Birth Voices East Blog
Updates on what we're doing and how your feedback is making a difference
It was great to see some new faces (adult and baby!) at the meeting today – thanks to all for coming! Thank you very much also to Jodie, who resigned as chair today to focus on her bump! Her hard work over the past year is really appreciated and she has really made a difference to the amount of people we have reached, including those with non-English speaking and difficult to reach groups.
I'll split this update into two - this one on the hospital/midwifery side, and the next one on health visiting and mental health. There are lots of new developments from JPUH:
1. There is now a perinatal mental health clinic happening fortnightly, that midwives can refer women to antenatally or postnatally. There is a consultant psychiatrist and obstetrician present, and this means women at this crucial time do not have to wait weeks to be seen. The focus is on women concerned about antenatal/postnatal depression and related issues, and a personal care pathway is made for each woman. They say there is much work still to do, but they are very proud they are making steps in the right direction. We really welcome this, and of course, would love to hear from any women that have used the new service what their experiences were
2. Partners staying: after working with us user reps on this since the start of the year, JPUH is planning to launch a trial scheme from October:
4. Ward tours are now available every Tuesday at 1pm and include Central Delivery Suite, Dolphin Suite, and Ward 11 – which is great as we asked for this at the last meeting :)
5. Children at scans – Norfolk and Norwich hospital has announced under-12s are not allowed at scans anymore. JPUH is not going down this route, despite some staff concerns. Instead, the wording on the scan letters will be changed to limit the number of children, and make clear that an additional adult should be present to take any disruptive children out if necessary, as sonographers need to be able to concentrate (especially during the anomaly scan), and of course there is also the possibility of bad news, which mums may not wish children to be present for.
6. Breastfeeding – the hospital was very proud to get accredited for ‘Unicef Babyfriendly Initiative Stage 3’ a couple of year ago but must now apply for re-evaluation to keep that status. The Head of Midwifery feels that this is very expensive at around £9,000 plus a large amount of time by specialist midwives on paperwork for the auditing process. She is concerned this is not the best use of funds and wonders if women would rather that money and time was spent increasing the amount of face-to-face time the specialist infant-feeding midwives can spend with new mums – and hopefully setting up a drop-in breastfeeding clinic (unlike peer-supporters, midwives can refer for tongue-tie etc). She says that the Unicef BFI standards would still be carried on, just without the certificate. What do you think?
Here are the key results of the survey we ran back in March-April this year - we showed the raw data at the June meeting, but its taken a while to write them up here. We have been discussing this issue with JPUH staff over the last six months and there are strong feelings on both sides, both from mums and partners and staff. Clearly, there is no simple answer, and no course of action would please everyone!
The overwhelming response from women is that they feel the need for more support on Ward 11, both practical but especially emotional support. This is especially on the first night postnatal; after a C-section; a first-time mum, or during painful phases of induction. A massive 83% of surveyed women said they wished partners could stay.
However, safeguarding is clearly an issue for the majority of women, as 60% said partners with certain convictions (eg sex offences) should not be allowed to stay - this would be a large admin responsibility for the ward staff and could be difficult to implement (Eg forcibly remove someone if necessary).
Also, nearly half of women had additional concerns about the impact of partners staying, particularly overcrowding, additional noise (30% of women), privacy and dignity (30%), safety and security (25%) and women not feeling at ease or having lower emotional well-being (13%). The 14% of total respondents who said they were against partners staying or had mixed feelings, also deserve to be listened to as it is not a straightforward vote.
From the staff point of view, there are serious concerns about the impact on their safety, wellbeing, and workload. We were shocked to hear how often staff are verbally - and even physically - abused on the ward - one said they were literally told to 'F--k off' on a daily basis - which cannot be pleasant, especially when its someone aggressive or of a large size. Some told us that the time taken dealing with awkward birth partners had a significant impact on their care for other women - and security/police have been called numerous times.
In our survey, we asked how women and partners felt about signing a code of conduct for partners, which is standard at other hospitals. However, only around half of men and women surveyed were happy with the restrictions (eg partner not getting in/on the bed - standard in other wards, for infection control). This would clearly pose a problem for staff, who would have to spend time and energy sorting out these issues.
So as you can see, there is no simple answer! And no course of action would please everyone!
Our conclusion is: clearly, many women staying overnight on ward 11 in recent years have not felt adequately supported emotionally and/or practically. We therefore have five recommendations for potential courses of action JPUH could take to improve maternity care on ward 11:
Phew - long post! If you want to get involved, come along to our quarterly meeting with JPUH staff on Wednesday 11th September at Seagulls Childrens Centre, to hear the latest on a proposed compromise and discuss our next focus topic: improving maternal mental health and detection/care of Postnatal Depression. We hope you appreciate the work we have put in to this research and analysis. It has taken a long time and we desperately need more volunteers to give local women and partners a voice in maternity care. Please get in touch if you can help!
All the best,
Gemma and Jodie
I'm Jodie, the Chair of Birth Voices East 'Maternity Services Liaison Committee'. I joined the group as a result of my own personal experiences following my second pregnancy.
When I had my first baby I was fortunate to have a very straightforward pregnancy and delivery, sadly, second time round this wasn't to be the case. Whilst pregnant with my second child, I experienced some unexpected complications that led to a difficult and traumatic delivery. Nothing like I'd hoped for.
These types of experiences do happen, they're not talked about enough and often things can be learned from them.
I soon realised, after a debrief with a senior Midwife, that I could use my experiences to help ensure that other families didn't go through what we had. I was introduced to the MSLC and this was the best thing for me, I could be proactive and support the people that design the services to better understand what local families actually want.
Together with a dedicated group of volunteer mums, the Vice Chair and myself meet regularly with Senior Midwifery staff, Health Visiting Leaders, local Council Public Health, Healthwatch and the CCG (people that fund the services we receive), to pass on feedback and offer our suggestions on their propositions.
Us mums have a unique ability to connect with other new mums and their families to understand what is really important to them. Using the feedback we get, we look for common themes and then support the professionals to understand what women and their families want. Themes we are working on at the moment include: postnatal care on Ward 11; partners staying overnight, and maternal mental health.
So... where is the opportunity I hear you say??
I'm very happy to share I'm now expecting my third baby and therefore we are looking for a new Chair! The position is hugely rewarding as I really feel I can make a difference to other mums. I manage this around two children and working 25hrs+ a week - it is flexible, and myself and the other mums make it work around us.
If you would like to get involved, it doesn't have to be as a result of a difficult experience, (that just happens to be what prompted my involvement), and you would get lots of support.
We have an excellent relationship with the professionals who come along to our meetings, they understand that we are busy mums and are always grateful of our time and input. Please have a look at our below advert.
Watch our page as I will be adding an informal style recruitment event where anyone interested in any type of involvement- from just a bit nosey and want to know what we're about, to interested in the Chair role, can come along and meet some of us mums that are involved in the MSLC.
Here is the full advert-
Vacancy for a Volunteer Chairperson
Maternity Services Liaison Committee ("MSLC")
Are you interested in improving and developing maternity services for local women and their families?
Birth Voices East, the 'MSLC' for Great Yarmouth and Waveney, are looking for a new Chairperson and would love to hear from you. This is an excellent and unique opportunity to play an active role in ensuring local maternity services meet the needs of your community.
The MSLC: We meet quarterly in a child friendly location, for example local Children's Centres. We are a dedicated committee made up of local user representatives (mums who have used the services recently) and health professionals, advising and working with the senior maternity staff from the James Paget Hospital and the Great Yarmouth and Waveney Clinical Commissioning Group (CCG) on the care provided to women, their partners and their babies during pregnancy, birth and in the weeks after the baby’s arrival.
You would be part of a nationwide network of MSLCs (about to be rebranded as Maternity Voices Partnership) who share ideas, network and support.
Our role is to help improve services by making sure the views and experiences of people who use the James Paget's maternity services are listened to and taken account of.
You can read more on our website: www.birthvoiceseast.co.uk
The Chair: Should be independent from those commissioning or providing services; ideally someone from the local community who has used the services within the last two years or has close links with those using the services, i.e. a ‘user representative’. Responsibilities include developing the direction of the MSLC’s work in consultation with MSLC members.
He/she will need to attend and lead MSLC meetings (but will get lots of support to do this if needed), setting the agenda in accordance with the annual programme and, where appropriate, ensuring decisions of the committee are followed up.
This is a voluntary role with expenses paid. In addition, the budget last year allowed for a £500 honararium.
You would initially be working alongside the Vice Chair - however that role is also up for renewal shortly so this may be an opportunity for two people who know each other to apply together.
If you would like to apply or find out more about this position, or any other involvement in the committee, please contact firstname.lastname@example.org, including your name and contact number. Please also include a brief description of what interested you about the role. This will be forwarded to Jayne Utting, the Head of Midwifery at James Paget who will be involved in the recruitment of a new chairperson. Gemma (vice chair) and myself are happy to answer any questions you might have about the two leadership roles - and would love more people to get involved as user reps too!
Applications should be received no later than 5pm on 14/08/17
Thank you - we look forward to hearing from you!
sorry we've been really quiet in the last couple of months, we were exhausted from a manic Jan-March, with over 800 surveys, facebook comments and emails to sort through! On the upside, that means local women and partners want to have a say maternity care when they have the opportunity, and that health professionals are keen to hear what women have to say :)
The task of doing such a big update has been so daunting that we keep putting it off. The minutes the CCG provided us with were very brief which is a shame as we covered so much ground - normally we document everything! So, as briefly as I can:
1) Cuts to breastfeeding support - this was covered in Jodie's last post so I won't repeat it - apart from emphasising how we were the only organisation that actually got all the people involved and affected by the decision in one room talking about the issues - unfortunately after the decision had been made. Still, at least our County Council health commissioners now understand why things like tongue tie diagnosis is so crucial to new mums, and know they can contac tus if they wish to consult local women about any other aspects of maternity/postnatal care!
2) Funding and recruitment - We now have funding! Finally...that means we can now get money back for all the posters, leaflets, meeting rooms bookings, website costs etc that we (Gemma and Jodie) have incurred over the past 18 months. And get a small 'honararium' to cover some of the immense time it takes. Also, we can now cover transport and childcare costs for any local mums/dads that would like to come to our meetings (Ofted registered, 3 hours max). We are looking for a new chair/vice chair due to maternity cover, as well as more people to help out and share ideas/tasks so please get in contact if you're interested! We fit it into spare hour here and there around work/family. An interest in maternity care, access to a computer and ideally willingness to read through answers and statistics from surveys would be all that is needed :)
3) General feedback survey: We had over 80 new surveys back covering antenatal, labour/delivery, postnatal (Ward) and community postnatal. Overall, satisfaction rates are very good for antenatal care, labour/delivery and community postnatal, but Ward 11 postnatal is still giving much lower ratings. This ties in with the next topic...
4) Partners staying overnight on Ward 11: We had nearly 450 unique surveys back so thank you so much to everyone that took part! I will do a separate post shortly with the results but the main message is:
Phew, think that's all the main things! I will do a focus post on the results of partner staying survey, and possible compromise options next week
All the best!
You may have seen the recent Facebook posts from dedicated community Peer Supporters who discovered, with little notice, that funding for this service was being withdrawn from East Coast Community Healthcare (ECCH) by Suffolk County Council (SCC).
Cuts would include not only the paid Breastfeeding Practitioners who until recently visited the homes of women that were struggling, provided one to one support as well as being qualified to diagnose and refer for Tongue Ties, (missed diagnosis in the newborn checks being an issue we hear about often), but the equally hard working unpaid volunteers who run community based Baby Cafe's for pregnant women, new mum's and their families to attend were also being cut. The cafe's provide a haven where mum's can comfortably feed their babies without fear of any negativity towards breastfeeding; building up confidence to feed publicly, they meet UNICEF accredited Peer Supporters who can help mum's to correctly latch their baby and give heaps of useful information like expressing and safely storing milk. Not just that, they know how it really feels to have been up all night the previous night, they're mum's too, giving up their time and a listening ear.
The Facebook posts were very emotive and we could see how angry local parents were at this service being withdrawn, not to mention the disappointment from the volunteers who were not involved in any way in the discussions around the service being withdrawn.
We felt that due to our unique position of regularly interacting with the stakeholders who are key in Maternity Services decision making, we could provide a platform for Peer Supporters and local women by bringing all of the right people together in one room.
Here are some of the outcomes-
The fact that Baby Café’s will continue to run and that the JPUH are benefitting from additional Peer Supporters (and still recruiting more to support at the hospital) is great news for local women.
It's not the same level of service that there previously was though, where Breastfeeding Practitioners would do home visits and were able to refer for tongue ties etc. We will monitor feedback from women and if it becomes clear that this reduction in service is affecting local parents, we will feed this back to the relevant decision makers and push for change.
Get in touch if you want to support with the work Birth Voices East does.
Local women have recently contacted us to voice concerns after news that from 31st March, there will no longer be a breastfeeding support contract in place for community-based breastfeeding services across Suffolk. Last year the same happened in the Great Yarmouth area, and women are told to talk to health visitors instead.
So what will change?
• No local breastfeeding hotline to support new mums having difficulties
• No home visits from trained breastfeeding practitioners who could refer to tongue tie clinics
• No funding for baby cafes, where trained volunteers are on hand to help with any problems or provide moral support about feeding in public
Once women leave hospital they don't stop needing support to breastfeed. Although initiation rates are high (82% in October at JPUH), by 6-8 weeks postnatal this drops to only 46% (full or combi-feeding) across Suffolk (Jan-July 2016, Public Health England data).
We are interested in hearing from local mums and pregnant women about what impact they feel this may have. We can then use this to make a case to Maternity Staff and Commissioners to explore what other funding sources might be available.
HAVE YOUR SAY
Recently Healthwatch Suffolk recommended that James Paget Hospital should allow all partners to stay after the birth if they wish. It is a topic many people feel very strongly about, both for and against. On the upside, partners could provide additional support, both practically and emotionally. But there would be potential trade-offs for privacy and dignity, not to mention safeguarding of vulnerable people.
The maternity department has asked us to help find out exactly how women and birth partners feel about this - how strong objections might be, and how it could work in practice given the limited space and budget - for example, sleeping on chairs with no food/drink provided - and of course, just curtains separating you from the next family, even during examinations.
We have made TWO surveys - one for mums and one for birth partners (male or female) - to make sure everyone's opinions are listened to (anonymously of course). But we need hundreds of people to repond to make it work, so please fill it in and then help us to share it!
We will also be holding a DROP IN DISCUSSION AND PLAY SESSION on 18TH JANUARY AT KIRKLEY CHILDRENS CENTRE at 10-12. There will be toys for the little ones and an opportunity for anyone wishing to talk about this subject or any other aspect of local maternity care (induction, postnatal depression etc) to come along, have a cup of tea/cake and a chat.
We also have the formal committee meeting booked for the 22nd of February at Hopton Village Hall, this is where we mums (no dads yet unfortunately - would be useful) meet with senior maternity staff as well as other professionals from the CCG, Public Health, and Healthwatch amongst others to talk through the feedback responses and what can be done to address them. Please let us know if you are interested in attending - the formal meeting is not normally for discussing individual experiences but more if you are interested in hearing about and suggesting ways to improve different aspects fo amternity care, or helping us gather feedback, promote and organise!
Through feedback received from women regarding Antenatal care and preparation for labour and delivery, we have heard that women and their birth partners would feel more confident if they knew where they were going when they got to the hospital. Often this is the first time in a woman's life that she will need to visit a hospital, it is also a time when women may be feeling nervous, in pain and scared.
We raised that women would like to be able to see the Maternity Suite before labour and delivery in the April and July Birth Voices committee meetings.
It was explained that visits to the unit were difficult to accomodate due to infection control concerns and not knowing when there would be rooms available to show women and their partner's around.
We were also awaiting an update to the JPUH website before pictures or a video could be uploaded.
At a more recent meeting with JPUH we suggested a simple YouTube video that we could we link to on our page.
Since then, JPUH Head of Midwifery, Jayne, has set up a Facebook page 'JPUH Bumps, Babies and Mum's' and at our November Birth Voices meeting Pip, the Women's Experience Lead, came up with the idea of a #mannequinchallenge video for the Facebook site.
The video shows the new Central Delivery Suite, in the video you'll see a typical delivery room and some of the staff and equipment that you would expect to see in this part of the Maternity Suite.
We are looking forward to seeing future videos of the other areas within maternity at JPUH to help women and their birth partner to prepare for what they may find when they go to hospital.
Use the link or see the video on our Facebook page.
Opinion poll: when is the best time (before or after giving birth) for health professionals to ask about your future family planning/contraception plans?
We have been asked by JPUH to ask local bumps and mums when they would prefer to discuss any requirements for contraception after their baby's birth. Did you know that you can get pregnant again just 3 weeks/21 days after giving birth? (if you feel like it sooner than we did anyway!) And that's even if you're breastfeeding. Its also worth knowing that for those considering sterilisation, this can be done as part of a Caesarean section, saving a separate operation.
What do you think?
Here is a poster that we have made for the staff room in Central Delivery Suite at JPUH, showcasing some of the wonderful praise that has come from new mums, via our online survey.
We have had 82 survey responses since we launched this website in April, which we are very happy about! All the feedback has been passed on to senior maternity staff at JPUH, as well as the 'Clinical Commissioning Group'. In our report we have analysed the data and responses and picked up key areas - both positive and negative - to discuss with hospital staff for action. If anyone is interested in finding out more about the results please get in contact. We will be making more detailed surveys on some of the key topics over the coming months to help find out what can be done to tackle re-occurring negative comments, particularly in early post-natal care. One of the aims of this poster is to re-enforce what women do need and appreciate, to make sure this is achieved wherever possible.
We would like to highlight that of the 2016 births so far, around 80% have rated the labour/delivery phase as 'excellent' or 'very good'. And the community care is also getting a lot of mainly positive feedback :)