Conditions that threaten women’s lives in childbirth & pregnancy
Access to the baby after an emergency
Key Learning Points
- Even when very ill, women want to be a mother to their new baby
- Many women face challenges in seeing their new baby, and it would be helpful to develop protocols ahead of time for women who require high dependency or intensive care to facilitate the baby being allowed to visit the mother or vice versa
- Where it is not possible for women to see or be with their baby, they really appreciate being kept in touch with the baby’s progress through:
- Photos
- regular verbal or written updates such as a diary of the baby’s day
- direct contact with the paediatrician when the baby is ill
- Missing a baby’s “firsts” is something women really notice; if at all possible they want to be there for important milestones such as the first feed.
When a mother experiences a near miss event in childbirth, the professionals’ focus is on saving her life and stabilising her. In this summary we discuss what mothers and fathers told us about being separated from their newborn after the emergency and how it affected them.
Mother’s distress at not being able to be with their newborn baby
Most new mothers have an overwhelming desire to see and start caring for their newborn baby. When the mother experiences a near miss in childbirth, this is often not possible. While some mothers may have understood and expected the birth of their child was going to be life-threatening (for example, where placenta praevia has been diagnosed), for others it comes as a profound shock. They are not prepared to wake up in intensive care (ITU) or a high dependency unit (HDU) and find themselves separated from their baby.
Karen was in ITU after her haemorrhage and hysterectomy. Intensive care nurses helped her to go...
Karen was in ITU after her haemorrhage and hysterectomy. Intensive care nurses helped her to go...
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Your motherly instincts are crying out for you to do what other, you know, wants to breast feed and stuff like that and I couldn’t. I didn’t hold him. I went up to see him about two days. When I was in Intensive Care one of the nurses somehow, I don’t know how the hell she did it, but she got me in a wheelchair with all the bags and drips and God knows what and wheeled me up to special care to see [son] and that was the first time I’d seen him, obviously after the C section. And I couldn’t hold him. It was really hard.
And when I went up there, [husband] was, my husband, he was feeding him. He was really surprised to see me. And it was lovely to see him feeding, feeding him. So the first time I actually got to hold [son] was, properly was when I was transferred back to the labour, actually the delivery ward. I had to go back to the delivery ward before going back to the labour ward. That was on the Saturday. So, yes. That was hard, sort of three days of not being able to me a Mum. Yes, so.
Women who woke up in intensive care (or high dependency) found it very frightening. They also did not know very much about what an ITU/HDU was and that there would be limitations on how easily they could see their baby.
Hannah was in intensive care and not able to see her daughter for 12 hours. She was frustrated by...
Hannah was in intensive care and not able to see her daughter for 12 hours. She was frustrated by...
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So was he allowed to come and be with you in intensive care at all?
And then she, I mean you’re allowed to push, the family aren’t allowed to push the baby around the hospital, only the breast feeding counsellor or a midwife is allowed to, and they weren’t available for hours, and that’s why I couldn’t see the baby. There were all sorts of weird rules and regulations about why, who can push a baby in a trolley round the hospital. It’s all very strange. So that was why we had to wait so long, because the breast feeding counsellor wasn’t there.
Who were you dealing with at that point? Was that intensive care? Nurses that you were talking to, or your husband was talking to?
No we had, they were very, very good actually. We didn’t have any problems with them at all. They were very although they weren’t very keyed up on breast feeding or using the pumps or anything like that. And would say quite unhelpful things, but that’s not their area of specialty, so you wouldn’t really expect to… But no, it was mainly negotiating with the post natal ward staff, who were quite set in their ways about things. And that we found that actually more difficult than what had happened in many way.
What dealing with their intransigence?
Yes, the fact that my husband wasn’t allowed to stay overnight with the baby . They said, your options are, if you want to stay with the baby, you have to sign the baby out. And he said, “Well I can’t do that. She’s had a difficult birth. And there might, you know, be things wrong with it we can’t.” “Ah no, but the security says you can’t stay in the ward.” And he said, “Oh fair enough, I’m a man, I understand that.” “You’re not allowed to sleep with a baby in the intensive care waiting room. We don’t have another space where you can be with the baby.” And so he said, “Oh can my sister come in and be with the baby?” And they said, “Oh no, because it’s a security risk.” And then he said, “Well actually she’s police officer.” And they were like, “Oh no, we just can’t.”
Women who were not able to see and look after their newborn babies straight away described feeling traumatised, cheated and saddened. The emotional highs and lows of childbirth were overlaid with realising and starting to come to terms with how critically ill they had been. While they understood that their serious illness made it necessary to be separated from their baby, because they were in intensive care or not yet stabilised after the emergency, it was nevertheless intensely painful. Hannah said, “We had to fight for her to come up to intensive care, all sorts of things I shouldn’t really have to cope with.”
Alison had to wait 27 hours before she met her son, as she was still on ITU. She felt sad that...
Alison had to wait 27 hours before she met her son, as she was still on ITU. She felt sad that...
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When did you finally get to see your son?
When he was 27 hours old, 3 o’clock in the afternoon. A long, long time. They decided that he couldn’t be brought into Intensive Care because the infection risk was just too great for him. And I guess, that’s hard to, it’s hard to sort of hear that, because that’s what I really wanted to see him. But again I didn’t want to expose him to any unnecessary risk. So I had to just wait until I was stable enough to be transferred to the labour suite and we had to wait for a porter to come and get me, and [laughs] It was the longest… we had waited about three hours to be, from the point at which they said I could go to the point at which I actually went. And that’s the longest three hours ever. It was horrible. It was really, really horrible waiting such a long time.
And… that… all that was going through my head the whole time was I haven’t even had a cuddle with him yet. I’ve not even, I’ve not even touched him yet. And that was, I’d seen pictures, because Mum and Dad, and husband had taken pictures and shown them to me, so I’d seen him. But, in a way he’s kind of that… it was lovely to see the pictures and actually see. They’d taken loads of pictures of his first feed. And that kind of thing, but in a way that’s hard as well, because you think I should have been there for that. And I still feel that. I still feel I should have been there for those things. And that’s, you’re never going to get that, never get that back.
And where had he been at that time. Had he been in the maternity ward?
Yes, he was above the maternity ward, and all the midwives loved him [laughs]. They looked after him so well and you know, they’d all, yes, they’d all really taken to him which was nice that, you know, that he’d been so well looked after. So yes, that was good, to know that he’d been looked after so well.
And your husband had been able to spend some time with him as well?
Yes, yes, so he’d been up there and yes, and obviously sat with me for a bit, and then there comes a point where there is only so many beeping machines that you can sit and listen to and if, if I’m not, he knew they weren’t going to bring me, bring me round any time soon. So it makes sense that he’s with, with our son, and sort of spending some time with him. And he’s having cuddles with somebody, rather than nobody.
And when you finally got to see him, were you able to hold him at that point?
Yes, yes.
Getting news about the baby
Some women described being intensely worried about their baby’s health because they couldn’t see them. Clear communication from staff would have alleviated their anxieties.
Some women had examples of communication from staff about where the baby was, and how she/he was doing which they found really helpful and reassuring.
Getting to see the baby
In some instances, staff were able to support mothers getting to see their newborn babies, either by bringing them to the ITU or helping the mother out of ITU for a short while. Cara was aware that her daughter was brought to see her in intensive care for short visits, although she was being cared for by her husband and nurses elsewhere. While Sarah was grateful that staff brought her baby to see her in ITU, she is sad now that she can’t really remember very much about it.
In some instances the baby was sent to neo-natal intensive care (NICU) but the mothers were not able to go and visit them easily because they were still unwell. Helen had to wait until she was out of HDU before she could go and visit her son. This caused distress, and women described being very grateful to staff for supporting them to visit their newborns.
Visiting her son was the highlight of Farkhanda's days. She really appreciated the help staff...
Visiting her son was the highlight of Farkhanda's days. She really appreciated the help staff...
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You know, sometimes I would see the baby every day. And for me it was like the highlight of my day. I’m going to get enough courage. I’m going to take my painkillers now. “Why do you want your painkillers now, Farkhanda?” “Because they’re going to kick in in ten minutes. I can go and see my baby. It’s going to take ten minutes. That will be ten minutes with the baby. By the time I come back I’ll need my morphine again.” And I would like plan it out, so well so I can go and see my baby, pain free, come back, don’t worry about it. When I come back you can meet me in the corridors and I’ll be like literally waiting in the room with morphine in the, in the corridors for me, because the baby unit was far away then.
Now it’s next door, but it was quite a trek. And if, God forbid, if the porters would be late with the wheelchair, it would trigger off a whole load of emotions. If he’s late my morphine’s going to run out, they’re not going to give me morphine again until three hours. That means I’m going to have to wait another three hours and I would speak to, you know, the nurse, and I’d say, “Please ring him again. Tell him that if he’s not here in ten minutes, my pain relief is going to finish and I won’t be able to sit in the chair.” So little things like that would mean the world to me. But when you’ve got a whole ward to run, why am I going to matter? Why are you going to take time out from your busy schedule with other people who are just as in need as I am, to keeping ringing the bloody porter. But I said, “I feel really, really bad, but would you …” She said, “Of course I will. Why do you feel bad?” And she goes, “Get down here now. Morphine’s got ten minutes.”
So that, little things like that, you wouldn’t ever have to consider being a priority but getting the porter to this lady on time can make a difference between whether she sees her baby now, or in the evening. But it made a difference to me. Because I thought my baby needed to be near me for me to try to produce milk. And I wasn’t producing milk.
Difficulties with transfer
In some instances, staff transferred mothers to other areas of the hospital so they could be with their baby. This was hard to balance as sometimes, although the mother was desperate to see her baby, she needed more care than was possible in those areas of the hospital. For more see, “Transfer from critical care” & “Contact with the baby”.
In some instances, staff transferred mothers to other areas of the hospital so they could be with their baby. This was hard to balance as sometimes, although the mother was desperate to see her baby, she needed more care than was possible in those areas of the hospital. For more see, “Transfer from critical care” & “Contact with the baby”.
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