MNHQ here: after your thoughts on a possible campaign on postnatal care

[RowanMumsnet]

Hello all

As lots of you will hopefully know, we at MNHQ run campaigns every now and then on issues that really matter to MNers. Ongoing campaigns include better miscarriage care (keep an eye out for developments on that in the next month or so), support for families caring for children with disabilities and additional needs (MNHQ has signed up to a new campaigning alliance on that and we'll fill you in on what's happening soon), and rape myths.

We've been thinking for a while, though, that many of the most urgent and upsetting things our users talk about fall under the heading of - frankly - inadequate postnatal care.

MNHQ was involved in the National Maternity Review recently, and even among the senior NHS professionals there it was evident that there's a consensus that postnatal is the 'Cinderalla' of maternity services: underfunded, poorly resourced and rarely thought about - except when it goes horribly wrong.

Obviously this is a huge area and a very complex issue to address - so we'd like to hear from you:

• is this something you'd like to see MNHQ get into?
• which aspects of postnatal care need to be improved? We're already thinking about things like: breastfeeding support; perinatal mental health; staffing and conditions on postnatal wards; partners on postnatal wards (we know most of you aren't in favour ); care in the community from health visitors and community midwives; injury care for women post-birth, and longer-term care for pelvic floors; the six-week check and whether it really works for women and babies... but we're sure there are more.
• what solutions would you like to see? What's needed (up to and including money) to improve postnatal services for women and their families?

The aim of this thread is to find out whether you think this is a good idea overall, and to get a sense of which issues and which problems you think need attention - so please fire away and let us know your thoughts. When we've got something to work with we'll put together a survey for all our users so that we can get a bit of data to help us make some decisions.

Thanks
MNHQ

First time mum last year, private room and subsequently forgotten about. Tbf they did check regularly on my baby for blood sugar (gestational diabetes) and re: my strep b diagnosis but no one showed me how to be a mum (baths, feeds etc) and I felt very lost when leaving (same day). So yes in answer to your question ☺

Postnatal ward was awful. I know my discharge paperwork was done while I was in recovery, because I read it. I had a catheter post spinal and forceps but was up with it asap (it fitted on the shelf under DD's fishtank!)

I asked for it to be removed at 12 hours as per protocol, although that would have been 0130 ish. They agreed then didn't take it out until about 10am as they said they came to do it but I was asleep. I HAD NO SLEEP THAT NIGHT AFTER I DOZED OFF TO FIND A MW PICKING DD UP WITHOUT ASKING ME. I only woke up as she bashed into my bed. Not a wink after that, I had no idea who she was!

bounty woman left a bag of crap on my bed while I was in the shower but was pleasantly dismissible when I met her in the corridor.

At 1530 I threatened to self discharge as my early morning d/c was still not forthcoming. The woman having he second dc opposite me seemed to get fab care, but every time the mw went to her they nodded in my direction saying they'd be back in a sec, never to be seen again.

Told to go to the mw clinic on the tues after discharge, to get there and be told it was the Wednesday they had booked me in. Finally, after having the same lovely mw for all my antenatal care, who said she'd see me at that appointment, and I asked specifically to see her, I got stuck in some random mws clinic. Not giving biscuits to a randomer, thank you!

I did get a very odd unsolicited phone call from a community bf advisor though, but it wasn't until I got in with lll that the bf felt normal.

Care after birth. I think fathers should be allowed to stay on the ward and support their partner. My partner had to go home because he wasn't allowed on the ward. I'd had post birth surgery and couldn't feel my legs so I was unable to pick my baby up. I had to keep ringing for help with feeding and the staff were plainly irritated. My urine bag needed changing and my blood soaked covers needed changing and I felt I had to beg to get seen to. It was such a horrible experience I won't have any more children. Please campaign for fathers to be allowed to stay and for there to be support staff based on the ward to care for new mothers.

Yes, absolutely.

Integrated breastfeeding support: antenatal, hospital, community. Proper peer support in all settings. This should be a de minimus for sound financial reasons (support those who want to breastfeed for as long as they wish to and watch the knock-on public health savings), not the optional 'icing on the cake'.

There is a hell of a lot better to aim for than just a 'safe' birth with an alive mother and child. Yet sometimes this feels like all anyone can expect. The mental health implications of poor postnatal care (inc shit breastfeeding support) are huge. And no. HVs are not the be all and end all, and MW clinics in supermarkets for women who are 2 days postpartum are a fucking dreadful idea.

Superb idea. Please go for it MNHQ.

I am certain that my PND with DC1 started from my horrific time on a postnatal ward. It really is not just "a bit unpleasant" for a few hours/ day or two; it knocks new mothers sideways right from the start. With my second DC I knew the score and got in a private postnatal midwife- best few hundred quid I ever spent.

We had an excellent thread on this a few years back, before your mutiny on the bounty campaign. Has anyone dug it up? Bet nothing has changed.

Yes please look in to this mumsnet. My stay in the postnatal ward was awful, I wish I had discharged myself. I got conflicting advice about breastfeeding and was left to just get on with it. I could barely walk, had lost a lot of blood but the care was basic, just given my medication and that was that.
I also had no kind of post natal check with my GP. I still have no idea if this was supposed to happen. I developed PND and finally saw my doctor when my child was four months old. The care I received for that was great but I think the main problem is that maternity wards are so short staffed that midwives don't have time to care unless a patient is seriously ill.

Private rooms
communal wards are an abomination, and should be a thing of the past in a so-called civilised country! Other European countries manage to offer private room + bathrooms (even for a very small fee). Why do we treat women like cattle in this country!
It would solve the issue of partners staying, sleeping whilst your own baby sleep and just let mums feel like they are human being. Come on, having to leave the hospital 24h after major surgery to get some sleep is insane!

More staff
The loveliest and caring nurses can only do so much. There is no one to show you and help you with feeding, bathing. You leave the hospital without a clue on how to handle a baby, how to deal with reflux/ colic/ blocked nose, how often to feed, nappy rash...A lot of unknown for a first time mum. You can have classes about giving birth, but nothing about caring for your baby. It's nuts.

Long term care.
Again some countries offer monthly then regular check-ups with pediatricians. Here you can go to a crowded room full of strangers to check the weight of your baby for the first year (and good luck if you had bad c-section and are unable to move or drive) but nothing else. Appointments with GP can only answer a specific question, not help in general.

There would be less PND if mothers had more support. Apparently it takes a village to raise a child. If you are living next door to your family it's great, but if you are not, you are completely abandoned, and you relay on random strangers on internet forum to find help. Having mums suffer and struggle for a year or 2 after birth because of the system is a damn shame.

I would suggest researching how other countries function, and learn from them (for positive and negative things). We are not asking for rainbows and unicorn, but to be treated like human being and be provided help and support when needed. It happens elsewhere, why not here.

I would def like to see a campaign on this. I have experienced pretty mediocre postnatal care myself and am now training to be a midwife. Typically there are two midwives on the ward in my hospital looking after up to 24 women and babies. it is all you can do to keep on top of the drugs round and discharge paperwork, babies on antibiotics etc. There is just no time for actual care. And we are lucky to have nursery nurses to help with feeding etc. The staff are stretched far too thin and I worry that something serious will be missed.

Don't get me started on Bounty...

Fabulous idea.

I'm a mental health nurse .... There is so much research and evidence about how vulnerable women are to mental ill health in their babies first five years.

Where I work we have a nationally recognised mother & baby unit for those mothers who are mentally unwell post delivery.

But it just isn't big enough & the criteria for a bed is so strict .

Fortunately there has been a big drive to recruit health visitors who are mental health nurses .

I have nursed women for nearly 2 decades now and I know that having a baby , difficult delivery, death of a baby , or having a special care baby can leave such lasting profound trauma.

Women need access to supportive GPs, specialist obstetric counsellors and health visitors with a thorough understanding of postnatal care.

Thanks Cheby

Please do this, MNHQ. Communal postnatal wards should be abolished. I was induced with DS1 and spent two full days and nights contracting before I could go to delivery - with approx 5 hours broken sleep in that time, So, by the time I actually gave birth seven hours later, I was beyond exhausted. And I had to spend another 36 hours on a ward with five other women and their newborns. By the time I got home after four days in hospital, I was nearly hallucinating from lack of sleep. Not a good start.

Agree with pps about mealtimes and general inflexibility of routines.

And Bounty should be banned.

Would love to see a campaign for better ante/post/perinatal care.
As a soon to qualify HV I've seen the difference good quality care and intervention can provide mums/infants/families & am pleased the govt say that they support early intervention/1001 critical days & set up the maternity review.
However, their words ring hollow given the severe cuts & underfunding to the service - Having had a huge injection of money for training and boost in numbers of HV's, many areas are freezing recruitment of & even cutting HV numbers which will result in difficulties sustaining the level of care we need to offer and preventing the evidence to show what a difference the call to action has made.
I know many on MN love a bit of HV-bashing, but would hope that many over the last few years have noticed the improvements in service and be sad to know it is being compromised.

Yes please. ..my two days on postnatal have been the worst part of my parenting journey so far (7 years). I thought I'd totally failed in that first 48 hours.

I find it bizarre that one minute you're the patient and as soon as you give birth you're suddenly in sole charge of another patient...and neither of you have a clue what to do.

My antenatal care was actually really good second time around but I'd like to see:

• dedicated breast feeding support peers to help mums immediately
• proper training to identify tongue-tie
• get rid of bounty reps. It's intrusive and inappropriately timed. I had a bounty rep come into my birthing suite 2 hours after giving birth. I realise maternity services receive a handsome wedge for letting them promote their goods but surely they can set up a station and let people go to them if they're interested.

Yes please do campaign on this! The way women are treated postnatally in this country is absolutely scandalous.

My experience was that I was basically abandoned after giving birth, there was no bed for me on the postnatal ward so we were stuck in a side room on delivery and forgotten about until a mw came in and TOLD me to go home. I had no check up and no food in hospital and it was my first baby and a horrible delivery with lots of stitches. Only 2 home visits which were rushed and one was not even from a qualified midwife! They were only concerned about the baby, I had an infection and knew something was wrong but no one would check me over, I really was made to feel like a nuisance for telling them I was in pain. My health visitor was fantastic and she got me sorted but since we moved house just before dc's 1st birthday I don't know who our hv is or if we even have one! The system is completely failing women and we are being conditioned to accept it.

Yes definitely campaign. My post natal care was by far the worst part of giving birth.

Also yes to getting the bounty vultures away from hospitals! I had one of them lie to me at the antenatal clinic that unless I gave her my details I would not be able to claim child benefit, I doubt I would have had the mental capacity to tell her where to go if she'd tried that when I had just given birth.

I could front this campaign myself. I think that postnatal care is appalling. I've had two pregnancies with complications and babies in SCBU, 1st and 3rd. I have had PND with all three and PTSD due to a traumatic birth with my first with absolutely no follow up. I only received mental health support the 2nd time round.
There is so much that is wrong with maternity services I could write an essay! However there are pockets of amazing maternity services and I found 1 with my last baby. So yes I think this is a campaign worth fighting for and I would be more than happy to help.

Yes please, my own experience was awful (7 years ago now) with not a single member of staff coming near me in the 36 hours I was there, no one told me where the showers were, where to go for meals (I went without both food and drinks til DH came in and brought me something, not ideal when trying to breastfeed) literally no one spoke to me or checked on DD til discharge. My friend brought her baby home today and her treatment has been no better so yes, more staff (preferably ones who actually care about the women and babies they're looking after), more breastfeeding support, more training and resources for dealing with birth trauma and generally a more supportive environment for new mums. Thanks for choosing this campaign.

Responded to the OP without reading any of the other replies but am horrified now reading through other peoples' experiences The amount of us who've gone without absolute basics like food is shocking as is how many of us describe just feeling completely abandoned despite being in no state to physically look after ourselves and our babies. I honestly thought my experience was unusual, I'm appalled that it actually appears to be bordering on the norm

I agree.

Pre natal - excellent
Induction ward - excellent
Labour suite - amazing
Wars - shite.

Not enough nurses, thank god for the hca's. Breast feeding support - patchy at best and wrong advice given by different nurses.

I couldn't wait to get out of there.

PLEASE do this. The impact of post-birth events can have such a damaging effect.

I accessed lots of 'support' with breastfeeding but it was quite contradictory and nothing worked, so I'm a bit meh about that. But there weren't enough staff to help me wash after a 30 hour labour, the ones who came by later offered no practical help with my screaming baby who wouldn't feed and were really 'judgey' about him keeping everyone awake.

When I got home, there was one midwife out of four who was utterly, astonishingly brilliant, and all she did to achieve this goddess-like status in my mind was spot that I was on my last legs, empathise calmly, tell me DS was doing really well and promise to come back the next day to see how I was doing.

• sorry - one HV out of four, not midwife.

Oh, and I took up the offer to go talk to someone at the hospital about the birth some weeks afterwards and just talking it through really helped (turned out my midwife had been sent back for training as a result of my labour). Surely this can be provided without incurring too much cost?