A campaign to improve postpartum care for British women?

[juneau]

Hi MNHQ,

This article: amp.theguardian.com/us-news/commentisfree/2017/dec/28/vaginal-health-post-partum-maternity-rectocele struck a chord with many MNers this week and started a thread of women telling their stories about birth trauma, a lack of information before and after birth, a lack of compassion or understanding when they did seek treatment (if they even felt able to - some posts talked about women suffering in silence, too embarrassed to seek help), and general dismissal from many medical professionals about this all-too-common issue. This is the thread: www.mumsnet.com/Talk/womens_rights/3125584-Impact-of-birth-injuries-prolapse-etc?

It got me (and many others) asking why postpartum care is so bad in the UK? Why, if the medical establishment in France is so pro-active in helping women recover from birth, is the NHS so disinterested? When the NHS does acknowledge its existence, why are British women being told, by and large, to suck it up, to get on with it, to accept that this is life? In the thread there are some pretty graphic descriptions of what women are being told to get on and live with - and it's not pretty.

MN had a campaign to address the treatment of women post-miscarriage and shone a much-needed light on the issue. This is another issue relating to women's health, one affecting many thousands of British women annually (if the statistics in the article are correct), and it deserves our attention and could, if successful, really help British women in future. Birth trauma is simply not talked about. Prolapse is not talked about. I wasn't remotely worried about those things when I was pregnant, because no one told me it was a risk - and a pretty big one at that. The possible outcomes of childbirth should be talked about, should be known by all pregnant women, and physical therapy should be available to all, to catch those who have been injured early on. It would even make financial sense to do so - and we all know how important that is these days for those holding the purse strings.

Bump

Agree postpartum care should be massively improved.

The possible outcomes of childbirth should be discussed at school as part of PSHE (or whatever it is called now) by all. It should not just be raised when someone is pregnant women. And if we are truly to remove stigma and shame, it needs to be openly discussed with men too.

I am so pleased to see awareness of potential issues being highlighted in this. I went to all sorts of pregnancy and birth classes and nobody ever talked to me about the long-term physical consequences of birth. You are given the impression that everything will just magically go back to normal, but that is just not true, particularly after any sort of intervention. My body will never be the same again. I wish someone had at least bothered to prepare me for this fact.

I would support such a campaign. I haven't commented on the other thread, and only skim-read it, but my birth experience had more of an effect on my than I could have anticipated. While I believe it's important for women to have realistic information pre-birth, I would particularly welcome more support post-birth.

My 8 hour long second stage of labour and forceps birth meant I automatically ruled out having a second child. Returning to work was a worry, due to continence issues - which still affect me, albeit to a lesser degree four years on. I know there are surgical options, but the horror stories about mesh repairs put me off.

I would welcome any campaign that draws attention to how far-reaching some of these issues are - to mental health, to our sex lives, to our ability to exercise, to our ability to carry out the work we might have done previously...and that calls to provide women with greater support

Yes, I think this would be a great idea. It will require a lot of work to get past the NHS aversion to admitting any downsides to 'natural' birth, for one thing. But very worthwhile.

This may be a bit of a tangent from the specific issues being discussed on this op, but hey ho. I was thinking about care after birth recently, and I think every woman should be given two meetings shortly after a birth as standard practice.

One with a medical professional who can go through the events of the birth with you, explain anything you aren't sure about and any potential issues to look out for. There are still some things I don't really understand from my DDs birth, I would have loved the chance to discuss it properly without feeling I was making a fuss. I think this would have given me the closure that I still don't know I really have almost 6 years later.

The other meeting should be with a trained counsellor who who can talk to about the emotional and mental health aspects of the birth. This should be completely confidential, obviously and focused on the mother's experience and feelings. A lot of women suffer from anxiety, guilt and even PTSD following birth and there is really no acknowledgement of the mental and physical trauma of birth for women.

I'm actually getting a bit furious about this now.

Bump. Just to let you know I reported the thread to MNHQ so they would see it and they said they would flag it to their Campaigns Team.

Bump

I’d love to see a MN campaign on this. It’s a massive but hidden problem. A huge difference could be made by MN’s involvement.

Birth trauma and POP are absolutely 2 intersecting and significant women's health issues that need a light shined brightly and continuously on them.

I agree something needs to be done to address post partum issues. There appears to be no NHS funding in some areas to even try to deal with these issues. I also think more could be done antenatally eg every pregnant lady told of the risks (POP was not mentioned at NHS or NCT classes) and offered the opportunity to go see a physio to check they're doing their pelvic floor exercises correctly.

I'm pregnant with DC2 but still have a cystocele after DC1. My midwife said that they no longer have obstetric physios and that I (as a junior physio) should consider specialising in women's health physio. However, having already had to seek private physio for my POP (the physio is the same lady I saw antenatally for pelvic pain with DC1 in the NHS) , I'm aware that the NHS, in my area at least, does not fund physio for post partum problems UNLESS you can get referred by the continence team. I'm fortunate and have no continence issues, but this means I cannot get physio on the NHS for this issue. Even my GP seems unaware of this as she said (4mths ago) she would refer me for physio due to the POP (obviously I never got an appointment).

Can I suggest the words ‘Pelvic Organ Prolapse (POP)’ are put in the title? As there are so many other postpartum issues (that also need addressing) but this one in particular is so under the radar.
Plus POP also effects women in menopause, who may have never had children or certainly no longer consider themselves postpartum.

I would wholeheartedly support a campaign. To the point of attending meetings, giving an impact statement, whatever it takes. I'm intensely passionate about it and feel robbed actually, I've "lost" so many areas of my life to it. I also posted the following on the Sherrie Palm webchat page-

I would like to add a personal note. I have read many, many heartbreaking accounts of women dealing with prolapse. The degradation cannot be minimised/ignored any more. It can be devastating, affect all aspects of day to day life .Who doesn't need the toilet every day? Imagine having to insert digits into your vagina in order to have a bowel movement? Spending ages in the loo at work with foul smelling movement due to constipation. Leaking urine everywhere, not to mention some women, me including, who haven't had penetrative sex in god knows how long as there simply isn't enough room? The list goes on and on and on. And I'm sorry, but if the boot was on the other foot and mens testicles and penises were rendered out of action, they were unable to have PIV/masturbate/have a bowel movement/leaked urine then I'll warrant there wouldn't even be a need for a campaign as it would be addressed immediately. Apologies if that's out of order blush but it's how I feel. We need voices, then we need action

@JustineMumsnet- It's one of the things you do best and you are a prominent voice for women, and not just in the UK. How amazing though, if we could start, drive a campaign to change things in this SO important area. We've been ignored silent for so long on this issue, it really needs to change. I'll hold a placard, sign a petition, hand deliver it to Theresa if need be, whatever it takes. Can we change things? Can we catch up to France at least lead the way?

Totally support you in all of that, Shakey. I think this is exactly the issue MN could make a significant impact on - unglamorous and hidden, but such a huge deal for so many women.

Hello

Apologies - we only just saw this as we wandered in to the topic to start a thread about something else: seems to be have been some sort of snarl-up - very sorry about that.

We're really glad we spotted it though, because we are right now planning some activity for the second phase of our campaign for better postnatal care.

The first phase covered in-hospital care (mostly on postnatal wards) and immediate post-birth care, but the second phase is going to cover longer-term care for birth injuries and women's health after birth. So this is really timely - we'll go and have a good read of the thread, thank you.

In the meantime if you'd like to be kept up to date with developments in the campaign, or would like to campaign locally on these issues, or would consider being a media case study for us when we launch the second phase of the campaign, please email us on [email protected]

Thanks
MNHQ

I didn't have a forceps delivery but I did have a pretty traumatic manual removal of the placenta, this contributed greatly to the PTSD I was diagnosed with a few months after my first child's birth. I still get flashbacks now over six years later. I suspect this procedure has caused my POP issues.

I had no knowledge of POP at all and accepted that the stress incontinence that I developed after the birth was just 'part and parcel' of having a baby. It was only after speaking to my mother who had delivered four babies naturally that I realised that maybe it wasn't OK after all and saw a GP. The GP diagnosed me with a 'mild' prolapse and I was added to the lengthy waiting list to see a Women's Health Physiotherapist - there are apparently two of these in our pretty large city hospital!

To cut a long story short I was referred on to see a Urogynaecologist and after a pretty grim urodynamics test he recommended a TVT which I am having in a few day's time. The dilemma about whether or not to have it because of the mesh scandal is a whole other story.

Last week I had a very scary episode where my symptoms worsened and so I was examined again. This time I have been told that I actually have three prolapses and that it is 'up to me' when I want surgery to sort them out based on 'how long I can manage the symptoms for'. The Consultant is clearly very respected and knowledgeable in his field but its very apparent that he doesn't really appreciate not just the physical discomfort (obviously!) but also the negative impact on mental health that I am finding the POP is causing me.

Its left me reeling a bit and I am feeling all kinds of emotions. I am very grateful to have my two beautiful children but I really think more needs to be done to raise awareness of POP in both medical professionals and also expectant mothers so I fully back this campaign.

That’s fantastic news, RowanMumsnet.

Gotofriggingsleep

You definitely should. And its not just France that has excellent post partum care check out what we have here in Luxembourg too. Everyone gets at least 8 sessions of post partum physiotherapy free of charge. More if needed.

Just seen we need to email you at mumsnet to be kept up to date.
Really looking forward to this campaign.

Absolutely there should be better postnatal care. But there aren't enough midwives at all.

The government massively needs to step up the training of new staff and the retention of experienced staff.

Many trusts have vacancies of up to 20%. This means that so often almost all the available midwives are deployed to delivery where 1 to 1 care is essential leaving a skeleton staff of the bare minimum midwives and care assistants in the postnatal wards.

It's not acceptable but you can't magic qualified staff out of nowhere.

imo pelvic floor health should be a priority as well.

france/germany offer gymnastic classes for rebuilding core strength and pelvic muscle

Postnatal Cardiac Arrest and Hypoxic Brain Injury.

My daughter gave birth to our first grandchild 18th July 2015. The baby wasn't due for another 3.5 weeks. The day before birth she had visited the local Antenatal Day Unit (ANDU) upon the instruction of her GP who had recorded reduced fetal movement. She was at that time on iron supplements prescribed by her GP for anaemia.

She had shown us (parents) a particularly large pulsating vein in her right side neck that appeared to be going at a rapid speed. While in Maternity during birth, a nurse noted her neck vein and wrote: "right side neck going +++." It was reported to the midwife for review.

Unfortunately, on Jessica's medical notes, daily observations after day two had the word written "Well" but no temperature or pulse recordings. There was no review of Jessica's neck vein and she was discharged after five days. A video on postnatal day 2, on her bed with her son Lewin, shows her visual pulse at approx 160 bpm.

She began to deteriorate 13 days after birth, I took her to ED, she had lost her appetite, was breathless and had a persistent cough. Her heart rate was 170 bpm. Jessica appeared to be suffering a tachyarrhythmia or (SVT). The treatment in ED seemed aggressive, fast and there was no plan were lots of discussions between doctors.

No senior Obstetrician was called and no senior review of Anaesthesia. No on-call Cardiology attended but were called. Phone advice was given.

Jessica had received 9 different drugs, was anaesthetised for electric shock treatment (cardioversion) and remained unconscious. Shortly after, with her Mother present, she went into cardiac arrest. In retrospect, the doctors say Jessica had Tachycardia-induced Cardiomyopathy. We will never know for sure as no urgent investigations were conducted chest-x-ray, echocardiogram, heart function and no personal attendance by a consultant cardiologist.

I share this experience not to alarm or scare, however, I would hope one day the changes I am proposing will be implemented so there can be no repeat of Jessica's incident. I am Jessica's full-time carer as she received a severe brain injury. He little boy Lewin is 30 months old now and I love them both dearly.

We have started a campaign on change.org to:

Help promote a specific escalation process
I am praying hoping this petition will change the way all Hospitals Investigate serious incidents where harm or death has occurred. I am very aware a specific escalation process that must should be in place for pregnant and recently-pregnant patients presenting as an emergency does not exist in many Hospitals.

Please help and support the petition, both the changes in how serious incidents are investigated and the escalation process need to be a recognised process and standard throughout all healthcare providers.

YouTube Video Diaries goo.gl/5k5uMw
Change.org Campaign goo.gl/MQ8Zbg

Hi IAmJustADad - we're so sorry to read about what happened to Jessica. It sounds like a really appalling experience for you all.

This thread is specifically about a postnatal care campaign. If you want more Mumsnet users to see your story and consider supporting the petition, you might like to repost in our Petitions topic, here.

Best wishes to you and your family.
MNHQ

cannot do it, tried 10 times or more, the message at bottom of page "Please login first" done that 10 times.