water again!

today was my first Maternity Services Liason Committee meeting, the water
issue had been followed up by other members of the committee as well as my
sharing the information I had found. Anyway they are still not going to
budge on providing jugs, but are going to tell people they should bring
bottles of water in with them and ask partners to fill them up. I am
concerned about this as you get such a huge list of stuff to bring in that
things are going to get forgotten and deemed unnecessary.

As the discussion moved on, it became apparent that people were considering
the vast majority of patients to be "well", even c-section mums after the
first 12hrs should be sorting that kind of thing out for themselves. My
impression is that this really isn't the case, over the past few years,
delivery area has expanded, NICU has expanded, vastly reducing the number of
beds, so I much smaller proportion of mums staying in are "well". In my
opinion even well mums need a bit of TLC, but not so well mums really do
need the help. One midwife even suggested that if you can't get a drink
yourself you should ask another mum to get it for you, I thought that was
just a silly idea, very few people would do that, I'm the kind of person
that would ask someone to do it, but then there was no one to ask because of
the proportion of women that had had c-sections or forceps deliveries. All
in all I got the impression that there was very little idea of what it
really felt like to be a women who had just had birth, even feeling very
well after I had Ada, DH still got every drink that a drank for several
days, because even if you are pottering about, you're not always able to
jump out of bed at just the moment you need your bottle refilling.

Now I'm wondering where to go, there is no point harping on about the water,
that is more symptomatic of a deeper problem. I think I need to look into
the proportion of women who have had various procedures, to see if this
impression of the women being "well" is true of false.

Also, how do people think you should be cared for after the birth of a
child? I think you are often feeling like a child yourself, it is no good
being told well you could have had that if you asked, actually you don't
ask, I'm the kind of person who will ask if I need something, but after
Nathanael's birth when I was told breaskfast was available, I just nodded, I
didn't say, please could you bring me some cornflakes! I know my experience
of PND was fairly extreme, but I'm sure it would have lessened by better
care after the delivery.

Cheers

Anne

Anne Rogers wrote:

Also, how do people think you should be cared for after the birth of a
child? I think you are often feeling like a child yourself, it is no good
being told well you could have had that if you asked, actually you don't
ask, I'm the kind of person who will ask if I need something, but after
Nathanael's birth when I was told breaskfast was available, I just nodded, I
didn't say, please could you bring me some cornflakes! I know my experience
of PND was fairly extreme, but I'm sure it would have lessened by better
care after the delivery.

Hmmm...I don't know about characterizing the situation
as feeling like a child one's self, but I do think that care
is advisable ;-) I don't think women are generally invalids
after birth, but I think it is right and appropriate that the
first several days postpartum should be times when mom has
nothing to do but hang out with the baby (dad too, in an
ideal world--he hasn't gone through labor and delivery,
but he is going through a transformation). However, that's
not necessarily a medical need or something that is really
a hospital's responsibility. It seems to me that a hospital
is likely to take the position that they will provide necessary
*medical* care (and I think you've got a leg to stand on with
the water issue, as staying sufficiently hydrated is a
medical issue), but I rather doubt it's going to go beyond
that.
I know that both sets of midwives I've had wanted
assurances up front that we had arranged for effective
postpartum care for...hmmm...two weeks? Not that they
were saying I *should* be an invalid, but their position
was that I should be granted at least that amount of
time to recover and focus on the baby and get breastfeeding
established and so on and so forth. It was fine with
them for me to get up and do things as I felt ready and
able, but they wanted to make sure I had the time and
space to do it as I was ready rather than having an
earlier deadline I had to meet for being up and back
into my regular routine. For me, that was easy to
accomplish. My husband had time off work, my mother
stayed with us for the first two (and was next door
for the third, so was available as needed) and there
were all sorts of other folks happy to help. So,
whatever needed doing got done and I didn't feel
any need to do anything other than what I wanted to
do. (Well, I had some hard work deadlines with #3,
so I was doing stuff there, but that didn't require
physical effort.)
I can't say I had the experience of feeling
childlike or needing someone to remind me of basic
needs. I was fine with asking for what I wanted or
needed. On the other hand, it was family and friends
supporting me. I suspect I'd have been more reticent
about asking in a hospital environment, wanting to
be a "good" patient and not being too much of a bother.
And, of course, I was fortunate to have uncomplicated
deliveries so my physical recovery was easier and I
didn't struggle with PND, so there wasn't that aspect
to deal with either.

Best wishes,
Ericka

Anne Rogers wrote:

Also, how do people think you should be cared for after the birth of a
child? I think you are often feeling like a child yourself, it is no good
being told well you could have had that if you asked, actually you don't
ask, I'm the kind of person who will ask if I need something, but after
Nathanael's birth when I was told breaskfast was available, I just
nodded, I didn't say, please could you bring me some cornflakes! I know
my experience of PND was fairly extreme, but I'm sure it would have
lessened by better care after the delivery.

Ericka replied

Hmmm...I don't know about characterizing the situation
as feeling like a child one's self, but I do think that care
is advisable ;-)

bother wrong word, what I meant is need mothering, which isn't the same as
feeling like a child, because that is the last way you want a women to feel,
but the sentiment would be that instead of being told food is available a
lot of women may actually need more encouragement, instead of "ask if you
need anything", using "I'll just get you a drink, is there anything else you
need" could make a real difference.

I don't think they are going to budge on the water, despite being as far as
I can tell being the only place where water is not provided at the bedside.
However one thing I have thought of is perhaps they could have jugs
available for patients to use, because with the not providing it thing, all
of them have been disposed of so when I asked if I could have a jug,
intending to fill it myself, one wasn't available.

I'm still very concerned, because it seems to be the women who most need it
are the ones that aren't going to get it, for example a PPH, I wonder if
they might reduce the number of blood transfusions needed if in the 12hrs
after it happening enough food and water was given, obviously the most
severe ones are not going to be avoided, but there are a significant number,
where after the woman is stabilised and a transfusion isn't urgent, that
they are transferred to the ward and then 2 or 3 days later after blood
tests show there levels aren't improving, they then have one.

Anne

Haven given birth at the same hospital as you, my overall impression of
the place was that they were too busy to be as helpful as they could
have. When we arrrived originally I wasn't going to theMLBU as they
didn't have enough midwives, but when I got there I think someone else
had either given birth or been transferred, as I was the only one there
so could be admitted (thank goodness!). In the care I recieved the was
very good. The main unit not so much. When I was concerned about the
amount I was bleeding after the birth the nurse who spoke to me was
very huffy and short. I was told by my midwife they would supply pads
if I needed them but none were to be found. When dp went to get some
toast one of the nurses said they would bring it but only managed to a
lot later on. It would have been a better decision to let him do it and
focus their time on those that needed. It took forever to discharge
from the main ward back to the MLBU and as I've mentioned before the bf
advice I got there wasn't great. Although I was capable of shuffling to
the main ward to get water (there was no machine in the MLBU?!), it
wasn't ideal, although I did have dp to do it. Overall I would say the
care could be better for all mums but if those who had a c-section etc.
and no partner on hand all the time had the same experience, the care
would be far less than satisfactory.

Jeni

Overall I would say the
care could be better for all mums but if those who had a c-section etc.
and no partner on hand all the time had the same experience, the care
would be far less than satisfactory.

I see little evidence for there being much better care for c-section mums,
marginally better, but not much. Discharge is a tricky one, it is time
consuming, but also low priority, but of course whilst you are waiting to be
discharged you are taking up a bed etc.

I'll check out the water cooler on MLBU thing, it may have changed, or there
may still not be one.

Breastfeeding is a whole separate issue, which is also being looked into.

But in the end it comes down to staffing, which although they are not
technically understaffed, they often are down a person from shift to shift,
so care gets reduced at the least critical point i.e. postnatal ward. There
is severe problems recruiting, they were interviewing on Monday and should
have had 5 people, but only 2 showed and a whole host of other issues.
Whenever anyone leaves they are not allowed to automatically recruit a
replacement they have to go through a control thing, which means it is
months before people are replaced if they leave at short notice.

Would you be interested in joining the committee? The more lay members we
have the better!

Anne

Anne Rogers wrote:
Overall I would say the
care could be better for all mums but if those who had a c-section etc.
and no partner on hand all the time had the same experience, the care
would be far less than satisfactory.

I see little evidence for there being much better care for c-section mums,
marginally better, but not much. Discharge is a tricky one, it is time
consuming, but also low priority, but of course whilst you are waiting to be
discharged you are taking up a bed etc.

And again comes down to staffing I guess.

I'll check out the water cooler on MLBU thing, it may have changed, or there
may still not be one.

I suppose it's not as important to them as the mums in the MLBU
wouldn't be c-sections. However I had an episiostomy in the main ward
(but asked to be transferred back to the MLBU because it was much nicer
and quieter) so had it was quite uncomfortable to walk far.

Breastfeeding is a whole separate issue, which is also being looked into.

It's possible I just had a nurse that as someone suggested 'who had
been too long in the job' and that others are better. Hard to say
having done it once.

But in the end it comes down to staffing, which although they are not
technically understaffed, they often are down a person from shift to shift,
so care gets reduced at the least critical point i.e. postnatal ward.

That would explain most things. It's an age old problem with the NHS
everywhere .

There
is severe problems recruiting, they were interviewing on Monday and should
have had 5 people, but only 2 showed and a whole host of other issues.
Whenever anyone leaves they are not allowed to automatically recruit a
replacement they have to go through a control thing, which means it is
months before people are replaced if they leave at short notice.

How bizarre and badly thought out.

Would you be interested in joining the committee? The more lay members we
have the better!

I would. Email me with more details.

Ah, baby awake...

Jeni