"A great experience with a few suggestions for improvements"

My baby is six months old today and this has spurred me to reflect on my stay in Aberdeen Maternity Hospital. I would like to share my experience and I hope you find my feedback useful.

I delivered my baby girl in the Midwives Unit in February 2015. It was a quick labour and near the point of delivery the Bank Midwife was joined by Staff Midwife Linda Stewart. Coincidentally, Linda was my midwife in the early stages of my labour with my first child. Linda brimmed with confidence and experience, this was demonstrated by simple little things which to me made a huge difference to my delivery (a little trickle of cold water at the right time in the right place cannot be underestimated! ! ). Immediately on delivery Linda went to place my little girl on my chest but just before her skin touched mine she swiftly scooped her up again and with the same movement she deftly and efficiently used her elbow to press the nurse call button and rushed my little girl out of the room. Something was seriously wrong with my newborn and I was terrified but I also experienced a simultaneous feeling of calm because I had every confidence that Linda was there to oversee whatever interventions were required. Thank you, Linda.

My little girl was successfully resuscitated and transferred to the Neonatal Unit. All of the Neonatal Unit staff were fantastic and their standard of care was faultless. They are clearly a dedicated and highly skilled team. However, one member of staff stood out to me and my family – Neonatal Staff Nurse Susan Crabb.

Susan brought a “human” element to what can only be described as an alien environment. At first my husband and father were both overwhelmed by this scary place but Susan instantly put them at ease. She clearly had a huge amount of knowledge and skill and could easily have used her extensive technical language to highlight her abilities but instead she spoke to my husband and father in language they could easily understand. She used everyday analogies to help them comprehend the situation and despite my daughter being in an intensive care setting Susan sensitively used humour at appropriate times and my family greatly appreciated this. Both my husband and father walked out of the NNU with smiles on their faces instead of tears in their eyes. Thank you, Susan.

I was keen to breastfeed but I had previously had a negative experience trying to breastfeed my first child. Susan Crabb picked up on this and referred me to Kate Buchan. Kate is a Senior Nurse in the NNU and was also working to support breastfeeding, I cannot recall her correct job title but that didn’t matter because to me she was my “Breastfeeding Angel”. Kate is singlehandedly responsible for my ability to breastfeed my daughter. If it wasn’t for the support and advice that Kate gave to me I can honestly say that I would not have been able to breastfeed. As a result I am still breastfeeding now and I engage with the local NHS Grampian Inverurie Breastfeeding Support Group supported by some local NHS Grampian Breastfeeding Peer Supporters. Kate’s initial support was invaluable; she accompanied me from the NNU back to my postnatal ward and listened to my “story”. She gave me some great advice and then personally sourced an appropriate pump and accessories and took the time to show me how to use it and ensured I fully understood the instructions (the ward staff were great but they simply did not have time to go into the detail that Kate did, and it was the “detail” that I needed). She then provided written advice to back up her verbal advice. The following day she then supported me in the NNU as I had the opportunity to breastfeed my daughter. Each day she was on shift (whether in her role on the NNU or whether in her role supporting breastfeeding) she always sought me out for a chat and provided follow-up advice. Six months on I can still hear Kate’s words of advice and still use her “breastfeeding mantras” as I continue to breastfeed my daughter. Thank you, Kate.

My overall experience was positive but I would like to take this opportunity to highlight a couple of issues where perhaps improvements could be made in order to benefit future service users.

Following delivery of my daughter in the Midwives Unit I had to wait for a couple of hours before I could go through to the NNU and another couple of hours before I was transferred to the postnatal ward. Unfortunately there was no equipment in the Midwives Unit to allow me to express my breastmilk. There were no sterile galipots, oral syringes or appropriate labels nor was there anywhere for me to store my precious first few drops of colostrum. I knew the importance of expressing to start stimulating my supply but I also knew that there was an acute shortage of staff on the unit during those few hours that I needed support and equipment. By this time a Community Midwife was on duty in the Unit and I heard her on the phone three times asking for staff to come through from the Labour Ward to help her and to take me up to the Postnatal ward. The help never came and I knew that the midwife was next door delivering another baby. Therefore, with a heavy heart, I expressed my precious colostrum into a paper tissue. I had to do this twice in the hours that I was waiting in the Midwives Unit until I had access to equipment and storage facilities in the NNU and the Postnatal Ward. In an ideal world you would not need to provide expressing equipment and storage in the Midwives Unit as ideally patients should be transferred without significant delay to the Postnatal ward and everything is there. However, I’m sure you will agree that at times the staffing levels are not always optimal and at times beds are not always immediately available. This leads to patients having to wait in the Midwives Unit and perhaps you could consider a contingency plan for those who are separated from their baby and need to express.

The chairs in the Postnatal Ward and most of the chairs in the NNU were not conducive to comfortable breastfeeding. There were a couple of large, comfortable adjustable breastfeeding chairs in the NNU but they were often in use and not enough to go round. On the Postnatal Ward there was simply not enough room for large comfortable breastfeeding chairs even if they were available. Throughout my antenatal journey I received numerous leaflets and booklets promoting breastfeeding, I also received a DVD and even the plastic folder to hold my notes promoted breastfeeding so you can imagine my disappointment to find that I didn’t always have access to a simple comfortable chair. I believe that there is a new maternity hospital being built in Aberdeen and also a maternity unit in Inverurie. I would be grateful if you could pass on my feedback to the Project Teams to provide more breastfeeding chairs and space for breastfeeding chairs in these new builds.

Finally I would like to highlight the numerous pieces of conflicting advice I received, too much to list but a couple of examples are: Footstools – in the NNU I was offered a small plastic footstool to assist with appropriate positioning for breastfeeding. On return to the postnatal ward I asked for a footstool to be told “they were banned by Infection Control”. By coincidence I worked as an Infection Prevention and Control Nurse and I cannot see an issue with the small plastic footstools (they looked like simple toddler steps that are widely available) as it appears that they can be easily and appropriately decontaminated. So either the Postnatal Ward have discarded their footstools in error, or perhaps they had older style footstools were could not be decontaminated, or perhaps indeed there is an infection control issue with them but if so that would lead me to question why they are in use in the NNU. Either way there is one practice going on in one area and a different practice in another and I think both areas would benefit from clear clarification which is then (most importantly ) communicated to all staff members. Another source of conflicting advice was how and when to pump whilst my newborn was in NNU. Different midwives gave different advice regarding how often to pump and which pump to use. I was even given advice in a room right next to a poster on a cupboard door which listed completely different advice. I understand that in a big organisation it is difficult to ensure that everyone is singing from the same hymn sheet but I’m sure you would agree that everyone would benefit from clear and consistent advice.

Although I have raised these issues I would like to emphasise that overall my experience was a very positive one and I am delighted with the care received.