shouldn't happen rather than why it should. And again, First Night wouldn't have helped you at five nights in, so perhaps it would have been better as your DD was the patient for her to be on a children's ward where either parent could stay with her.

Coming very late to this thread but I don't think that fathers staying overnight is possible with wards laid out the way they are. You're basically asking women in about as vulnerable a state as it's possible to be to share a ward with random strange men. Just because they have procreated does not mean they're not inappropriate people to share a room with. All the more so if you have to share bathrooms etc with them. What you are asking is for at the moment is for fit and healthy men to share rooms with women they don't know who are vulnerable and weak and often out of their depth.

Imagine how vulnerable you'd feel if you were evacuated from your house for some reason and forced to sleep in a refugee centre overnight with a bunch of relative strangers? Now imagine doing it when you haven't slept for days, are bleeding and exhausted and have to wake up bleary-eyed every two hours. Sound fun? No, I think not.

If wards in maternity had individual rooms with their own bathroom, I'd be far more in favour. Even then, there would have to be safeguards.

Personally, the fact that other men would be around, using loos and showers etc whilst I was virtually topless trying to feed a newborn would make me want avoid any hospital that did this. I found it bad enough that people were on their phones at all hours without there being double the amount of people there having a nice chat - not very restful.

I cannot imagine how this would work logistically and think that money would be better spent on improving staffing levels.

This isn't just about men. It's about other people staying on a hospital ward when some patients don't want so many unnecessary people there. As I said, I think it's a dreadful idea, whether men or women. Can we look at the whole issue, not just men.

Sarah, if you had read my earlier posts, you would have learnt that I am opposed to this initiative. I wouldn't want DH staying over night, because I would need him during the day to help me. And tbh there was no way he would survive on the ward, both of us would have got ill with sleep deprivation.

What I was suggesting though was that wards should provide more flexibility in terms of which parent stays the night when the mother doesn't need to be the one staying in.

Our midwife led unit has private rooms with ensuite and allow partners to stay over. That night I'm really glad DH was there, as I was terrified of being completely alone, but the midwives completely ignored me despite calling them many times. When I moved to the ward without DH, it was much better at night, midwives came when you rang the bell and the support was there.

Surely the whole point of maternity wards is that they're there for the parturient patient- she (it's usually a she) needs minor details like blood pressure, wounds if any and catheters checked... No bleeding point the dad staying in for that! If the child is healthy then it's at less risk than the recently delivered woman. Maybe they could consider discharging newborns before their mothers but that just seems wrong, especially if a breastfeeding relationship is to be established.

Basically, giving birth is women's stuff. There's nothing there that the man can do. He could be at home cleaning, cooking/freezing and changing the towels and bed sheets frankly until the mother and baby return home.

What I am saying is that with proper medical, PAMs, nursing and midwifery care, the fact that a woman has a baby to care for on top of her post natal trauma becomes more of the moot point mentioned above because staff will be able to support her through it. They should be able to empower their patients through adaptive strategies, proper BFing advice especially for women who don't take to it like a duck to water, attentive nursing, decent wound care and hygiene, help with ADLs etc. But they don't. And having partners there will do sod all to sort this problem out.

And even with well staffed units, you will always meet an unsympathetic sod of a staff member who lacks empathy and is brusque and the issue is a combination of low staff morale, underfunding, unreasonable expectation on the part of management and misjudgement within recruitment. You will also meet these unkind staff members on private units too. It is a problem of personality.

Yes I realise that other sick people do not have babies to care for but it is not unreasonable to expect pregnant women to prepare for the fact that their deliveries and pregnancies may not go textbook, that they may have terrible complications and side effects of delivery and need extra time for recovery. You know you are going to have a baby to look after and possibly having to do this after a traumatic delivery is always going to be a potential outcome.

Unless a woman has an occult pregnancy, they will have at least a few months to think about this possibility and prepare emotionally for it. No, you may not be able to do anything about the physical incapacity (unless the ward is properly staffed) but you can accept that it may happen because the issue of complicated pregnancy and labour in itself is not a hidden subject nor rare- it is not hard to anticipate that you might struggle to cope, that you might not dance out of the unit on day one. Whereas the illnesses and accidents that life throws up at one by definition usually will be associated with a lack of preparation- even with planned surgery one worryingly has to be prepared for post surgery infection, lack of discharge meds and premature discharge these days (among many other obstructions to peace of mind and recovery).

I myself experienced one of the more bizarre and rarer complications necessitating life saving surgery and an inability to have any more children so I have some experience too of laying helpless in a hospital bed, unable to care for my child, watching everybody else pick them up. Everybody but me. Decent staff and resources means this is something that can be managed and the woman is not left with feelings of helplessness, pain and inadequacy.

Re the general argument that help by relative can ensure some of these tasks are done- the responsibility is not one to be passed onto a relative or friend. For a start, this places the HCP in a precarious legal position according to her code of conduct. We cannot hive off tasks to patients no matter how capable they appear without having a sound evidenced rationale for doing so. Even allowing a relative to feed a sick patient can have consequences for us if the patient is burned, chokes etc because the relative doesn't properly account for any physical limitation.

Moomin - Re your awful experience - Fact is there should have been nursing care to enable you to manage and not compromise your physical health and recovery. Nursing care plans are VERY clear about this. Nursing care to help patients achieve those ADL's is not a basic tenet of nursing, it is a fundamental one.

For me, having nursing staff look after your child when you're lying helpless isn't anything like having a loving partner looking after them. However good nursing staff are, they are generally strangers whom you have no idea about, and however much intellectual trust you can put in their training and procedures, you don't have an emotional bond with them.

I realise Birthrights are coming at this form the point of view of trying to help. But the fact remains, not every woman has access to someone to stay over night with them.

So this whole campaign does precisely fuck all for them.

What the need is better health care. Campaign for that, I would support that. But don't make their situation worse by diverting funds towards kitting out rooms for men. Don't make midwive have to choose before helping the woman who needs their help most and the woman whose husband shouts the loudest.

Normally I say let people who have the time and energy and money campaign for whatever they choose and I won't tell them how they should spend their energy..but in this case I really believe it will negatively impact the most very vulnerable women in society.

Well my maternal care was fine, it was the other service users who made the experience so miserable. I'm sure birthright envisage sensitive, quiet, gentle dads helping the mums. They really should live in the real world.

Allisgood1 -- for a post natal condition such as the one you described involving both you and your baby, in the hospitals (outside the UK thank God) where I gave birth, you would have had a nurse in the room with you at all times.

PhantomTollbooth -- amen.
Onesleeptillwembley -- I agree it's not just men who would make this idea unworkable and objectionable for all sorts of solid reasons.

On childrens wards we have gone from parents being allowed to stay to most parents needing to stay and judgy pants being hoiked if they don't. I'm worried that it will go the same way on maternity wards, and that women whose partners can't stay will suffer. There were a lot of judgy comments in my notes about DH's absence in HDU and the postnatal ward after I had DS5. I expect it would have been worse if partners were allowed in 24/7.

Gosh Ellie, that'd ridiculous. I should have it was obvious that your dh had enough to do at home if you'd just had ds5!!

I think this is a cynical ploy to cut staffing in maternity wards at the expense of patients. If this is implemented, our hospitals will become like developing world ones where you only eat if your relatives bring you food and stay to feed you if you can't feed yourself. Is this really what we want for our health system?

I'm struck by the catalogue of poor post-natal care written about on this thread. I think that Birthright have the wrong end of the stick with the situation.

Really hoping that they re-frame the arguments and therefore the campaign; the Director's comments on Friday give me hope. AS a by the by she mentioned research in this area giving rise to their campaign, I wonder what that was?

I think it's fine for men to stay with their partners in private rooms, but not on wards. After I had DS I felt quite intimidated by the husband of one of the other Mum's during visiting time. He would 'jokingly' stick his head round the curtain while I was learning to breastfeed. I was relieved when visiting time was up! I would have felt very uncomfortable if I had ended up sleeping in the same room.

Bit late coming to this but have only just been through my own experience of this which involved five nights in hospital (1 pre, 1 during, 3 post of which last was in a private room).

DH's support during the whole period was so important to me, and getting through the nights without him was tough. To be fair some of this could have been made less arduous with better care on the ward.

I would rather have more rights for birth partners to stay and support post-natally and compromise on other daytime visitors (all the annoyances I suffered were either the result of other visitors or the mother's themselves) plus enforcement of simple rules to give people more quiet and privacy (like if the curtain was shut before you came in, damn well respect there might be a reason for it!)