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

Birth imprinting – SkinToSkin contact

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

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

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

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

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

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

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

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

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

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

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

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

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

The Caesarean experience 

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

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

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

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

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

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

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

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

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

Why am I calling this BIRTH DISCRIMINATION

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

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

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

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

Thank you for reading – jenny ❤️

To be continued ….. 

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

r – Evolution in the NHS is happening right now 

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

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

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

Let’s keep on evolving 
Thank you for reading 

With love  , 

Jenny ❤️

Against the odds, Care of the elderly, Community, Compassion, Courage, Fables, Helping others, Hospital, Human kindness, Human rights, Kindness, Learning, MatExp, Midwife, Midwifery, New parents, Newborn, Newborn attachment, NHS Systems and processes, Patient care, Psychology, Respect, Teaching, Women's health, Working from the heart

The fable of the napkin folder 

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❤️

Babies, Being busy as a midwife, Birth, Breastfeeding, Caesarean section, Care of the elderly, Change management, Children, Community care, Compassion, Courage, Helping others, Hospital, Human rights, Kindness, Labour and birth, Learning, Media, Midwife, Midwifery, Midwifery and birth, New parents, Newborn, Newborn attachment, NHS, NHS Systems and processes, Nursing, Obstetrics, Patient care, Respect, Surgery, Teaching, Women's health, Young mothers, Young women

#LeadToAdd 

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 

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 . 

Antenatal education, Babies, Birth, Breastfeeding, Caesarean section, Change management, Children, Compassion, Courage, Discharge from hospital, Helping others, Hospital, Human rights, Intra-operative care, Kindness, Labour and birth, Learning, MatExp, Midwife, Midwifery, Midwifery and birth, New parents, Newborn, Newborn attachment, NHS Systems and processes, Obstetrics, Patient care, Postnatal care, Respect, Skin to skin contact, Surgery, Teaching, Women's rights, Young mothers

The Gentle Caesarean – Gentle with what ?

Last year I was lucky enough to work in a general theatre for a week . I met a wonderful general surgeon and watched him perform bowel surgery . I noticed immediately how gentle and kind he was with the internal tissues and how calm and respectful he was not only towards the patient and his body , but also the staff in the operating theatre. All the staff admired this surgeon – you know when you can just tell ?  

I asked the surgeon afterwards about his technique and he said this

 “I always respect the tissue Jenny- tissues , blood vessels  , muscle and skin are part  of our human make up and being gentle with them means I am showing tissue respect and respect to the patient who is a fellow human . Being a gentle surgeon takes longer but believe me the outcomes are better and I know that there is less trauma , post-op bleeding , infection, pain and therefore happier patients and staff .”

Currently there is a lot in the news and emerging research around “The Gentle caesarean” and I am looking at this from a different angle  (and for those who know me well I don’t do acceptance well – I like to ask things so that others unable to ask might think differently ) so I am questioning what this term “Gentle Caesarean” actually means . Does Gentle Caesarean mean just the moment of birth or should it be right from the decision or choice of the woman to have an operative birth through to arriving home ? 

So for all those who work in the field of midwifery , obstetrics , intra-operative care, surgery , pain management -I would like you to watch a caesarean from start to finish and ask yourself “was that a gentle caesarean from that the moment that the woman arrived in theatre ? Was there gentleness with the woman’s feelings and choices ? Did the obstetrician, scrub midwife and others maintain gentleness towards the internal tissues and the to the baby? Was the transfer to the bed from the operating theatre table gentle ? Was privacy and dignity maintained at all times? 

Just because we have always done something a certain way does not mean that “the way” is always the best . 

I hope I spark someone to change practice and make “The gentle caesarean” standard across the NHS because then it will spread  globally – we must question on a  daily basis what we do and why we do it .
Thank you for reading , please leave feedback and / or share this blog with your colleagues 
With love and midwifery kindness , 

❤️Jenny❤️
Addendum today I am thrilled that The Times journalist Katie Gibbons has written an article about skin to skin contact at Caesarean  CLICK HERE to access or being the rebel that I am here’s a photo 😁

 

Antenatal education, Babies, Birth, Breastfeeding, Children, Courage, Helping others, Human rights, Kindness, Labour and birth, Midwifery and birth, New parents, Newborn, NHS Systems and processes, Patient care, Postnatal care, Skin to skin contact, Teaching, Women's rights, Young mothers, Young women

Memories of skin to skin contact 

Those were the days weren’t they? Or were they ? 

This week I met up with a friend (pseudonym Niamh) who is a mother of four. She recounted to me each tender moment that each of her children was born . The last three were born by Caesarean section . “Did you hold them straightway?” I  asked .

Niamh replied “to be perfectly honest no – I held none of my children that were born by Caesarean section immediately in fact not for severel  hours ” Niamh then recounted to me the birth of her son – when he was about 6 hours old she had still not seen him properly and asked a midwife how he was doing – the midwife told her that he was fine but due to breathing problems he was in an incubator . SIX HOURS !! I want to add that no one had told her until she asked . 

If you are a midwife , an anaesthetist , an operating department practitioner or a theatre nurse. If you work in an operating theatre , or  if you teach those who do -I want you to think carefully about why we must all strive to keep mothers and babies together in the theatre setting . 

I know it’s becoming more common for skin to skin to happen and I realise that if it’s not happening that to fight the system and challenge separation is difficult but we must keep moving forwards  . The reason is simple – skin to skin makes babies happy and it makes mothers happy and feel like mothers . It reduces postnatal depression and admissions  to neonatal units , I’ve even seen it stabilise a mother’s parameters. There is new evidence emerging to show that in effect if Nimah had held her son straightaway he may not have been admitted to neonatal unit with breathing difficulties . 

Skin to skin is human nature – we must tell women why it’s important not just ask 

      “would you like skin to skin contact ?” 

We need to say

 “If you hold your baby immediately against your skin and WE will provide help and support . As a mother you can instantly reduce the chance of your baby producing  the stress hormone cortisol and this contact can and does have a positive nurturing effect that is invisible as it happening.

As health care professional we must practice evidence based medicine and skin to skin is evidence based . We are responsible for teaching why it matters – not just throwing it into a checklist, box ticking exercise . 

The ‘Niamh’ I am talking about is in her late 70s – her children ages range  from 38 to 48 years of age . Niamh recalls each birth , each separation  but even more than that she remembers her feelings of despair at wanting to see touch and smell her babies but feeling like she couldn’t ask . 

That to me puts it all into perspective .
If you’d like more evidence here is some of the latest publications 
Pronurturance 

http://www.sciencedirect.com/science/article/pii/S1871519215003558

Skin to skin at caesarean 

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003519.pub3/pdf/

http://onlinelibrary.wiley.com/doi/10.1111/mcn.12128/full 

I recommend you follow the following people and organisations so that you can converse  with those who are champions for skin to skin contact 

@JeniStevensS2S @CarolynHastie @HeartMummy @FWmaternitykhft @KathrynAshton1 @Natasha47 @Csectioninfocus @hannahdahlen @bloodtobaby @AAGBI 

Please take a look at my “skin to skin FB page”  for more resources 

https://www.facebook.com/Mother-Infant-contact-skin-to-skin-in-the-operating-theatre-setting-445225315630071/ 

Thank you for reading  #Keepgoing ❤️
With Love , Jenny ❤️

Babies, Birth, Care of the elderly, Community, Courage, Discharge from hospital, Discharge planning, Human rights, Kindness, Learning, Newborn, NHS, NHS Systems and processes, Nursing, Patient care, Skin to skin contact, Teaching

Processes within the NHS 

There is a phrase “going around” that takes the impact of what it’s like to be an elderly person without support and this derogatory term totally dehumanises a very human situation. Talking about humans as processes instead of shouting out loud that caring does not start and begin in a hospital is like saying that once a person reaches 70 nobody really cares about them. The roots of care, compassion and indeed humanity itself  are intertwined into community , family life and neighbourhoods. Love and care begin at birth when the impact of instinctual kindness and love from one’s own mother is portrayed immediately at the moment of arrival by her display of emotions, indescribable craving and total need to hold her newborn child. It is my quest that every midwife, obstetrician and in fact anyone who is privileged to be there when a child is born knows this and thinks about it every second before birth occurs and is instrumental I helping to facilitate it or shout out when it doesn’t seem to be . 

NOW I’d like you to imagine that you are a senior NHS manager questioning your clinical leaders about how to address the problem of  “bed blockers” you are driven and you don’t tolerate excuses . Suddenly fast forward your own life – you are 79 years old and living alone . Your family live just far enough away from you to prevent a daily visit . You are isolated and feel depressed so gradually without any realisation of it , you stop looking after yourself . Your home becomes as uncared for as you are and then you fall . The reason for your fall is that you didn’t like the new slippers your granddaughter bought you for Christmas they were too much like shoes. You therefore continue to wear your old worn ones and on this particular day as you descend your steep unsafe-for-a-79-year-old stairs, your slippers “tread free” soles slip on the edge of a stair – suddenly you’re in flight mode. Your hip dislocates and your femur breaks – time to realise after your operation and recovery in a rehabilitation centre that you can’t get home. Mainly due to the fact that your family are away for a few days in France and social services have deemed your house as unfit for you to move back into . One particular day you are “sat out” in a chair behind some curtains and you overhear a Dr and an occupational therapist talking – your name is used and that familiar term “bed blocker” Is mentioned. The words ring in your ears from when you used to say them about others and now you are one. 

Did you know  when ambulance crews take patients to accident and emergency that they have to wait and cannot leave their charge until the care is taken over by the hospital team. I know this because last year  I worked with an ambulance team for a day . We were transferring a woman to another hospital & I was the escort midwife – once in another zone the ambulance was recognised on the radar and unable to leave each time a 999 call was made . It was like being in another galaxy unable to return to our own a sort of NHS antithesis to Brigadoon. So if SEVEN ambulance crews arrive at a particular Accident and Emergency department all waiting to handover the care of their patients -SEVEN ambulances are simultaneously  off the road-what’s to be done about this?

A few months ago I realised I was digressing from my ” #skinToSkin” work and asked a friend what I should do . Political issues were starting to interest me more , I felt more aware of care for people living with dementia . I had started reading about how mental  health issues are addressed and pigeon holed. Nick Chinn taught me about silos and I realised that the NHS works in silos. My friends reply was “keep going Jenny – as a NHS Midwife you have a duty to be political so that you can tell others about the day you spent with the ambulance  crew, why skin to skin matters to society and is a public health issue . To be frank I’d be more worried if you said you felt apolitical” 

So my friends let’s keep going and let’s keep championing good care , outing systems that don’t put the patient and/or family at the heart of what we do – one day that “bed blocker” might just be you . 

Thank you for reading please feel free to leave comments – your input helps me to reflect and develop as a midwife , mother and human . 

❤️Jenny ❤️

Antenatal education, Babies, Birth, Breastfeeding, Kindness, Labour and birth, Learning, Midwifery and birth, New parents, Newborn, NHS, Postnatal care, Skin to skin contact, Teaching, Young mothers, Young women

A little book of labour and L❤️ve  

A while ago one of my dearest friends appeared at the front door of my home .When I say dear friend, she’s the kind of friend that you might not see for a few weeks or months yet when you do see her it’s just as if you saw each other yesterday- as if no time has passed since you last saw one another .You know what I mean – you both remain the same age as when you first met and restart  a conversation exactly where you left off . You know the kind of friend I’m talking about – one that will drop anything  anytime when he/she  hears those words “I need you”. That is exactly what she did for me and continues to do for me so many times I’ve lost count . She shows no judgment , never tells me what I “need to do” , doesn’t gossip and listens to me with true friendship and love in her heart for me , which is equally as strong as the love I have for her . 

Anyway back to the door – my friend was standing there and before she spoke I knew something was wrong , very wrong . I could tell in the wildness of her hair ,  the look in her eyes , the way she was standing and her sense of upset . I pulled her inside my home and hugged her . The news was that her 15 year old daughter “Verity” was pregnant .

We talked and I recalled a celebrity that once said ( I’m sorry but I’ve forgotten who it was) ….

” it might not be the right time or the right situation , but it will always be the right baby” 

I said those words to my friend , I listened , I didn’t tell her what to do I just gave her the love back that she’s always given me . 

The months went by and her daughter “Verity” (name changed for reasons of privacy)  was blooming , looking beautiful everything was going well . I sensed however that she was worried about labour and I decided to make her my “Little book for labour ”  I felt I had to do something to help her prepare in order to realise her own strength and to believe in her capability to give birth . I started the book I didn’t want to make it boring or prescriptive but fun and positive . I also realised the importance of going through the book , discussing induction of labour , vaginal examinations , acting on complications, early labour, food, and breastfeeding but most of all key support people and after the birth . 

So to sum up the book was a success with Verity . We held  a  “mini” Jen & Verity one to one antenatal group in my lounge which taught me things about not just what younger women want to know (perhaps women of all ages?) . I really don’t know if I could’ve written it in the same manner if I hadn’t made it especially for Verity . She calls me “Auntie Jen” so I wrote it not just as a midwife , but as her dear mum’s friend and as an “auntie”. 

Veritys baby is now over two years old and her birth was beautiful. I wasn’t there but my friend was ,they took the book in and read it . There were no complications and the birth was physiological . 

Last night I asked Verity if I could borrow the book back to look at it – I’d not seen it for over two years. Verity had kept it safe and sound – I was thrilled that she still had it . 

So here are a selection of pages from the book  – I am very proud of it but more proud of Verity and her beautiful daughter . It’s going straight back to Verity after I’ve published my blog.  (not her real name) 
Thank you for reading 
❤️Jenny ❤️