Posts tagged maternity care

They say there are only two certainties in life: death and taxes. But in the 21st century there’s a third eventuality we cannot escape — advertising.

There’s been a bit of a fuss kicked up in the papers lately about the infamous ‘Bounty ladies’ and how these representatives are allowed to roam maternity wards up and down the country, handing out the free ‘goody bags’ that have become ubiquitous with having a baby in the UK. In addition to the goody bags, some of the Bounty reps also pester new parents to agree to and then purchase photographs of their new arrival, often before the baby has even had its first breastfeed or before the new mother’s stitches have set. They are also asked for their contact details, which are (surprise surprise!) sold onto third parties and used to market additional products, sent directly to the parents’ homes.

The pack contains a few inoffensive and even useful things, certainly — Child Benefit and Child Trust Fund forms, perhaps a ‘guide to your newborn’ or other inane pamphlet — but the rest of it is purely an exercise in corporate PR. It generally features samples of a particular brand of nappies, wipes, nappy rash cream, breast pads, toiletries and laundry tablets, with accompanying coupons and promotional materials. I’m sure that if it weren’t prevented by various ethics and health codes, a carton of formula would be in there, too. To some, it’s less Helpful Items To Get You Started and more Parenthood: What a Cash Cow! The fact the hospitals get £1 per bag handed out, amounting to a tidy profit for them, as well as Bounty, is just the icing on the capitalism cake.

My dislike of blatant marketing aside, this isn’t what disturbs me the most. Many of the mothers who called into Vanessa Feltz’s BBC London radio show on Friday morning to discuss it said that they’d thought the Bounty rep was some kind of hospital aide or auxiliary person and so didn’t feel they could say no, especially to the personal information. This is not to mention the fact that many of the callers said they’d just had cesarean sections and so were pretty drugged up on pain medication and not sure what was going on or who all of the people coming in and out of their rooms were. Even those who’d had vaginal births were, as is to be expected, extremely exhausted and overwhelmed. Women in the immediate postnatal period should not be having to think about whether they want to give their personal details to a spammer, or if they want to pay £10 (or however much it is) to have a single photograph taken of their newborn.

I remember when I had my first child in a birth centre attached to a hospital, the Bounty rep coming and giving me my free pack and asking for my details, all whilst I was attempting to change my daughter’s first Oh My God This Stuff Is Like Tar nappy and before my husband had arrived from his overnight sleep at home. I was in pain, hadn’t slept in two days and was being ignored by the overworked and understaffed midwives, who rarely came when I pressed the buzzer for assistance. I was in absolutely no state to realise she was trying to sell me things, nor did I have the energy to tell her to sod off. Thankfully, I declined the overpriced newborn photo but I was not pleased to begin to receive a mountain of junk mail a few weeks later. I didn’t make the connection between that and the details I’d given the Bounty rep until months later. I was angry that I’d been approached by someone peddling their wares under the guise of concern for new mums and that this lady had been able to wander round the maternity ward as she pleased, going into people’s rooms without being invited in, when my own husband had been kicked out the previous night when ‘visiting hours’ were over, as if he just come to be a spectator at the birth of his child and that was his bit done.

Looking back, that night I spent alone in my room — with a brand new baby in a bassinet next to me that I had to learn to hold and care for and breastfeed, so physically exhausted that I couldn’t lift my arms to wash my hair and with less than two hours’ sleep in 48 hours — was the loneliest, most terrifying and draining of my life, and that’s the night AFTER I gave birth! That my husband wasn’t ‘allowed’ to stay with me was so infuriating. He’d helped make this baby and now he got to go home and get some sleep while I, the one who pushed our 9-lb. daughter out of my body after carrying her for 9 months was supposed to just suck it up and look after her on my own?! It just seemed (and still seems) so cruel. According to this Times article, 70 per cent of parents think a father should be able to stay with his partner after the birth.

Having said that, I understand that with most women being put on wards after they’ve given birth, and not private rooms, this plays a big part in the decision not to allow fathers to stay overnight. The NHS worries about the safety and privacy concerns of other women on the ward, who may be wary of strange men passing by while they’re attempting to breastfeed for the first few times or get out of bed while wearing a flimsy hospital gown. There’s also the cost and practicality issue — the NHS is so stretched as it is, they worry that having to accommodate overnight visitors for each woman in the maternity unit would mean overcrowding, more money spent on reclining chairs or extra beds and possible conflicts over use of the already-oversubscribed toilet and kitchen facilities. I’ve heard many midwives, like this one, say that having fathers stay overnight would be a nightmare. So whilst I understand the reasons against it, I stand firm in my belief that it is not only unfair and cruel to the new mother, but that it sends a very strong message to the new dads that their role is really not all that important and that the mother is chiefly responsible for the baby, with him around as some kind of ‘happy helper’. While only women can give birth and breastfeed, there is no reason that a father couldn’t hold, rock, comfort, bathe and change his baby’s nappies in that first day or two, letting the mother get some well-deserved rest.

That’s why I think, really, that most women are better off at home. Not being left alone and separated from your partner at such a monumentally life-changing and emotionally volatile time seems like common sense to me. Unfortunately, not that many people want or are able to birth at home and the current system and attitudes towards home birth aren’t likely to change any time soon.

One possible solution (aside from the perhaps more unrealistic demand, due to space and finances, that all women have private rooms after birth) is to follow the Dutch model of postnatal care, called Kraamzorg. Under this system, all women who have had relatively uncomplicated births (i.e. not an instrumental or surgical delivery or other medical complications) are discharged within hours and sent home, where a maternity nurse meets them almost straight away. There, in the comfort of their own homes, women are given one-to-one postnatal care which includes checking on the health of mother and baby, breastfeeding advice, preparation of lunch and snacks, light housekeeping, emotional support and practical help with the shopping and visitors, and just allowing the family time to bond with and get to know one another.

We have this here, in the form of a postnatal doula, but it is a service that is not widely known and, because it is done privately, rather costly as well. It is a role that used to be played by a woman’s own mother, or other close family member, but which has become increasingly more rare due to changed family dynamics, work commitments and the logistical difficulties of distance and time that many families face.

Funnily enough, this is something that David Cameron suggested back in 2008 as part of a Conservative reform of maternity services and is probably one of the few areas in which I agree with him. The cost of implementing this system, while perhaps great at first, would be an absolute bargain in the long and even medium-term, as beds are freed up for labouring women or those who had complicated deliveries and with midwives free to concentrate more on those women than the ones who just need a bit of help with breastfeeding or need assistance going to the toilet but are often deprioritised on a busy ward. Breastfeeding rates flourish and postnatal depression rates decrease when one-to-one support is on hand in the first week or two after birth, showing how vital this kind of support in the period immediately after birth is. Until all fathers are taking the the paternity leave they are entitled to (which we know from previous discussions will only likely happen very slowly and with more legislation), an alternative solution and support system for new mothers is desperately needed.

What are your thoughts on better handling the postnatal experience for women? Do you think fathers should be allowed to stay overnight or would you rather they not be there? Are private rooms for all a realistic solution? What do you make of the Kraamzorg system, would you have benefited from and welcomed something like that?

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