Nikki asks for input from places where mothers and babies bed-share on postpartum wards.  This is the standard practice throughout Norway, though we have not removed the clear plastic boxes on wheels from the old days when babies were kept segregated from their mothers and 'looked after' by staff.  The cots are in the mothers' rooms and there seems to be a running battle with the babies to try to get them to sleep in them, but they generally end up in bed with the mother most of the time anyway.  

My unit would give a US 'risk management' person apoplexy since we don't have any kind of safety arrangements beyond telling the mother to keep the siderails up - and the space between them is more than wide enough for a baby to fall through.  We have some hotel-like rooms on the part of the ward for completely uncomplicated mothers and babies, and the beds there are normal beds, wider and closer to the floor than a standard hospital bed, and they have no side rails.  Mothers report sleeping well in them because they are wide enough for two, whereas in the hospital beds they don't really let go and sleep soundly because they have to keep track of the baby or lie contorted so as not so squish her/him.
I can't say for sure but I think practice in Sweden is very like ours, and in at least one unit in Sweden the cots have been removed completely, to underscore the expectation that mother and baby will be sleeping on the same surface.

I have seen a Danish colleague tuck a mother and baby in together by anchoring a draw sheet under the mattress, stretching it over the siderail, and back in under the mattress.  At least I think that was what she did!  It made a screen that prevented the baby from falling out of the bed.

If we were to change all of our beds to a proper width for bedsharing we would have to widen all the doorways, if it were even possible to find beds on wheels in that width.  Since that isn't going to happen, we use what we have.  The chances of us buying sidecars to put on all the beds are about nil too.  Nobody has money for anything in postpartum care, since we spend it all on things aimed at fetal safety.  I see the lengths we go to in an attempt to provide safety up to the moment of birth, but after that, it's like we can't imagine they still need a modicum of protection.

Rachel Myr
Kristiansand, Norway

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