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Conditions that threaten women’s lives in childbirth & pregnancy

Breastfeeding

Establishing breastfeeding can be very difficult after a severe medical emergency. Women were sometimes in intensive care units (ITUs) for several days, still critically ill and separated from their newborn babies. Even when women were not in intensive care, some women we spoke to, while very keen to breastfeed, found they did not feel strong enough or were in too much pain. Several women found expressing milk stressful.

Sometimes women who were in intensive care were supported by staff and able to establish breastfeeding. A combination of breastfeeding, expressing milk and supplementing with bottle feeding made this possible. But it was often a struggle. Although she had breastfed her first child and felt confident in what she was doing, Hannah often felt powerless while she was in ITU. After the birth of her first child, Alison was supported by staff to try to breastfeed, but she found it an enormous struggle after her hysterectomy and haemorrhage (heavy uncontrolled bleeding).
 

Hannah was able to establish breastfeeding while she was still in intensive care. But it was a...

Hannah was able to establish breastfeeding while she was still in intensive care. But it was a...

Age at interview: 36
Sex: Female
Age at diagnosis: 34
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And I remember… because I wasn’t that ill. I think I came round quite quickly. I was able to feed my daughter in intensive care. That was quite nice because they said; they’d never had a baby brought up before. And that was quite good, because I insistent I was going to feed her. Even though they did insist on bottle feeding her overnight, on the ward, which I was really cross about and my husband was really cross about.
 
So you know, this sort of thing was quite difficult and they were supposed to send a courier up to get pumped milk in the middle of the night and it was my responsibility to do it, but I was, you know, off my head on morphine.
 
What do you mean it was your responsibility to do it?
 
I had to ask, you know, because you have a nurse at the end of your bed, and I was really, I was feeling really rather poorly and I was on morphine pump, every, you know, four minutes or whatever, and so I had to say to her, “I want, I think I should pump now, some milk.” And then she would do it, sort it out, and then she would call for the courier to come and get it. It was all on me, you know, and I just wasn’t able to do it, you know, I just, I wasn’t really that aware of what was going on. And so baby was cup fed overnight which really annoyed me.  Because they really didn’t need to do that, you know, but it was just easier for the post natal staff to do it.
 
So where was she overnight then?
 
On the ward.
 
By herself?
 
No, well no they put them in  I think there’s a little room off the nurses’ station where they put babies that  but yes, that felt bad actually, you know.
 
And did you have any problems with the suction breast feeding?
 
No. No I knew, well I find it easy with, not easy at first actually because it’s never easy at first is it? But I knew that I could do it because I had breast fed my son. And so, and it was just, I was just insistent that I was going to do it. Because I haven’t even, I haven’t managed this natural birth that I wanted, there’s no way that I’m not feeding this baby, and the breast feeding counsellor was actually very negative and said, “You know, I don’t think you’ll be able to.” And I was like, “I think I will actually.” Until she brought up.
 
And actually she came up first and squeezed some colostrum out and she said, “Oh yes, you have managed.” I said, “Yes, yes, thank you.” And then she relented and she brought the baby up, and it fed quite happily and then they took it away again. It was all very strange, because it was the first time I’d seen the baby properly and yet there was five people there. So I felt that I couldn’t have, I couldn’t be over… oh it was very odd and I was on morphine as well, and I was just, you know, and so I wanted to have, you know, a nice moment with my baby and yet it just wasn’t really at all [laughs]. And I couldn’t hold her properly because I still had like a central line in and tube down my nose and it was all, you know. It was all very difficult so…
 
 

Alison was eventually successful in breastfeeding her son, and went on to feed him for a year....

Alison was eventually successful in breastfeeding her son, and went on to feed him for a year....

Age at interview: 32
Sex: Female
Age at diagnosis: 30
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Yes, and what about breastfeeding was that, were you able to do that at all?
 
Yes, yes. So they, when, obviously when it was obvious that I, because I was still in theatre and he needed a feed, the midwife spoke to my husband and  he told them that I wanted to breastfeed and so they cup fed him for the first, for the first two days, and so on his third day, so on the Tuesday while I was still on the labour ward, they started to, they cup, they started to give him to me to try and feed him, but he was, he didn’t have, he had hardly anything, but you know, it got him used to starting to try. And then they’d cup feed him, and then when I went onto the maternity ward, they got the breast pump out, so I started to, it was quite, it was really tiring day, it was, actually, probably my lowest day was that day, which is quite a, sort of three or four days in, you think, I think all your hormones are flying around all over the place, and so I was. I was feeding him and he was being cup fed, and then an hour and a half later, I was having to, to express milk, and then an hour and a half later, try and feed him, and then he would have a cup feed of the expressed milk and then some formula and then an hour and a half later he was back on the pump, and it just was relentless but at the end of the day, I just said, “I can’t do this anymore.” [Laughs]. “I just can’t.” And I just was in tears that evening. I just thought, oh I’m just not, because I didn’t feel physically strong enough to deal with it either. I just thought I’m trying to get over this major operation. I’m trying to look after my baby. I’ve got this silly machine that’s just driving me mad. I felt like a cow, and it was just horrible. And I just was miserable. And I just didn’t know what to do. And I just thought how can I do this all night? When I need to sleep. It’s bad enough having to feed a baby every three hours or so. Without having to get up every hour and a half to be expressing milk as well.
 
And so I spoke to the midwife. The midwife came in to talk to me, and she said, “Well what we’ll do is we’ll knock it on the head overnight.” And they actually, the first three or four nights, three nights I think, they actually, for about a four hour period or so, they took him to like where the midwives’ station was in the ward, and they looked after him for me, so they did that on the labour suite, and they did that for one or two nights when I was up on the maternity ward. And then I could get a block of sort of four or five hours sleep. Which was kind of what I needed I think, just to get my body to start repairing itself. 
 
And then on the Thursday morning the doctors came in to see me, and to see how I was doing and they were asking about how I was getting on with breast feeding and I just burst into tears and said, “I just don’t think I can do it.” And one doctor said to me, “If you can breastfeed after all of this. Then that’s amazing. But nobody will think any worse of you, if you can’t.” And that made me realise that I’d been, not putting the pressure on myself, but I’d been thinking that other people were expecting me to do it. And as soon as somebody said, “its okay if you can’t, I was able to do it.” But my rule was the pump goes, because that was the bit that was getting me stressed. So the pump went, and I said, “If I can’t do it by myself today, that’s it. He’s on a bottle.
 
And just knowing that it was okay if I couldn’t, I relaxed and I fed him until he was a year old [laughs]. And he had no more formula and that was it. It was just like someone had flipped a switch and I think it was jus
 

Cara was supported in establishing breastfeeding and managed for about three weeks, but after...

Cara was supported in establishing breastfeeding and managed for about three weeks, but after...

Age at interview: 37
Sex: Female
Age at diagnosis: 29
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Well actually, yes, I did actually ask about that and I was given, Daisy, you know, one of these electric pumps and I was pumping actually. I did pump and even though I was in intensive care for a week, I wasn’t breastfeeding her during that time, I did do some pumping. And when I went… when I was transferred to the post, post natal ward, I did actually start breastfeeding her. I was quite concerned because I was pumped full of a lot of drugs, and I did ask all these drugs, and I was assured that it wasn’t a problem and it would be safe. So I did start breastfeeding her, and even though she had been bottle fed for the first week, she didn’t have any problems latching on. And I did actually go on to breastfeed her for about three weeks. But truthfully my milk never really came in, you know, it just didn’t. And I started supplementing with a bottle quite quickly and it’s not a very big jump to suddenly saying this is too much. I’m going to be making a bottle anyway, let’s… I’ve done my, I’ve done my best and my milk was not going to come in and my Mother hadn’t successfully breastfed, my sister hadn’t. So they were both sort of quite encouraging to say, enough call it a day. Well who’s to say your milk would have come in anyway? It was very disappointing, but to be honest it was not top of my concerns by that point. So, I was bottle fed.
 
Yes, and your body had been through so much…
 
Quite it’s a bit unrealistic for them to expect that you’d have enough nourishment to share after all of that. I think you’ve got to kind of replenish your own natural blood supply and stuff. But I did, I did have that bonding moment, and we did sort of give it a go. 
 
Hana had severe complications after developing obstetric cholestasis (a problem with the liver that causes a persistent itch) and having an emergency caesarean to deliver her twins. She felt pressure to try and breastfeed her babies, but found it a “physical, emotional nightmare”. With the support of her midwife she felt able to start bottle feeding them.
 

Hana struggled to establish breastfeeding her twins. It was a nightmare and when she stopped she...

Hana struggled to establish breastfeeding her twins. It was a nightmare and when she stopped she...

Age at interview: 38
Sex: Female
Age at diagnosis: 38
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And [son] was in there, because I say he had jaundice and then he was low birth weight, group B Strep and then he had had some sort of, they thought an infection. He was being fed by tube initially, and then he was rejecting. He was rejecting the milk, so then they had to do it through a tube through his nose. 
 
And then there was the pressure on trying to breastfeed. My daughter, who obviously I’d not seen for 24 hours or whatever, she’d started on a bottle and she was taking the milk. I tried to breastfeed. It didn’t work. Then I was trying to express with the pump. And then, then my son he wasn’t taking milk. So I was literally, they were saying, “Your breastmilk would be really, really good for him.”
 
So I remember of a night time, it was like an hour trying to feed my daughter with the bottle because I thought I just can’t do breastfeed with her because she wouldn’t take it. And then I was doing an hour on the breast pump, trying to create milk for my son to try and help him, and then literally the next time round, it was like 30 mins later, I was started to feed my daughter again and it was just continual. And I just had no energy whatsoever. I was just completely exhausted. And then my son, as I say, he was rejecting the milk. So I was trying my best to try and give him something. I felt so guilty because I wasn’t producing enough for him. It was just really stressful. It was not a nice time at all.
 
And my son, he came home, two weeks after and we were having… The hospital said to us, he’ll be feeding I think it was 40 mls, 40 to 60 mls every three to four hours. And I was like okay that was fine. He was taking 10 or 20 mls. Nothing. And he was not feeding hardly at all. We were feeding him every two hours and obviously with my daughter trying to feed her as well, expressing at the same time, it was just, it was just a nightmare. A physical, emotional nightmare. It was just awful. And it was just, it was just so wrong in terms of the expectation that we had when we took my son home.
 
So obviously within time, and I was very, very fortunate that I had the support of the midwife who was very, very good. She made me feel so much better when I’d made the decision not to, to stop expressing and to not breast feed, and she did say to me, “After what you’ve been through [name]” She said, “Nobody would actually look down on you and say that you’ve not tried etc.” She said, “I’d probably be exactly the same.” It made me feel so much better having made the decision to stop expressing. It made me. It was like a bit weight off my shoulders. 
 
Some women we spoke to felt very strongly about breastfeeding their newborns. For some, like Hannah, it was all the more important because they had not managed a “normal birth”. Alex was determined that she was going to breastfeed her second daughter, as it was the “only thing I could do for her” while she was in neo-natal intensive care.
 

Alex had her baby prematurely due to her placenta praevia. Being able to breastfeed her daughter...

Alex had her baby prematurely due to her placenta praevia. Being able to breastfeed her daughter...

Age at interview: 37
Sex: Male
Age at diagnosis: 36
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Meanwhile I’d been trying to start expressing, you know, to get things, you know, midwife there with her syringe, trying to get this miniscule amounts of colostrum [laughs] and we’re all getting excited when there was one or two mls of colostrum chasing it around the syringe. But that was the only thing I could do for her, and then I was like I’ve got to start expressing, and they were like, “Well there’s not much point this early on.” And me saying, “I don’t care. I’ve got… you know, I can’t do anything else. I’ve got to, I’ve got to start.” 
 
And so then I, then very early Saturday morning I’d gone round to the nurses quarters to get my pump and stuff and I saw the paediatrician, well one of the paediatricians and I said, “Oh how’s my daughter.” And she said, “Oh self extubated.” She said, “All the machines went off and they ran out, you know, ran over and there she was with her tube in her hand as if to say I don’t say I don’t need this anymore,” [laughs]. So that was, you know, that made me feel, I was like well she’s a bit of a fighter, so she’s going to be fine. And, then she started becoming quite jaundiced which was also related to these, to these antibodies and those levels. So they gave her three doses of the phototherapy and then she just started getting stronger and stronger and then all of a sudden, you know. So after she’d self extubated she went back on the CPAP but only for a few hours and then she was breathing in oxygen for about, I think after eight days, and then she was breathing on her own, and without any sort of oxygen. They’d moved it around to the next room in special care for, you know, the babies that are getting stronger and just learning to feed really. So 
 
And did it work the expressing?
 
Yes, yes, I mean I didn’t breastfeed my daughter, my first daughter, and I was really upset about it, and I had a much more relaxed view the second time around. I thought well, I’ll try, if it doesn’t work, I’ll just go onto formula I know, you know, [first daughter]’s absolutely fine. But as soon as I knew she was coming early and I couldn’t do anything else, I was absolutely determined. But again, I think it was in a way easier than having to breastfeed a new born that demanded every hour or two. Because I could set when I was going to express and she was taking such small amounts that I was able to, you know, I mean I can remember that first day getting that one or two mls and then we got ten, and then 40 and by the time I left hospital I was expressing about one and a half litres of milk a day [laughs]. And we had to buy a new freezer when we came home, just to put the milk in [laughs]. So, I mean I’m still expressing now twice a day. That’s you know, about, nearly five months later. Starting to tail that off on a bit, but sort of got slightly obsessed by making sure she had enough milk. 
 
And those first few days that was all I was worried about. I can remember going down once at about 3 o’clock in the morning in tears, saying, “Every time I express, I’m only getting a 100mls and I’m really worried I’m not, I haven’t got enough milk.” And [husband]’s like, “Look at her she’s having 70 mls at a time and you’re expressing, you know, about every five hours you’re expressing 800 mls a day, you’re fine,” [laughs]. So you get everything completely out of proportion. So yes, it was just, again you don’t think about yourself much. It’s just, I mean I can remember calling my Mum at one point, and just being petrified and saying, just saying, “How w
Lisa was determined to try to breastfeed because after having a hysterectomy she knew it would be the only chance she would have to do it. Samantha had pre-eclampsia (high blood pressure) and tried to breastfeed her daughter. It didn’t work out which she found “upsetting, so I felt like a failure”.
Sometimes women found it difficult to talk to their midwives about whether they would breastfeed or formula feed their baby. Although Lisa had briefly started breastfeeding while in intensive care she felt the midwives in the maternity ward discouraged her from breastfeeding because she was too ill after her haemorrhage and hysterectomy. But she wanted a chance to let her milk come in - she felt “robbed” of the opportunity to breastfeed. Amy had a haemorrhage and was “really cross” when she saw the midwives bring a bottle to feed her daughter. She felt it was really important for her to be able to breastfeed her, “to form a bond”, as she felt she had “totally failed and let her down”. She was grateful for their encouragement when she did successfully breastfeed.
 

Lisa only experienced an hour of breastfeeding before her haemorrhage. After the emergency she...

Lisa only experienced an hour of breastfeeding before her haemorrhage. After the emergency she...

Age at interview: 36
Sex: Female
Age at diagnosis: 35
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It’s the only one hour of my life that I experienced breast feeding. I couldn’t do it afterwards, because of all the drugs that were in me, and the exhaustion and the blood loss, the milk just dried up. And she was such a gannet that I couldn’t, I couldn’t produce enough, and I tried, my God I tried. 
 
Even the midwives, this is one thing that makes me really angry. A midwife was discouraging me from breastfeeding. They actively discouraged me. They stopped me from doing it, because they said that I was too exhausted, that I was too ill, and I couldn’t. And I’ve got to bottle feed. I’ve got bottle feed.
I said, “No, I am determined to breastfeed. This is something I’ve always dreamt about. I am going to feed my child. Will you just give me a chance?” 
 
And I woke up to see a woman bottle feeding my child. And I said, “What are you doing?” And she said, “Oh she’s starving. You’ve got…” I said, “Well I told you, just give me a chance. She’ll this is natural; she’ll get into the swing of it herself. If she wants feeding, she will suckle. Just give me a chance.” I was producing, just not enough. But I wasn’t given the opportunity to keep on and on and ongoing with it. When [sighs] I wanted to. Soreness or no soreness. I wanted to give it a go, and I knew this was going to be the only time. When someone tells you, you’ve had a hysterectomy, you will wait till your boobs drop off. You know, they were saying, “You can’t do it [name] come on. Just give up now. Give up.” I was like, “No, this is the only time I’m going to do this. I have to try.”  
 
And I woke up and saw this woman with a bottle in her mouth. And I was like, “What the hell are you doing?” So of course she was like, “Ooh this is a hose pipe all of sudden. I much prefer this.” And she gave up. And it started to get to the point where I was putting her to me, and she was screaming the place down and pinching me because she knew she wasn’t getting enough. So a midwife had given her the bottle, what’s she going to choose. I’ve got a nine pound one baby that’s gaining weight by the second, she’s not going to want you. She wants the bottle. She’s still a gannet now. So that was another thing I was robbed of.
 
Women may feel concerned about breastfeeding when they are taking strong medication to recover from their medical emergency, but this need not always be an obstacle, as Clare eventually discovered.
 

Clare was wrongly told to stop breastfeeding for a few days when taking warfarin after a deep...

Clare was wrongly told to stop breastfeeding for a few days when taking warfarin after a deep...

Age at interview: 34
Sex: Female
Age at diagnosis: 34
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So it was quite an ordeal really. Because I obviously had [son] who was three weeks old and I was just sort of getting into the swing of things I suppose. I was enjoying being a lot more active because I’d found pregnancy quite hard work. This time I was much bigger and it was over the summer when it was hot, and I couldn’t be as active as I wanted to be with [daughter], so I was just got into the swing of it, and it was the day that [husband] was due to go back to work. So I was all psyched up for him to go back to work and everything and then this happened. So… I was quite emotional I think. And so by the time I saw the doctor who explained that I had DVT and that I needed to go on Warfarin, which I knew a bit about Warfarin because my brother was on it at the time, and, and I have worked with patients who’d been on Warfarin as well. It was quite hard to take it all in, and my main concern really was breastfeeding. I’d breast fed [daughter] and I was breast feeding [son] and it was going really well, and my main concern was breast feeding him on medication.
 
And I think this is the worst thing about the whole experience for me was the doctor I saw, she, she was quite nice, and I was in tears actually because she said I had to start of something called Clexane which is a fast acting anticoagulant that I had to inject. So I wasn’t too thrilled at the prospect of injecting myself. But also going onto the warfarin a few days later, she said that I couldn’t breastfeed on the Clexane. She said I’d have to speak to my GP about whether I could breastfeed on warfarin. So that for me was the worst thing about the whole experience was that suddenly I had this baby who I’d got to breastfeeding really well and I was suddenly out of the blue going to have to stop that. So I was really upset and, and she gave me literature to go with it, but I did find it very hard to take everything in. 
 
But it turned out that I was given wrong information about breastfeeding. Which, and that’s the one thing that I’m really quite cross about. Everything else, I think, well I couldn’t have done anything about it. It was just really bad luck. But it’s the one thing I feel quite cross about. 
 
Because what happened was we had to stop on the way home. I gave [son] one last breastfeed thinking I don’t know when I’ll ever breastfeed him again. And we had to stop at the supermarket and get formula. I had to ring [husband] and say, “Can you sterilise bottles?” Luckily being second time parents. I’m glad it didn’t happen to be first time, being second time parents we had bottles. And I had back up formula, just in case breastfeeding didn’t work out. So luckily they were out the loft and they were kind of ready I suppose.
 
So I told him to sterilise some or bring some formula and we had to start him on formula when I got home and it was really… It was heartbreaking actually. Sorry.
 
I think the thing was, that was really awful having to come home and I had all these drugs to take and inject myself with, and suddenly I had to introduce a bottle to him, and he didn’t take it very well. He was very good in that he took the bottle, but obviously it’s a different feeding mechanism to breastfeeding. And he really struggled and he was clearly taking a lot of air in. So he was sort of very unsettled. He was screaming and uncomfortable and in pain all night. I was in agony because of my leg. And basically for two days we had to bottlefeed him, until we could sort of sort out whether I could carry on breastfeeding. But I kept expressing milk to keep my milk supply up. And I’ve never been good at expressing. It’s never really worked very well for me, so, but I wan

Last reviewed April 2016.
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