"Discharged with undiagnosed and untreated postpartum preeclampsia"

About: Box Hill Hospital Box Hill Hospital / Maternity Service

(as the patient),

I gave birth to my daughter recently at Box Hill Hospital, in a natural, unmedicated labour. I was an inpatient of the maternity wards, for 48 hours after the birth. My child was born healthy, apart from an initial low blood sugar reading.

Unfortunately, even though the birth went well, the level of care I received when I became ill postnatally was, I believe, just so incredibly poor. I'm feeling so traumatised by my experience there, following the birth of my child. I believed I could trust the hospital to take care of me, as a woman who had just given birth there, days previously. However, I was left crying alone for hours in A&E and genuinely feared for my life. It will take me a long time to get over it.

During the second day at the hospital as an inpatient, after the birth, I complained to the midwives about excessive uterine pain, headache, dizziness, swelling, itching, weakness and generally feeling 'all was not right'. At 2am, the midwife took my blood pressure, which was over 140. I had had normal blood pressure in pregnancy.

The same midwife told me, later on, that she had put in my notes that I was not well enough to be discharged the following day, on day 3. I was discharged on day 3, anyway.

By day 7 postpartum at home, I felt seriously unwell and went to my GP, who ordered an ultrasound and a review by a private OB. Luckily the OB there identified I had a uterine infection and advised me, if I were his patient, I'd be re-admitted right away. He wrote me a letter to take to Box Hill that afternoon.

My concerned partner called the postpartum nurse at Box Hill, to ask if I could re-present to maternity as I had a debilitating headache, nausea and suspected uterine infection. My partner was told I would have to present at A&E and would not be accepted at maternity.

So, without my newborn, who I did not want to expose to A&E, I had to make the first journey to A&E that evening, where I was given antibiotics (but not any kind of exam or test to determine what kind of infection I had), discharged and told to take panadol for my headache. No investigation was done for my headache's causation and swelling in my legs.

Back home, by 2am I was in agony with headache, flashing lights, visual disturbances and swelling.

My partner again called maternity and was told we had to, again, present to A&E. So I went in at 2:30am and was there for 12 hours without my baby. 12 hours being left to cry in pain, with nurses there telling me they didn't know what to do with me - and saying that they could not get a straight answer from anyone at the OBGYN department. Every time I asked what was happening with me, I was told someone at another department had to write a report and decide what was to be done with me. I was told a bed was being organised at maternity, but this never transpired.

I was eventually discharged from A&E, having first been put on a drip with a medication to treat a migraine and afterwards given some generic advise from a doctor about how to lower my blood pressure with fruit, vegetables and walking!

I received a call from the postpartum nurse the next day, to say she had spoken to the registrar, who was happy for me to have been discharged by A&E and said my GP could call if he wanted to.

I went straight back to my GP, who was shocked by this and immediately ordered more blood/urine tests and an MRI. By now, I had severe swelling (I was 4 kilos over the weight I was the day I gave birth), I had pitting oedema in my legs, could not tolerate light and was getting severe visual disturbances.

Within the hour, my GP did call the registrar at Box Hill. The registrar, upon speaking to my GP, finally acknowledged how serious this was - and asked my GP to ask me to come back immediately.

I cannot express how disturbing I find it, that it took another medical professional to highlight the severity of my symptoms, when I myself was ignored and discharged from Box Hill Hospital on multiple occasions prior to this, despite presenting all the same concerns, symptoms and information.

This time, I refused to go to A&E again and was finally allowed to return to maternity, so I was not separated from my child again.

On readmission to the maternity hospital I began to finally be treated for the problem – postpartum preeclampsia. I could have died. My health would have only deteriorated out in the community, without the intervention of my GP. I believe he saved my life with that phone call. The registrar advised me that they would immediately focus on bringing down my blood pressure to reduce my risk of stroke. If my GP had not pursued my case, I may have had a stroke at home or out in the community.

Even when I was finally back at hospital, each successive medic who came to my room clearly hadn't read the notes of his/her predecessor and did not know my situation. One doctor told me I certainly had preeclampisa; the one I encountered on my final discharge said I did not - the latter having not read my up-to-date notes containing results of protein in my urine. When I asked for blood tests to be taken, I was left to wait for hours. I saw a junior doctor at 6am and did not see another doctor until I demanded to see one - and had a midwife trying hard to get a doctor to come on my behalf - at 11pm!

Finally a doctor came in and agreed to give me blood tests – in my opinion, it was just a farce. Numerous times, flustered members of the staffing teams - doctors and midwives - strongly advised me to complain and gave me feedback forms - acknowledging their system was broken, but exasperated and unable to explain why things were so bad.

In a final nod to what I believe was their style of lacking in care and common sense - my baby, who had not received the Hepatitis B vaccine at birth at this hospital because the hospital ran out of supply, again was refused treatment with the vaccine, even though she was physically with me, because she was a boarder of the hospital and they would not readmit her.

I left the hospital hoping I would never, ever have to go back.

I'm so upset with the whole experience and just hope it never happens to another new mum.

Box Hill Hospital must fix its numerous broken processes! It is, in my opinion, clearly a hospital under massive duress. The good people who are there (among what I believe are the clearly incompetent) are obviously detached and exhausted and patient care is suffering.

All departments appear to work in silos, not communicating with each other for the benefit of patients.

We found there was a real reluctance to accept responsibility – in our case, A&E staff blaming maternity and vice versa, for the mess up. I feel as thought this breakdown of communication and process could have cost me my life.

Something needs to be done about this to protect future patients. I'm at home, recovering, with my GP monitoring my blood pressure. To date, no one from Box Hill has contacted me to follow up on my wellbeing or aftercare.

Responses

Response from David Plunkett, Chief Executive, Eastern Health

picture of David Plunkett

Dear Healing-with-baby-cuddles

Thank you so much for taking the time to share your experiences with Box Hill Hospital. Your experience greatly disturbed me and I would sincerely like to apologise your experiences were not positive ones.

I thank you for already making contact with the Patient Relations Advisors in the Eastern Health Centre for Patient Experience. I know the leaders from our maternity service will be very keen to review your experience in depth to make sure we can make the necessary improvements.

With the assistance of your GP, I hope you are now able to enjoy time with your new baby and are returning to better health. My aim, is that through learning from your experience, we can do much better and improve the experience of all women.

Kind regards

David

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