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

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

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, Change management, Communication, Compassion, Courage, Discharge planning, Giving information, Helping others, Hospital, Labour and birth, Learning, Midwife, Midwifery, Midwifery and birth, NHS, NHS Systems and processes, Obstetrics, Postnatal care, sepsis, Women's health, Working from the heart

Here is your role as a NHS Midwife …… my suggestions

Here is your role as a Midwife in the NHS

  1. learn about the guidelines and policies at your place of work .
  2. Complete your mandatory training come hell or high water despite not being given allocated time to do so
  3. Get up in the morning / the evening travel to work be on time , report for duty .
  4. Push yourself each day to be a little better than you were the day before
  5. When you are upset about something try and soldier on because everyone else is in the same situation
  6. Support new midwives and future midwives – be a role model as everyone takes note of the way you behave at work (don’t for a minute think that they don’t !)
  7. Practice 1-5 each day now add in caring  for women families ,getting along with your colleagues , getting a break everyday and leaving your shift on time

Stick to …….

Wait a minute Wait a minute.   REWIND REWIND REWIND ……

  1. Get on Twitter and join the community of midwives there sharing evidence based practice
  2. Immerse yourself in the computer system that will give you stats for your own practice (as well as others ) and look at how to improve them.
  3. Practice a daily ritual that is kind to you – respect yourself and your body clock get fresh air and sunlight each day pre or post shift Watch this programme “The body clock- what makes us tick?” on the relevance light (measured in LUX) has on the body clock and circadian rhythm .
  4. When you are happy and /or upset about something try and reflect on it through writing or recordings and seek advice from your occupational Health dept. Team up with another midwife from a different NHS trust and see yourselves as support buddies , reflect together on what helps you at work and learn new positive ways of staying focused and compassionate in your midwifery work
  5. Be professional in all you do through the your words / deeds / behaviour towards others including the way you communicate on your break – integrity is a huge part of being a Midwife . The words you speak in the office / break room and out of work are like a fragrance upon you when you are caring / mentoring and teaching.
  6. Having a break is set into statutory employment law – it ain’t no privilege – so plan your own break and get away from your work environment eat your food in a quiet place, do three minutes of mindfulness – your break time belongs to YOU – if you can’t take the full amount at once try breaking into bite sized amounts so you can eat / / rest / reflect but perhaps on three short breaks instead of one long one -also support your colleagues to do the same
  7. If you are a manager/head of midwifery consider how you get your lunch and try to be a role model – go and eat with the staff you manage – you might find out more through this than leading meetings
  8. If you hear a group talking about another colleague in a derogatory manner then challenge them why are they discussing someone who isn’t there to defend themself, then ask them to stop – if you choose to ignore this kind of behaviour you are condoning it
  • Always remember you are not at work to socialise but to put the women and families at the heart of what you do . If you find yourself questioning a colleagues work style – ask yourself this “is that colleague putting the woman first ? “
  • You’ll probably find the answer for the style of work is because the answer is YES!! So if you have a colleague who may seems to take a little longer with women or isn’t seen in the office much try and shadow them – sometimes taking some extra time can be more cost effective – a long chat pre discharge can arm women with knowledge about how to recognise SEPSIS , help her to recognise when her baby is feeding well or not and also to pickup POSTNATAL DEPRESSION earlier .
  • These are just my thoughts and it’s my first blog for ages so I hope you enjoy it
  • Be kind ❤️
  • Yours in midwifery love
  • Jenny ❤️©️2018
  • 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

    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, 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 ❤️

    Birth, Communication, Compassion, Helping others, Human kindness, Labour , birth, Labour and birth, Learning, MatExp, Midwife, Midwifery, Midwifery and birth, Newborn, NHS, Skin to skin contact, Student Midwives, Women's health, Women's rights, Working from the heart

    The future midwife and the midwife 

    A few weeks ago I was working with Emily Leeder a student midwife who has since completed her training and has now finished her time at my trust . I really like Emily she totally gets me and my sense of humour and she has picked up some of my traits – which is strange but lovely to see – I feel that when I do retire I will leave a little bit of me within Emily’s practice .  Emily also inspired this blog CLICK HERE TO READ about the importance of appropriate touch in midwifery . 

    We both saw the positive effect of a small glass of a well known energy drink (NOT Redbull!) made flat by stirring profusely and how women who hadn’t eaten in labour felt better after it . We christened it our ‘chemistry set recipe’ for an energy boost in labour .

    When we worked together we automatically shared roles and I think that neither of us felt controlled or ruled by the other – we were there for the women and supported them but we were in harmony as future midwife and midwife . Emily taught me the true meaning of mentorship as she messaged me for support and also wrote me lovely feedback for my revalidation.  I gelled with her and never felt judged by her or unable to ask if she knew something I didn’t . 

    A few weeks ago we were with a woman who was at the start of her journey to becoming a mother . With this wonderful woman was her partner and her mum . We were having a discussion about skin to skin and delayed cord clamping and I asked the woman’s mum if she had experienced skin to skin contact at birth  with her children. The mum said “not really , my baby was born then weighed , measured and checked by another midwife , whilst the birth midwife was helping me to birth my placenta and check if I needed stitches – which I didn’t – so then I was told to have a shower . Within half an hour I was transferred to the postnatal ward ” 

    My reply was off the cuff and I didn’t realise how funny it was until Emily had to leave the room crying in laugher . 

    I said “a shower ? You gave up skin to skin contact because someone told you to have a shower ?! We are mammals – imagine other mammals giving birth and being forced to wash within an hour of birth . In fact right here right now let’s just imagine an elephant giving birth to a baby elephant cub and one of the female elephants shouting out ‘Get into that river now & wash !’ It just wouldn’t happen would it – no one would argue with a newly birthed elephant mum would they ? ” 

    It really doesn’t seem as funny now but it’s left a great memory for me , Emily and the family – and the woman gave birth and did NOT get pushed into the shower at all . In fact she chose to have a wash a bout three hours later , after LOTS of skin to skin with her newborn ❤️
    Thank you Emily for helping me with my journey as a mentor – I’m always learning and I wish you well at your new NHS trust – keep in touch 

    This is my first ever scheduled blog and it’s for three reasons 

    1. Today will be the third anniversary of the day I started presenting to raise awareness of skin to skin contact – you can read the storify of the day HERE or just search #MAMMevent on Twitter 

    2. I will be presenting at Coventry midwifery Society today the # will be #CovBF17 

    3. To thank Sheena Byrom OBE for believing in me as a public speaker and also for friendship and kindness when life was tough for me . 

    I am proud to be a midwife 
    Love from Jenny xx 😘 

    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 ❤️<<<<
    gt;

    Babies, Being busy as a midwife, Birth, Compassion, Courage, Giving information, Helping others, Hospital, Human kindness, Kindness, Labour , birth, Labour and birth, Learning, MatExp, Midwife, Midwifery, Midwifery and birth, Motherhood, New parents, Newborn, NHS, NHS Systems and processes, Obstetrics, Patient care, Respect, Uncategorized, Women's health, Women's rights, Working from the heart

    With woman midwifery 

    ❤️Before I start I’d like to thank Soo Downe for using this photo of me with my pinards in her slides during this years EMA ❤️ &  thanks to Jacque Gerrard RCM for letting me know. 

    Hello , are you a midwife ? Have you ever heard or said any of the following sentences ? 

    “I’m coming in the office for a few minutes , they don’t want me in there all the time” 

    “I’ll leave you in peace for a while – you don’t need me here all the time” 

    “I’m giving them some time to themselves whilst she’s in the early stages” 

    There is evidence and research to prove unanimously that women who have continuous one to one care have less pain relief , more incidence of normal birth , less perineal trauma and feel more positive about their birth process . As midwives there’s always information to share and explain that the woman may not know about . I also view my role as a guardian to the partner making sure he or she feels involved and free to ask questions . So the next time you hear yourself or a colleague say “I’m leaving the couple I’m caring for as they don’t need me in their birth room all the time” just remember leaving them  isn’t evidence based practice – staying with them totally is 

    Resources on continuity 

    http://onlinelibrary.wiley.com/store/10.1002/14651858.CD004667.pub5/asset/CD004667.pdf?v=1&t=iwl6t8eo&s=72d734e7de6a3665a8d183e2d5df1492e37dc2ec

    http://www.sciencedirect.com/science/article/pii/S0140673616314726

    http://www.sciencedirect.com/science/article/pii/S0266613816300572&nbsp;

    Against the odds, Caesarean section, Cancer, Care of the elderly, Change management, Community, Giving information, Helping others, Hospital, Human kindness, Human rights, Learning, Media, Midwifery, NHS Systems and processes, Nursing, Social media health care, Surgery, Teaching, Working from the heart

    r – Evolution in the NHS is happening right now 

    Let’s go right back to 1980 the year I joined the NHS . I was a student nurse . My first ward was E1 a male surgical ward which was run like a tight ship. The captain was the sister and she ruled the seas – quite literally especially when I flooded the ward because I’d left the metal bed pan steriliser running during a ward round !!! 💦💦The consultant was paddling in his leather shoes, his trousers suspended at half mast like sails  – he never spoke to me but I was told off , humiliated and belittled. I wonder if that’s when I first saw the value of humour at work ?  Because suddenly the patients adored me ! Fast forwards 33 years to 2013 , you’d think I’d have learnt my lesson ! A busy shift and I was working on the beloved birth centre , women were spilling  into it because the delivery suite (a term I do not like – birth ward would be better) was full . A midwife friend asked me to keep an eye on the birth pool she was filling and I forgot as the woman I was with was overflowing with oxytocin and gave birth . So the best thing I hear is someone shouting ‘flood!’ Oops a daisy – run outside the woman’s room (not the room or my room – take note!) to find Mr Amu our lovely consultant standing in water laughing at me and saying “how do we sort this ?” My friend Carol the cleaner in hysterics with me as we rallied water suction machines , towels , sheets ANYTHING to stop the water moving further . Do you see the difference between 1980 and 2013 ? Now those of you who know me well know I’m a joker as I regularly shout to lovely Carol the cleaner “quick I’ve had another water incident !” Of course I’m joking and of course we laugh out loud and Carol tells me off – giggling . 

    The evolution is happening because  as the years have passed social media has been accepted as a form of communications and is effective connecting more staff and service users than emails and/or phone calls. However much more than that NHS staff can find out what’s happening (or not as the case maybe) either within their own trusts or in other trusts they may never ever visit or work at . By sharing evidence, good practice  , learning from others and communicating openly we are slowly stamping out poor practice and improving quality . Patients talk to staff within an open forum , staff read more articles and are constantly trying to improve the patient experience . 

    For me I think the lightbulb moment has been that I can make a difference , I can challenge practice and I allow myself to keep learning, growing and connecting . I’ll take you back to 1980 – all I knew was where I worked – now I see so much more-  and the wonderful people I’ve met on social media ? Well we would have never met ! So thank you social media from the staff and families of the NHS.

    Let’s keep on evolving 
    Thank you for reading 

    With love  , 

    Jenny ❤️

    Antenatal education, Anxiety, Birth, Breastfeeding, Caesarean section, Compassion, Courage, Fear of Birth, 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 Systems and processes, Obstetrics, Patient care, Post traumatic stress disorder, Postnatal care, Psychology, PTSD, Respect, Skin to skin contact, Women's health, Women's rights, Working from the heart, Young mothers, Young women

    Fear of birth 

    How can midwives help women who have a fear of birth ? 

    If you meet pre labour I cannot over emphasise the benefits of using a doula service – doulas connect with women and support them through pregnancy , labour, birth and the postnatal period – I value all doulas and I have learnt so much from them . 

    Sit beside the woman at her level , listen carefully with your eyes and your  ears . Demonstrate that you accept her fear as real and tangible and do not dismiss  it by saying “you’ll be fine, lots of women give birth”. When as a midwife you first meet a woman, it’s crucial for you to have open body language which means arms by your side , warmth in your eyes, and you should display love and truth . Ask the woman if she wants you to hold her hand , this is a connective proces and a simple yet effective of cementing your relationship with her . 

    Help the woman to gain a rapport with you and confidence in herself by demystifying some of her previous experiences  eg the gas and air didn’t help last time , I tore badly last time , I failed at breastfeeding last time. this time it just might . Be a source of knowledge and light for her .  Explain that you are with her that you love your job and you will be her advocate throughout .  

    Explain the process of pain in the cervix and why relaxation can help , use mindfulness links for her to listen to and actively take part in them with the woman and her partner to show your commitment to them both . Teach her that an internal examination is about choice, consent and that she is the one in control with an ability to stop the process at any time . Also explain her human rights matte in labour. . The woman may decide against internal examinations – be with her in this decision. 

    Hold the woman’s hand when she is talking to you , this will let her see that you are kind and that you  want to help her . Say things like ” I can see vulnerability in your eyes , tell me how I can help you , I am with you” “how are you feeling at this present moment? ” 

    Ask what her fears are – one woman I met recently was so scared , she thought that she might die in labour – this may seem irrational but it’s acutely important to know that these expressions of fear are very real to the woman herself . 

    Don’t talk about feeding intention , sometimes a woman’s confidence and belief in herself are knocked for six when there have been difficulties with breastfeeding and this can manifest as fear in labour . Discuss instead why her newborn craves for skin to skin with her at birth and that these physiologically magical hours are also to help her feel validated once she has given birth . 

    Help the woman to focus on the moment not what might happen this is mindfulness in labour.

    If a woman has had a straightforward birth before , her perception of it is what matters not what the notes say or the fact that it appears to have gone smoothly. 

    Try your best to stay in the room most of the time , even use the ensuite in the room yourself once you have asked her permission to do so . Your aim is to to reduce her anxiety and fear of being left by the midwife .

    Handover information to the team on shift about the woman and her fear of birth so that staff enter the room peacefully and introduce themselves . If someone enters the room and doesn’t introduce themselves, do it for them. 

    Ensure that the partners voice is heard and that they see you are trying to help by using open questions . Learn what they do , how they met and see their love for one another . 

    Don’t push the woman to have stronger analgesia , the key is give information. It’s crucial to give full explanation of all analgesia and their effects not only on the woman but on the baby and its ability to feed after birth . The pain is the woman’s pain and she must feel heard regarding her analgesic choices. 
    Never underestimate the value of finding  a midwife that knows the woman and also suggest aromatherapy. Frankincense is wonderful scent that reduces anxiety and if used in combination with other scents has a calming pain relieving quality . 

    Keep the room darker and ask staff to be respectful by not  entering the sacred birth room – interruptions increase adrenalin response which blocks the production of oxytocin and if her partner can get on the bed too this helps the woman to feel safe and loved . 

    Explain that you will not talk loudly during the birth and also try not to leave the woman afterwards , complete all notes in the room . Sometimes the most vulnerable time for a new mother is immediately after her child is born . Staying with her to help with positioning and handling of her baby will serve to strengthen her own belief in herself .

    Avoid using terms such as “good girl” use the woman’s name to speak to her so that a sense of trust is built upon . 

    Explain why prolonged skin to skin contact will help the woman after the birth , it is revalidating

    If you think she might need your help with a shower or bath that’s fine – ancient cultures have washing rituals and cleansing is sometimes quite cathartic for a postnatal woman plus you are showing that you care about her and reaffirming that human kindness makes a difference to someone’s experience .

    It’s important to be aware of fear of birth and how it manifests in women sometimes it’s difficult to recognise  in the antenatal period and might not be disclosed until labour . Women with a fear of birth  must’ve given time , feel listened to and feel supported . 

    Whichever way the birth takes place stay with the woman , and be a constant for her . 

    Read as many articles as you can about fear of birth let women know that you understand , follow @FearOfBirth , Yana Richens is a consultant midwife at University College Hospitals London NHS Trust who has just submitted her PhD on fear of birth , she has extensive knowledge and experience . Also Kathryn Gutteridge aka @Sanctummid who is a consultant midwife at Birmingham Women’s who recently co- hosted a tweet chat on  the @WeMidwives platform together with   @TheLovelyMaeve  Maeve O’Connell (a senior Irish Midwife who has also submitted her PhD) . The tweet chat discussed  the subject of Tocophobia . 

    Lastly try to write a birth story for the woman from her newborn . When a woman sees words on paper that reflect how she gave birth and her newborns belief in her the effect is indescribable . This will pass into the next generation and you will be affirming birth to many others who read the letter. Never underestimate the effect that your actions , inactions or displays of love , kindness and compassion will have on a woman and her family , they will unknowingly to you. Quite simply your support kindness and compassion will last much longer than a lifetime. 

    Thankyou for reading and thank you to wonderful Claire Harrison midwife and friend for believing in me and inspiring me to write this piece .

    Love from Jenny 💛❤️💛XXXX