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The demands of postnatal care

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A member wrote:
I have recently become ward manager on a 32-bedded post/antenatal ward. The ward is very busy and is often running at capacity. On the day shift, there are three to four midwives, one to two MSWs and one to two healthcare assistants (HCAs). At night, there are two midwives, one MSW and one HCA. The ward consists of 13 single rooms and five bays with three to five beds.

It has been 12 years since I last worked on the ward, and I have been struck by how demanding the women have become. The buzzers are constantly ringing, the women are totally dependent on the staff and take no responsibility for themselves or their babies – it is like they are in hospital so need to behave as if they are ill and require nursing. 

I appreciate that women who have had operative deliveries need to recover, and we do give them extra care, but encourage them to be self-caring, because they can go home after 24 hours.

Are there any progressive postnatal wards that promote self-caring with the support of staff, rather than dependence? Any ideas?

Topic created By - Rhea Johnson (23 October 2009 - 12:26:20) A recent BMJ study sparked off a renewed debate on the link between cot deaths and co-sleeping. Would you advise parents not to sleep with their babies under any circumstances?

Responses

Submitted By - Emma Godfrey 12/11/2009 16:43:53 Submitted By - Guest 26/10/2009 08:58:19 
 
No, I would not. I agree with the comments posted by the previous lady also. 
 
I personally have had more than eight children, they have all slept in my bed up till the age of 18 months - 2 years. They are all healthy and have had no problems. 
 
Coincidently though, none of my children have had immunizations either. Perhaps therein lies the connection? 
 
Submitted By - Guest 20/07/2010 17:13:06 I must congratulate you on your great achievements on breastfeeding 8 healthy children, however, I think it must be bore in mind that not everyone is as fortunate for one reason or another and through no fault of there own
Submitted By - Emma Godfrey 12/11/2009 17:01:28  
 
Submitted By - Guest 26/10/2009 09:02:06 
 
I have used the bed sharing leaflet for a while now, and aim to give advice to support parents when caring for their babies and not issue sweeping statements. 
 
My concern is the level of conflicting advice our families are exposed to. My health visiting colleagues and I are trying to get a consensus of opinion ensure there is no confusion for our mothers. 
The trouble I have is that they still feel very strongly against any form of bed sharing. 
 
I am still working on this and plan to try and develop a bed sharing policy for our organisation to prevent this kind of problem in the future. 
 
At the moment I do not hold out much hope for a consistent level of advice within our organisation – wish me luck. 
Submitted By - Emma Godfrey 12/11/2009 17:02:02  
 
Submitted By - Guest 29/10/2009 09:30:24 
 
I too have these issues and have started the process of joint thinking by developing a joint breastfeeding policy, with the view to amalgamating the bedsharing policy in the future. A thought you may wish to consider taking forward.
Submitted By - Emma Godfrey 12/11/2009 17:02:33  
Submitted By - Guest 29/10/2009 09:31:21 
 
Alison's comments say it all. The normal place for a baby to be is with his mother, it is where the human baby is most stable and grows best. When blanket advice not to co-sleep is given, parents will do it unsafely and not tell the health professional. 
 
We must ensure that we always give well balanced, evidence-based information to allow parent to make properly informed choices. That means not getting our information from newspapers or the media but reading the original research and understanding what it is actually saying. 
Submitted By - Guest 16/11/2009 11:59:24 I am a midwife with a 14 month old daughter who much prefers sleeping with mummy and daddy to her cot. We didn't plan it this way, it just happened. I am originally from Nigeria and several of my friends who have children do not even consider buying a cot. Babies sleep with mums, breastfeed, do not have vitamin k after birth, are wrapped up in several layers (even though it's a tropical country) and are seldom immunised. I'm not sure if there is a right or wrong about co-sleeping but I do thing we should stop using scare tactics to frighten parents in to doing what we think is best. We have to accept that we cannot take responsibility for other peoples actions. We provide an informed choice for a reason and we have to remember that sadly cot death also occurs among babies who do not co-sleep with their parents. 
 
Lola Midwife (London)
Submitted By - Guest 19/11/2009 11:43:29 I am a midwife, ex breastfeeding counsellor and also a mother of four. All of my children slept in my bed for the first 6-12 months and all were breastfed for between 12 and 36 months (on demand). I do not beleive that there is any danger in sleeping with your baby as long as sensible guidlines are adhered to, such as: no alcohol consumption by either parent, no drugs in the system, care taken with over heating etc. 
 
There are many, many cultures where co-sleeping is the norm, and yet we do not seem to hear much about cot death in these cultures. I think we should be doing some research into how different cultures co-sleep before scaring women into not doing what feels natural!
Submitted By - Guest 19/11/2009 11:48:15 Hay all, 
 
My son is now 16 months old and has only now started sleeping in his own bed, because of sufferening from bad posnatal depression after giving birth to him. My mother offered to give me as much support and encourgment as possible but to my horror, the only way he would sleep is on her chest and in her bed I was so terrified of somthing happening to him. 
 
Yes people like to share their bed with their new little one, don't get me wrong its a lovely idea and very cosy, but the practicalities of it is not very good, because you have to take in to account of cot death and things like this. 
 
I found that if he was put in a sleep suite which looks like a sleeping bag it keeps him from moving around completely 
and a blanket with holes in keeps his tempreature down and reduces cot death again. 
 
If any one is worried about cot death then invest in the state of the art monitor system from one of the top leading baby brands it's well worth the money. This monitior includes a sensor pad which goes under baby: this bit of equipment gives you the piece of mind you are looking for because there are sensors in it which shows the heartbeat and if the baby moves off the mat or stops breathing an alarm goes of and u will be there with out delay.. 
 
I find midwifery is a rewarding career and I hope to be able to study for it very soon.
Submitted By - Guest 25/11/2009 09:24:56 It's not really about giving advice, is it? 
 
A woman has to make her own choice about whether to co-sleep. She needs to be provided with the current information and left to sleep how she wishes. 
 
Incidentally I am personally hugely pro co-sleeping, especially to help a breastfeeding mother cope with the demanding early months - but that is beside the point surely! 
 
I would never advise a mother to do anything
Submitted By - Guest 25/11/2009 14:28:36 Our policy is to advise against co-sleeping and bed sharing.  Would be interested in any research or evidence to suggest breasted babies are at an increased risk of cot death - as isn't it a/f babies that all the research so far has been carried out on!? 
 
Both my b/f babies slept with me and hubby and they fed as they liked.
Submitted By - Guest 18/12/2009 16:25:37 I recently attended a study day regarding the ‘give me room to breath’ training. I was hoping for an evidence base with which to share with new/potential parents. Despite their leaflet advising not to bed share when under influence of alcohol, drugs etc etc. However, their radio advertisements and the speakers were vehemently against any form of bed sharing. When questioned about breastfeeding baby in bed and possibly falling asleep they said not to, under any circumstances. When questioned about the research whereby  the mother protected her baby during breastfeeding etc, the lady speaker from FSID dismissed the findings of that research as too small and as such not safe. Similarly, she dismissed the fact that breastfed babies are less likely to die from cot death. 
We were shown a video that shows what happens when a baby dies in such circumstances. They stated that the woman is innocent until proven guilty. However, it is the child abuse team from the police who investigate these deaths. 
 
I would argue that there is definitely a lack of research specifically around breastfed babies and cot death. However, the apparent obsession around child abuse/safeguarding etc appears to have put a stop to all rational thinking by some. 
 
Obviously I never breastfed. However, my wife did breastfeed all of our four children, frequently falling asleep in bed afterward. They all survived and benefited greatly from those experiences with their mother. 
 
Ian Kemp, 
Midwife. 
Submitted By - Guest 08/03/2010 10:04:03 Since the beginning of time babies have breastfed sleeping next to mum and continue to do so in the world where western socialisation and medicalised childbirth have not reached or adversely impacted. Studies by anthropologists show this and continue to explain the normalcy of this practice (e.g. James McKenna (http://www.nd.edu/~jmckenn1/lab/faq.html) and look at the benefits with Skin-to-Skin (http://www.kangaroomothercare.com/). This fear-based reaction is predictable and should be addressed with such information!
Submitted By - Guest 28/04/2010 09:35:47 I am a student midwife in Queensland, Australia. The hospital that I am attached to for my clinical work has a policy on co-sleeping. It is not supported and we inform mothers on admission and request that they sign to acknowledge that they have been informed of the policy. By signing they are giving an undertaking not to co-sleep with their babies. 
 
No doubt many women will do it when they get home, however here in Australia it is a SIDS risk and we tell the parents this.