Postnatal care for women when a baby needs neonatal surgery

Postnatal care is important for all women who give birth, but when the baby is being rushed away for surgery there is a risk that the woman’s own needs get a bit lost. Women we spoke to said that both they themselves and health professionals sometimes overlooked their postnatal care because the baby’s needs seemed more of a priority.

Pamela recovered well from her caesarean operation, ‘which was just as well really because me and everyone else forgot that I’d had major surgery as well because all the focus was on the baby.’

Mothers unwell after birth

Many women we interviewed were quite unwell after they had given birth. Some had had caesareans as an emergency, particularly if their baby was being born prematurely. Others had a caesarean because doctors felt that was the safest way to deliver their baby. Trying to rest and recover after a caesarean was a challenge when they also wanted to see their baby in another part of the hospital or in another hospital some miles away.

Rebekah had a caesarean so couldn’st follow her daughter to the specialist hospital, where she was sent straight into surgery.

Several women also had other complications. Louise had pre-eclampsia*and Joe had a post-partum haemorrhage (severe bleeding) and needed to be looked after in intensive care herself for several days. Staff were able to bring her daughter to see her, which meant a lot as she was terribly worried her daughter wouldn’t survive her forthcoming surgery. Mary’s blood pressure was very high after her son was born. She was given medication, so she could be with her son while he was in neonatal intensive care (NICU)* as soon as possible.

Amy E was so focused on her daughter’s health (she had gastroschisis* and was due immediate surgery) she did not pay enough attention to her own. This was made worse by her postnatal care not being based in the hospital where her daughter was being looked after. She developed mastitis and didn’t pick up that her tailbone (coccyx) had been damaged during birth.

Amy E wasn’st really bothering to look after herself, and there was no one to look after her as she wasn’st at home but miles away in another hospital.

Age at interview 32

Age at diagnosis 29

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Joe had a postpartum haemorrhage after her daughter was born and was in intensive care for several days. Staff were able to bring her daughter to see her.

Age at interview 36

Age at diagnosis 34

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Postnatal wards

It was a terribly worrying time as mothers were desperate to see and be with their baby. They had often not even been able to hold them before they were whisked away. This was made worse for some women because they were put on postnatal wards with other mothers and babies. Amy said the first night was ‘so painful’ and hard. Her daughter had been taken to another hospital for surgery, while she was on a ward with mothers and their crying newborns.

Amy E said it was one of the low points of her experience, to be put on a ward with mothers and their babies, and she had no baby.

Age at interview 32

Age at diagnosis 29

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But some hospitals were very sensitive to these concerns and made sure that these new mothers who had been separated from their babies were given privacy to recover. Jane said the hospital found her a little corner to be private which she really appreciated. ‘But they put me in a room on my own, it was, I didn’t pay for a private room. They just found me a little corner which was brilliant and. I just, I remember I just, there were, you know, my husband, I went down to see her with my husband and gave her a cuddle and breastfed her.’ When Joe left intensive care and went back to the post-natal ward she was put in a room with other mums who didn’t have their babies with them because they were in special care. She really appreciated this. ‘The nurses were lovely, they were really understanding.’ Shanise was wheeled into the NICU in the middle of the night to see her newly born son. She appreciated this but felt out of place, as she was on a bed and ‘just felt like I was intruding on these premature babies’.

Mothers discharging themselves

Many mothers we spoke to were so desperate to follow their baby that they discharged themselves from hospital as quickly as they could. Sally-Anne threatened to discharge herself unless staff discharged her after three days. Even though Amy was still recovering from a caesarean and had high blood pressure, she discharged herself for a few hours, so she could go and be with her daughter.

Amy said even if you have to write in my notes, not agreeing with medical opinion, I’m going.

Age at interview 39

Age at diagnosis 33

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Mary had a very positive experience. Her obstetrician appreciated that although she was still recovering from delivery and had high blood pressure, her priority was to be with her son. So she arranged for her postnatal care to be transferred to the hospital where her son was now being cared for and made a point of phoning through details of the pregnancy and birth, which Mary really appreciated. She had a follow-up appointment at six weeks to go through all the details of the birth, which was very helpful.

Mary was supported in her discharge so she could be with her son who had been transferred to another hospital.

Age at interview 42

Age at diagnosis 41

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*Footnote definitions:

Pre-eclampsia is a condition where women develop high blood pressure, fluid retention (oedema or swelling) and protein in their urine. While mild pre-eclampsia can be monitored with blood pressure and urine tests at regular antenatal appointments or by the GP, more serious cases need to be monitored in the hospital. Treatment focuses on lowering blood pressure but the only way to cure pre-eclampsia, if it is severe, is to deliver the baby. If it is not treated pre-eclampsia can lead to serious complications.

Neonatal Intensive Care (NICU)
A unit for critically ill newborn babies and infants who need the highest level of nursing and medical care. Babies in NICU often require support for their breathing. Those undergoing major surgery will often be looked after in a NICU.

An abdominal wall defect, that occurs when the baby’s tummy wall does not develop fully in the womb. A hole is present next to the umbilical cord through which the baby’s intestines protrude into fluid around the baby while in the womb, and outside the baby’s tummy after birth.