"Antenatal and postnatal care"

I attended ward 8 for a planned induction due to Gestational Diabetes. The midwives, auxiliary nurses and students that we encountered were wonderful. Nurse was very helpful and supportive when baby's heart rate became erratic, indicating some distress. They explained that they were going to sound the emergency alarm in my room, why they were doing so, and what the response would be. This ensured the moment was not as scary as it could have been.

Due to hyper responding to the induction medication, I was moved to the labour ward about 17 hrs after arrival, where my husband and I were introduced to our midwife. They were lovely, had a calm nature and sunny disposition. I needed an emergency section. The midwife kept things light, and they were so calm that this rubbed off on us, meaning we were not as stressed as the situation warranted. The midwife's demeanour and professionalism throughout the surgery meant that we both felt like we had a positive experience. My husband  and I were supported and kept informed throughout surgery by the midwife while I was given a running commentary of what was happening by the anaesthetist, which helped me remain calm and feel included.

Our baby was born breach, despite earlier scans and physical examinations where baby was believed to be in a head down position. This took the medical team by surprise and affirmed that the surgery was the correct route. Husband was encouraged to cut the cord, was able to hold our baby as soon as he had been weighed and health checked. I was then encouraged to do skin to skin contact as soon as I was ready to leave theatre. Overall, the service we received from the antenatal team, labour ward and the theatre team was excellent.

I was then placed under the care of the postnatal team for aftercare. Unfortunately, our overall experience there was in complete contrast! 

When I had been initially diagnosed with Gestational Diabetes during my pregnancy I was informed that it would be important to feed baby as soon as possible to help stabilise blood sugars. I was encouraged to harvest some colostrum to take to hospital and was met with encouragement when I said I wanted to exclusively breast feed. There was no mention of feeding protocols or what would specifically happen should baby's blood sugar be low. 

The first low blood sugar I was told that baby would need glycogel via syringe. This was given by midwife who took baby from me while baby was breastfeeding. I was told from the midwife and others throughout the weekend that I wold not be making any/enough colostrum/milk for baby's needs. Despite the fact I had been hand expressing for weeks, baby was clearly swallowing and colostrum visible leaking from my breast. I was then told that baby would need a formula top up. I voiced that I didn't want baby getting formula but was willing to if there was a clinical need. I felt I was told this rather than being given information to make an informed decision and only after much insistence on my part was it agreed that I could try breastfeeding, then give colostrum then bottle top up. 

When I asked if I could feed my baby the colostrum syringes I had brought in, I was told no in case baby choked. Not being able to feed my child fully via breast, not being able to give colostrum, relying on formula, and being told I wasn't enough for baby made me feel inadequate and a failure. I also did not have the energy to advocate for myself and baby as much as I wanted due to the morphine and general exhaustion of the section. 

One auxillary nurse/nursery nurse was very supportive and helped me to hand express and provided a collection bottle. They also showed my husband how to bottle feed the top up. 

I was then told that baby needed an NG tube for feeding because of two low bloods in a row and because baby wasn't finishing 40ml feed in 20 mins. Still no explanation why this was relevant?  

A midwife wearing purple scrubs came to do baby's top up, but I was told that the full feed of 50 mls would be given by tube. Explanation being to ensure baby can take the volume. In my view, this midwife showed poor technique, feeding too quickly, allowing tube to run dry between top ups, and when I asked if I could hold baby while they were doing it I was told no - I didn't want to question the midwife as I thought their training would be more up to date than mine.

Baby projectile vomited the feed. Next feed the midwife attended again with an auxiliary, who talked them through how to fit NG and midwife asked them questions on the parts they had done wrong before. Auxiliary stood between myself and baby - I felt excluded from the process and baby vomited again. Midwife got paediatrician to explain why 50 ml feed via tube as I was upset. Husband advocated for us and helped me voice my concerns that we were force feeding baby. Paediatrician agreed to go back to breast, bottle, then tube the remainder. 

One HCSW was a great support, showed me breastfeeding positions, how to use hospital pump and was first and only staff member to ask husband his name since moving to post natal ward. 

Midwife attended following day wearing light blue uniform and Nursery Nurse name badge. When I queried this they said that they wear scrubs when ward manager is off because they are cooler but ward manager is in today. This made us angry because they had shown poor feeding technique, was masquerading as a higher trained professional, and gave impression that staff do what they want when ward manager is off.