Thursday, 25 May 2017

Better Postnatal Care


Our new baby, MissA is here. When I'm a bit less sleep deprived I'll write more about her but for the moment I want to share an old post. 

The Mumsnet Better Postnatal Care Campaign began not long before MissA was born, when the subject was very much on my mind. Even when facing a potentially complicated Cesarean I was often more scared of the ward afterwards than the surgery itself. That's because of what happened when my eldest child, MissE was born. That birth was long and terrifying but what followed only added to the trauma and has stayed with me ever since. It took me almost six years to be able to write about it but I'm sharing that post again now in support of the Mumsnet campaign:

#BetterPostnatalCare

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.




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.

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