"Difficulties after giving birth"

I don't like to write reviews... but now that I'm pregnant with my second child and SJUH remains the closest hospital to me... I wish to write this review as a reminder to myself and also to help anyone else. Mainly I hope somebody in management might review how things are done.

I had pre-eclampsia so was admitted to hospital at 34 weeks. Before birth of the baby, things were good. I felt comfortable at the antenatal ward and all of the staff were lovely. The O&G consultant was excellent and so were the on-call O&G team and delivering midwife as I was induced early and needed emergency forceps delivery. I'm ever so grateful for this care in having my precious baby born safely at 34 weeks.

Unfortunately everything became difficult after giving birth.

A couple of hours after the birth, the baby was taken away from me for some sort of checking whilst my husband and family were still with me in the delivery suite. What happened next I gleaned more properly over the next few days as I asked different staff members for their recollections. Apparently the baby was left alone in the nursery room of the Transitional Care ward. It just so happened that one of the midwives was going into that room to do a BM on another baby and noticed that my baby was blue. The baby was revived with oxygen and paediatric registrar called and the baby then transferred to Neonatal Intensive Unit (NIU). If this was all that happened, I could somehow overlook this as unpredictable although I think the less-than-4-pound baby should not have been left alone so soon after birth without any monitoring device and I shudder to think what would have happened if he wasn’t seen early enough.

Things seemed ok for about 2 days whilst the baby was in NIU. But on the 2nd morning that I went to NIU I was told the baby was moving to Transitional Care ward in the afternoon. I wasn’t told anything further and did not see any doctor either. I waited for my husband to arrive, and since we did not hear anything further, we went to NIU in the afternoon but the baby had ALREADY been transferred and was left all alone on the Transitional Care ward. We were really angry about this. How pathetic it was to then buzz the entrance door of the Transitional Care ward saying we thought our baby may be on the ward. The baby was left all alone by an empty bedside in Transitional Care ward, likely for one-to-two hours. We did complain (as in speak our grievances) to both Transitional Care and NIU staff in attendance, and it seems they both assumed the other would have communicated to postnatal ward where I was.

My baby at this point still weighing less than 4-pounds, on 2-hourly NG feeds, and jaundiced. If I had been allowed to speak to a doctor and have a say in the decision, I would have not wanted the baby moved to Transitional Care ward. For what it’s worth, the environment in NIU is calm, quiet and peaceful, and there are enough staff members present to deal with the babies. In Transitional Care ward, the presumption is that your baby is a completely normal baby just needing to feed and grow and you are left to it. There is no need for any baby to be on a monitor on Transitional Care ward. And you should do everything for your baby irrespective of whether you are well or not and irrespective of how much care the baby needs.

It was incredibly difficult being on Transitional Care ward. The staff seemed to change every single day and each one seemed to have their own opinion on how the baby should be dealt with - whether lying on front or back, whether a heated mattress is needed or not, whether the baby’s vomiting is significant or not. Whilst all of the staff are lovely, things just didn’t seem to roll.

My blood pressure was becoming low and if felt so difficult being ordered around all the time. Because the baby moved to 3-hourly feeds and the nursing staff had a chart asking about nappy content, I had to ensure like clockwork that the baby’s nappy was changed every 3 hours and I was even told by one midwife to write it down in the chart what I find. In the 24 hour period, I was told I could miss one nappy change in the night. Feeling as tired as I was and being in a ward with other mothers-and-babies and being disturbed most of the time by the constant interventions, even this felt very difficult. Yet I was told on 2 different nights by 2 different staff members to put on my mobile alarm clock to change the nappy in the middle of the night. It was so difficult to even sleep for an hour or two, that this order was not very welcome. Anyway I told them I won’t put my alarm clock on as it will disturb the other mothers - I was told not to worry about it as the mother’s are used to it. So much for empathy for newborn mothers then. Anyway I said I wasn’t happy to do that. In which case they will come to wake you up to tell you to change the nappy. I was also expressing milk, which I then had to put in the fridge, and I was later told that I should measure out and heat the milk ready for the staff member to use for the NG feed. So basically do everything and let the staff members do the minimum they possibly can.

If you’re well and at home with a newborn baby, life is difficult but you can appreciate the help of any partner or family member whilst being in your own home and not being disturbed all night by other newborn babies, and you can at least deal with the baby on-demand when it cries rather than on a 3-hourly clock on top of responding to on-demand cries and interventions throughout the night. When you’re not well and the baby is constantly vomiting and you’re spending an hour after each feed trying to settle the baby, you soon realise you’re stuck in a nightmare.

Things seemed surreal. My baby went for a feed at 2am in the night, and was then returned to me without his monitor. I was confused and angry. Apparently communication with mother about what will happen to your baby is not important. Another example of this was when both heel-prick blood tests the baby had done were clotted and I was only told after both attempts when they wanted my permission for a doctor to do a venous sample from his hand/arm. Well if you use heel-prick blood test with a good technique, it does not clot. Fortunately I knew this and so asked them to ask the doctor to do the heel-prick test rather than transitional care midwives who aren’t well-practised in doing heel-prick tests for full blood counts for jaundiced babies. Again I was told I’m just being wrong and it will likely clot again because there is probably something wrong with my baby’s blood. But no, the doctor did the heel-prick test and it didn’t clot and the result was fine.

About a week after being in Transitional Care ward, the baby was not taking to bottle feeding well and it was expected that I’m likely to stay in Transitional Care ward for a long time (at least another week - honestly a week felt like the longest time ever in that ward). The ward was filling up. Another couple moved into the bay next to me and there was just the curtain and a few inches separating my baby from their loud conversations and TV. I could see my baby was jolting from his sleep with the noise. Yet what can I possibly say to another new couple who are rightly happy and excited about their new baby. I had to move my baby’s cot to my other side, by the window, despite knowing there was a draught somewhere from that window.

I’m sorry but my baby was too small to have been moved to Transitional Care ward for a prolonged stay where no doctors would review the baby despite the baby doing large vomits after nearly every other feed (thus clothes and blankets needing to constantly be sent home to be washed as well).

I may as well mention on here that the toilets in Transitional Care ward were dirty. There was blood. I expected it to be cleaned by at least the next working day, but, no, they were left like that. I actually would go to use Antenatal ward toilets which were better. And there is a sign on the Transitional Care staff door that says “Do not disturb - handover in progress” and it is permanently left on there, I suppose to daze any newcomers on the ward.

I’m sorry my experience overall of Transitional Care ward was dreadful. I’m sorry because most of the staff members seem lovely, and some of them I really liked. But things just don’t seem to work.

In the end I broke down in tears and had to discuss with the midwife how difficult I found the Transitional Care ward. It was agreed for me to be discharged and the baby to move back to NIU. The baby gained weight and went to bottle-feeding so much faster whilst in NIU. Since parents can visit NIU 24/7, my husband could actually see my baby more on that ward. Although it meant the baby wasn’t by my bedside, I knew that the baby was on a monitor and being checked more thoroughly and would be reviewed by doctors. It was peaceful, warm and quiet for my baby.

Not all the NIU nursing staff were happy and one NIU nursing staff member outright said to me that my baby was a bed-blocker. Some of the nursing staff in SJUH NIU just aren’t as professional as I’d expect from a NIU ward. I wasn’t happy to find in the NIU fridge three syringes of colostrum that I had left for my baby on days 1 and 2 which I had been told had been given to the baby but had just been left there, now a week out of date. That all said, I would happily pay private fees for my baby to be in a NIU or SCBU rather than Transitional Care ward. I did ask for my baby to be transferred to another SCBU if they weren’t happy for my baby to be there.

I’m sorry but unless you’ve actually been on SJUH Transitional Care ward with an underweight newborn baby, don’t ask anyone else to stay there for a prolonged time. The ward seems to work for babies who just need BMs monitoring. But not for underweight sick babies.

1 week in NIU and my baby improved so much faster, stopped vomiting, went onto bottle-feeding and was discharged.