Observer campaign to improve maternity care

The Observer: Five Steps to Improve Care
Fears for Health of New Mothers
'I felt isolated and uncared for; I needed a friendly face'

Today the Observer kicks off its campaign to improve maternity care with these articles looking at post-natal care. I blogged a bit about it and my own experience on the post-natal ward here.

I was back on the ward at 6am and gone by 1pm.  If I could have gotten out of there quicker, I would have because I knew that the only place I'd have an opportunity to recover was at my home.

Thirty-seven hours with no sleep and a brand new baby.  It's a good thing I had a child before and knew how to cope.  I pity the first-time mothers that are a bundle of nerves and hormones, and that have had no sleep and no time to recover.  It sounds like a perfect recipe for post-partum depression.

BTW, Stella, I didn't know that you could have a private room either.  No one bothered to tell me.

Yeah, it may vary hosptial to hospital but apparently at my local maternity hosp, if it is available you can secure a private room for £35/night. Had I known then I would have happily beaten down the door for it.

Thirty-seven hours with no sleep and a brand new baby.  It's a good thing I had a child before and knew how to cope.  I pity the first-time mothers that are a bundle of nerves and hormones, and that have had no sleep and no time to recover.  It sounds like a perfect recipe for post-partum depression.

I was one of those unfortunate new mums, Cait.  32 hours with no sleep, 24 hours in labour, not given any fluids so horribly dehydrated, forceps delivery with loads of stiches.  Left on my own to care for 1st baby, no oral pain relief, and no help getting about (despite my legs and feet still being on pins and needles from the epidural).  I had NO idea how to care for baby or what was 'normal' - such as her coughing up mucus all night.  Husband told to go home.  So I wound up staying up all night with her, buzzing and buzzing - no one came.  The next day I tried to throw myself out a window - out of my mind with depression, anxiety, dehydration and exhaustion. 

Hospital too cheap to fund a well-baby nursery, and chronic shortage of beds means women are regularly sent to other hospitals as far as Tayside and Glasgow to give birth.

Wound up on anti-depressants, anti-anxiety drugs, sleeping pills and hypertension medication for the next 18 months.

I refuse to give birth in that hospital again!  I'm pushing for another one in West Lothian and would like to go home as soon as able so I'll have my spouse, ILs and mom around to help me get some rest.  Or even go for a home birth - probably less risk of infection there.

Putting mums and babies lives at risk to save a few pennies to pay fat cat managers is what it sounds like to me.

I'm really sorry to hear about your experience, expat; it sounds truly horrible.  Here's hoping that your second round is the joyful experience it should be.

I'm really sorry to hear about your experience, expat; it sounds truly horrible.  Here's hoping that your second round is the joyful experience it should be.

I'm so keyed up I'm scheduled to go see a psychiatrist at 6 months to discuss going back on anti-depressants.  The anxiety attacks are coming back, and if I had a million dollars I'd buy a completely private birth.  This will be our last child.  I can't take the mental strain again. 

At the time, you don't realise how mismanaged it all is.  I was lucky - on a parenting board I frequent, no less than 3 women have suffered stillbirths of healthy, full-term infants directly due to staffing shortages and maternity care shortcomings. 

That is just awful. Mismanaged is an understatement.  I hope you can get better care this time around.

It is not just the maternity wards that are having these problems.  It's hospital wide, probably worse on the general wards. This is why I am leaving nursing forever and never looking back and it is a shame because I'm a hell of a good nurse.  I know a lot of midwives who feel the same way.  Would you like going to work and working like a dog for 12 hours with no break of any kind only to have a patient you were responsible for have a stillbirth because you couldn't be ten places at once?  How does that feel at the end of the day?

 I wouldn't go back into nursing for a 50 million pound pay packet.  The shortages are a result of a retention problem of staff, it's not a recruitment problem.  And let me tell you, the hospital managers love it when they are running the ward short staffed.  They save money.  They aren't interested better staffing.  They will leave one RN alone on the ward for 20 patients, send her new critical admissions CONSTANTLY,  and refuse to get agency it because they don't want to pay for it.
Then of course, if anything happens its the nurses fault.  I have been alone on the ward with 20 patients, 10 of whom were so sick that they needed my constant presence and constant monitering.   If one would have died due to the fact that I wasn't with him because I was in the next room trying stop another patient from crashing and dying, it would have been entirely my fault and I would have been held responsible.  The managers who refuse to pay for extra staff would have got off scot free.   These are not isolated incidents, I was put into these kinds of situations almost everyday when I went to work.  And no, the docs are usually not on the wards to help.  The most I get out of them is a phone order for something useless after I have spent three hours paging them.

These kinds of scenarios are occuring frequently and are causing a mass exodus of nurses and midwives from the profession due to fear.  I don't want to be the defendent in a wrongful death lawsuit because I cannot be two places at once thank you very much.   I also cannot STAND watching patients suffer.  When my cancer patient waited over an hour for pain medicine to be given because I was alone on the ward again and had 2 cardiac arrests back to back I wanted to shoot myself.
I was on the ward 12 hours that day, with no lunch, bathroom, or drink break, breaking my back and still could not get around to people fast enough or for long enough to make them feel as if someone gave a damn. That is devastating to me because I care a lot about every patient that I take care of.  :\\\'(

I am moaning and rambling so I will stop.  My point is that it is the mass exodus of nurses due to fear and frustration and that is what is causing some of the problems people are experiencing on maternity and other wards.  The hospitals are loving it because they hate paying our salaries. Things are not going to improve until the hospitals are forced to be serious about staffing.  They may be saying that they are recruiting and  blah blah blah but they are full of it.  They love keeping the wards open and open to admissions and meeting targets with a skeleton staff on. $$$$$ 

Oh Expat, that sounds like a nightmare.  Good for you for being proactive so early on this time.  I really hope things are better this time around. 

I have to say that my experiences with delivery and postpartum care with both my kids were without complaint.  I had phenomenal midwives and almost too much attention. My biggest problems that I had was the fact that I was in a ward and didn't get much sleep due to other babies crying and it grossed me out to have to share bathroom/shower rooms with 5 other post partum women. I think things may have been different if I hadn't moved to the Highlands during my first pregnancy.  I received the first 20 weeks of my antenatal care in London where my 12 week scan was at 16 weeks, my 20 week scan was booked to be done when I was 28 weeks, they lost all of my blood in the lab, I never saw the midwifes, etc.  When I moved, I was in to see the midwifes, have my scan etc within the first week.  After reading all of these stories, I feel amazingly lucky. 

As a nurse, I completely understand what you mean, Nicole. It is a system wide problem.  IMO, the NHS is way too top heavy.  Too many administrators and too few qualified staff to care for patients. 

Really glad to learn of a concerted effort to improve things.  I see that Elle MacPherson is traveling the UK, promoting breastfeeding.  Good on her!!  Not one hospital in London has the 'baby friendly' stamp of approval.  The Baby Friendly program is the only proven mechanism to increase rates of breastfeeding and sadly, the UK has the lowest rates in all of Europe.

As Elle said:

"I find it shocking that London women have no choice over where to go to receive good care."

I would never birth in hospital, so I have no experience there.  I just couldn't brave that sort of birth!  I've been so thrilled with both my births, just launched me into mothering on the biggest high of my life and with what mothering requires, I needed that high big time.

Expat that's terrible. I hope you do get into a different hopsital next time.  My experience wasn't too bad but I was very surprised that I was left to my own devices once the baby was born.  The midwife I had at delivery told me newborn babies should not be fed for the first 24 hours and no-one showed me how to latch him on until about 10pm (over 12 hours after the birth) when one of the midwives hear him crying and came to ask why I hadn't fed him.  As well as that, there wasn't anywhere to bath babies, which I was very surprised about, although I wouldn't have known where to start anyway. As it was I had to look in my baby book the first time I changed his nappy.

Expat that's terrible. I hope you do get into a different hopsital next time.  My experience wasn't too bad but I was very surprised that I was left to my own devices once the baby was born.  The midwife I had at delivery told me newborn babies should not be fed for the first 24 hours and no-one showed me how to latch him on until about 10pm (over 12 hours after the birth) when one of the midwives hear him crying and came to ask why I hadn't fed him.  As well as that, there wasn't anywhere to bath babies, which I was very surprised about, although I wouldn't have known where to start anyway. As it was I had to look in my baby book the first time I changed his nappy.

 

That is shocking.  What was that midwife thinking when she told you not to feed him?  I was always taught to try and start them nursing straight away.

It may not be that uncommon as my mum said she'd heard of that before.  But you would think the hospital would stick to one or the other theory in stead of one midwife telling you one thing and another telling you something else. I also had one midwife tell me my baby was too cold because his feet were cold then another one told me he was too hot and that all newborns have cold hands & feet because their circulation hasn't got going properly yet. 

I don't fault the nurses or midwives at all.  They were all brilliant, but they were soooo short-staffed.  There weren't enough consultants, either.  Maternity has been short-changed. 

What's sad is that the babies are short-changed.  I have a big problem with a system - any system - in which children are so poorly valued. 

And it's the not the fault of the nurses or midwives.  It's the fault of the managers - and they don't give a toss so long as it's not their wife or child this is happening to.

I'd love, love, love to start a group of women volunteers - mums of older kids who now sleep all night - to go into these maternity wards and just help these ladies out for a night or two after they give birth.  So they can sleep knowing someone who cares is next to their baby, keeping an eye on their child, helping them get up, fetching things for them, showing them how to change the baby's nappy, bringing their old plastic tubs in to help the mums give their babies a wash.  It would have meant the world to me if someone had been able to be there.  But of course my family wasn't allowed to stay with me.

Some of these mums may be frightened, others may just be exhausted or feeling overwhelmed. 

I need to talk it over at my booking in, but I am considering a home birth. 

I'd love, love, love to start a group of women volunteers - mums of older kids who now sleep all night - to go into these maternity wards and just help these ladies out for a night or two after they give birth ... [snip] ...  But of course my family wasn't allowed to stay with me.

Herein lies part of the problem.  The husbands, mothers, sisters, etc that could be there to help you are tossed out until visiting hours which -- IMHO -- is utter bollocks.  If you aren't going to provide a well-nursery, then don't toss out potential helpers.