Wednesday, November 28, 2007

Lewisham hospital maternity services

As those of you who know me well know, I didn't think an awful lot of the postnatal care I got at Lewisham hospital. I have no major issues with my antenatal care, or with care during labour/delivery, but I felt that the postnatal care really was bad. I'm not the only one to have experienced this, quite a few of the local mums I have chatted to feel the same.

However, being a data analyst-type person in my day job, I know that the plural of anecdote is not evidence, so it was very interesting to see some hard evidence that points to my experience being rather more typical. Today the Healthcare Commission published the first results from the survey of maternity services carried out earlier this year. Overall results for England were positive but they noted significant variations within this by NHS Trust.

I had a look at Lewisham's results, obviously having an interest in this and having taken part in the survey myself. I haven't, I admit, done a comprehensive examination of the results for Lewisham - I rather hope that someone from within the trust will be doing that. I did look at the section on postnatal care in the hospital though, as that's where I'm really interested.

Someone in Lewisham NHS Trust needs to sit up and take notice of these results. Looking at mums' overall experience of care after birth, 23 per cent of respondents for Lewisham rated the care as poor, compared to 8 per cent nationally and a percentage as low as 2 per cent in the best performing trusts. Only Barts and the London did worse in the whole of England. Looking at this in a bit more detail: only 30 per cent of respondents in Lewisham said they were always treated with respect and dignity after the birth of their baby and 25 per cent said they were not treated with respect and dignity. This compares with 66 and 7 per cent respectively for the whole of England. Again only Barts and the London fare worse. Fourteen per cent of respondents said they were not spoken to in a way they could understand, compared with 3 per cent for England as a whole. This is the worst figure in the country. And, interestingly, 29 per cent of respondents felt they were kept in the hospital too long. I'm not surprised!

Obviously the information I've pulled out above is not comprehensive and there's a lot more to be read. I hope that Lewisham fares better on other aspects of maternity care, because it seems, in respect of postnatal care in the hospital, they've got a long way to go.

Tuesday, November 27, 2007

My breastfeeding story

I wrote this for a print publication but for whatever reason it wasn't used, but I thought as I'd gone through the emotional mill a bit in writing it, it would be a shame for it never to see the light of day or to go on record. It's still a bit upsetting for me to think about, but perhaps putting it here will help me draw a line under things and move on. Something I think I now need to do for my mental state and for the future too.

Anyway, here goes. It is unedited so the writing isn't as good as it could be:

Before I had my baby, I had always assumed I would breastfeed him. I didn’t really give it much more thought, so when James was born 6 weeks early by Caesarean section, weighing 5lb 1oz, and taken away from me to the Special Care Baby Unit it was a real shock that I wasn’t able to breastfeed him. At first, he was fed through a tube in SCBU, but they switched to bottle-feeding without discussing it with me first. I didn’t really question this, as I just assumed that the hospital knows best.

In SCBU James’s weight was monitored constantly, and when I started to try breastfeeding, rather than just expressing milk for him, on about day 5 or 6, he lost weight on that day. This meant that we couldn’t take him home and the nurses insisted on feeding him from the bottle themselves to make sure he took in enough food. This was incredibly upsetting and in the end I gave up attempting to breastfeed in the hospital. I decided to carry on expressing and wait to try when I got home.

I had no one to turn to for advice on how to start breastfeeding from this point and was panic stricken that if James hadn’t gained enough weight by the time the midwife came to visit at home he would be taken back into hospital. Every time I tried to feed, he wouldn’t latch on, so I would switch to giving him a bottle for the rest of the feed. My milk never really came in and after 6 weeks of trying, expressing milk and feeling totally shattered I gave up on breastfeeding completely.

I felt that I had failed James and it still upsets me to think about how little support I was given in the hospital to establish breast (rather than bottle) feeding before bringing him home. I am convinced it is because he was healthy in all other respects and they needed the space in SCBU for another less fortunate baby.

Mums in this country are made to feel pretty guilty if they don’t breastfeed, but almost no support is given to make sure this happens. This contrasts with other nations where full support is given and breastfeeding rates are higher. Until we stop simply paying lip service to the breastfeeding message and actually start supporting it, the UK will remain at the bottom of the breastfeeding league tables, and sadly there will be a lot of mums out there with stories like mine.

Thursday, November 22, 2007

Oyster cards

Something else I've wanted to blog about. Now I am back at work full time but only in the office three days a week, my once cherished gold card is but a distant memory. I now have a prepay Oyster card which is absolutely fab for the bus and tube and of course does price capping, discounts and is generally the bees knees.

But, and you know this is coming, I am going to have a moan. The lack of Oyster functionality on SE Trains is causing me a big headache. I don't think (though I'm not brilliant at unravelling fares policies so I might be wrong) it's actually costing me money but it is a pain in the neck - I usually go to work on the bus as I go in early enough for the traffic not to be a nightmare. But, at hometime it's busy so the tube then train and walk is the order of the day. And this is where it gets problematic. Every day I have to buy a single ticket for the train part of my journey - and all because the TOCs couldn't (or wouldn't) get their acts together and join in with Oyster prepay.

By the time they have got their acts together, I will be redundant and in all likelihood commuter journeys in to London will be a distant memory in themselves. Ho hum.

Tuesday, November 20, 2007

What is charity?

I am pondering this one at the moment. I have a selection of things that we no longer have use for - some old curtains, a scanner that only works with Windows 98 or earlier, some old style printer cables, an old modem and a metal framed rucksack that may have seen service on the ark. I had a look round on ebay to see what they were worth, this being my favourite way to dispose of unwanted goods and make a few bob at the same time. However, none of these items seem to have any value on ebay at all. So, I decided to have a go at freecycling them. Freecycle is a fantastic way to get rid of unwanted things that probably won't make any money but might be of use to someone.

Anyway, to cut a long story short, no-one on freecycle wanted these things, so desirable are they. So, I decided in one final last ditch attempt to be rid of them that I would advertise them as free for collection on my work bulletin board. I made the quip that unless anyone wanted them, they would be heading to landfill (actually they would probably mostly be burned at SELCHP wouldn't they but this is mere detail). To my surprise I received an email from a colleague based at one of our offices outside London suggesting that I was being somewhat reckless in sending these goods to landfill and what I should really do with them is give them to charity.

Now, is that actually the case? I replied that I thought charity shops probably only wanted items that they could sell rather than tat that clearly no one wants even if it's free. Imagine my shock to receive another response from said colleague suggesting that I should just put the stuff in a black bag, dump it outside the nearest charity shop and they could decide what to do with it.

I'm really not sure that's the best thing to do with this stuff. Surely a charity shop would have to pay to dispose of my unwanted junk if they decided it was unsaleable (which it surely is, as the above sequence of events shows), whereas I can either stick it in the wheely bin or take it down to SELCHP myself and dispose of it for nowt. What good am I doing to the charity therefore by passing on this stuff?

I have deleted my colleague's email and am pondering my next course of action, but I think it will be to reuse the curtains as weed control fabric in our garden and bin the rest. Anyone got any better ideas? Am I being daft and charity shops would be crying out to receive this rubbish?

Sunday, November 11, 2007

A whinge

It's about time we had one.

So where shall we start? Lewisham's health visiting service....

I have had multiple whinges about them in the past (mostly in my head rather than on here) but I feel I must post about the 8 month check. Or in fact what should really be known as the non-existent 8 month check. I got a phone call from the surgery when James was 7 months old (so that's 5.5 months adjusted for those that remember he was prem) asking me to bring him in for his 8 month check. I refused on the grounds that he was only 5.5 months old so wouldn't be doing anything that they were supposed to be checking.

Fast forward to now - James is 9 months old. Last time I was at the baby clinic (after waiting 1.5 hours just to have him weighed) I spoke to the HV on duty, asking when I should bring James in for his 8 month check. "Oh we aren't doing them," says the HV. "We don't have the resources." Oh great. So she proceeds to ask a few questions but basically that's it. I asked for my Bookstart pack and she said they didn't have any but she would bring one round. This was a week and a half ago. To be honest, if I'd known they weren't going to be doing the checks any more I'd have gone at 5.5months. I only wanted the flippin Bookstart pack anyway! I am going to have to call into the clinic at some point and have a serious moan. Or get Mike to.

Anyhow, there is a serious part to this moan. For two reasons - 1. 8 month checks aren't for parents that have kept in touch with health services etc are they? They are for catching up with everyone and making sure their babies are ok. 2. Bookstart is not about giving books to relatively well off mummies. It is about making sure every baby has at least a couple of books. The Lewisham HV service is not helping Bookstart meet this aim in Lewisham.

One positive thing to end the post - I did think the postnatal group they ran was great. It wouldn't surprise me if they don't do them any more either.

And another thing - we haven't heard anything about James's referral for a follow-up hearing test, which he should have had at 8 months (or should have within the next 2 weeks if they are doing it on an adjusted basis).