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

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

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 ❤️

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

Postnatal transfer to the ward from labour ward – my thoughts

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

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

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

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

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

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

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

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

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

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

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

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

❤️Be a holistic professional caring Midwife ❤️

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

Thank you for reading

Yours in midwifery love

JennyTheM

❤️

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

Birth imprinting – SkinToSkin contact

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

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

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

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

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

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

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

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

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

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

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

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

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Lifting the lid – my life as a midwife PART ONE 

 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

To be continued ….,..

Thank you for reading

Love , as always
Jenny x ❤️

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

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

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

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

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

Anyway back to the operating theatre . 

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

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

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

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

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

Happy Saturday -with love  Jenny xx 

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

The Caesarean experience 

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

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

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

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

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

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

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

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

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

Why am I calling this BIRTH DISCRIMINATION

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

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

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

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

Thank you for reading – jenny ❤️

To be continued ….. 

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

The baby’s here – NOW what ? 

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

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

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

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

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

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

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

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

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

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

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

1.Recover from birth

2. Feel safe and nurtured

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Birth, Midwife, Midwifery, Midwifery and birth, New parents, Newborn, NHS, Night shifts in the NHS, Obstetrics, Patient care, Postnatal care, Psychology, Student Midwives, Women's health

How to keep your ‘Midwifery Passion’

Ideas to help midwives through NIGHT SHIFTS the past couple of weeks I’ve been on night shifts – hence my temporary disappearance from Twitter . I have been forced to practice self-care and be mindful of my own health and wellbeing in order to not only survive night shifts but also to ensure the women in my care were kept safe. A huge part of my role  is to support women and families and also to be a team player by helping and listening to my colleagues of all disciplines. Factor into this the additional pressure like teaching my body to sleep in the day and stay up all night – all this has an adverse effect on causes on my hormones and body  physiology – so it must be the same for any midwife working the night shift.

 I try my best to visit women who may still be on the postnatal ward (ones that I have cared for in labour or met antenatally) to offer a debriefing session and go through parts of the birth they may have forgotten- I find this helps me as much as it helps them . Women become tired during long nights of labour and may forget their own strength during labour and birth so I like to remind them. As midwives we must make a firm relationship foundation with the woman and her birth partner(s) and we must also display  love for our job and show it’s something we do because we enjoy it not because we have to – when did you last show that you love your job?  Women want to know that you care about them and getting food and drink in the middle of the night is a real challenge but I take it firmly onboard . I scour the fridges for left over unopened  in date sandwiches- dash to the vending machine to buy a packet of fruit pastilles or a small bar of chocolate , offer my pre-packed fruit salad, make toast and encourage food in labour – women use on average 150 kcal an hour in labour and it’s important to explain why you are encouraging eating .  Women don’t want to face a labour with a midwife who hasn’t slept or who is complaining about being at work . My philosophy the past two weeks has been to

  • Get some sunlight every day before bed
  • Eat a meal before work that will sustain me through the night – a balance of protein, carbohydrates and vegetables
  • Laugh with colleagues – I am quite well known ay work for my gangnam style dance so one night I was on the postnatal ward I danced in the office – the future midwives face was picture !!
  • Understand why I may have bouts of moodiness
  • Speak to a friend every other day
  • Walk my dog pre-bed and pre-work to ensure I am getting exercise and fresh air
  • Reduce my screen time – that includes Google and Twitter – I am on screen time at work with the maternity system online and screen time can affect our circadian rhythm.

Don’t underestimate how hard it is for me to get in from work and drive to the beach – I struggle, but I have noticed a definite change in myself during these nights and I am sure its because I have exercised prior to sleeping . I have also used some aromatherapy and mindfulness (which I do every single day – nights or days )

I prepared my fridge – chicken , vegetables , pre-packed fruit portions , cheese for protein in the night , and faced my dislike of drinking water . I googled jet-lag and circadian rhythm to help me face up to how my body might react and went in for the positive approach . I took the decision to walk on the beach with my Labrador puppy Buddie post each shift and eat my favourite breakfast sat outside my favourite cafe before I went to sleep. These positive  activities helped me to switch off from my shift , gave me a sense of wellbeing and also helped me to interact with others before I became a hermit for the day . Once home in bed, all curtains were closed and all lights switched off – as a visual hint to ‘popper inners’ those friends of mine who I adore as they pop in to visit me unannounced and I do love that but not on night shifts. I also prayed that my neighbours would be quiet and that their dog wouldn’t bark too much – it worked !!

Night shifts are special for midwives , the hustle and bustle of the hospital is turned down , the ward round is vanquished, the tea trolley is ever present and I can drink tea in the birth room with the families .

After night shifts it’s ok to feel tired and nap in the day – listen to your body carefully . Take time to recover post nights – don’t push your body beyond its limits thinking you are doing it a favour – you aren’t !

I’d like to dedicate this blog to all the midwives who work night shifts – and especially Olivia and Jude as they often discuss the effects of nights with me –  thank you to all NHS nightworkers  for all you do .

Further reading and resources 

information on The BODY CLOCK 

What is sleep drive ? Sleep drive and your body clock

Try a few of my ideas and see if they help your night shifts – I hope they do .

With kindness & midwifery love ❤️

Your friend Jenny

XxX