Category: Newborn attachment

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

The birth of my son

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

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

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

Off I went on my merry way .

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

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

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

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

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

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

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

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

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

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

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

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

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

Happy birthday son ❤️.

Thank you all for reading.

With love

❤️Jenny ❤️

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

SkinToSkin poem © by Jenny Clarke

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it really doesn’t matter where you are

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

The ultimate way for a baby’s life to begin

Is right next to her mother in SkinToSkin

Your baby doesn’t care what she weighs

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

SkinToSkin contact for babies 37 weeks or more

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

It helps stop separation of you and your baby

That’s a fact – no ifs,buts or maybe

Prolonged SkinToSkin makes you more of a team

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

SkinToSkin is no fad, craze or latest trend

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

your ears soon in Breastfeeding Week.

I have read all the research by the SkinToSkin geeks

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

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

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

SkinToSkin sets off behaviour ,keeps baby’s calm

Us humans are mammals -made to keep our young warm

So at birth just consider how your baby will feel

SkinToSkin will tell her –

YOU ARE the real deal ❤️

© @JennyTheM 27.3.19

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

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

Making a sacred space for birth

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

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

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

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

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

My tips for making a sacred space are

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

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

Be a true Midwife .

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

Thank you for reading

Yours in midwifery love 💕

Jenny ❤️

Against the odds, 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

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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 ❤️

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 

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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 ? 

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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 babies sleep . 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;

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 

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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

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The fable of the napkin folder 

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There was once a factory in a far away land . The factory owner Fred  took immense pride in his factory .

This was no normal place to work , the employees had to fold napkins at the same time as caring for an elderly person . This care involved mainly talking to the elderly person and making the person happy through conversation – this was an intrinsic  part of their work – but I’d like you remember that  the employee also had to fold napkins .

Suki was an employee at the factory , she was an amazing napkin folder and the top napkin folder at the factory . The factory owner raved on and on about how good Suki was at her job – he promoted her and used her as a role model of efficiency whenever he went to other napkin folding factories . Suki felt very proud and kept working hard .

One day Suki’s chair broke – so she had to move to another area whilst it was fixed . Suki sat next to Giles who was also a napkin folder – Giles wasn’t very productive but he did attain adequate levels of napkin folding  to keep himself in employment . Suki noticed amazing things about Giles he was working but also chatting away to his allocated elderly person quite a lot , the elderly person was called Gertrude . Suki noticed that Gertrude looked very happy and Suki suddenly realised that all the years at the napkin folding factory her own allocated elderly person had never laughed like Gertrude . 

The next day Suki went to see Fred the factory manager and told him about Giles & Gertrude . “I think we should watch Giles” Suki said . Fred the factory owner went to see Giles and immediately noticed how joyful he was in his work – Suki was happy but Giles had that extra ‘je ne sais quoi’ . The factory owner also checked all the records of all the elderly people that Giles had sat with whilst he folded napkins . A wonderful thing had come to light not only had no one complained but there were letters of thanks from families of the elderly people stating how kind Giles had been and recommendations for his promotion .

The next day Fred the factory owner made an announcement to all the people at the factory  

“All of us within this factory should give a higher priority to making each elderly person happy  over and above folding napkins. In this wonderful life  we are simply spreading kindness , compassion and the human spirit . Look at Giles and Getrude and the happiness they emit and share . ”

Over the next few months the factory workers tried their best each day to give their priority to each of their allocated elderly people. A remarkable thing started to happen – productivity increased and surprise,y more napkins were folded than ever before  but also the workers felt more valued  and much happier about being at work – plus much more than that the physical and mental health of the elderly people involved took a significant improvement – because in the end we are on earth to be human .

I hope you enjoy my fable . 
Thank you for reading 
❤️Jenny❤️

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#LeadToAdd 

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LeadToAdd click HERE to learn more is the latest NHS England campaign # is #LeadToAdd. As a Caremaker I will be linking this on Twitter with my work on #skinToskin , #futuremidwives and #couragebutter to inspire others to see themselves as leaders regardless of their role . Patients, women, families and non-clinical staff are also leaders .  
I feel this will inspire/activate different meanings to different people

Here are some of my thoughts around it

What does to lead mean ? 
To take charge , to be at the front , to inspire , to educate, to be diverse 
Leading is about being at the front and CONSTANTLY looking back to bring others with you

Leading is about being the first to begin something but not necessarily holding onto that but looking at how your actions impact on the way others fulfil their role. Leading is being a positive role model, leading is about looking inwards at your own behaviour and also looking outwards at the behaviour of others . 

In the NHS all staff need encouragement to recognise themselves as leaders and also to see that some behaviours do not embody leadership. We are all learning each day, so don’t stay still – question yourself and the way you speak to others . Ask a colleague to listen to you talking to patients and staff and to give you feedback -what could you change ? Integrate telephone conversations into drills training-  talk to your practice development team – think outside the box . 

Someone who leads others into poor practice is a poor leader but a leader non the less so be aware of your own commitment to pass the positive leadership baton . We are human and it’s ok to make mistakes , however we must learn, evolve and change .

The other day I had a car journey with Joan Pons Laplana (@ThebestJoan on twitter) and once again he made me think hard about how the 6Cs are integrated into practice . Joan said to me that as a health care professional all tasks and procedures must embody the 6Cs – even answering a telephone call. 
As a form of reflection I’d like you to read passage one and then passage two
Passage One 
Busy labour ward – phone ringing , midwife answered the phone – we will call the person making the call Tony and his partner who is having a baby is called Dolores. The midwives name will be Darcy . 
Midwife ( confident and cheery) ” hello labour ward , midwife speaking how can I help you?”
Tony (nervous voice) ” oh hi – err my partner thinks she’s in labour , it’s our first baby and we are a bit nervous . Could I ask you some questions , she’s here but having a contraction right now and then she feels sick for a few minutes after its gone. 
Midwife “oh right well I need to talk to her please and decide what’s happening’  
I’m not going to continue this but could the midwife change her approach ? Is this midwife you ? A colleague? This approach has been learnt from a peer
Passage Two 

Busy labour ward – phone ringing , midwife answered the phone – we will call the person making the call Tony and his partner who is having a baby is called Dolores. The midwives name will be Darcy . ….

Midwife ( confident and cheery) ” hello labour ward , my name is Darcy Jones I’m a midwife and how can I help you?”
Tony (nervous voice) ” oh hi Darcy – I’m Tony – err my partner Dolores thinks she’s in labour , it’s our first baby and we are a bit nervous . Could I ask you some questions , she’s here but having a contraction right now and then she feels sick for a few minutes after its gone. 
Midwife “ok well I would like to take some details first whilst Dolores has a contraction . Thank you so much for ringing us . How are you feeling ? This is your first baby ? How exciting for you both!” 
I’m not going to continue this but could the midwife change her approach In either scenario – which is the best one in your opinion ?  ? Is either of these scenarios you ? A colleague? This approach has been learnt from a peer. 
So you see two examples each one leaving the person contacting  the service with different emotions . 
Start your journey as a #LeadToAdd leader today  ❤️
Thank you for reading 
Love , Jenny ❤️

Antenatal education, Babies, Being busy as a midwife, Birth, Breastfeeding, Caesarean section, Change management, Children, Compassion, Courage, Helping others, Hospital, Human rights, Intra-operative care, Kindness, Labour and birth, Learning, Manual removal of the placenta, MatExp, Media, Midwife, Midwifery, Midwifery and birth, New parents, Newborn, Newborn attachment, NHS, NHS Systems and processes, Obstetrics, Patient care, Post traumatic stress disorder, Postnatal care, Respect, Skin to skin contact, Surgery, Teaching, Women's health, Women's rights, Young mothers, Young women

The natural caesarean / the gentle caesarean 

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There’s a debate on Twitter this morning about the ‘natural caesarean’ as a term that promotes a positive experience of birth by caesarean. I don’t agree with the term and I think as health care professionals working in the area of birth we should ensure that every birth is a positive birth . Milli Hill started the The Positive Birth Movement  with this goal in mind (@birthpositive on Twitter ) 

Bearing this in mind I’d like to ask the following questions for you to consider and share with with your colleagues, family , friends , midwives and obstetricians . 
1. How many women who have an emergency caeserean and/or instrumental birth (forceps or ventouse) are given information in the antenatal period about the far reaching health and psychological benefits of skin to skin contact in this setting to both mother and baby ? 

2. Compare the above with how many women are given information about  skin to skin contact around normal birth ? 

3. Compare both to how many woman are informed that skin to skin is possible during manual removal of placenta and repair of any perineal trauma in the theatre setting ? 

4. Are women informed 

  • They can TELL midwives to defer the weighing of their newborn in order to enjoy the benefits of prolonged skin to skin contact 
  • That they should never be separated from their baby unless a clinical situation becomes apparent or they themselves choose not to have skin to skin contact despite being FULLY informed
  • That their baby could ‘self latch’ at the breast without any handling by staff and also correct its own acidosis and stabilise its own breathing because of skin to skin contact ? 
  • That skin to skin and early breastfeeding “Pronurturance ” is linked to a reduction in the incidence of  postpartum haemorrhage?  CLICK RIGHT HERE for the Pronurturance paper 
  • That if babies could talk they would choose skin to skin contact despite their birth environment 
  • That skin to skin contact is the building block for a persons social and psychological development 

The midwives and staff on social media who talk about caesarean are not promoters of it , they are giving women information about choice – so that if the operation (which is major surgery) does take place then these women are able to not only enjoy their birth experience but give their relationship with their baby the best possible start . 

I suppose it’s similar to the question “does having a teenage pregnancy strategy increase teenage pregnancy rates ?  (and I much prefer the term  “young women”to ‘teenage pregnancy’) 

Does having full information about your choices if you do go on to have a caeserean increase caesarean rates ? I don’t know the answer to either of these questions but I do know that the women I have assisted and sometimes fought for to have skin to skin contact with their newborns in different birth situations have all told me this 

 
-that they never realised the positive impact it had on them as a successful mother

To me this is enough .   
Thank you for reading 

With love , Jenny ❤️

I am also promoting #MatExp as a platform which enables and encourages discussion between women, families and health care professionals .