Tuesday, 17 February 2015

Post Natal Care; My After The Birth Story



This post is mostly for the #MatExp folks who I have been trying to keep up with on twitter (it really wouldn't have fitted into 140 characters!) Heads up other readers this isn't a very happy or positive story, although thankfully we were ok in the end. If you are expecting a baby and anxious about postnatal care, you may want to skip this post, but don't go away there will be more ranting soon!

*****

I started thinking about this after seeing a new report which shows that women in the UK spend less time in hospital after giving birth than our counterparts in any other EU country. This made me wonder- is this a bad thing? It is if women are being rushed out before they are ready just to clear the bed for the next person. A generation ago it was normal to spend a week in hospital after the birth of a first baby. Now, if it was straightforward, you could be home within hours. But many women are very glad of that, so perhaps the UK's short hospital stays should be welcomed?

Overall I suspect both aspects are at work, but for once I don't want to critique a study or the media coverage of it. I'm going to do something that is much harder for me and tell a very personal story about my own experience of postnatal care when my first child, MissE was born. I've touched on this before but never managed to put it all into text. It's long and upsetting and to be honest it's something I try to avoid reliving. I also know that I could have done things differently and spoken up for myself more, but at the time I was tired and traumatised from a very difficult birth and just wan't thinking clearly.

As a first for this blog I'm also going to put up a linky at the end and I really hope that other people will be able to share their own stories of post natal care,  good or bad.

So here's my story:

Tuesday
I arrived on the postnatal ward of a busy London hospital at some point on a Tuesday morning. I was oblivious to the time by then, days and nights had blurred together as the straight forward, natural birth I had planned (and foolish assumed was pretty much guaranteed), had taken me from wallowing in the birthing pool of the midwife unit to, eventually, lying shaking and terrified on the operating table. 

I do know that my daughter was born by emergency caesarean at 2.33am. Afterwards I was taken back to the delivery room for a few hours. I hadn't slept since the previous Saturday night, my husband had done a little better but was still extremely tired. He dragged out a sort of school gym mat that was propped in the corner and fell asleep on the floor. My beautiful new daughter dozed peaceful in her little plastic crib next to me. I was utterly exhausted, I should have slept but I couldn't. I'd been convinced of the very worst when my baby was whisked away, silent and unseen behind the blue surgical screen. But even once she was sleeping safely beside me I couldn't relax, I couldn't let go of the fear that something might happen, that someone needed to stay awake and watch her. At some point one of the midwives who had looked after me earlier in my labour popped in to say hello as she started her next shift. She'd been home, probably seen her family, slept, eaten. This was a whole new day for her but for me it was just a continuation of a timeless blur, I barely recognised her and couldn't speak to thank her for her help, whenever it was that she had helped.



I don't remember much about that day after I got to the postnatal ward. I was wheeled down on my bed, unable to move. The staff on the delivery ward all cooed over how beautiful miss E was with her full head of dark hair. I kept wondering if this was really my baby, I already loved her fiercely but how could something this beautiful have come from my ugly body? Had some switch been made behind that blue screen? I told myself that that made no sense, but still the doubts crept back.

I do remember that night though.

For a while it seemed that everything would be fine, I was the only person in a four bed room and at some point the lights were dimmed and I lay down, with one hand resting protectively on the tiny crib, and started to drift into sleep. I looked at the time on my phone, amazed I'd been awake for so long. An hour later I was woken up by voices and the clanking of equipment as another mother was brought into the room. I never learnt this lady's story. My best guess is that she was readmitted as her baby was jaundiced and had to be put under a lamp. Whatever had happened, the mother was clearly in desperate need of help herself. She spent the rest of the night pacing up and down the room, rambling and shouting, I couldn't make out what she was saying or in what language, I had no idea if it was directed at her baby, herself or maybe at me. With hindsight I know she was harmless, that I should have tried to help her but that's not what I thought at the time. At the time I felt extremely vulnerable, I still couldn't move and I was terrified of this "crazy lady"* and what she might do to me or my baby, the baby I needed to protect. So I did what I could and lay awake and vigilant all night. Once, a midwife came in and asked her to be quiet, but then they left us alone for the rest of the night. I should have called them, asked them to do more for my sake and hers but I was too scared that she would over hear me complaining and then take her revenge once the midwife's back was turned. Our room was at the end of the ward, out of the way and I had already learnt that the call button could wait twenty minutes for a response, if anyone came at all.

By now time had definitely returned and I was acutely aware of it. I watched the minutes and hours tick past, snatching glimpses of it on my phone screen, hidden under the bed sheet. Until it was just about morning and I thought it would be ok to call my husband. To shake him out of his much needed sleep and ask him to come back in the moment visiting hours began.

Wednesday
I remember a little more of my second day on the ward, there were family visitors, all delighted to meet the first member of a new generation, I felt the need to tell them all about her birth but I slowly realised, everyone was there for the baby. Not me. At some point we discovered that I still had a catheter in and the bag was full so it was removed, along with the cannula that had been tugging at my veins for days. I desperately wanted a shower but wasn't sure if I could, was it ok to get the scar wet? Would I even manage to stand in the room alone? Was I allowed? I managed it in the end, trying hard to get clean without actually looking at my body, trying to leave no trace of my blood in the shared bathroom.

By this point I'd been moved to a busier room, I couldn't help overhearing the conversations with the lady in the bed opposite. She had a new baby, just like me, but she had no where to take him home to and was waiting for a bed in some kind of hostel. How dare I complain in the face of that? What right had I with my lovely husband and nice flat to demand more time of the staff?

I remember the next night vividly too, far too vividly. Once again the lights were turned off and partners ushered out. But this time the ward stayed noisy. In the bed next to me another mum talked loudly on her phone, her TV blaring. She was told to keep it down but paid no attention. The bed opposite was briefly free until a new occupant arrived, her baby had just been born by emergency C section and her shocked and exhausted expression mirrored my own. As she was brought in I was sitting sideways on my bed, half naked, trying desperately to get a decent feed into my uninterested baby. I remember the look of horror on the face of the new woman's partner when he saw me. One of the midwives noisily changed the bed sheets, clanking the sinks and bins right next to me. I could feel again by now and the pain was growing. I pressed the call button to ask for some pain relief but no one came. Later I tried again, to get someone to help me lift my baby so I could feed her but again no one came.

Eventually the adults on the ward grew quieter just as the babies grew louder. I managed to flag down some pain relief but it wasn't enough and eventually, reluctantly, I was given a morphine tablet. I don't know if it was that or just the shear exhaustion but suddenly I began to hallucinate. At first it was just a little movement in the corner of my eye, down on the floor near the door - a mouse? Surely there wouldn't be mice running around the ward? If nothing else it was spotlessly clean. Then slowly the creature took the form not of a mouse but a moose, a cartoon moose that I used to draw at school. I knew it wasn't real but that only made it all the more terrifying, was I loosing my mind now? Would I soon be the "crazy lady" pacing the ward?

Still my baby wouldn't feed. For two days I been told this was terrible, or absolutely fine.  That there was something wrong with her mouth or she just needed a rest. But I needed to feed her, I had to make her ok and do something right for her, but she just wouldn't, what was I doing wrong? I wanted help but couldn't ask for it, no one seemed interested, every bit of advice I'd had contradicted the last and besides, I really shouldn't make a nuisance of myself.

Eventually it all became too much and I allowed the tears come. But it wasn't the quiet restrained little weep I had expected. It was the gulping, sobbing, unstoppable cry of a small child, I knew everyone could hear me but once I had started I couldn't haul back any control. After a while one of the midwives came over and asked what was wrong. For a moment I thought she would help me, that she would do something, so my baby would feed and I could sleep. Or she would just just tell me that yes, what I'd been through was horrible and I had every right to feel shocked and upset by it. But no. She told me sharply that I must stop crying and making a fuss or I would spoil my milk and not be able to feed my baby at all.

Then she left.

I should have called her supervisor, I should have complained and asked for help. But I didn't. Instead I listened as the supervisor (who I think was informed of the incident by another of the mums) and the midwife argued about her behavior in the corridor outside. The midwife then stomped off leaving the rest of the staff chatting about last night's TV. The supervisor did briefly come over to check I was ok but didn't mention the incident. Neither did I, I knew better than to ask for help now.

Not long after that the baby screaming really kicked off, my own alternating with one of the others in the room so that it was a constant din. I had to get out of there, I staggered to the desk and asked if there was anywhere I could go to be alone with my baby and away from the noise. Someone waved in the direction of the ward lounge, but it had dazzling automatic lights that left me feeling exposed so I asked if there was anywhere else and was pointed down the corridor to to a little room used for expressing milk.

I spent the rest of the night in that small, beige, rectangular room. There were two big machines and a plastic chair. MissE slept on and off in her crib or in my arms, though I was scared I might finally fall asleep and then drop her. Mostly I sat on the plastic chair, alone in the dark, checking off the minutes and hours on my phone until morning. When I thought it would be getting light outside I went back to my bed. No one checked on me, no one noticed I'd been gone for hours.

All I knew now was that I needed to leave. Yes I had had major surgery and my baby wasn't feeding well, but there was no way either of us could recover there and I doubted my body or mind would hold out for another night. I lay on display in my bed as the doctors and midwives did their morning ward round, discussing me as if I wasn't there, ignoring my attempts to join in the conversation about my body and it's failings.

It took hours and a lot of nagging but eventually, against the advice of the medical staff, I left. Shuffling painfully down the corridor, not fast enough to get to the room where my baby was having her first checks, but I made it out, using our new pram as a walking aid.

It was Thursday afternoon, I'd slept for a total of one hour since the previous Saturday night. I had been through an exhausting labour and emergency surgery, followed by two nights awake and afraid. I felt broken in every way and now, I had to go out and become a mother.



*******

Thankfully this was all more than five years ago now and that precious little baby is now a vibrant, chatty schoolgirl. We moved a few months after her birth and so her little sister was born at a different hospital and, although the postnatal stay was noisy, I was cared for with warmth and respect. My husband was able to stay with me all night and one of the midwives happily took my baby away for a cuddle so I could get some rest. I woke up hours later to find a my little one, wrapped cosily in a blanket my Aunt had made for her, fast asleep in the crib next to me.

So what would make postnatal care better? In an ideal world, we would have individual rooms, so mothers had some privacy and only their own baby's crying to deal with. There would be plenty of midwives popping in to check everyone was ok and partners would have at least a good comfy chair to spend the night in.

Of course that may be impossible for many hospitals but there are things that could be improved for very little cost. Simply checking if a woman has any questions about what to do now would be a start. Is it ok to shower? To eat? Should she be up and walking about or taking it easy in bed? Is it ok to lift the baby? Even a really big baby? What about pain relief? When a birth hasn't gone to plan a woman may be completely unprepared for the aftermath. I did virtually no research into C sections as I never thought it would happen to me, so I had only old, outdated, second hand information to draw on.

Consistency is also a big thing, I got completely contradictory information about breast feeding, my very large baby simply wasn't interested at the start. Some of the midwives were unconcerned by this, others terrified me with the possible consequences of letting her sleep, unfed for more than two hours at a time.

Then there is kindness, that costs nothing, not even a great deal of time. The midwife who told me I would spoil my milk should not be in that job, I don't care how busy or stressed she felt, there is no excuse for that.

Second time around, the hospital was just as busy as the first, the staff no doubt under just as much pressure but what really made the difference was just a few snatched moments of kindness and empathy. A quick smile and acknowledgment that I was a person, not merely the occupant of a bed, or the vessel from which a baby had been removed. Even when resources and time are acutely limited surely that can be achieved everywhere?

SBx

* I don't use the phrase "crazy lady" lightly, and I certainly hope it doesn't cause anyone any offense, it is just the best way I can think of to describe my perception of her at the time.



5 comments:

  1. Please tell me which hospital you're talking about. My due date is in less than 2 weeks, I got only my husband with me (all my family is abroad and my mom is having surgery next week :( ) and I'm scared to death about the attitude and approach some maternities have to new mothers. Thank you!!

    ReplyDelete
  2. Oh Delice I am so sorry if this has added to your concerns that was absolutely not my intention in writing it. I want to emphasise that this was all over 5 years ago and I am told that things are much improved at the hospital since, certainly the one where I had my second baby was completely different and still a major london hospital. Please talk to your midwife about your concerns and ensure your husband knows about it too and see if he can stay with you, many hospitals now allow this an I found it very reassuring second time around to have him there 24/7. I could have avoided much of this if I had been able to speak up for myself or had asked my husband to do it for me. I was just completely unprepared for a hospital stay. I don't really want to name the hospital publicly here as it might just add to others concerns if they are going there, but honestly, I was just unlucky. Please take a look at my birth story from second time around http://southwarkbelle.blogspot.co.uk/2012/12/introducing-m.html and seek out other positive stories there are plenty out there

    SBx

    ReplyDelete
  3. Hi Kirsty, long time no speak but love reading your blog! I am very sorry you had such a traumatic experience pre and post birth with your first baby. I can only comment on my post birth experience in Switzerland which was in most parts poles apart from yours. I too had a c section with my daughter, it wasn't emergency but done same day after a routine check up at 41 weeks (long story and last thing I wanted after planning a natural birth using hypnobirthing). Any way after the birth I had a few hrs in the delivery room to get to know my baby, midwife present at all times to help with feeding. Then we were transferred to our private room. We chose this at an extra cost but no one is more than 2 women to a room if you don't "upgrade". With a c section birth all women are expected to stay on hospital for 5 days. Although I don't speak perfect german my care was mainly great, lots of checks and pain relief offered frequently. I had some issues with breast feeding support but I really can't complain about my care as midwifes were plentiful had time and on the whole caring. I cannot imagine going home the day after such a procedure and agree that all you want is someone to reassure and care. With baby number two due in 3 weeks and currently not head down I am facing the prospect of another c section rather than the VBAC I had hoped for but feel confident in the health system here and aftercare. I also know I am so lucky to have access to the Swiss private health system.
    Louise Bates

    ReplyDelete
  4. Louise! So lovely to hear from you and congratulations on baby number 2! I know nothing about the Swiss health care system, would that standard of care apply to everyone or does it require some kind of insurance? Really glad to hear that you were well looked after last time and sorry that you may not get your VBAC (still time for the baby to move maybe?). However it happens I hope it all goes well and I'll look forward to seeing pictures!

    ReplyDelete
  5. Thanks so much for sharing your story. I agree that consistency, kindness and compassion are so important. Thank you for linking up to #MaternityMatters x x x

    ReplyDelete