NHS Cut Backs and now feel totally lost

[BabyAcorn]

I have just rang my local after care maternity unit to arrange a visit. And have just been told they dont do them any more.

I know this may sound strange to you ladies but with this being my 1st . I had got myself ready to have the baby in hospital, then to be looked after for a couple of days, shown what to do etc.

I am now totally crapping my pants, Im so worried,nervous and upset I am typing this with a few tears...

I can still go to this maternity unit to give birth but then after so many hours, have to go. Plus if I needed etc special care or epidural i cant have it, which scares me no end. Plus the fact the hospital carts you out straight away now, i feel like boom bash, its out, your going .. done..

Can any one help me in my thoughts? Can you pay for private after care, I just feel like the last place i will want to be is at home worrying about the ironing :(

Yes, you can definitely pay for aftercare. I'm not in the UK but I know you could hire a doula/independent mw to get you started and set-up at home. I'd also imagine () that you can throw the NHS some cash too.

I find it hard to believe they'd kick you out after x hours - although perhaps the cynic in me does believe it.

You will be OK though - we are all absolutely bloody petrified about walking out through those hospital doors with a newborn. Who me? Allowed home with this precious thing?

I agree - a postnatal doula can help you to settle in as a new family, giving you time to rest and enjoy your baby. We offer practical and emotional help, support with establishing feeding and can also give a hand with household chores.

Doula UK (www.doula.org.uk) and Nurturing Birth (www.nurturingbirth.co.uk) will have listings of doulas in your area.

Wishing you all the best.

Obviously things will be different from NHS area to area... but I gave birth last month, and they tried to discharge me less than 6 hours after I gave birth (this is my first baby). I put my foot down and said I wanted to stay overnight, and they let me with no issues. However, I have heard of other people who don't feel able to say they want to stay. But I think it is a bit of a 'don't ask don't get' type of system.

I was then lucky enough to transfer to a birthing centre for another night, but that is currently in the consultation period for being closed down. Which is such a massive shame. Makes me quite angry actually...

it would surprise me if you were thrown on the street and got no follow up. I was forced to stay overnight and they might have kept me a second night if I hadn't found a doctor to sign my discharge papers at the last minute (after all day trying and having then been in hospital for nearly 48 hours.)

I was then visited by a midwife every day for a week and the health visitor turned up a couple of times too. I still had trouble BFing though so paid for a doula type to come a couple of times to help.

And i don't understand how you can be at a maternity unit but no epidural or intervention is available?? That doesn't sound right.

"And i don't understand how you can be at a maternity unit but no epidural or intervention is available?? That doesn't sound right"

BabyAcorn I'm guessing you're going to a Midwife-Led Unit? I'm hoping to use the MLU in my local hospital and I understand that they don't do epidurals and possibly some other forms of intervention. If you need those you just go down one floor to the standard maternity unit, so it isn't a big deal. Once there are no complications women seem to vary hugely in how long they want to stay, so I guess hospitals are getting it from both directions.

Good luck!

Thanks ladies - well the update of it is we have found 1 place in the whole area of 40 miles of where we live. It is a trek but I think it's going to be worth it.

I may totally be ready for the challenge on my ow, but it's the knowledge of knowing I can go if i feel I need to etc.

Midwife said it all changed from this summer, and to my amazement was in the papers, tv and parliament [ i didnt know anything about that!]

I agree with good night moon - i dont think these centres should be able to open themselves up without being able to give women other drugs, your then moved pillar to post, just seems wrong - especially for the 1st time mummies! Anyway rant over, sorry for being upset yesterday, just a total shock :()

A midwife lead unit can't give epidurals or carry out certain procedures because they are run by midwives. They don't have anesthesiologists and they don't have surgeons etc so there is nobody qualified.

Some MLUs are located within hospitals which can provide those services and so you can be moved floors/ buildings. Others (like our local one) are an ambulance journey away.

For many women who have straight forward births there is no need for the drugs or intervention. In this case the more relaxed, low-key atmosphere of a MLU is often what people want and has positive outcomes.

For people who want the reassurance of the availability of intervetions then a hospital is the answer.

I do agree though, that good postnatal help and guidence is invaluable especially to establish breast feeding. Sadly it often isn't available, or as good as it could be.

"i dont think these centres should be able to open themselves up without being able to give women other drugs, your then moved pillar to post, just seems wrong - especially for the 1st time mummies!"

That is an utterly ridiculous thing to say. It's a midwife-led unit, which is good enough for a lot of women. In fact, many seek them out consciously.
If you want more pain relief, just go somewhere else, which you seem to be doing. No need to rant about MLUs like that...

When I had DS, even though I was low risk I opted to go to the labour ward rather than the MLU upstairs so that I knew I'd have access to epidurals etc should I need them. I was told if I was on the MLU and needed to be transferred but there were no beds on the LW, I'd need to go to a different hospital.

Personally, although I liked the idea of a water birth, it was more important to have the drugs on hand so the MLU was just not for me. For others, however, their priorities are elsewhere so MLU's are perfect. I think as long as you have a choice and make an informed decision, you'll be fine.

As far as being able to stay in after the birth, well! I was forced to stay following a spinal and EMCS, then DS had jaundice so needed phototherapy. I went in in Tue, gave birth on Wed, and came home on Sat. There was a medical need for me to stay, unfortunately, but it was, frankly, awful, and I would have neen much better at home if I hadn't needed the intervention I did. I got no assistance with bathing DS, changing nappies etc. The bf advice was pretty rubbish and this only got better when I came home and had the local bf counsellors round to my home. I hated every second I was stuck on that ward.
so my advice is, go home as soon as you can! (as long as you are well).

I delivered on labour ward (forceps retained placenta big tear etc etc) then had 3 wonderful nights 10miles away in a birthing unit (where I'd never have been able to give birth as MLU and no forceps etc available) where I was looked after and learned to breastfeed. I suspect paying a load of cash toa doula would have similar effect but I loved having 1:1 BF support every singlke feed for 4 days (they kicked me out on day 4 or I'd probably still be there 2yrs later!) Unfortunately I suspect when lookign at value for money in a cash strapped NHS it probably wouldn't stand up to the test but it was lovely

Glad you have found a choice you're happy with, even if it's a way away.

Where I live, you pretty much get kicked out unless there are any complications. However, they do make sure you can breastfeed first, if you want to and keep you in for that, then visit when you get home. I thought that was normal to be honest and assumed I would be happy to come home asap, although it is hard to predict how I will feel (also my first).

As others have said, hiring a doula or similar may be your best bet to ensure attention, or be prepared to insist on staying longer.

My priority would be to have the baby in the labour ward where all the pain relief options are to hand.

I very much doubt ironing will cross your mind (for several years!) once you have your baby!

Care does seem to vary enormously up and down the country

I found this book on how to actually look after your newborn baby very helpful, very straightforward and it covers bathing and lots of other stuff!

As some of you may know, there is also a Mumsnet Campaign for improved Postnatal Care so PLEASE, if you're not happy with how things are in your area then get involved. Don't just wait for someone else to do it - add your voice to the debate in your area, it really counts! - otherwise our services will continue to be cut "restructured" . So, get involved!

You can also write to your MP to raise your concerns about the lack of care available and the cuts to maternity services (in particular, do read this BBC article about the births to midwives ratio in your area). If you're not sure who your MP is, you can find their details here