"Mother separated from newborn baby"

About: King Edward Memorial Hospital / Maternity King Edward Memorial Hospital / Neonatology

(as the patient),

I gave birth (VBAC – vaginal birth after caesarean) to my second child at King Edward Memorial Hospital. She was full term at 40+1. I had laboured well at home for 4 hours and was already in transition when I arrived at the hospital as it had gone faster than expected. Despite the baby being asynclitic, I was able to birth her fairly quickly after about 45 mins and there were no further complications. We were assessed as normal and were almost sent home with our baby that night. Concerns were raised about a slight grunting to the baby's breathing and after some debate and discussion, the midwife and pediatrician decided to send her to NICU for observation. Around midnight she went to NICU and I was admitted to a room in a ward upstairs. I was called every 2-3 hours to come down an breastfeed my baby and sometimes even just to settle her as she was distressed.

Scans were done on her lungs and it was thought to be either fluid left from her rapid birth or possible infection. Some blood cultures were taken to check for infection and she was given antibiotics in the meantime as a precaution.

I was discharged on the following day, a little under 24 hours after the birth. My baby, however, was kept for observation for another two nights. Despite trying to establish breastfeeding and to maintain skin-to-skin contact (both recommended strongly by the hospital) I was separated from my newborn just a day after birth. This meant that I was driving home and back to the hospital every 2-3 hours night and day for two days having just given birth. This included driving myself to and from the hospital at 11pm and again at 3am or 4am both nights so that she was only given one or two formula feeds during her stay. Despite my best efforts, she was given formula to top up a couple of feeds and because I had to miss one overnight feed each night as it was not safe for me to be driving on so little sleep. My husband had to stay home with our toddler so I was driving myself.

While we were separated, my baby became distressed and at one point refused a feed altogether. As a result, she was put on full IV to bring her fluids up. It took another day to get her sodium, sugars and hydration levels back. By the time she was discharged, it was decided that she had never had an infection.

Although I am glad of the extra precautions taken to ensure my healthy baby remained healthy while being observed, ultimately she was given antibiotics and IV and was separated from her mother for two days all just "as a precaution."

I also understand that I had recovered from my VBAC well and didn't need to be hospitalised myself, I think there must be a better way than sending a new mum home and separating her from her baby. All I needed was a bed to use between 8pm-8am so I could be available around the clock to feed my baby. Although not ideal, it was manageable for me to go home during the day and provide my own meals and care but driving through the night and spending 1 hour feeding in hospital, 1 hour driving and 1 hour at home as a cycle for two days was exhausting and did not help my recovery or my baby's. Yes, I could have allowed her to be formula feed overnight but that would not have been the best for establishing my milk supply or for my baby to get the breast milk and skin to skin contact that was recommended. Expressing wasn't much of an option as my milk didn't come through until a few days after birth and although I expressed as much colostrum as I could for the nursing staff to use, it wasn't enough to replace full feeds. The midwives that had to discharge me and the neonatal nurses were all frustrated at our separation as well. It was a decision dictated by protocol or budgets and clearly not with my recovery or my baby’s health in mind.

I was told stories of other mothers living much further away being in similar or worse situations than mine and it seems ridiculous that there cannot be a room somewhere that allows for a mother to stay for one or two nights to be with her baby in these short-term situations. By the third day, the separation and hassle of having to go home and back started to have an effect on me and I was becoming frustrated, distressed and exhausted. I was so glad she was discharged and not kept any longer. My toddler also became very distressed at seeing me coming and going so frequently and not having her baby sister come home and the forced separation affected my whole family.

Responses

Response from Graeme Boardley, Director, Midwifery, Nursing and Patient Support Services, Women and Newborn Health Service, King Edward Memorial Hospital

picture of Graeme Boardley

Dear confused mum,

Thank you for bringing these matters to my attention. I am sorry that you have had this experience with our service.

Please be assured that while we have policies and guidelines for the discharge of patients, individual discharges are managed according to clinical assessment.

It is our usual practice for a mum in your situation to be offered alternative accommodation, particularly if it is known that you would be breast feeding through the night. I have discussed your experience with our Senior Midwives and Nurses and apologise that this was neither discussed with, or offered to you. Our staff will be reminded of this.

I trust that you and your baby are now doing well.

Once again, thank you for bringing these matters to my attention and I apologise for the inconvenience caused to you and your family.

Kind regards,

Graeme Boardley.

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