A-Z

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...

Age at interview: 44
Sex: Female
Age at diagnosis: 42
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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.
 
 

Kate was in a different hospital from her son. Photographs and the little diary the nurses wrote...

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Kate was in a different hospital from her son. Photographs and the little diary the nurses wrote...

Age at interview: 35
Sex: Female
Age at diagnosis: 34
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And obviously I didn’t see my son for four days. Such an odd feeling. I mean not expecting to have the baby so early and then I wasn’t a Mother. I was just some useless person lying there.
 
I did have some physio on the fourth day when they finally got me to sit up and I felt really sick. [ But I couldn’t walk anywhere because I was so wired up to the machines, so I could go about a metre and then I couldn’t move any further. Just the lack of dignity was tremendous. You know, people having to wash you everywhere and I could feed myself eventually, which is good. But they kept saying, you know, you’ll look forward to seeing your son. And I thought what son? What do you mean? Didn’t really mean a lot to me.
 
Where was he?
 
He was in neonatal.
 
In the same hospital?
 
No a different hospital a few miles away. But the nurses there were ever so good. They, they wrote a little diary from my son to me and of course that got me. So he wrote about what he’d been doing that day, but it was not real to me. And my partner showed me photographs and I actually said, “Have you got the right baby?” I didn’t recognize him. 
 
So I didn’t have this maternal side to me, because I wasn’t allowed to have that. So I worried, I worried about when I’d see him again. Would he know me? Would he like me? Because I felt like I’d let him down.

 

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...

Age at interview: 36
Sex: Female
Age at diagnosis: 34
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So was he allowed to come and be with you in intensive care at all?
 
No, no, he had to wait quite a long time actually. I think it was it was a good few hours, yes. I don’t know why. He could probably tell you, but I don’t really know why. And then I didn’t see the baby until, I think it was about 2 o’clock in the afternoon and I’d given birth at 2 in the morning. Because we had to fight to be allowed to, for her to come up to intensive care, all sorts of things, that you think, I shouldn’t really have to cope with this while I’m in intensive care. For goodness sake. But I suppose it was a measure of how well I was by then that, you know, that you were able to have a conversation about it. Because they were worried that the baby would get ill from intensive care and then the intensive care people were saying, “Well actually it’s much cleaner up here, than it is on your ward. If anything you’re bringing, you know, stuff with you.” So there was this ridiculous fight between them. 
 
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...

Age at interview: 32
Sex: Female
Age at diagnosis: 30
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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.
 
 

After she was born, Linda's daughter was taken away to be cared for elsewhere, but she wishes...

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After she was born, Linda's daughter was taken away to be cared for elsewhere, but she wishes...

Age at interview: 57
Sex: Female
Age at diagnosis: 34
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Yes, it was just odd to be handed a baby from the Caesarean, I found anyway. Whether it was just from the epidural or… I think it was the whole rushed thing, that it all… I just remember being rushed down the corridor, in there, these big green sheets up. Tugging and she’s born. And then I was handed her. And it just felt like she could have come from anywhere.
 
How long did that feeling last?
 
Well it’s so difficult because I was just so exhausted, so it took a while to recover from I suppose the anaemia. I could see straight away in fact when she was born, the consultant held her up and said “you’ve got a big bouncing…” and I thought he was going to say boy, and he said “girl”. Because she was a big girl and she looked exactly like her brother when he was born. So that’s how I knew she was mine.
 
Did she stay with you for the whole time after she was born, or did she go off to another part of the hospital?
 
No they did take her off actually and also at that time. Yes, I did feel a bit out of control. I should have insisted she stayed with me. They took them away at night which was why they were giving her bottle feeds, which I don’t think I was aware of for the first couple of nights. And I should have insisted which I think they do now, you keep the baby with you. I think I’d have found it better and I should have asked to have her
 
I guess when you’re not well…
 

I think that’s exactly what it was, yes, and you tend to listen to what people advise and they say its best for her and best for you, but I think I might have been better with her. 

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.
 

When Paula woke up in intensive care, she was worried about whether her daughter was OK. If...

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When Paula woke up in intensive care, she was worried about whether her daughter was OK. If...

Age at interview: 49
Sex: Female
Age at diagnosis: 46
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Of course I woke up just thinking really, like thick head, and thinking, you know, this is really dark and then immediately just said, “How’s the baby?” Because as far as I was concerned it was like minutes ago so … It took a good few minutes. I mean somebody was there immediately, somebody was there. Right away. But that person… I think I had the same person actually, through the time I was there, who was a chap who I still to this day don’t remember his name which is awful but he was wonderful and he was immediately very calmly telling me “You’re okay, you’ve had to have a bit of an operation. You’re… the baby’s fine, but you are in Intensive Care” He was just kind of going through the motions of very calmly telling me. And then started asking me certain things about did I feel, you know, presumably checking me over. I remember saying, “Oh can I have a drink of water.” And things like that, you know, just gradually computing as to what’s happening and I think I probably asked again, “Are you sure the baby’s okay.” Because I suppose what was immediately dawning on me was that something serious must have happened to me.
 
Yes.
 
Therefore how could I be this bad, and the baby be okay. You know, so that was, I think that’s the confused thing that’s going on immediately you know, and also the fact that you have no concept of time, or how much time has passed or any of that.

 

 

Rebecca said it was traumatic to wake up and know she had had a baby and not be able to see her....

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Rebecca said it was traumatic to wake up and know she had had a baby and not be able to see her....

Age at interview: 42
Sex: Female
Age at diagnosis: 40
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It was awful experience to wake up, and you know, you’ve had a baby. You can’t see the baby. She was in in the neo natal unit. I couldn’t see because I wasn’t even on site then, because I was at the hospital. I woke up, my husband wasn’t there because it wasn’t visiting times and they weren’t flexible. And you know, my leg had swollen up, my whole body had swollen but my leg had swollen up and a few, I think he next day they ended up having to take me into, into surgery again because I’d got a , I think it’s called an embolism in my leg. And they had to do a fasciotomy which involved three more operations, to open up, to close one side, close the next side and which is in the end resulted in me having drop foot. I can’t move my foot. I need to wear a brace in my shoes now and things like that.
 
I was in the High Care Unit for, I think it was four or five days. I do remember the day I came round. It was very, very traumatic for me. I had a visit from my Mum, my husband and my brother in law brought them along. And I hadn’t seen my daughter at that stage, and I was very upset because I thought, I thought personally that something was wrong with her that they weren’t letting me see her because there was something wrong and I got to the point that I really got myself worked up and eventually. They weren’t very, the neonatal unit wasn’t very accommodating. They said to me, “Look she’s not in any danger. She’s there because first of all you can’t take care of her, and because had been, she didn’t breathe for the first ten minutes they had to give her oxygen.” So it was just a standard procedure. 
 
Eventually after a lot of me being hysterical I think, they agreed to bring her for literally ten minutes. It really was literally you see your baby and that’s it. It was like that for the five days I was in. I never saw her for more than a few minutes every …. Not even every day. It was a very unpleasant experience

 

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.
 

When she came round in intensive care, nurses chatted to Paula and found out news about how her...

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When she came round in intensive care, nurses chatted to Paula and found out news about how her...

Age at interview: 49
Sex: Female
Age at diagnosis: 46
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Was there a point at which you started to feel more awake?
 
Yes, a bit. Yes. I was chatting quite a lot to one particular you know, the kind of nurse in overall charge there of that part. She was very good and you know, we chatted. I suppose she was doing distraction stuff, you know, chatting about other things. And she was certainly finding out whatever information I needed to know. She was doing her best to keep the communication going because of course, with the unit where my daughter was, you know, a completely separate building, a completely separate place from where I was. So she was doing checks and all the rest of it and feeding information back to me about, oh yes, either she’s sleeping or she’s had a feed or whatever you say, stuff like that, so that was reassurance.
 
But then of course when my partner did turn up, before he’d been in to see me, he’d gone in to see her anyway. So he was able to come in and he’d got photos as well and stuff, so … we just sat and kind of tried to piece things together a bit for a while.

 

 

Alex's daughter was born early and sent to neo-natal intensive care. She couldn't visit her...

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Alex's daughter was born early and sent to neo-natal intensive care. She couldn't visit her...

Age at interview: 37
Sex: Male
Age at diagnosis: 36
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Those first two days were a bit of blur, but the Friday the paediatrician said that she was starting to become unwell and that she was going to need some help breathing and that she would need a blood transfusion. And so they put her in CPAP and they were going to give the blood transfusion and then she became even more unwell.
 
I was obviously getting most of this third hand from my husband, because he was down, going back and forth from special care, and in the end he asked the paediatrician to come and explain it to me on the labour ward. And they said that they’d done an x-ray and her lungs were quite under-developed and they felt she needed to have some surfactant and that they would have ventilate her to do that, and that one of the risks of ventilation is that it’s so much easier for the babies being ventilated because they’re not working so hard, that they don’t then want to come off.
 
So they ventilated her on that Friday night and gave her a dose of surfactant and she was too sleepy from the morphine to come off, so they had to keep her ventilated, and their plan was to give her another dose in twelve hours and then try and extubate her. Meanwhile they gave her the blood transfusion and of course, I then asked a stupid question of, “Oh my gosh, is she going to die?” To which, quite rightly, they said they couldn’t give me that answer and of course you then think they’re not answering because they think she is. Which is not what it was at all… but I was lying there with this balloon up me, the catheter and drain coming out and I couldn’t even cry. It hurt so much. So I was sort of trying to cry while holding myself and I’d only seen her once. They wheeled me down in the bed and I held her that first night.
 

At first they weren’t going to let me go down and, the doctor, one of the registrars said no, because there was still the risk of haemorrhaging post-surgery, and then eventually one of the midwives came back and they said, “They’ve told me I can’t. Are you sure I can’t go down?” And she said, “Let me speak to someone else.” And they did let me go down. 

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...

Age at interview: 35
Sex: Female
Age at diagnosis: 34
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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”. 
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