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#BirthLeadership ©️ is Born

Today is an exciting day for me . I have just registered a new hashtag that I hope will influence every woman and midwife . The hashtag is

#BirthLeadership ©️

As a midwife one of my aims is to display leadership towards women in order to support them through their labour and birth . I hope that this cascades onto future midwives so that they too can show leadership. This process may involve eye contact , holding hands , a hand on a shoulder , researching,debating decisions, reading information, challenging the system BUT together as a team to help make women feel like they are the leaders of their own births . Whatever the mode of birth it’s right that midwives let go and give the lead control to the woman . This can be through education and sharing views but first and foremost it must be about midwives listening to women’s hearts, voices, dreams and plans.

Midwives begin by championing women’s choices so that birth is given back to women .

Sheena Byrom OBE and Professor Soo Downe of UCLAN co-wrote an research article called “She sort of shines” Click here for PDF

in Box 1 as above the midwives interviewed were asked about the connection between leadership identifying commonalities between both .

The huge psychological impact of having no voice in a birth is well documented and can have long term physiological effects on a woman’s mental health . Studies on post birth PTSD (Post traumatic stress disorder) often highlight the lost voice of the woman and her fear of speaking out .

Birth leadership is created so that every midwife questions her own practice in order to ask herself “am I displaying birth leadership skills?” – in other words “what am I giving to this woman and her birth to relinquish my control and give her the lead in her own birth”

Let’s take for example coached pushing in the second stage of labour something which is neither evidence based practice or conducive to effective care – yet still it goes on. Click here for NICE guidance in 2nd stage of labour April 19

Some midwives FOLLOW this tradition and their fear of changing practice influences others negatively, preventing birth leadership in some NHS maternity units.

We must become champion challengers and this doesn’t mean loudly-it can be quite subtle and indeed this quiet way is less likely to disrupt a woman’s oxytocin flow – promoting both a sense of security and safety .

Let’s talk optimal cord clamping – and how Amanda Burleigh knew in her midwifery bones that immediate cord clamping wasn’t quite right – it didn’t sit well in her midwifery skin- @OptimalCordClamping showed Birth Leadership and started to challenge research and change practice which led to optimal cord clamping (OCC) being included on NICE guidance – Quality statement on OCC Amanda’s Birth Leadership is ongoing and she has inspired others to talk about OCC by inspiring them for example Hannah Tizard who is @BloodToBaby on Twitter . This is true practice change for women and babies . Here’s Amanda’s twitter feed .

The way you act in and out of work shows the person you really are . Your aim should always be to help others as much as you’d help yourself – keep that formula equal every minute in your midwifery career and you won’t go wrong .

Women need to know we care ❤️

Try and wear a new pair of glasses when you go into work – sit in a different chair for your lunch , ask colleagues “what are my good and bad habits?”, question your usual behaviour and remember why you became a midwife – to give the lead to women.

Birth leadership is about small steps or huge steps beginning with the next woman you are with as she gives birth .

If you have shown birth leadership of any kind use #BirthLeadership and tweet about it

Here are a few Birth Leadership examples

SkinToSkin in the operating theatre

Not weighing a baby until after it’s first feed

Leading a woman to change position in the second stage to avoid lithotomy

Helping a woman to birth and hold her stillborn baby and making the family a safe space ❤️

Helping a woman who has been constantly monitored on CTG to the bathroom for a walk and a wash

Being silent as a woman is in the second stage of labour

Supporting a woman compassionately through a difficult birth

Helping a woman to avoid unnecessary internal examinations

Being a baby’s advocate when the woman is having a GA Caesarean

Holding a woman’s hand in an emergency situation

Caring for a woman’s relatives as well as the woman herself

Here is an uplifting reply from @FWmaternity co-founder of MatExp and inspiring obstetrician who is supportive of Midwives and promotes her Trusts home birth team ❤️

NB please don’t think this about starting a campaign yourself although that would be great it’s about sharing the little things that signify BirthLeadership to inspire change – so please add yours on Twitter ❤️

Thank you for reading

Yours in Birth leadership love

Jenny ❤️

PS

Please add your comments to my blog – I welcome all feedback

❤️Facilitate what is happening rather than what you think ought to be happening. If you must take the lead, lead so that the mother is helped, yet still free and in charge. When the baby is born, the mother will rightly say, “We did it ourselves!”

Tao Te Ching – ancient Chinese quote about what being a midwife means ❤️

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The birth of my son

25 years ago today I gave birth by Caesarean to my second child . A boisterous boy to compliment my daughter who had been waiting to become a big sister for over 5 years .

I was so excited about going into labour as I was now a midwife – I “knew” what to do – I felt positive and excited .

A few weeks before my due date I suspected my baby was breech and told the consultant “Oh Jenny why are you doing self palpation ? “It’s obviously cephalic” he said (I didn’t know I was going to have a boy ) – “stop worrying!!”

Off I went on my merry way .

Fast forward to my term appointment with my midwife (I had started to have a few niggles but I was determined not to rush into hospital and previous complications meant a home-birth wasn’t an option) . My midwife confirmed my concerns – the baby is breech and there’s nothing in the pelvis at all . I was sent to the hospital – I felt annoyed with myself .

About 5 hours later I was in theatre having a spinal in preparation for a Caesarean. In those days the false evidence of the vaginal breech trial was forced upon many women – I was frightened into having a Caesarean – I truly felt robbed .

I took it all on the chin and decided that it as a midwife would be an asset to have experience of normal birth and Caesarean. This personal experience of mine would help women to know that I’d understand and support them through any birth .

At my Caesarean my son was born – I saw him for less than a few seconds and he was whisked out of theatre into an ante room . There he was wiped down, rubbed, touched and handled by midwives. Then my son was measured,weighed, given vitamin k dressed and wrapped up . I didn’t hold him for 4 hours and I wish I’d been able to.

Not having skin to skin contact in the Operating theatre hasn’t affected the relationship I have with my son . I did however long to hold him whilst I was in theatre and kept asking where he was and when I could see him.

Not having skin to skin contact has made me determined to educate women and those who attend birth in the operating theatre as to why skin to skin it’s so utterly important- it’s a physiological norm for human mammals .

Each time I’m with a woman in the operating theatre I don’t feel angry or upset about my experiences- I just feel very thankful and grateful that times are changing and that skin to skin is becoming normal in the theatre environment.

Skin to skin was never mentioned to me at all for my son’s birth – God forbid a woman would want to hold her baby whilst being operated on in the 1990s !!

Well thank goodness times have changed and that there are lots of brilliant midwives, theatre nurses , obstetricians, anaesthetists and operating department practitioners who know why skin to skin matters . In helping families they are changing the system. They realise that birth in the Operating theatre isn’t about “their theatre” functioning in the same way it always had done but about making the Operating theatre a “family space” .

Once I got to the ward a dear colleague of mine (who has since retired) came to see me and asked me if I’d had skin to skin contact. I hadn’t even fed my son yet!! – luckily my son was a sturdy 8 pounder . My lovely friend passed my son to me so that I could take his sleep suit off , explore his skin , check his fingers and toes , gaze into his face and start our journey as mother and son . He was soon breastfeeding and I felt relieved that my friend had supported me .

If you are wondering whether I’d be such a protagonist for skin to skin if my second birth had been different? I know I would be !! The infamous Dr Nils Bergman set off my interest in why skin to skin matters for all newborns and he instilled in me a duty to spread the word.

I am really proud to have helped many women to overcome their doubts and fears about skin to skin in the operating theatre and I hope I continue this journey with many more families.

This blog is dedicated to my son and daughter who have made me the mother who I am .

Happy birthday son ❤️.

Thank you all for reading.

With love

❤️Jenny ❤️

Babies, Being a mum, Birth, Breastfeeding, Caesarean section, Communication, Compassion, Hospital, Human kindness, Human rights, Kindness, Labour , birth, Labour and birth, MatExp, Midwife, Midwifery, Midwifery and birth, Motherhood, New parents, Newborn, Newborn attachment, NHS, Obstetrics, Skin to skin contact, Women's rights, zero separation

SkinToSkin poem © by Jenny Clarke

it really doesn’t matter where you are

Home , hospital , Operating theatre, birth-pool or sat on a star 🌟

The ultimate way for a baby’s life to begin

Is right next to her mother in SkinToSkin

Your baby doesn’t care what she weighs

Read and digest the ATAIN study – we adore what that says

SkinToSkin contact for babies 37 weeks or more

can reduce unplanned admissions to special care- that’s the score

It helps stop separation of you and your baby

That’s a fact – no ifs,buts or maybe

Prolonged SkinToSkin makes you more of a team

So that baby can understand you (and vice versa) – see what we mean ?

SkinToSkin is no fad, craze or latest trend

SkinToSkin makes mother’s better mothers that’s why @JennyTheM is here to bend

your ears soon in Breastfeeding Week.

I have read all the research by the SkinToSkin geeks

I am giving you the evidence and it’s right up your street

So make plans , prepare for SkinToSkin don’t leave it to chance

When your baby gets SkinToSkin she’ll move about – a newborn birth dance

SkinToSkin sets off behaviour ,keeps baby’s calm

Us humans are mammals -made to keep our young warm

So at birth just consider how your baby will feel

SkinToSkin will tell her –

YOU ARE the real deal ❤️

© @JennyTheM 27.3.19

My next blog will be about the need for correct positioning for mother and baby (or other mother and baby or father and baby ) in order for SkinToSkin to reach its full potential and benefits ❤️

12.5 hour shifts, Being a mum, Birth, Breastfeeding, Hospital, Labour , birth, Labour and birth, Midwife, Midwifery, Midwifery and birth, Motherhood, NHS, NHS Systems and processes, Night shifts in the NHS, Obstetrics, Student Midwives, Women's health, Women's rights

Jenny’s mutterings , midwives childcare and 12.5 hour shifts ….

This blog is for #70MidwifeBloggers and I was inspired to write it by my two grown up children . When I look at them and the way they treat other people I always think “you did good Jen”

I have worked in the NHS for almost 40 years , so I was IN IT for ten years before I became a parent .

When my daughter was 6 months old I returned to work as a Ward Sister on a medical ward in Oldham Hospital (now Penine Acute Trust) . Part of the reason for my return to work was to prove to myself that I could be a good mummy and a good nurse. I have always liked a challenge and do I regret my decision ? Yes and No is the answer .

When I first thought about child care for my daughter there was no “on site” hospital nursery. Both my parents had died when I was younger. To go back to work meant I was driving 25 miles each way to start at 7.30am – was I mad ?

I was blessed – I found Gaynor a former nurse who totally understood my predicament. I managed to get my daughter ready put her in the car drop her off at Gaynor’s house and pick her up after work . I chose Gaynor as she was close to the hospital and I instantly connected with her . When I was on a late shift which ended at 21.00 I’d get to Gaynor’s to find my daughter ready for bed and a breastfeed and then I’d feed her at Gaynor’s house , pop her into the car (yes I had a car seat ) and drive home . Lots of times I arrived to find washing done for me / a meal to eat / a cup of tea / a hug and a huge welcome . Gaynor was also a mum and her children loved my daughter as much as she loved them . One particular thing about Gaynor was that her mum and dad owned a nursing home ( we are talking traditional family run home full of love , activities and good food – this was 1989)

Gaynor regularly took my daughter to the nursing home with her and she made the residents day – I also went to the home and felt like I’d grown a new family – his lucky we were .

My son was born 5 years later and I was also lucky with his childcare – he went to Maureen who I met when I had to find childcare in a new area to start my midwifery in 1991 and she became Auntie Maureen to both my children .

My blog is really to raise awareness of working mothers and fathers in the NHS and my question is this —

“Do 12 hour shifts have a negative impact on families NHS workers family love and home dynamics of NHS workers ? In fact if someone works a 12 hour shift they probably get up at 6am and get home around 10pm or later – that’s 16 hours of being up and active / put another day into that = 32 hours then three long days together = 48 hours – do you see where I’m coming from ?

If a child does not see its own parent for three whole days does it have attachment implications ? Has anyone done any research on this ?

IMO the 12 hour shift is seen as a money saving initiative for the NHS – 6 shifts covered in three days – bargain !!

However a bargain ain’t a bargain unles you can prove it saves money.

I hear both many sides to the arguments about 12 hour shifts but I also hear of staff who work 12 hour shifts “pacing” themselves , resting more on shift and I wondered if those working 8 hour shifts ever thought of “pacing” themselves at work ?

More research and evidence is coming out about long shifts , that they can be a contributing factor in thyroid disease, cancer , heart disease , burn out and long term sick . Perhaps it’s time to analyse data on nursing and midwifery sick leave to see if the NHS sick leave has improved or worsened since 12 hour shifts became a “thing” .

I have juggled child care most of my children’s lives and thank fully it’s been ok – even the time I caught one so called childminder pushing my daughter across a busy road by placing my three year old daughter across a pram!! I was actually a driver on that road (working as a community Midwifery student ) , so I went straight to her house and removed my daughter then & there . I rang my community manager in tears and she gave me two days of compassionate leave to help me arrange new childcare, this is how I stumbled onto Maureen – she embraced both my children into her family and like me she loved art and baking , so my children saw her home as an extension of mine .

Anyway I’d just like the NHS to seriously consider why going back to short shifts might be the answer – it also costs more to pay a 12.5 hour Midwife as if she works both Saturday and Sunday her after tax salary can be from £600 upwards more than someone working short shifts – so think again NHS

The 4 days that the long shift staff do not cover need to be covered – whereas when we all worked 8 hour shifts some staff would volunteer to stay late – this is impossible and dangerous on a long day .

thank you for reading

Yours in love and light ,

Jenny ❤️

Against the odds, Babies, Being a mum, Being busy as a midwife, Birth, Breastfeeding, Caesarean section, Change management, Communication, Compassion, Giving information, Helping others, Hospital, Human kindness, Kindness, Labour , birth, Labour and birth, MatExp, Midwife, Midwifery, Midwifery and birth, Motherhood, New parents, Newborn, NHS Systems and processes, Obstetrics, Postnatal care, Respect, Skin to skin contact, Student Midwives, Women's health, Women's rights, Working from the heart, Young mothers, Young women

Postnatal transfer to the ward from labour ward – my thoughts

A DM (Direct Message) on Twitter is a message you receive from someone that no one else can see – apart from the people included in the message.

In the past four weeks I have received 7 DMs from a mixture of midwives , future midwives and women all with the same subject matter . This subject is mainly about ‘who decides when a woman is transferred from the room she gave birth in to the postnatal ward’ This seems to be a hot topic at the moment as the variation in time from birth to transfer is huge – especially when comparing Caesarean birth transfers to other birth transfers (and it might surprise you to know that the variation in birth to transfer time to the ward for women who have Caesarean birth is also vast – some units care for these women on the labour ward until their spinal has worn off , some units transfer to ward within a short time in recovery which leads me to question that support with breastfeeding must be patchy).

Just the other week at Salford University Midwifery Society Conference ‘Transforming Birth’ click HERE for a summary of the day – I asked a question to the audience “are you, as future midwives pressured to move women to the postnatal ward (after they have birthed their babies) faster than the women themselves would like or you as a future autonomous practitioner would like ?” The result was that over 80% said YES.

Do we as Midwives consider our own autonomy enough when we are working ? In order to give the woman a sense of feeling cared for and nurtured individualised, compassionate, holistic midwifery is paramount . Each woman is different- some may prefer a rapid transfer , others may not . Some women may need extra support to establish breastfeeding or be debriefed post birth or some women may want to rest in a quiet place with minimal noise before they are moved to the ward . If a birth takes place in a birth centre which doesn’t focus on time , women will stay in the same room post birth until their discharge home.

In the NHS patient care sadly revolves around the concept of time . If a patient is not seen , admitted or discharged within a four hour time frame (see photo below ) it is considered a “breach”

Certain procedures have a standard time frame in which so many can be done – this is how operating theatre lists are generated and how the NHS deals with waiting lists .

However birth is and must be a positive experience – even though it has coding costs and some births are planned to the day -we must give women more than they expect – stand up for them , be their advocates. Challenging the system is one of the ways we can make change happen – if we all accept each day “this is the way we do this” we cannot be developing our roles or our practice to improve woman centred care . I’m not saying it’s easy but I want you to imagine what care you would want for your sisters and your daughters ? Then give the women THIS care – I am in the NHS as I nursed my own mother until her death at home – I see the connection between care at birth and care at death . I have been a nurse to the dying and that experience has impacted on the care I give to women in a most human way .

Whatever care you give , whether you transfer a woman in your fastest time or not is all rather irrelevant when you focus on the bigger picture – YOU are responsible for the care you provide , or you don’t provide -if you tell a student to do something that is YOUR responsibility and I suggest referring to this NMC publication which I look at each day The NMC CODE . If advice or suggestions are not kind , caring and have a direct clash with your duty of care , if a more senior Midwife tells you to do something this should be documented in the notes and be evidence based, kind and resonate with your trust guidelines plus the NMC code.

Sometimes we are stretched short staffed , rushed and under pressure but at no point should this be the woman’s problem.

So the next time you are preparing a woman for transfer to a ward just think

  • Have I given her & her partner enough time alone with their newborn
  • Have I helped initiate feeding
  • Am I rushing her ?
  • Do I feel under pressure ?

Then if necessary give her some more time – and when you arrive on the ward give continuity of care to the woman and her newborn by transferring in SkinToSkin contact , admitting them both to the ward environment yourself , taking and recording observations , checking the woman’s pad and fundus ,getting the woman a drink and this will also help your colleagues on the ward immensely.

❤️Be a holistic professional caring Midwife ❤️

Thank you to the student of Salford University and those who DM’d me on Twitter – you inspired this blog

Thank you for reading

Yours in midwifery love

JennyTheM

❤️

Against the odds, Anaesthetics, Antenatal education, Babies, Being a mum, Birth, Breastfeeding, Caesarean section, Change management, Communication, Compassion, Courage, Giving information, Helping others, Hospital, Human kindness, Human rights, Intra-operative care, Kindness, Labour , birth, Labour and birth, Learning, MatExp, Midwife, Midwifery, Midwifery and birth, Motherhood, New parents, Newborn, Newborn attachment, NHS, NHS Systems and processes, Obstetrics, Patient care, Postnatal care, Respect, Skin to skin contact, Student Midwives, Teaching, Women's health, Women's rights, Young women

Birth imprinting – SkinToSkin contact

As a child is born to a mother there are emotional , hormonal, physical and psychological needs that are satisfied when SkinToSkin contact occurs and these will give both short and long term health benefits to mother and child .

A mother should be the first person to touch her newborn and that is one of the reasons that midwives should wear gloves. The mother’s skin will imprint the newborn with her smell, touch and love – the newborns face, smell and skin will imprint onto the mother and these are processes which are golden moments not to be missed .

If a mother is feeling unwell or anaesthetised the midwife should hold the newborn next to the mother’s skin for her , taking photographs with the mother’s phone or camera will enable the first sight of the baby to be saved and also surpass consent issues around photographs- the parents can then choose what they show to others and what they keep .

A Midwife is the woman’s and the newborn’s advocate and it’s crucial that the Midwife finds a way to involve the second parent in skin to skin contact somehow after the mother has held her newborn for a sufficient time to enable the first breastfeed .

If a woman wants to breastfeed once this has the benefit of giving colostrum as a gut protector and immuniser- colostrum contains immunoglobulin.

In cases of premature birth courage , knowledge, dexterity and skill are needed to enable skin to skin to take place . The value of collaboration (as discussed by @CharleneSTMW at a recent MatExp event at Warwick Hospitals cannot be understated – all members of the team must be aware of the benefits of SkinToSkin contact at Caesarean or instrumental birth .

We must all sing from the same sheet and share the same values so that everyone agrees that skin to skin with mother takes place before any other intervention .

Skin to skin is not an intervention it is something as natural as putting your key into your front door without thinking about it . However it seems that women and newborns are in a postcode lottery – where you live and which hospital you attend for your birth can determine and influence your chance of skin to skin .

I receive many requests from midwives from the NHS and across the world asking me to help them overcome barriers to facilitating skin to skin contact within their workplaces especially in the operating theatre . Some are stopped by anaesthetists, obstetricians , some ridiculed as strange by their colleagues and told “it’s not happening here” . We must remember that nothing is final and show the evidence which is growing by the day that skin to skin contact is not something that can be measured , it’s a primitive response which comes as second nature to a new mother – if that mother is out of her comfort zone she won’t have the strength or courage to question why – that’s OUR JOB !

Many ago I recall being told by some midwives “it won’t be happening – it’s too complicated ” and now I smile as I see midwives like @jenistevenssts in Australia studying skin to skin in the operating theatre for her PhD thesis, NICE GUIDANCE CG190 even includes SkinToSkin thanks to midwives like @drtraceyc who campaigned for its involvement and birth activist @millihill writing about it in her book (picture below)

The priceless value SkinToSkin is spreading across the world and if it’s not happening I’d like YOU to question why

This blog is dedicated to my mum Dorothy Guiney 22.2.1925 – 22.9.1978 ❤️

Babies, Birth, Breastfeeding, Community, Community care, Compassion, Discharge from hospital, Giving information, Helping others, Hospital, Human kindness, Labour , birth, Labour and birth, MatExp, Midwife, Midwifery, Midwifery and birth, Motherhood, New parents, NHS, Obstetrics, Postnatal care, Skin to skin contact, Women's health, Women's rights

Lifting the lid – my life as a midwife PART ONE 

 

This blog has a few aims and I’d like to set them down before anyone panics about what’s going to be said

  • To try and encourage other midwives why it’s ok to bend the system – but only if it benefits the woman and her family
  • To inspire others to be different and think outside the box 📦
  • I’m telling my journey and not only what led me into midwifery but what keeps me there
  • I want to show the media that midwives do care about women
  • There will be no breaches of confidentiality
  • The blog is of my thoughts and feelings

My life as a midwife began in 1982. I was a student nurse and on placement on a maternity unit learning about midwifery. I was sent into a room to watch a forceps birth – this was not in an operating theatre where complex forceps births take place nowadays but in a simple birth room – I can’t recall anything apart from the woman screaming and the way the forceps were used – it marked me for life so I don’t know how the woman progressed from it . I put off any thoughts of having my own children because of the way this woman seemed to suffer. Back then I was learning about life in the NHS , how to become a patients advocate , running my dad’s newsagents , continuing with my student nurse course which was run by the nursing school attached to the hospital . I was in shock afterwards and decided then I would never be a midwife . 

Fast forwards to the birth of my beautiful daughter in 1989 . I was admitted at 0.5cm dilatation and refused permission to go home because that’s how it was then – I was given a cervical sweep without being asked or consented for it and felt violated after the event asking the midwife “what did you just do to me ?” .

“I swept and stretched your cervix , you’ll labour now” was the reply – I didn’t know what to say and I was in pain but I accepted it and just felt lost .

I did eventually give birth 22 hours after my admission and struggled with the pushing part – the consultant was called in and I recall him shouting at me how to push and threatening me with forceps if I didn’t push harder . I gave birth on my back , semi – recumbent – no-one encouraged or suggested a change of position . I was GIVEN an episiotomy without consent and cannot recall any conversation about why this was DONE to me . More or less straight after my birth I was left alone with my daughter she was in skin to skin contact with me . This wasn’t because I knew about the benefits of skin to skin contact at all , but because I just didn’t want to let Jane  go – my mums death when I was just 18 years old had impacted on me massively and I saw something in my daughter Jane’s face that reminded me of my darling mum , I was so emotional I couldn’t put Jane down – despite being encouraged to .

After the birth I developed bladder problems so had to be kept in for 5 days . I recall feelings of loneliness , sadness , especially when my partner and visitors left . There were strict visiting times in those days , no rule bending , no partners staying overnight allowed .

Once home I felt more relaxed but my partner was only given one day off work . I had no one, both my sisters were in high profile jobs and both my parents had died when I was younger . A friend came for a few hours a day and tucked me into bed with Jane , I slept whilst she tidied up , cooked and was there for me , I didn’t know what had hit me .

My community midwife Jean Duerden was amazing , I felt unwell had terrible perineal pain and couldn’t walk far – I accepted this as normal – I was a medical ward sister – I knew nothing about babies and / or petineums . My speciality was caring for men and women with medical conditions – a world apart .

My community midwife Jean realised something was wrong and I was quickly fast tracked and diagnosed with a perineal haematoma – my sutures were subcuticular and very difficult to release so I had to persevere with analgesia and antibiotics .

The visits from Jean my community midwife were the highlight of my days – she would bring a student midwife with her and we would talk about how I was feeling , the importance of rest and nutrition and emotional support . Jean also gave me brilliant Breastfeeding advice . One day I blurted out to Jean about my birth experience and she was amazing . I felt from my moments with Jean that she inspired me to become a midwife . Although my labour experience wasn’t great , my postnatal care was so different .

Almost three years later I started my midwifery training and I have to say despite the ups and downs , staff shortages , media portrayal of midwives , the difficulties I’ve gone through in my career I love being a midwife . My own experiences have shaped me and taught me to listen , act and trust women .

When I started my midwifery there were no computers – we wrote everything and risk management was very low key . I recall the Fire Officer teaching my group that the most important thing was to keep corridors clear and know which extinguisher to use in the event of a fire . This has stayed with me through my career and I get very upset when I see corridors with obstacles , I make it my mission to clear them .

I kept a diary and was so thankful to form a life long friendship on my course with another nurse called April . My tutor Anne Ivill suggested that we would get on and we are still good friends to this day . April went to work on neonatal unit as soon as she qualified and is now a health visitor working with children who have congenital illnesses and special needs . We don’t see each other as much as we should but when we do it’s like we’ve never been apart .

I’ve always been quirky and don’t like discipline or rules that restrict creativity, I was the same at school and used to get into trouble for standing up for friends who were unable to stand up for themselves . Once at high school a friend asked me to wait for her after a detention as she was scared of walking home on her own . We were barred from doing such things but I had a plan ! One of the teachers saw me on the corridor and asked what I was doing, I explained that I was waiting for Mr Heathcote to give me extra maths (a total lie).  Mr Heathcote was found and my cover was blown – I had to stay late all week and clean all the desks in T6 (one of our classrooms) . I made those desks so clean and using my anger with myself as energy to get the job done – the relief was that I didn’t get extra maths I suppose ! 😂

So how has my life affected who I am as a midwife and a woman ? The most influential part of my life was growing up in a newsagents shop , talking to people from all walks of life and respecting them all as valued customers . I worked in the shop from a very young age because I mithered my parents to let me . At first I was only “allowed” to sell newspapers or one item sales . The best day was DECIMALISATION DAY . I had learnt a lot at school about this and was determined to help in the shop but my parents said no . I was so upset – then around 7.30 my dad called me into the shop they were struggling – I was to be allowed to help ! I recall elderly people asking me “how much is that in old money ?” And I dutifully exchanged prices bank to pounds , shillings and pence to help them understand . I can recall if I was off school that day or not but if I was in school I still went in as for my parents not to send me I would’ve had to be really unwell .

So I hope you enjoyed part one of my lifting the lid blog – in part two I will be referring to my student diary and how hard it was being the only one on the midwifery cohort with a young child.

To be continued ….,..

Thank you for reading

Love , as always
Jenny x ❤️

Anaesthetics, Antenatal education, Birth, Breastfeeding, Caesarean section, Change management, Communication, Compassion, Helping others, Hospital, Human kindness, Human rights, Intra-operative care, Labour , birth, Labour and birth, MatExp, Midwife, Midwifery, Midwifery and birth, New parents, Newborn, NHS, Nursing, Obstetrics, Paediatrics, Patient care, Respect, Skin to skin contact

The operating theatre tea party – read on to find out more 

This week I was lucky enough to be in the multi-disciplinary team involved in the care of women pre peri and post – Caesarean section . 

Lucky you say ? Aren’t midwives supposed to only be focused on PHYSIOLOGICAL  birth ? well yes that’s one of our roles but we also care for women in the antenatal period – we run triage clinics with the fab support of a skilled maternity support worker – running tests on women then contacting the Dr for advice with the results – pure team work . We also care for women in labour who have complex medical needs , complex mental health issues and we work WITH the obstetric team to find the best plan of care – we do this together with the woman’s input . I am proud of everyone I work with – they give me hope . We also work on birth centres and attend pool births . We are community midwives we attend home births , we support women who have safeguarding issues , women who live under the threat of Domestic violence and women who have disabilities. We manage wards , units , we are heads of midwifery , we are ward midwives , labour ward midwives , specialist midwives  and we are mothers , fathers ,single women/men  , gay women/men  , straight women/men  , married men/women , we are spinsters / bachelors but most of all we are HUMAN BEINGS .  

Each birth I see means a lot to me as a woman, a midwife and a human . I don’t judge a woman because she has a more complex or simple birth than the births I had – I’m in MIDWIFERY because I want women to feel positive about their birth experience and EVEN after this weeks news I am still determined to try my best to promote physiology in all birth settings . 

Anyway back to the operating theatre . 

The team in the operating theatre where I work are so together with the families they meet . They all know the importance of #SkinToSkin contact and how utterly important it is for the woman involved to hold her newborn asap . So the ODP makes sure that the woman tucks one sleeve of her theatre gown under her arm , places the ECG electrodes on the woman’s back and adds a mini – extension to the top of the theatre table so as to give the woman a greater sense of space to hold her newborn . The scrub nurse prepares a sterile space on the cot for the obstetrician to place the baby onto AFTER delayed cord clamping has taken place . The baby is dried on the theatre table and then placed on a sterile sheet on a cot with wheels – the Midwife assesses the baby’s condition at the side of the parents – so they feel involved and the baby is not weighed – we aim for skin to skin contact prior to 5 minutes of age – unless there are concerns with the baby’s health – both parents see the baby immediately and one of them cuts the cord . The other parent is then helped with placing the newborn on the mothers upper chest safely in a prone position and the midwife STAYS next to the woman and her newborn supporting them so that skin to skin can continue for as long as possible , I have piloted this and women who are supported hold their babies for longer – so I leave my records until we go into recovery area . Photographs are encouraged (as many as the family want to take) and also music . This week we asked a woman which music she’d like – we don’t yet have a Bluetooth speaker in  theatre just yet (watch this space)  so I put my phone on as Coldplay was requested . The consultant anaesthetist (Dr Richard Cross ) left the senior registrar in anaesthetics in charge whilst he was away for two minutes . When he returned he was holding a metal NHS supply teapot – we all looked puzzled 😕 . Then he carefully placed my phone into the empty teapot – this acted like a mini speaker and it was just the right volume for the family – but not too loud to disturb the surgeons and the safety in the theatre . 

What I’m trying to say is that this kind gesture was all for the family – especially the woman – we were making memories for her – she’ll always remember that she held her newborn , whilst listening to Coldplay from a teapot – what could be better than that 

Once safely in recovery (transfer to recovery area takes place with skin to skin ongoing ) we encourage birthcrawl by the newborn and praise the infants behaviour as this helps with the maternal connection . The woman is offered water quite soon after (unless she has had a general anaesthetic- in which case we wait until she is safe to tolerate water ) and then a cup of tea ( two half cups so none has the potential to spill onto the newborn ) and some toast which helps with enhanced recovery – we try to take our time with being in recovery as the woman needs more time to bond with her child due to restrictions on movement due to theatre drapes & position . 

Thank you Richard Cross and all the team in theatre for your kindness , laughter , compassion and care 
I hope you enjoyed reading this latest blog 

P.S what I didn’t mention was that there was a language barrier , but kindness , compassion and communication still took place – and the music connected us all ❤️

Happy Saturday -with love  Jenny xx 

Against the odds, Anaesthetics, Antenatal education, Babies, Birth, Breastfeeding, Caesarean section, Change management, Children, Compassion, Courage, Giving information, Helping others, Hospital, Human kindness, Human rights, Intra-operative care, Kindness, Labour , birth, Labour and birth, MatExp, Midwife, Midwifery, Midwifery and birth, Motherhood, New parents, Newborn, Newborn attachment, NHS, NHS Systems and processes, Obstetrics, Paediatrics, Patient care, Postnatal care, Respect, Skin to skin contact, Student Midwives, Teaching, Women's health, Women's rights, Working from the heart

The Caesarean experience 

How good is the approach to women who have a caesarean to birth their babies ? Do all NHS trusts routinely give the same care to each woman and newborn or is it tailored to each individual ? 

I am passionate that the caesarean procedure is also a positive uplifting experience for the woman her partner and their newborn . 

I get upset when I hear stories from different midwives at various NHS Trusts that skin to skin contact at Caesarean section isn’t routine or perhaps not discussed antenatally . From today I’m championing that skin to skin contact should be a priority for ALL WOMEN AND BABIES in the operating theatre and I’m doing this for several groups of women including those who

1. Were totally unaware that  skin to skin contact at caesarean was possible . 

2. Hear stories of women who held their baby skin to skin perioperatively when own their babies are older and they missed out on it which leaves them feeling robbed and upset. 

3. See photographs of babies in skin to skin contact during caesarean and they didn’t know they could take photographs 

4. Realised that skin to skin is possible but they weren’t given the choice 

5. Feel sad that the baby’s other parent wasn’t encouraged to hold their baby skin to skin during the caesarean operation . 

And this blog post is also for any woman who has an assisted birth in an operating theatre – I’m going to help you challenge NHS systems and change the birth discrimination between normal birth and birth in theatre . 

Why am I calling this BIRTH DISCRIMINATION

In my opinion every woman who gives birth should have the chance to hold her newborn in skin to skin contact even if only for a few minutes perhaps because the newborn requires transfer to neonatal unit or the woman feels unwell peri-operatively . 

Women who have a normal vaginal birth are more likely to hold their newborn for longer and separation from their newborns during the ‘golden skin to skin  hour’ will be less likely to happen. However, if a child is born in the operating theatre separation will occur within half an hour because of risk assessments meaning that the baby is moved as well as that within some NHS Trusts phones or cameras are not allowed in theatre and here are my thoughts on this matter which is close to my heart . 
We can no longer ignore the birth discrimination that exists between normal birth – where the woman has prolonged uninterrupted skin to skin contact – and assisted birth . It’s the role of everyone who is involved with birth in the operating theatre to work together to reduce and / or eliminate this birth discrimination.  I’m talking about midwives , anaesthetists , paediatricians , obstetricians , neonatal nurses , ODPs , maternity support workers coming together to form multi-disciplinary teams to plan how skin to skin contact length and opportunity can me maximised and separation minimised . 

We are all aware that skin to skin contact is beneficial in numerous evidence based ways (just go onto google scholar and search “skin to skin contact at birth”  to both mother and baby. It is NOW time to take action and assess each woman and baby individually instead of adhering to a ‘one size fits all’ approach . Of course there are women who may have to have a general anaesthetic – so consider this from the baby’s point of view – and work out a way that the other parent might be able to provide skin to skin for the newborn . 

We are in 2017 and now is the time to make change happen – talk about this to your MSLCs , the labour ward forum meetings , MDT meetings and be pro-active – together we can all make a difference 

Thank you for reading – jenny ❤️

To be continued ….. 

Babies, Birth, Breastfeeding, Caesarean section, Children, Compassion, Giving information, Helping others, Hospital, Human kindness, Kindness, Labour and birth, Learning, MatExp, Midwifery, Motherhood, New parents, Newborn, Newborn attachment, NHS, Obstetrics, Patient care, Skin to skin contact, Women's health, Women's rights, Young mothers, Young women

The baby’s here – NOW what ? 

You have just given birth – it’s your first child and I’m not sure whether you had a Caesarean birth or a forceps birth or your newborn arrived in a birth pool . What really matters is that you receive consistent, evidence based advice from the health care professionals you come into contact with and positive support from your family and friends –  you’ll be exhausted and must try not to rush yourself back to normality too soon – try installing a mindfulness app into your phone and ALLOW your friends to do your shopping/ ironing / take some laundry off your hands . Don’t be too proud to admit tiredness , worry and emotions .

Take a good look at the #MatExp website and join the Facebook page for access to health care professionals , peer supporters and other new parents – ask questions and interact with others so you can gain knowledge and know when to recognise that things might not be quite right .

The biggest thing to hit you right between the eyes is the responsibility of parenthood including how to cope with reduced amounts of sleep , hormone imbalances , post birth bleeding , the increase in laundry (which seems so huge for such a tiny person and more than double with twins !) and how to deal with unexpected visitors who always seem to turn up when it’s nap time . Who said babies sleep all day ?

Well here is my blog to try and help you to make some sense of your early days

Humans have been parenting for thousands of years , babies communicate through crying and facial expressions and you have an inbuilt mechanism that is made to help you to nurture your young . Keep on keeping on with skin to skin contact as new evidence shows that mothers who give their babies plenty of skin to skin contact are more responsive parents . Picking up your baby each time he or she cries is not spoiling the child – HERE IS A LINK TO EXPLAIN WHY A BABY DEVELOPS BETTER WHEN HE SHE IS PICKED UP MORE. UNICEF have lots of evidence based resources and this is a wonderful PDF document UNICEF leaflet on building a happier baby – we are in fact building humans – kindness and compassion towards our young helps the brain take in more information and this in turn reinforces to the child that kindness matters , so he she grows up to be more aware of her / his own feelings and the feelings of others .

Trying to sift thought all the postnatal advice leaflets and decide which friend / in-law , relative has the best advice on getting your baby to sleep is just overwhelming .

First of all don’t push yourself too much to get through one week unscathed – it’s better and more realistic to try and get through a couple of hours feeling positive about what you’ve achieved. Take regular pain relief to help your mobility and well-being and don’t scrimp on rest – did you know that skin to skin contact reduces pain in mother AND newborn?

Let’s move onto  the key things your baby needs to grow and develop as well as feeling nurtured
1.Love which includes feeling nurtured and receiving kindness . Love also means giving yourself kindness and listening to your own mind and body .A baby knows from the tone of your voice whether you are happy and feeling loving towards it – so try hard to keep love in your heart . If you are not feeling this way seek some advice – your love might come later , or you may just be exhausted . If you feel unwell , emotionally drained , or just flat talk to your midwife and let her know – she’s not their to judge you but to signpost you to the correct services available . Do not berate yourself if you are suffering from post-natal depression and/or anxiety – we live in a modern world that doesn’t seem to support the value of resting , being still and calmness – digital advances seem to put more and more pressure on us humans to try and prove we are beyond human – the modern woman  is the equivalent of a plate spinner – don’t take on too many committtments – try practising some self-care and slow down – your body and mind  need rest and stillness as much as they need love , nourishment , kindness and compassion . Here is a wonderful blog about a mother who realised she was shouting too much and was too distracted by others things that led to a kind of moodiness towards her children CLICK HERE TO READ

2. Feeding your newborn is not just about giving a baby milk – the way a baby is held during a feed , the way a mother talks to her newborn and keeping the number of people who give the feed to a minimum has a more positive impact on the baby’s developing brain. I hear many women say “I’m not going to breastfeed as my family want to help me with bottle feeding”.

The first feed of colostrum is a crucial power food to help the newborn to  begin its journey of life. Obesity is a now a public health problem and it’s time to address the low numbers of babies that are breastfed – if a baby maintains skin to skin contact with its mother at birth for over two hours – there is an increase in breastfeeding success – we are talking about not moving baby at all for any reasons including during Caesarean section, perineal sutures, returning to theatre for any reason and always considering SkinToSkin contact.

The postnatal period should include regular prolonged episodes of skin to skin contact to soothe babies , maintain the all important bond with the parents and help milk production . Breastfeeding helps babies to …

1.Recover from birth

2. Feel safe and nurtured

3.protect the immature gut and bowel by receiving immunity from the mother via her bespoke breast milk .

4.feel comforted – because a baby that breastfeeds must be held close and that situation is very comforting to a newborn

The one to “oneness” that #SkinToSkin and breastfeeding gives a newborn is actually is not something that can be replicated in another form – it’s a one off that’s been passed down the centuries , a primitive response that goes back in time to when we lived in caves and our mothers held us close away from other predators . It’s much more grounding for a newborn to feel close to less people and as it gets older you can widen the circle very gradually. SkinToSkin during breastfeeding gives the baby a strong sense of belonging . There are also responsive bottle feeding methods . The SLING LIBRARY offers information about slings across the U.K. click HERE for the website and slings give freedom to do other things whilst carrying your newborn hands free : )

A baby should never be fed without being held – being held during a feed is soothing and promotes a sense of safety & emotional security . Talking , singing and smiling during feeds with intense eye to eye contact is of paramount importance for a newborn’s brain development .

3. Warmth – so important that a baby feels comfortably warm not overheated and is unable to move down under its blankets – the baby’s position should always always be on the back . The “Back to sleep ” campaign was started by Anne Diamond . Click HERE for more information about how Ann spread the word after the death of her beloved son Sebastian died from Cot death at only four months of age. It is now advised that babies are put on their BACKS to sleep and also that they sleep in their parent/s room until after the age of 6 months old . 

The media in general doesn’t give out evidence based advice and seems to berate parents who choose to co-sleep . Co-sleeping is something that must be discussed and Durham University has a sleep laboratory which has looked at how and why mothers co-sleep with their offspring – Click here for evidence and sound advice about Co-sleeping. Professor Helen Ball has filmed parents in sleep situations to help us to learn what’s safe and what’s not . The problem with the media is that by criticising co-sleeping they are actually promoting sofa sharing and feeding which is a dangerous practice . Click  HERE for an honest upfront article by the fabulous Milli Hill parenting and birth guru about co-sleeping.

Your house is the environment your child will see as their safe place – so don’t try to change it too much as a temporary measure – keep it as your home to welcome your newborn . You can adapt areas as your child grows and develops . Try keeping changing equipment in two different areas so you don’t have to go to one room all the time .

Let your bedroom be your safe haven where you can escape with your baby to feed , rest and avoid the “popper inners” the visitors who simply turn up unannounced .

Try not to plan too many trips out too soon or those that require a long drive – as mothers soon get tired in the initial few months . A change of scenery is good though and can be a welcome escape from the house . Don’t be talked into your newborn going for a sleepover too soon – when it does happen you may  find yourself unable to relax until you hold your baby again . The other parent can walk the baby whilst mum rests (that doesn’t mean cleaning etc!!) and it’s a good thing to try and learn how to sleep in the day – even though it’s against everything you are accustomed to as a new parent you are  in fact a shift worker so must try and care for yourself or you will become burnt out , exhausted and this could lead to anxiety and / or depression and this applies to BOTH parents.

What about Dads ? Well I love social media and I found this great tool called TheDadPad which is £8.75 supported by the NHS and basically a set of information pads that are wipe clean and give good advice on caring for your newborn as a new dad .

Same sex couples also need support – just because a baby has two mummies doesn’t mean that life is all hunky dory – all parents need to know they are doing ok .

Isolation , poverty and lack of friends can affect parenting- but believe me , not having the latest pram or changing bag does not make you less of a parent . Health visitors are skilled at knowing where there is safe second hand baby equipment which is a lot less expensive – always google the product so that any warnings regarding safety are found before you commit yourselves to it – second hand equipment must come with full instructions and explanations as well as safety recommendations on how NOT to use .

If you feel unwell at anytime in the first 6-8 your lifeline contact is with your local delivery suite . Here waiting isn’t long and you get to talk to a midwife one to one and discuss your symptoms . The problem with going to A & E is that they aren’t designed for mothers and/or newborns and they hold a lot of unwell people . If you have any pains or swellings in your legs / chest pain / fast heart beat / your bleeding heavily / your bleeding has an odour / you are hot and cold please do not delay as any of these symptoms could be a venous thrombosis or signs of sepsis – getting to the Women’s unit faster means quicker diagnosis and treatment . Read about sepsis in more detail HERE on the Sepsis Trust website where you can read about symptoms of sepsis clear concise information.

Refer to your postnatal notes for yourself and your baby for clear advice on minor postnatal symptoms as well as why you may feel unwell – but more importantly talk to health care workers who will give you consistent advice about coping with a newborn . Don’t be fooled by perfect photos – underneath it all most new parents struggle with their lack of sleep .

Try to get out during the day even if it’s just visiting a family member or friend at a house . Being isolated is not a good feeling and can be detrimental not only to your own mental and physical health but also the newborn’s ability to socially connect and brain growth .

In this modern world it’s important to switch off digital devices and talk to babies – if you find this hard reading a book or singing songs is a positive way of communicating.
Keep a mini journal of your days when you felt tired out and see if you are feeling less or more tired as the weeks go by . If you are feeling more tired look at what kind of activity you missed out on OR overdid . Did you eat well ? Rest ? See friends ? Spend any time in skin to skin with your newborn ?

I’ve written this blog so you can try to find information that’s sensible and not prescriptive and I hope you find it useful . If it’s any consolation I was totally exhausted for months and I developed post-natal depression which wasn’t really talked about much in the 80s. I even left my daughter in her pram outside the local post office , not realising until I had say down with a well deserved cup of tea – needless to say I ran back for her and never did that again !! So you see if I can admit to that , what do you think other new mum’s have got up to ?

Becoming a parent is lovely but it is not as perfect as it’s made out to be. Best beginnings have launched a series of films called “Out of the blue” and CLICKHERE for a link to a film on how new mothers can learn to look after themselves . If parents take good care of themselves they will be more likely to care for their children well and be positive role models .

I hope my blog inspires you all on the start of your journey as parents and I wish you and your newborn love , kindness and understanding ❤️<<<<
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