Category: Postnatal care

Against the odds, Anaesthetics, Babies, Being a mum, Being busy as a midwife, Birth, Caesarean section, Communication, Compassion, Courage, culture in nhs, Digital, Hospital, Human kindness, Labour , birth, Labour and birth, leadership, Midwife, Midwifery, Midwifery and birth, Motherhood, New parents, Newborn, NHS, NHS Systems and processes, Obstetrics, parents, Patient care, Postnatal care, Respect, Skin to skin contact, Student Midwives, Women's rights, zero separation

A midwifes role in the maternity theatre – support from managers

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Here it is my blog aimed at NHS managers and fundholders of maternity services – time to explain a few home truths. MORE support is required for midwives in the operating theatre from upper NHS management in order to facilitate and maintain SkinToSkin contact between mothers , fathers and babies .

A few reasons the midwife may have for leaving theatre include : –

  • To check the placenta
  • To take blood gases
  • To obtain documentation from a printer (which is not actually in the operating theatre)
  • To complete digital or written records
  • To register the birth

Let’s look at it another way – if an operating department practitioner said to a midwife “I just need to nip out for a few minutes can you step in for me for a few minutes and help the anaesthetist? ” how would a midwife feel ? How often does this happen ? Never !!

We must respect each another’s professional competencies and abilities and not take advantage of any given situation . The operating theatre is governed by health and safety due to the highly clinical nature of its environment . Midwives are selling themselves short by trying to manage their workload instead of questioning why they need more support .

We must deal with the root cause which is midwives leaving theatre to complete routine tasks (when they should be staying with women and babies)

The symptom is the fear of other staff in theatre of caring for the dyad , the woman’s fear at being unable to speak out that she’s scared of holding her baby during her operation or procedure .

The midwife has a professional responsibility for the mother and her newborn as set out in the NMC code of conduct and The NMC Standards for Competence for Registered Midwives

I’d also like to refer to these key parts of the NMC code which seem to address care of the dyad in theatre so well .

If you are a manager support your midwives by auditing the reasons why a midwife might leave a woman in theatre for any length of time and address that issue with the multidisciplinary operating theatre team – there will be solutions and the solutions will improve care , safety , women’s and families experience of care in the operating theatre and well as giving midwives immense job satisfaction, plus enabling team cohesiveness – what more could you ask for ?

I am challenging all line managers to go into the operating theatre and watch the midwife – how can you make it better for the midwife and therefore the dyad ?

Keep on keeping on

Thank you for reading my blog

Please leave your comments as I appreciate all feedback

Jenny ❤️

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

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

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

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

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

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

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

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

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

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

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

“do to”

but to

“be with”

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

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

❤️❤️❤️❤️❤️❤️❤️❤️❤️❤️

Three stories of defending

Read on reader ….

Story one

The elective premature Caesarean birth – a courageous Midwife

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

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

Story Two

The “Failed” Induction challenging a decision

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

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

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

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

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

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

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

Story Three

Rebalancing the birth hormones

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

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

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

All was well

I am a defender ❤️

Summary

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

Stay curious and keep defending

❤️We are defenders❤️

#IDM2019

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

Thank you for reading my blog .

Yours in midwifery love

JennyTheM ❤️

Stay curious

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

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

The birth of my son

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

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

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

Off I went on my merry way .

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

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

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

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

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

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

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

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

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

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

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

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

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

Happy birthday son ❤️.

Thank you all for reading.

With love

❤️Jenny ❤️

Antenatal education, Babies, Being a mum, Birth, Children, Compassion, Hospital, Human rights, Labour , birth, Labour and birth, Midwife, Midwifery, Midwifery and birth, Motherhood, New parents, Newborn, NHS, Postnatal care, Respect, Skin to skin contact, soeaking out, Student Midwives, Women's rights, Young mothers, Young women, zero separation

Newborn babies – photographed without their parents – my bugbear

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Everyone who knows me knows that I promote , research and present about SkinToSkin contact . I know exactly why it matters to mothers , fathers and babies .

Just recently I’ve noticed an advert for an upcoming ITV series “Delivering Babies ” in which Emma Willis stars as a auxiliary nurse assisting on a maternity unit – the profile photo shows a picture of Emma holding someone else’s baby without any of the parents in the photograph – this is what prompted me to write this blog .

One particular bugbear I have is seeing a baby on a photograph with a health care professional without the mother or father being included in the picture .

I have discussed this with many future and new parents and explained that they are the guardians of the newborn – protecting it from unnecessary exposure to anything . At most schools there is a social media policy which prevents the posting of children on social media sites . However the same rules don’t seem to apply for newborn babies.

I see many programmes about pregnancy, labour , birth and the postnatal on TV which I choose to critique. Some I have given up watching through exasperation that the baby is not seem as a child of someone .

I have had heated debates with maternity managers , future midwives , midwives , maternity support workers about why a baby should not be photographed without any of its parents . I ask them this question “if you had a baby would you want it’s photo to be on someone else’s social media account , mobile phone or perhaps even framed on a sideboard in someone else’s home that’s not even related to you ?”

Just google “Midwife” and numerous photos will pop up of midwives holding someone else’s baby . There’s even one from Call The Midwife – time to rethink why these photos exist and consider the human rights of the newborn ?

Below are two collages I made following a google search – who are these babies and were the parents asked for full consent and counselled thoroughly about the fact that their babies would appear on internet searches ?

My other concern is WHO takes the photo ? If it’s on the parents phone and given to the midwife as a gift does that make it ok . What is consent ? Eg “could I have consent to use this photograph of me holding your baby to post on social media / put into a frame at home , look back on and wonder who that baby belonged to in 20 years time ” OR “could I have a photo of you as a family with me in the background which I will treasure and treat with respect , I will not post it on social media and it will remain a midwifery memory for me of meeting you ?”

In taking photos we must consider

Is it necessary ?

Please leave your comments below

Yours in midwifery love

@JennyTheM

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

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

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Here is your role as a Midwife in the NHS

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

Stick to …….

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

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

    Postnatal transfer to the ward from labour ward – my thoughts

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

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

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

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

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

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

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

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

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

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

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

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

    ❤️Be a holistic professional caring Midwife ❤️

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

    Thank you for reading

    Yours in midwifery love

    JennyTheM

    ❤️

    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 ❤️

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

    Lifting the lid – my life as a midwife PART ONE 

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    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 ❤️

    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 ….. 

    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’

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    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