After seeing the following video on Mumsnet…
…and experiencing a mix of emotions at the end, I had to start writing this blog immediately! Such feelings included anger, disappointment, sadness, guilt, frustration but overall a general remorse and empathy for the mothers & families who’ve had a negative experience as a result.
This video was all about postnatal care.
It saddens me to say that none of these experiences were positive. Without encroaching too much into the politics of our National Health Service, unfortunately the maternity service is incredibly understaffed and overstretched.
It’s really difficult to try to explain the pressures practitioners are under unless you work for the service and have experienced it first hand.
All I can really say is that 99% of us are trying our best but certain things prevent us from giving 100% of our time to direct patient care. It works both ways though too, as some patients can abuse the service and also treat it like a hotel. My friend who is a nurse once had a male patient shout at her whilst she was busy seeing to another individual, “You are going to give me what I want right now- I pay your wages!” As I’m sure you can imagine she wasn’t overly impressed by this comment.
Anyway in an attempt to steer away from these negatives, as most women (I hope) do go home having had wonderful maternity care. Plus, the majority of mums that I speak to have really positive experiences too. I’ll throw some in throughout- some you could say are too honest but I’m trying to give an accurate, reflective account. There are in fact many benefits to be gained from the postnatal ward. So in no particular order of importance, here are;
1. Don’t feel coerced/ pressured into going home
Some of you may have seen this and others not but trust me when I say they are BUSY! There is such a high demand for the beds because the service is so overstretched and because culturally we have shifted from having our babies at home, to having them in hospital. This means that it can sometimes seem like a conveyor belt system, with a one in, one out, type of approach. If you have had a normal birth and everything with you and baby is fine and you’ve ‘ticked our checklist’ so to speak, you will most likely be offered discharge home from the labour ward. If you don’t feel confident or comfortable to go, don’t. The midwives will book you a bed on the ward. We would always prefer you to stay and get the support you need than to go home and struggle.
Ps. If it isn’t your first baby and you’ve had a lovely birth and everything is well postnatally and you could go home but don’t want to because you just want to have one night alone with you and your newborn, it’s OK to say so. I’ve had plenty of women ask me that, it’s completely understandable and they’ll be accommodating.
2. Don’t be afraid to speak up.
We can’t read minds. On admission you are shown your call buzzer, again the midwives or other ward staff members will answer these. If you need help, then press it. We just ask that you are sensible and don’t take advantage of this. Often when it’s not your first baby and you’ve had a normal birth, we will conduct our daily postnatal checks and that might be it. Especially if the ward is really busy and you’re not on any regular medications, as we’ll probably assume that you’re getting on just fine. So if you’re not, please let someone know.
3. Take any student midwife help on offer.
There are people who are keen and others not so, re having students involved in their care. Yet they are such an untapped resource, especially when it comes to breastfeeding support! I remember vividly one shift as a student, the postnatal ward was completely full and each midwife had 8 women (their babies included, so essentially 16 patients!) My mentor was glad to have me with her that day as we split the women and shared the workload. I spent most of that shift giving feeding support, whilst my mentor did tasks that I couldn’t do such as administration of intravenous drugs. Student midwives have extensive lessons on infant feeding, really early on in their training and it’s also based on the most up to date research. It’s a win win for all, she’ll be happy to help, especially since they need to achieve a certain number of breastfeeding competencies.
4. Make use of the breastfeeding support workers.
Again other staff members to access. Depending on which hospital you are in, these wonderful people may go by different titles. Sometimes referred to as the above, in other trusts nursery support staff.
Their role tends to be totally baby related so if it’s your first time changing a nappy and aren’t sure of which bits go where or ‘THE WORST’ has happened and your newborn has done a projectile poo and it is everywhere. And I mean EVERYWHERE- I’ve seen it fired half way across a room before!
They can help, they’ve also been trained by the infant feeding leads to give breastfeeding support so please make use of them.
5. Take some home comforts in your hospital bag.
Pillows, old comfy pjs and some sweet treats. Some simple commodities will make your hospital stay that little bit nicer and help you to feel more settled in the new surroundings.
Our white ‘Lilly’ nursing slip is a must have! It’s 94% bamboo so will feel super soft against your skin because unfortunately the hospital sheets won’t! It will provide a feeling of equisite luxury and will be kind to yours and baby’s sensitive newborn skin because it’s made from organic and natural materials. It’s the perfect accompaniment to your pyjama bottoms during your hospital stay and at home. It allows easy access for breastfeeding with its strong, secure clasps and will keep you dry and comfortable all day and night because of bamboo’s natural moisture absorbency and ability to thermoregulate.
6. Be aware that you will be tired and not have the best night’s sleep.
I’m sure plenty of you have experienced this. Your baby has finally settled after what seems like forever and you finally get that precious wink of sleep and then the baby in the bed opposite starts shrieking and sets all of the babies off in the entire bay. There are a limited amount of individual rooms so just be prepared.
Ps. if it’s your baby that’s doing the screaming and you need some respite, you can take the baby into the nursery to settle, or some mums will bring them to the midwives station and they’ll take them off your hands for a bit,
7. Pack lots of disposable pants, pads and nappies.
Accompanied by lots of baby grows and vests, as you’ll be changing these a lot as they’re forever getting milk possets and sick on them. Pack a range of sizes too as they might be a lot smaller/bigger than expected. I’d opt for the latter- nothing wrong with having a little bit of growing space!
8. Have something to entertain you, if you’re staying in.
Hospital entertainment packages are quite expensive and also quite limited with regard to what’s on offer. If you’re staying a while have a selection of books/magazines or plenty of films/series downloaded on your iPad/ notebook. As you may have times, where you’re baby is flat out but you’re struggling to rest.
9. Keep visitation to a bare minimum
There are restrictions for the number of visitors and we don’t do this to be mean, there are protocols to follow for health and safety reasons. Also with partners staying this isn’t allowed on the wards because there are other women and babies present. Personally I would advise to stick with just your partner and any other children you may have for visits. This will depend on your length of stay of course but if it is just the one night, friends and relatives can surely wait, right? It’s a tricky time, you’re adapting to becoming a mum and caring for a newborn, getting to grips with feeding, nappy changing and trying to recover from the birth etc. so don’t give yourself the added pressure of having to ‘entertain’ visitors by the bedside.
Good news though! Having spoken recently with the consultant midwife for Nottingham University Hospitals there are plans in place to allow partners to stay overnight on the postnatal wards from June. So watch this space!
10. Take the pain killers that are offered on the drug round!
And if you missed it because you’d popped off the ward or were not at your bedside, please go and ask for some. As long as you are within the correct time frame ie. you haven’t recently taken some and haven’t had more than your prescribed dose in 24 hours, they’re all yours!
Also PLEASE PLEASE TELL the midwife if you have already taken any medication or have your own prescribed meds. This goes for the labour ward too if you’ve come in from home and had paracetamol one hour before, they need to know so you’re not overdosed. Most of the time you will be asked this already, so shouldn’t need to worry but just giving you a heads up.
I don’t generally take analgesia much, not because I’m trying to be a hard-nut but I don’t really suffer from headaches or bad period pains etc but trust me after having a baby I would be popping those pills! Especially if I’d undergone a C-section and this is where some mums get caught out, so take note.
When you have a Caesarean you have either a ‘spinal’ anaesthetic, or if you’re already labouring and have an epidural in situ, you may be given a ‘top up’ of the epidural medication to ensure you have effective analgesia for the surgery. Sometimes women will have Caesareans under general anaesthetic but this is not as typical. Now because each of these are really strong, opiate based pain killers you can feel somewhat numbed after the procedure, which is what we are essentially trying to achieve so you feel comfortable for some time after the birth. The anaesthetist will have informed the midwives of when it is safe for you to have any more analgesia. When you’re first offered it from the midwife, I would always advise taking it. This is because even though you might not feel any pain at this time, we are trying to maintain what’s called a ‘therapeutic dose’ which essentially is trying to stop any breakthrough pain. So we always advocate taking your regular, prescribed medications following an operative and instrumental birth.
And just on a separate note if you’ve had a fair few babies already you might notice that your after pains feel worse and more painful. This happens because the uterus is having to work harder to ‘involute’ which is the process of it returning back inside the pelvis and contracting back to its pre pregnancy state.
For the breastfeeders, you may notice these after pains more when you are feeding because of the oxytocin released. This is the hormone responsible for the ‘let down’ reflex and also the hormone that makes the uterus contract. There’s your answer.
That’s all for today. I could have extended this list but I’ve tried to keep it somewhat concise! Keep an eye out for my next blog- it’s going to be on postnatal perineal care and I wrote my dissertation on this topic so I’d hope that it will be an informative resource for you all, especially since I had to spend hours and hours looking at literature and images of this small area between our orifices!
Any queries on this in the meantime, you can contact me on my social media pages or at firstname.lastname@example.org