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

I agree Mrs Cakes, was so nice to see DH rested and ready to look after me in the morning and when we got home the focus was completely on me. He wasn't totally totally exhausted like me - that came soon enough!

There are particular issues with men being on the wards overnight, but I would object to any extra people being there as a rule. I've had to listen to couples rowing, grandmothers berating, siblings bickering, and a whole family group arguing about being thrown out at the end of visiting hours because they were having a party (that as a humdinger). All of that took staff

Why, at a point when the system is creaking at the seams probably more than at any stage in NHS history, is anyone proposing to increase the number of people on maternity wards?

There are sick people on hospital wards- including on obstetric wards and units. They need quiet and therapeutic time where privacy and dignity is respected and upheld. HCPs are very very busy, very very understaffed and under resourced- just who is going to police these extra heads roaming around at night, looking for bathrooms, going in and out to smoke, eat, call family?

Why not focus upon why some women feel they need this support? Especially if it is because they perceive services to be inadequate or uncaring.

Moomin I didn't particularly like it in the day either, although to be fair it wasn't just partners then but misc mums, aunts, children and friends. Was like Picadilly Circus. Was nice to havedh there for a couple of hours but then I just wanted peace and quiet and rest. Sharing a room with 3 other women and their babies, with staff in and out, it was enough.

Well, most of the women on my ward weren't keen on men (or anyone else) in the day either!

Not all visitors are considerate. My friend gave birth in St George's, Tooting and there were some families who came and camped en masse and refused to leave. The nurses and porters were powerless to do anything and the visitors were picnicking on the floor, taking over the ward etc. My friend said it was terrible.

I think it's telling that while some of the concerns are about potential abusers, the vast majority against could be summarized as feeling that their personal dignity would be compromised. Women who've given birth know what it does to the body and all are suffering largely similar physical effects.

Having male stranger see you in such a vulnerable position would be offputting for many, I think, and understandably.

Also, I wouldn't like to be in charge of making sure that the only men on a ward are the appropriate ones. With people coming and going, and men allowed after visiting hours, some woman would be savilled.

I ended up in hospital for an induction after planning a home birth, and I left as soon as I was allowed after the birth, precisely so I could keep DH with me - having him there was one of my big reasons for wanting a home birth, so it was very important to me. Luckily I was able to leave straight away, but I was terrified of being kept in and him being sent home. I don't know how it generally works for complication-free births, but maybe there could be more support available for women who are able to leave soon after birth so they can go home and be with their partners there. Other than that, I think it has to be women-only at night for all the reasons already suggested. More money to post-natal care, a push for maternity units or home births for low-risk pregnancies, and private rooms available so partners can stay in exceptional circumstances - babies in NICU/SCBU, particularly traumatic labours etc.

Ideally, with private rooms, yes. But that isnt going to happen. Although i guess the space would be there if all straightforward labours were sent straight home rather than having to hang around for two days waiting for a paediatrician to sign them out when nothing is wrong (especially as ds2 was supposed to be a home birth but the little bugger wouldnt come out!)

I do wonder how it works though, i have a friend who is disabled and needs a carer to use the toilet all of the time, yet she has been told her partner cant stay when her baby comes regardless of that. Would have thought the rules were different if you have a disability that requires care (that they'd automatically put her in a side room?), but then i thought, well actually, a lot of women are in a state that they require care post labour. Sadly, stories about women being left by midwives or told to pull themselves together and get on with it are hardly rare.

Sorry-all of that took staff away from dealing with patients to dealing with visitors, sometimes for extended periods. it's a real problem.

No. Not every DP is a kind caring and considerate person, in fact many are the absolute opposite. This would be particularly risky for an abused woman for whom it may the only time he isnt with her, and she could access help.

Instead of wasting time with this ill thought out scheme, I suggest you campaign for more staff on wards. Every time something like this is done it removes yet another responsibility from the NHS and is another nail in its coffin.

I have anxiety issues and the best thing to help me cope would be to allow my husband to stay with me.

I am in the fortunate position, where the hospital I am due to give birth at, understand this, support it and are making arrangements for it.

They have recently started doing this for private rooms generally which is good, but in my case they have deemed me a priority due to my health issues.

I can not understate how much of a reassurance this is.

I fully support the campaign in the sense that it has to be the direction in which future planning and decision making goes, but I do understand the various concerns of some women who may feel uncomfortable in a ward environment with this policy.

Provision has to be made for both women who need and want this extra support from partners and for those who would feel incredibly vulnerable with it. No one should be forced to compromise if it is to the benefit/detriment of their mental health. It can not be forced without proper thought of the facilities available at a particular hospital.

I do think that this is a policy that needs to be done over a long period of time, rather than trying to rush it as a result, because this is likely to be where problems crop up otherwise.

I think it has long term benefits to women, men and children in encouraging fathers to be fully engaged rather than allowing childbirth and care to simply be about a woman's physical needs and role in life.

I think the potential it carries to support women and encourage men to understand certain things in a hospital environment could be cost effective in helping with breast feeding and mental health.

Thanks very much for all these (and sorry about the typo in the OP). Fully take on board that the response is very much against so far.

Just a couple of things from Birthrights to address some of the questions that have been raised:

'We can understand these kind of concerns. They are exactly the sorts of things raised by units as reasons partners can't stay.

However, units who have welcomed partners have found that a few simple (often cost-free) measures enabling safe and private spaces for those who need it, while allowing women to choose to keep their partners by their side, has helped the new family to bond, ensured the mother has all her needs met even when wards are short-staffed, makes the often-confusing first day feel much less isolating and lonely for women, and makes life easier for the staff so they can concentrate on giving specialist medical help and breastfeeding support.

Over the next few months we will be pulling together lots of research, interviewing midwives, developing guidelines and talking to women (like you) to ensure our campaign is getting it right. Many of the women who contact us have explained that just having their partners with them would have made an enormous difference to their postnatal experience - something we all know is a worryingly patchy in the UK.'

They also say that they're drawing up possible best practice guidelines, to include things like providing private rooms when requested, zero tolerance policies when the rules aren't stuck to, and having areas of the wards where women who don't want their partners present can remain private.

I would say no. it is noisy and chaotic enough as it is on the post natal wards without even more people being crammed in. Unless each mother gets her own soundproofed room? In which case maybe it wouldn't be so bad?

When I had my first baby the woman in the bed next to mine came up to the ward late at night, not long after me, and her partner still with her. He was horrible. Speaking to her like dirt, hugely intimidating and just plain nasty and abrupt. I was in for 2 nights and the only respite anyone had from this man was at night. of course most dads aren't like that, I know this but there was so little privacy for new mothers on the ward I was on anyway. The thought of being stuck with even more noisy people would tip me over the edge and I include my own DP in that!

Well I would be in favour.

But I had my son at Kings College hospital and they already allow partners on the post natal wards. The room I was in had 6 beds all curtained off from eachother (so there is some (limited) privacy but obviously curtains only do so much and its very noisy).

I loved the fact that he could stay with me (post-section, first baby).

I totally understand why this wouldn't be ok for some women, not sure how Kings handle this actually.

Absolutely yes. Was in hospital for five days with DD and could really have used the support. I was so exhausted and hysterical by the time they discharged me, that I nearly just walked out before they told me that I could go. Also, as we were waiting on tests and were "forgotten" a couple of times by the consultants on the ward, I really needed an advocate with me to make sure everything was happening when it should have.

"things like providing private rooms when requested, zero tolerance policies when the rules aren't stuck to"

Thing is, its all very nice to aim for these as best practise guidelines, but guidelines are useless when they can't possibly be followed, which these can't.

Hospitals just don't have private rooms they can doll out for free to all those who request them (or even a fraction of those who would like them), and how on earth are nurses expected to manage 'zero tolerance"?

As you can see from comments above, it's very hard already for them to stop people abusing visiting rights, they aren't going to get involved in forcibly ejecting someone in the middle of the night when there is possibly only 1 or 2 of them around anyway. It's a campaign that comes from the right place, but just isn't workable within NHS constraints.

However, units who have welcomed partners have found that a few simple (often cost-free) measures enabling safe and private spaces for those who need it - what are those measures exactly?

They also say that they're drawing up possible best practice guidelines, to include things like providing private rooms when requested, zero tolerance policies when the rules aren't stuck to, and having areas of the wards where women who don't want their partners present can remain private - what if a private room isn't available on request? Who will be policing zero tolerance policies (presumably not the same HCPs now dedicated to giving medical and breastfeeding support)? What about the abused women who are too cowed by their partners to be able to request their partner be removed?

It seems that their mind is already made up.

Over the next few months we will be pulling together lots of research, interviewing midwives, developing guidelines and talking to women (like you) to ensure our campaign is getting it right.

In which case, I'd like to wait and see what their guidelines suggest before jumping in to support their campaign.

Beyond she won't be too unusual in that environment at all, most patients will be in the same boat for a while (especially if they've had a c section), most nurses should be used to working with patients who need a high level of assistance with using the loo etc and should be able to support her even if it means something that's not 'usual' for her e.g. being supported to use a commode at bedside or something.

In the case of patients needing full time care on my ward there's generally three options - one, ask the patient's usual professional carer to do what they normally do, but in hospital; two - 'special' the patient, so they are never alone at all; three - special the patient and rely on the patient's family coming in at visiting times and mealtimes to free staff for others.

I'm not sure if that's what happens in maternity (I'm neurosciences and working with often seriously ill adults) but I would imagine that if her needs are limited to assistance with toileting the staff should be able to support her with that in a way that best suits everyone.

I shouldn't imagine she'd automatically get a side room - they are usually for those who are facing exceptional circumstances e.g. baby in nicu, mum very unwell and needing help far beyond anyone else, stillbirth, etc.

No no no.

Only if all women on post-natal wards also have a private room they can secure. I have been on mixed wards and we are phasing those out for a reason - why should women be expected to put up with less privacy and more exposure to risk than any other patient just because they have had a baby? Nobody would ask this of any other hospital inpatient.

Frankly the resources should be put into better post-natal care, particularly higher staff levels and better monitoring, especially overnight.

No. Just no. For all the reasons stated above.

Those requested private rooms aren't going to magically appear from nowhere. Those that do exist should surely be given to women who actually need them, not those of us trying to get away from other people's partners.

As others have said, who exactly is going to be implementing those zero tolerance policies?

Far better to invest in making sure that these wards containing vulnerable newborns and adults aren't under-staffed in the first place.

Presumably the hospitals would be employing security staff to handle visitors who behave inappropriately.
Nothing says "safe, nurturing environment" like a couple of bouncers removing a pissed, fighty bloke (or in our area, granny).