Category: Kindness

Human kindness, Kindness, leadership, Midwife, Midwifery, NHS

The Journey

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On Friday 20.9.18 I presented via Skype to DeMontford midwifery society. I was in Wales presenting at the midwifery forum just before that . My journey back was not at all what I expected. For some reason my satnav decided to take me along narrow lanes and single track roads – No motorways 🛣 were harmed in the making of my journey 😂 . My average speed was 39 miles an hour so it took me almost 7 hours to get home.

I started to think about how midwifery is a journey that we set upon knowing our destination but not really contemplating how we are going to get there or indeed how unique each persons path is . There may be difficulty , loneliness, vulnerability , hunger , sore feet and tiredness – as well as friendship, happiness, compassion, satisfaction comfort and energy .

Each persons journey is totally different – some may take the motorway route and get there faster, some may walk, run, cycle and may take a break or leave the journey . My idea for my presentation was going to be how to make the journey .

Setting off on your journey of midwifery is about letting others know that you are on your way as this will give you support and strength knowing that those people are looking out for you .

The symbolism of wearing the right shoes will help you to feel able to walk in your own way – a good fit, stability and readiness for difficult paths inbuilt into your shoes will pass onto you that it’s not just about looks but dependability and longevity.

Self care and break time are a human right- break time is something that belongs to the person not the system do we talk about this enough ?

Find the things that give you joy and try to have key 🔑 friends outside your workplace 🏥 so you’re not always talking midwifery

  • Friends and family
  • Days out
  • Helping others
  • Self care
  • Reflection
  • Time out
  • Protected meal breaks
  • Planning trips
  • Walking
  • Exercise
  • Cooking

Taking a step away from the work environment to go to the canteen , sit outside. Taking a shower will give you a boost and help you feel refreshed and is one suggestion for self care so that you can help the women and colleagues you are with . Have a look at keeping a wash bag in your locker with shower gel , shampoo , deodorant and creams that you can use for yourself and also share with others .

I often think that about people who work in the corporate world let’s use finance as an example wouldn’t tolerate the work restrictions that many midwives have to deal with – no early finishes on Friday to network , no built in structure to ensure workload is distributed evenly , no protected time for online training , making those who work less hours to feel less a part of the team, missing meal breaks, being micromanaged , time in lieu when finishing late instead of pay -is this because we are predominantly female workforce ?

Midwives must seek out others who may act as their compass 🧭 , map 🗺 or guide. It may be a person not even connected with midwifery who is a good grounding force with an ability to listen not necessarily advise .

On my journey I have met many people some fake some real – by fake I mean those who pretend that everything in the garden is beautiful when truly it’s not. Real leaders don’t brush aside concerns or ignore those who are in difficulties at work , they nurture them and see past their rose coloured spectacles .

Consider not only your own journey but also how you behave toward others on their journeys . Do you equalise the voices of future midwives on the labour ward/ postnatal ward / birth centre / community and treat them as leaders or do you plain and simple see them as learners ?

With permanent staff , who are the ones whose voices are always the first to be heard ? Seek out the quieter ones as they too have their ideas and opinions . A midwife who thinks before she speaks to other colleagues will be one who is more likely to listen to women.

There is a dichotomy that exists in midwifery we are taught that we are autonomous practitioners in our own right yet we are micromanaged and constantly asked “where are you up to (with your work)?” In my opinion it’s up to us to rock this boat 🚣‍♂️ so we can stand strong for the women we care for and challenge time constraints so that we help others with a clouded view to see more clearly .

Becoming involved in someone else’s journey may make your journey more complicated but in time you will see it as an enrichment of your behaviour and realise that the best way to move forwards is always together .

In identifying the problems on your journey you will gain insight into how to improve and consider EVERY woman’s personal journey through maternity services ❤️

The analogy of never arriving keeps you grounded and helps you to stay humble .

Be kind to one another

With love Jenny ❤️

Being bullied, Being busy as a midwife, Birth, Change management, Courage, culture in nhs, data colllection, Digital, Discharge planning, Giving information, Hospital, Human kindness, Kindness, Labour , birth, Labour and birth, leadership, Midwife, Midwifery, Midwifery and birth, Motherhood, New parents, NHS, NHS Systems and processes, Obstetrics, organisational development, Student Midwives, Working from the heart

Does the NHS need to rethink the way health professionals are made to approach their work ?

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It’s been a while since my last blog. This post is to help those in the NHS whatever their role or position to consider that positive individuality makes for a better NHS . In embracing positive individuality all care will improve , status quo will be rocked and the NHS will develop doing things differently within your workplace.

Predictive text steps in as you type on your phone . Wikipedia have a link about predictive text CLICK HERE and surprisingly personal data in the way we write and assemble sentences means that each device is personalised to the user . This has set my brain off thinking that actually we are all diffferent generally. Sadly NHS management would like us to work in the same way a sort of “predictive” way of working . However humans are unpredictable that’s just how we are made. Are personalities and individualism therefore disregarded ? Let’s take for example shift work – some Trusts have a better family and also life friendly approach to staff . The Kings trust have researched that staff who are cared for and well-engaged make for a more successful NHS – that in turn has a positive effect on the people being cared for .

Midwifery cannot be like predictive text eg this is the way we do it , this is the length of time you need to help a woman, new offspring & partner postnatally before transfer to the ward and so on .

It’s time for managers to realise that each woman is as individual as the midwife who is “WITH” her . An acceptance that “this is the way that Midwife B works . Each midwife’s Way of working is in fact data. The midwife who spends longer explaining to the family who are going home (eg explaining symptoms of wellness , symptoms of illness , to contact the labour ward not the emergency department for advice , self care , and current evidence) is perceived as slower but in fact this is the midwife who probably is more thorough and probably a perfectionist who raises awareness in the women and families she meets .

If you ever get told you’re too slow – don’t take it as an insult take it as a compliment

You are dedicated , perceptive, compassionate, thorough and you promote self awareness to women and families

Keep on keeping on

Sending love to all the THOROUGH midwives nurses and other health care professionals out there in the NHS

Love , as always

Jenny ❤️

Antenatal education, Babies, Being a mum, being believed, Birth, Caesarean section, Charity, Communication, Compassion, Courage, culture in nhs, Fear of Birth, Giving information, Helping others, Hospital, Human kindness, Kindness, Labour , birth, Labour and birth, leadership, Learning, MatExp, Midwife, Midwifery, Midwifery and birth, Motherhood, New parents, Newborn, NHS, NHS Systems and processes, Obstetrics, Paediatrics, Postnatal care, Psychology, Respect, Student Midwives, Teaching, Women's health, Women's rights, Working from the heart, Young mothers, Young women

Midwives – Defenders of women’s rights @JennyTheM ©️ #IDM2019

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5.5.19 is international day of the Midwife and my blog is dedicated to all Midwives who have made a difference by defending a woman from any unnecessary intervention – be that anytime related to pregnancy 🤰🏾 antenatally , during any kind of birth or postnatally.

I’ve decided to share three stories which are true experiences written by midwives about defending women. One of the stories is mine but I won’t say which one .

As clinical midwives we are seen as equal members of the huge maternity wheel alongside women and their families, managers, obstetricians, future midwives , maternity support workers and many more – although in reality there is a hierarchy that many within our own discipline and other disciplines are striving to challenge and change .

The truth in plain sight is that just one member of the team is not engaged or equally involved (including the woman) then the intricate workings of the mechanism will be disrupted.

Women and families = get to know your midwife/midwives . Ask questions , be curious. Read books that are informative, recommended and that explain your bodies and your babies abilities with balance and clarity . Try the Positive Birth book by Milli Hill Click HERE to see on Amazon (founder of The Positive Birth Movement) .

Prepare yourself as much as you can. Don’t leave any stone of knowledge or information unturned . Join a positive birth group Click here to find out more . Be aware that midwives are defenders of women – talk to other women and find the midwife that helps you to believe in yourself . You’ll know when you’ve found her – don’t settle for second best. I believe women should rock the boat of maternity services like pregnancy pirates. Try reconnecting with midwife from a previous birth if you have other children – it’s evidence that continuity pf carer will reduce your chance of interventions so ask to see the same midwife at your appointments. Look at the birth statistics of your local units and choose wisely – ❤️ The Which birth guide is a good resource although might need updating Click HERE to view

Managers = be insightful of how staffing levels and skill mix will impact positively or negatively on birth outcomes – when you arrive to help us in our hour of need ask not what we can do but show us what you can do to improve our shift . Stay curious ❤️

Obstetricians = be mindful of the physiology of the female form and how your positive or negative behaviour will impact on the delicate balance of all hormones involved in playing out the birth process . Watch midwives working see them as equals . Stay curious ❤️.

Midwives = be aware of why you are a midwife. Embrace your role as not to

“do to”

but to

“be with”

to defend,to stand up for ,to support, to strengthen and to keep safe. Unite the team with your passion for all births❤️. Stay curious

Maternity support workers I am thankful for you all – you do support ❤️- your gratitude towards the midwives that make the toast and tea for the family and ensure rooms are left clean before transferring women from them . (we do ask other midwives to follow our suit) as we know you always have work to do within the scenes and behind them – running the operating theatre, birth-room turnaround time , restocking , clinical work, bringing the team together , being aware of all areas . The camaraderie and team work you display so strongly within your discipline is a benchmark for us all . Stay curious

❤️❤️❤️❤️❤️❤️❤️❤️❤️❤️

Three stories of defending

Read on reader ….

Story one

The elective premature Caesarean birth – a courageous Midwife

All eyes upon me , the baby is only 34 weeks old . The mother’s instinct to hold her newborn is tangible I hear her breath . The paediatric team stand around the resuscitaire , prepped , ready, waiting and impatient. Something inside me tells me “give the baby to the mother , give the baby to the mother” After delayed cord clamping I cocoon the newborn in a warm towel without touching and within seconds I’m helping the mother with her first embrace. Time stands still. I monitor the baby closely but without words for colour , breathing , heart rate (with my stethoscope) tone and reaction , a saturation monitor on the baby’s right hand (pre-ductal) reassures me. All is good . I offer to take photos of mum dad and baby, mum and baby , baby’s hands touching mum , many photographic variations evolve in so little time . I look across at the paediatrician- she knows me, trusts me – she smiles at me and nods mouthing “it’s ok” . Five or more minutes have passed – mum knows it’s time . Dad carries his newborn to be seen by the team . Mum is crying not with sadness but with joy that hers was the first skin to touch her newborns , then her partners – this is how every new beginning of life should be – we Midwives must step aside but wait in the wings ready to prompt or assist- our silent presence is reassuring to the family ❤️

It was all worth the fear – afterwards I hug the paediatrician and say “thank you for trusting me ” the mother scrolls through her photos in disbelief that her only ever precious child started its journey against her skin – I am a defender ❤️

Story Two

The “Failed” Induction challenging a decision

“Can I help ?” I offered “Oh great” replied the ward Midwife “we are so busy!! Can you go with the consultant to see the woman who’s Induction didn’t work ?”

I’d been sent from labour ward to help on the antenatal area . The consultant was counselling an elderly primigravida ( over 45 years old) . The woman “Joy” (false name) was being told that two attempts at induction and due to her age that a caesarean would be for the best . I was sent to get the consent sheets . I’d just completed the AQUA shared decision making course and I was keen to put what I’d learnt into practice.

The time on the clock was 16.55 so bear that in mind .

What happened next was that the consent forms were handed to the woman after the risk of Caesarean was explained . The woman dutifully signed the consent forms and the consultant left the department. Something inside me told me this didn’t feel right . My instinct and experience made me go back to the woman and her partner. I asked them if they were okay with everything. In fact I went as far as saying “are you okay about your Caesarean birth?” They both voiced their concerns but felt they haven’t been given a choice. I wanted to discuss further so I went to the phone and rang the consultant to return . The phone call did not go well -the consultant was quite irked that I’d phoned told me to check the clock and to ring the consultant on call.

I rang the on call consultant who came and discussed further the choices the woman had with her and her partner . She opted for an attempt at labour following artificial rupture of her membranes which would all take place on the labour ward .

To cut a long story short the woman progressed to 5cm dilatation and remained there . She was very pleased with the fact that she’d experienced labour and been listened to . Her caesarean birth was a positive unhurried experience.

A few weeks later I came face to face with the first consultant one my day off – I’d come into work to attend a two hour study session . The consultant openly criticised me in front of a new senior registrar who I’d never met before – belittled springs to mind . “Thank you for overruling my decision to plan a Caesarean without labour” were the words. I stated clearly that the best way to clarify the situation was to determine how the woman felt – “are you invited to the naming ceremony of the baby ?” I asked “no” was the consultant’s curt reply – “well here’s my invite” I said (by coincidence I’d found it in the staff mail box that day) . The consultant went quiet and walked away . I am a defender ❤️

Story Three

Rebalancing the birth hormones

I met Nasrit about one hour into my shift in the morning. (name changed) . The community midwives has brought her in because her labour had slowed then stopped. Nasrit was having her third child, she lived with anxiety and panic attacks which were inherited from her childhood . My opinion was that her fear had disrupted her birth hormones – I discussed this with her – she held my hand tightly . I went to the midwives station and put Nasrit’s name on the board – as I did I could hear staff chipping in “does she need an ARM?” “Get the syntocinon running when the Reg arrives ” “is she actually labouring ?”

I pretended not to hear the comments . I was going to go back to Nasrit, Nasrit’s partner and Nasrit’s mother . My plan was to try and get Nasrit into a birthing state of mind . I wanted to make her at home. In giving her possession of her room I made her space – no lights , quiet , no interruptions and a haven for her birth . I keep a set of battery powered fairy lights in my locker and I’m trained to use aromatherapy. My key goals were to make sure I had everything in the room that Nasrit needed and nothing in the room that anyone else needed -there were going to be no interruptions. I used a blend of lavender and frankincense in hot water as a room infusion. I explained to Nasrit how aromatherapy would work. I then turned off all the lights and switched on the fairy lights . As an equal I explained to Nasrit and her family how relaxing can help oxytocin and that anxiety can hinder by producing cortisol and adrenaline . Nasrit was with me . I sat and held her hand (at her request ) we all waited without talking . I reiterated that there was no pressure . It took about 15 minutes for Nasrits heart rate to drop from 96 to 68 – she was breathing more calmly .

Over the next two hours Nasrit’s labour recommenced and soon she was holding her newborn skin to skin . I never left the room .

All was well

I am a defender ❤️

Summary

So the reason for my blog is for you to try and reflect on your own practice as a midwife and find those times when you were a defender. Look to see when you recognise fellow defenders through their words and actions . Try not to ask “does this feel right for the woman ? ” “is the woman’s face reflecting agreement or disagreement ”

Stay curious and keep defending

❤️We are defenders❤️

#IDM2019

Post script dedication I’m dedicating this blog to all midwives in hardship – whether physically, emotionally or financially. The Cavell Trust is a charity that helps nurses , health care assistants , maternity support workers and midwives Click HERE for more information

Thank you for reading my blog .

Yours in midwifery love

JennyTheM ❤️

Stay curious

and like Professor Lesley Page (@Humanisingbirth on Twitter) be the leader of the dance ❤️❤️

Anaesthetics, Antenatal education, Babies, Being a mum, Birth, Breastfeeding, Caesarean section, Change management, Communication, Compassion, Courage, culture in nhs, Fear of Birth, Giving information, Helping others, Hospital, Human kindness, Human rights, Kindness, Labour , birth, Labour and birth, leadership, Learning, Midwife, Midwifery, Midwifery and birth, Motherhood, Newborn, Newborn attachment, NHS, NHS Systems and processes, Obstetrics, Postnatal care, Skin to skin contact, Student Midwives, Women's health, Women's rights, zero separation

The birth of my son

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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 ❤️

Being busy as a midwife, Birth, Compassion, Courage, culture in nhs, Giving information, Helping others, Hospital, Human kindness, Kindness, Labour , birth, Labour and birth, leadership, Midwife, Midwifery, Midwifery and birth, Motherhood, New parents, Newborn, NHS, NHS Systems and processes, Night shifts in the NHS, Obstetrics, organisational development, shift handover, Student Midwives, Working from the heart

This is the way it’s always been – Labour ward night shift to day shift handover NHS ❤️

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You may find yourself on a NHS Labour ward at approximately 7am one morning . Everyone is assembling for morning handover . Over the shoulders is being lifted up into bobbles and held back by clips. Pens, hand-creams, mints , note books , mini hand gels all squeezed into powerful pockets. The “not allowed” mobiles are hidden from plain sight “just in case my son/daughter’s school need me” or to “google something”

Some night shift midwives sit in the office desperate to get home – they look worn out and you want to hug them saying “you will go home on time” but you know it’s a lie Other midwives are out of sight – they remain “with woman” in rooms praying that the handover will go smoothly with minimal interruptions. They want the transition from one midwife to another to be compassionate, woman centred, slow and not hurried .

“Don’t forget the midwife on the birth centre – the woman she’s midwifing is in the pool and about to give birth any minute” says the maternity support worker as she leaves . “Has that Midwife had a break?” – “Not sure” comes the reply.

Drs hang around to chip in with their findings and recommendations as well as chomping on leftover unappetising snacks from the tea trolley. The wheeled aluminium “redeployed” dressing trolley cocoons several slices of curled up toast covered with re solidified butter and cups of cold tea in a hard steel exterior as if to say “this wasn’t my original job”

Seats are hard to come by and woe betide the future midwife who gets a chair before a senior Midwife . Some staff arrive late and hide just behind the door pretending they’ve been there all along – but they did go home late last night . Not one manager in sight .

There are comments circulating “I didn’t leave until 10pm last night!! ” “I’ve only had one day post nights now I’m back on days” “my son is poorly but I’ve sent him to school” “how is ***** in room 2?” “who is in theatre ?”

The labour ward lead’s face demands silence – report starts 3 minutes late – you can taste the angst .

The night staff are supposed to finish their shift approximately 15 minutes after the day shift start theirs . The night shift rarely leave on time and luckily someone has the foresight to recognise that the maternity support workers can go home as their reinforcements have arrived to take over – they like the new shift midwives and Drs smell of new freshly applied deodorant . Many perfumes and aftershaves mingle and brighten up the stale office air. The virtual RHS of the NHS in one tiny space.

Now do the math -for one lead Midwife to hand over the cases and care of 8-16 women to the other in just 5 minutes (depending on the different labour wards in the nhs ) so that the day team can split and go to their allocated families, THEN have another more detailed handover (but VERY similar in principal to the one in the handover room) is nigh on impossible- in fact it is INCROYABLE.

So many night staff leave late – some have many miles and hours to drive or travel in a post nights shift state of mind in order to reach the comfort of their own slumber stations. Some wisely choose to pay to sleep in hospital accommodation as they daren’t risk driving. Others travel as they don’t want to be away from home , they need to be up at 2.30pm to collect their children or their children’s children from school and then possibly cook dinner then prepare themselves for their third or fourth night shift .

Staff leave but not before putting their “time owing” in the designated book – it’s not paid you see – even thought leaving late is beyond their control . This is the NHS

So what’s the solution ? I’m not sure there even is one. If you compare the way office workers start their day there is a great disparity happening between humans who work.

It’s about time staff handover had a shake up – be punctual, be succinct , keep your opinions out of report , respect ALL. Allow each midwife to handover each women / family she/he is caring for with the back up of a written SBAR and encourage the lead midwife to take a step back . Someone somewhere must have an idea ??

It’s a handover state of mind .

We are all leaders

Thank you for reading

My thoughts

Jenny The M ❤️©

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

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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 ❤️

Babies, Bereavement, Birth, Compassion, Dying, Grieving, Helping others, Hospital, Human kindness, Kindness, Labour , birth, MatExp, Midwife, Midwifery, Midwifery and birth, New parents, Newborn, NHS, Obstetrics, Patient care, Post traumatic stress disorder, Student Midwives, Women's health, Women's rights, Working from the heart

A Midwife’s heart and caring for families through stillbirth ❤️

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This is a very difficult blog to write . Yesterday someone highlighted a tweet to me about midwives and how they deal with the impact of caring for a family who may have to face the loss of a baby . It was to do with midwives knitting hats for stillborn babies .

I have been a Midwife to many women whilst they birth their baby who has died before labour starts . It broke my heart each time I cared for these families. However I saw the fact that I was allocated to care for them as nothing but a true privilege and joy . I wanted to make the moments they had with their precious child special , full of love and memories . I helped them take the best photos . assisted them through washing their babies and also knew that I had to give them time to grieve and to communicate to them through deeds not words that I was “with them” totally . I cried with them , held them whilst they sobbed , even laughed with them – which may sound strange but it’s true . I cooked for them , made endless pots of tea and I washed their feet . I saw in these women & men a strength that can’t be put into words on a blog . I recall walking a couple through a labour ward to a bathroom with their stillborn son , so they could all be together in the bathroom whilst the mother took a bath – they insisted I sat with them ,so I did – on the bathroom floor – I know these memories are as special to them as they are to me.

Midwives do not routinely get counselling post events like this – fire workers and police staff do so is the NHS missing a clue ?

In 2006 I reflected on an incident at work where a woman came in to be induced and when I put her on the CTG monitor, we discovered that her darling son was not for this world . I was devastated and had to arrange childcare so that I could stay with the woman & her husband post my 21.00 shift finish . Another thing. that also hit me hard was that the friend I asked to help me with my young family had no qualms about saying yes – I later found out that the reason was that she had given birth to a stillborn son many years before (she told me that she felt by helping me she was helping the parents of the stillborn baby ).

As I left the couple to go home much later , I wept from sadness for them and their empty arms as well as emotional exhaustion and was told not to cry by a senior member of staff. I couldn’t go into work the next day .

What transpired was an article about my reflection by Rosemary Mander . The mother became a friend of mine & I helped her with a SANDS event – I went to her sons funeral and this connection helped me to cope as much as it did her to have someone who saw her son like she did – as a beautiful boy .

It’s so important that we see our role as supporting parents through sadness & also happiness . The midwives who choose to knit hats are simply trying their best – they might not know what else to do – it’s s coping mechanism. You can’t train for events like these just like parents can’t prepare for this to happen to them .

I’d like to thank Rosemary Mander for writing around my reflection in 2006 , the mum & dad of the darling son that was born asleep for giving consent to publish my reflection all those years ago (you gave me the courage to show my emotions to other parents) and also to my friend for her kindness in caring for my family whilst I stayed with the family ❤️

Also thanks to @kwelsh1 for showing me this powerful sculpture by Albert Gyorgi called “Melancholy ”

it sums up how any parent who loses a child must feel

Antenatal education, Being a mum, Birth, Caesarean section, Compassion, Courage, Fear of Birth, Giving information, Helping others, Hospital, Human kindness, Human rights, Kindness, Labour , birth, Labour and birth, MatExp, Midwife, Midwifery, Midwifery and birth, Motherhood, New parents, NHS, Obstetrics, Respect, Skin to skin contact, Student Midwives, Surgery, Women's health, Women's rights, Working from the heart

Fear of Birth – A Poem

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I didn’t want a labour -everyone in my family knew

I did want a baby though

-my desperate feeling was not new.

I’d always been nervous,fainted at the sight of blood

told myself time and again that at birthing I’d be no good

My husband eventually won me round

We started trying for a baby but my mind couldn’t rest

So many ifs and buts and a maybe

we were pleased when we found out the positive test,

Inside my body though I felt so stressed

I had a tightness in my chest

I almost wanted to shout & shriek (no one seemed to listen)

I tried to talk about Caesarean birth with health professionals through the weeks

-somehow they didn’t hear me -I felt soft , so ridiculous so weak.

I couldn’t express my feelings, my fear of giving birth

I felt anxiety would pass to my baby -I had no sense of worth .

I went into labour I was scared and full of fear

my husband and my mother were with me it helped me to have them near

I failed to express myself to the doctors that I just couldn’t do it

But it was as if my words couldn’t come out- I truly almost blew it .

What happened next was down to the perception of my midwife

She saw the turmoil I was in recognised my inner strife

She stood side by side with me , told the Drs what I’d said

She was my birthing advocate – my saviour through the dread

A plan was made they’d finally noted every word I’d spoken

I was going to have a Caesarean section it was as if I had awoken

Don’t presume my fear had simply run away

I was worried ,scared and still not quite sure what to say

During the birth I could not look or speak or move

But when I held my baby skin to skin I was overwhelmed with love

My child was born and passed to me – I had achieved so much

And to the midwife that heard me through the tears – THANK YOU – for your listening touch

You really made a difference to me and my family

I don’t know how I’d have coped if you hadn’t stood side by side with me

@JennyTheM 16.5.18

Dedicated to Yana Richens OBE @Fearofbirth on Twitter for raising the profile of women who have fear of birth and for teaching Midwives and future Midwives strategies to help women ❤️ thank you ❤️

Babies, Being a mum, Birth, Caesarean section, Communication, Compassion, Courage, Helping others, Hospital, Human kindness, Intra-operative care, Kindness, Labour , birth, Labour and birth, Learning, MatExp, Midwife, Midwifery, Midwifery and birth, Motherhood, New parents, Newborn, Newborn attachment, NHS Systems and processes, Obstetrics, Student Midwives, Women's health, Women's rights, Working from the heart

Making a sacred space for birth

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This blog is inspired by the women I have cared for as a Midwife and also the wonderful Spirituality and Childbirth book book by & Dr Susan Crowther and Dr Jenny Hall . The women I have met and cared for in my midwifery career have helped me to invent new ways of working for and with them.This experience has shown me that in order to achieve a special birth experience we must be connected with the woman . The value of approaching each woman with a different perspective but the same professional compassionate values regardless of their mode of birth is the core of individualised care .

It’s taken me all my midwifery career to reach this point and I am still evolving.

Making a sacred space for women and birth is something that we should all consider as midwives. How many times do we enter a room of birth to find the light shining brightly the window blinds up, the CTG machine on full volume and the sounds of the hospital permeating into the room ? Who has the right to enter the birth room ? Perhaps now is the time to talk about consent and to ask women whether they want people to come in and out of their room for non-essential reasons such as trying to find equipment or the medicine cupboard keys . Do your labour wards and your birth centre rooms have a curtain after the door to maintain the dignity and privacy of the woman and her partner and to keep the sacred space? Are the room, it’s people and contents treated as “our” (Midwives and obstetricians ) space or as the woman’s (family , partner , newborn) space. Do we GIVE the space to the woman she enters the room? Saying “this is your room , this is your space I am your guest” or is it seen that we take control of the area ? What exactly is the solution? . I think one of the answers is to start by questioning ourselves as to how we are behaving. There are guidelines to help us give evidence based care and evidence shows that dark quiet rooms , aromatherapy , touch and the continuous presence of a midwife are all beneficial for women in labour as they give birth . How do we transfer this to a birth in the operating theatre or an area where women with a higher chance of intervention are cared for ?

Do we need a new guideline that encompasses making a sacred space ? I think so .

We must celebrate that midwifery care is still an essential core aspect of birth in the U.K. and share our stories . To summarise the work of Dr Trish Greenhalgh – each person we care for shows us new evidence and this can be individual evidence – it doesn’t need to be large scale. Therefore if your compassionate care works then that’s your evidence .

My tips for making a sacred space are

  • Explain to the woman why a newborn appreciates a peaceful place to arrive in
  • Ask about aromatherapy try to stick with no more than three essential oils as using more can dilute the effect
  • Look at the lighting in birth rooms – can the lights be dimmed – find a lamp to give you some light for record keeping
  • Take all that’s required into the room and make yourself an area that does not intrude into the woman’s space but that also increases your time in the room
  • If the Drs come into the room and require extra lighting turn it down after that requirement ends and try to use local lighting instead of general lighting
  • Use a drape in theatre to create a skin to skin tent where the new family can bond and take photos and don’t leave them to do your notes – do that later . Keep a check on the mums and baby’s condition regularly.
  • Use massage to help increase the woman’s own oxytocin levels and darkness will also enhance the melatonin / oxytocin effect .
  • Stay calm and talk quietly – try not to disrupt the woman’s hormones which are affected by noise .
  • A sacred space means comfort , calm , love and kindness must be tangible within that area – it’s not about the space as much as the atmosphere- the way you help a woman to achieve this will have a long lasting positive effect not only on her self value but also impact you in your own practice in a wonderful way .

Please think carefully wether you are a hormone disruptor or a hormone enabler .

Be a true Midwife .

This blog is not to tell you how to be but to provoke thought on our practice and try to help you and others to see how we can effect a positive change for women in their birth settings

Thank you for reading

Yours in midwifery love 💕

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

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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

❤️