The excitement of the birth is done. The mother and baby snuggle close to one another, exploring one another, bonding. The baby may wish to feed or may just want to wallow in that precious first contact, that reassurance of the familiar voice and heartbeat, the gentle arms encircling him. The mother deserves peace, comfort, good food, love and security. The nascent family need time, support, reassurance, love.
Over the following days the parents can get to know their baby, supported if they wish by caring professionals as they increase their confidence. I love the concept of the babymoon where parents are cushioned from the outside world as they wallow in the first few days, doing nothing but rest, attend to their baby and themselves, surrounded by loving support.
But listening to postnatal mums I hear some very sad stories of how uncared for they felt in those precious first few hours and days. If a mum gives birth in hospital she is usually transferred to a postnatal ward and there the problems can start. Mums have told me they were left for hours in dirty bedding, having not been helped to wash after the birth on the birth unit. Some have told me how they needed help, pain killers, reassurance, regular medication.... but had to wait and wait while overworked midwives did their best to care for an unfeasible number of women, at least a quarter of whom were post surgical patients and therefore needed extra nursing care. This isn't universal -some women talk of superb care, staff with endless patience and wonderful support. But I'm sad to say that I hear more bad than good. Many women tell me how frightened and abandoned they felt, their partner sent home while they struggled to learn how to care for their new baby in an alien environment where everyone looked stressed and overworked.
Women may feel they would be better to go home, to be cared for by their families with support from community midwives. One woman I spoke to recently was discharged home one day after a cesarean section -one day after emergency major abdominal surgery. She was visited at home the following day by a rushed community midwife who promised to return on day 5. Is that adequate care? Are we doing enough for these women? This particular woman was readmitted as an emergency on day four as her scar ruptured due to infection -nobody had been checking it with her and she had no idea anything was wrong Her baby was deeply jaundiced and in need of treatment when they arrived back in hospital -as a mixed race family they had assumed the baby was supposed to be that colour and the mum was so glad he slept all the time as she felt so ill herself. luckily all is well -but that's a near miss.
I hear that in some parts of the country women are having all their postnatal care at a walk in clinic -that home visits have stopped altogether. I am staggered to hear that daily visits up to ten days post birth have been eroded to this in less than 10 years since I became a community midwife. Who is making sure these babies and mums are really living in a safe home environment? What message is this sending to mums -that it's fine to go out on day two? What if she has no transport or support with other children -she just doesn't get seen?
I left my NHS midwifery job 18 months ago as I felt I couldn't keep up the pace and cope with the stress of the job. I took my skills in to the private sector, lost to the NHS except for occasional agency shifts. My sister midwives are doing their utmost to care for families adequately but they often don't have enough colleagues to do their job well enough. Midwives are special women -they have a calling to do right by the families they care for -they are being pushed too hard to reduce and whittle back services. I am angry that they are being put in this appalling position. I feel guilty I'm not there with them.
What can we do? We can fill the gap a little. We can care for and support new parents in our families and communities -giving them the time and space they need to adjust and shift their focus, to rest and recover, to bond.
But we should be protesting -that a vital service is being eroded so quickly without thought for the consequences. We should be standing alongside midwives and saying NO -this isn't OK. Except we can't because the midwives are not fighting this, they are not marching or shouting -because they don't, they are gagged, they fear for their livelihoods.
Answers?
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