Antenatal education, Babies, Birth, Breastfeeding, Caesarean section, Change management, Children, Compassion, Courage, Discharge from hospital, Helping others, Hospital, Human rights, Intra-operative care, Kindness, Labour and birth, Learning, MatExp, Midwife, Midwifery, Midwifery and birth, New parents, Newborn, Newborn attachment, NHS Systems and processes, Obstetrics, Patient care, Postnatal care, Respect, Skin to skin contact, Surgery, Teaching, Women's rights, Young mothers

The Gentle Caesarean – Gentle with what ?

Last year I was lucky enough to work in a general theatre for a week . I met a wonderful general surgeon and watched him perform bowel surgery . I noticed immediately how gentle and kind he was with the internal tissues and how calm and respectful he was not only towards the patient and his body , but also the staff in the operating theatre. All the staff admired this surgeon – you know when you can just tell ?  

I asked the surgeon afterwards about his technique and he said this

 “I always respect the tissue Jenny- tissues , blood vessels  , muscle and skin are part  of our human make up and being gentle with them means I am showing tissue respect and respect to the patient who is a fellow human . Being a gentle surgeon takes longer but believe me the outcomes are better and I know that there is less trauma , post-op bleeding , infection, pain and therefore happier patients and staff .”

Currently there is a lot in the news and emerging research around “The Gentle caesarean” and I am looking at this from a different angle  (and for those who know me well I don’t do acceptance well – I like to ask things so that others unable to ask might think differently ) so I am questioning what this term “Gentle Caesarean” actually means . Does Gentle Caesarean mean just the moment of birth or should it be right from the decision or choice of the woman to have an operative birth through to arriving home ? 

So for all those who work in the field of midwifery , obstetrics , intra-operative care, surgery , pain management -I would like you to watch a caesarean from start to finish and ask yourself “was that a gentle caesarean from that the moment that the woman arrived in theatre ? Was there gentleness with the woman’s feelings and choices ? Did the obstetrician, scrub midwife and others maintain gentleness towards the internal tissues and the to the baby? Was the transfer to the bed from the operating theatre table gentle ? Was privacy and dignity maintained at all times? 

Just because we have always done something a certain way does not mean that “the way” is always the best . 

I hope I spark someone to change practice and make “The gentle caesarean” standard across the NHS because then it will spread  globally – we must question on a  daily basis what we do and why we do it .
Thank you for reading , please leave feedback and / or share this blog with your colleagues 
With love and midwifery kindness , 

❤️Jenny❤️
Addendum today I am thrilled that The Times journalist Katie Gibbons has written an article about skin to skin contact at Caesarean  CLICK HERE to access or being the rebel that I am here’s a photo 😁

 

Antenatal education, Babies, Birth, Breastfeeding, Children, Courage, Helping others, Human rights, Kindness, Labour and birth, Midwifery and birth, New parents, Newborn, NHS Systems and processes, Patient care, Postnatal care, Skin to skin contact, Teaching, Women's rights, Young mothers, Young women

Memories of skin to skin contact 

Those were the days weren’t they? Or were they ? 

This week I met up with a friend (pseudonym Niamh) who is a mother of four. She recounted to me each tender moment that each of her children was born . The last three were born by Caesarean section . “Did you hold them straightway?” I  asked .

Niamh replied “to be perfectly honest no – I held none of my children that were born by Caesarean section immediately in fact not for severel  hours ” Niamh then recounted to me the birth of her son – when he was about 6 hours old she had still not seen him properly and asked a midwife how he was doing – the midwife told her that he was fine but due to breathing problems he was in an incubator . SIX HOURS !! I want to add that no one had told her until she asked . 

If you are a midwife , an anaesthetist , an operating department practitioner or a theatre nurse. If you work in an operating theatre , or  if you teach those who do -I want you to think carefully about why we must all strive to keep mothers and babies together in the theatre setting . 

I know it’s becoming more common for skin to skin to happen and I realise that if it’s not happening that to fight the system and challenge separation is difficult but we must keep moving forwards  . The reason is simple – skin to skin makes babies happy and it makes mothers happy and feel like mothers . It reduces postnatal depression and admissions  to neonatal units , I’ve even seen it stabilise a mother’s parameters. There is new evidence emerging to show that in effect if Nimah had held her son straightaway he may not have been admitted to neonatal unit with breathing difficulties . 

Skin to skin is human nature – we must tell women why it’s important not just ask 

      “would you like skin to skin contact ?” 

We need to say

 “If you hold your baby immediately against your skin and WE will provide help and support . As a mother you can instantly reduce the chance of your baby producing  the stress hormone cortisol and this contact can and does have a positive nurturing effect that is invisible as it happening.

As health care professional we must practice evidence based medicine and skin to skin is evidence based . We are responsible for teaching why it matters – not just throwing it into a checklist, box ticking exercise . 

The ‘Niamh’ I am talking about is in her late 70s – her children ages range  from 38 to 48 years of age . Niamh recalls each birth , each separation  but even more than that she remembers her feelings of despair at wanting to see touch and smell her babies but feeling like she couldn’t ask . 

That to me puts it all into perspective .
If you’d like more evidence here is some of the latest publications 
Pronurturance 

http://www.sciencedirect.com/science/article/pii/S1871519215003558

Skin to skin at caesarean 

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003519.pub3/pdf/

http://onlinelibrary.wiley.com/doi/10.1111/mcn.12128/full 

I recommend you follow the following people and organisations so that you can converse  with those who are champions for skin to skin contact 

@JeniStevensS2S @CarolynHastie @HeartMummy @FWmaternitykhft @KathrynAshton1 @Natasha47 @Csectioninfocus @hannahdahlen @bloodtobaby @AAGBI 

Please take a look at my “skin to skin FB page”  for more resources 

https://www.facebook.com/Mother-Infant-contact-skin-to-skin-in-the-operating-theatre-setting-445225315630071/ 

Thank you for reading  #Keepgoing ❤️
With Love , Jenny ❤️

Antenatal education, Babies, Birth, Breastfeeding, Kindness, Labour and birth, Learning, Midwifery and birth, New parents, Newborn, NHS, Postnatal care, Skin to skin contact, Teaching, Young mothers, Young women

A little book of labour and L❤️ve  

A while ago one of my dearest friends appeared at the front door of my home .When I say dear friend, she’s the kind of friend that you might not see for a few weeks or months yet when you do see her it’s just as if you saw each other yesterday- as if no time has passed since you last saw one another .You know what I mean – you both remain the same age as when you first met and restart  a conversation exactly where you left off . You know the kind of friend I’m talking about – one that will drop anything  anytime when he/she  hears those words “I need you”. That is exactly what she did for me and continues to do for me so many times I’ve lost count . She shows no judgment , never tells me what I “need to do” , doesn’t gossip and listens to me with true friendship and love in her heart for me , which is equally as strong as the love I have for her . 

Anyway back to the door – my friend was standing there and before she spoke I knew something was wrong , very wrong . I could tell in the wildness of her hair ,  the look in her eyes , the way she was standing and her sense of upset . I pulled her inside my home and hugged her . The news was that her 15 year old daughter “Verity” was pregnant .

We talked and I recalled a celebrity that once said ( I’m sorry but I’ve forgotten who it was) ….

” it might not be the right time or the right situation , but it will always be the right baby” 

I said those words to my friend , I listened , I didn’t tell her what to do I just gave her the love back that she’s always given me . 

The months went by and her daughter “Verity” (name changed for reasons of privacy)  was blooming , looking beautiful everything was going well . I sensed however that she was worried about labour and I decided to make her my “Little book for labour ”  I felt I had to do something to help her prepare in order to realise her own strength and to believe in her capability to give birth . I started the book I didn’t want to make it boring or prescriptive but fun and positive . I also realised the importance of going through the book , discussing induction of labour , vaginal examinations , acting on complications, early labour, food, and breastfeeding but most of all key support people and after the birth . 

So to sum up the book was a success with Verity . We held  a  “mini” Jen & Verity one to one antenatal group in my lounge which taught me things about not just what younger women want to know (perhaps women of all ages?) . I really don’t know if I could’ve written it in the same manner if I hadn’t made it especially for Verity . She calls me “Auntie Jen” so I wrote it not just as a midwife , but as her dear mum’s friend and as an “auntie”. 

Veritys baby is now over two years old and her birth was beautiful. I wasn’t there but my friend was ,they took the book in and read it . There were no complications and the birth was physiological . 

Last night I asked Verity if I could borrow the book back to look at it – I’d not seen it for over two years. Verity had kept it safe and sound – I was thrilled that she still had it . 

So here are a selection of pages from the book  – I am very proud of it but more proud of Verity and her beautiful daughter . It’s going straight back to Verity after I’ve published my blog.  (not her real name) 
Thank you for reading 
❤️Jenny ❤️