Passion and Inspiration

Sometimes I find myself bogged down in the workload. For example, at the moment we are working on two assignments, about to return to placement and in January we have a presentation and a biology exam. In the midst of this, I am also attending meetings in my capacity as set rep and trying to plan for Christmas, spend time with my family and friends and there just isn't enough hours in the week. Consequently I'm a little rundown at the moment, with cold after cold and a constant feeling of tiredness. So it's easy to wonder how I maintain my passion for midwifery, and to keep that light at the end of the tunnel to aim for.

I try to maintain my passion for midwifery through reading - I'm always interested in the use of techniques I've never seen in practice and that we're unlikely to be taught. For example, the use of water blisters to help with the pain in a back to back labour. If you've not heard of them before then have a read, it's really interesting. Something else I was reading about recently was a technique for dealing with shoulder dystocia where the mother is aided into a running start position which is explained here.

I also recently attended a water birth study day which re-ignited my passion for water birth and home birth. Prior to beginning the course, it was of course my own home water birth that inspired me to become a midwife and yet I am still to attend one myself. The study day reminded me of how to trust in women to be able to birth their babies without any intervention. It also highlighted to me the amount of fear there is surrounding home birth - from the health professionals as well as the women. Fortunately this isn't true of everyone but clearly a significant enough number for the percentage of women having a home birth to be extremely low. According to Birth Choice UK, just 2.39% of births in the UK were home births and in the area where I work just 2.2%, a figure which hasn't changed much in the past 10 years.

This week I was fortunate to be able to attend the RCM student midwives conference in Brighton. As well as the superb amount of freebies from all the stands that were there, I also had the opportunity to listen to some inspirational speakers. I was able to hear from other students, newly qualified midwives and midwives who had been working in the profession for a long time. If you ever get the chance to attend then I thoroughly recommend it. It's hard for me to sum up exactly how much you can gain from the experience. I'd also recommend any other conferences you can attend, such as the ARM conference or any other event where you might have the opportunity to hear such inspirational speakers.

So when I'm feeling the pressure of my workload and all I'm really doing is worrying about how I am going to get it all done, to the best of my ability, sometimes I just take some time out to remind myself why I am doing it and I then find I can focus better on my work. Alternatively I also have times when I just have to push on, push past the point where I feel everything I am writing is rubbish, to the point where it begins to make sense. Trust me, it does happen sometimes.

If you haven't done so already, can you please sign the petition for more midwives!
http://www.rcm.org.uk/college/campaigns-events/protect-maternity-services/

Baby Loss Awareness Week

Today is the beginning of Baby Loss Awareness Week and tonight many women all over the world will be lighting candles to join in the Wave of Light, myself included. Will you join in?

Some time ago my friend Marie offered to write a guest post for me about baby loss and I didn't hesitate to accept. As often happens, life got busy and in the way, so it took some time to organise. However, both of us agreed that this week was the perfect timing and I think you'll agree that Marie offers some valuable advice to both students and qualified midwives alike. Thank you Marie x

How has this past week been for you? Has it been a normal week? Perhaps you were working long shifts in your local hospital, or you were on placement in the community. Maybe you were studying, or if you’re lucky you’ve been having a well-earned break.

I don’t know what all of you were doing, but I do know that about 120 of you last week were supporting someone who had lost a child to stillbirth or neonatal loss. And I know that 120 of you will be faced with doing this next week.

And then the same the week after.

And then the one after that.

Because as you may or may not already know, on average 17 babies older than 24 weeks’ gestation die every day in the UK, before or shortly after birth. As a midwife you absolutely will be dealing with these situations one day, repeatedly in most cases.

This week wasn’t a particularly out of the ordinary week, although you may well have seen more publicity about baby loss awareness recently. The campaign, for which I’m not a spokesperson may I say, brings together four UK charities that if you’re not aware of you could do worse than to have a read about: The Miscarriage Association, The Ectopic Pregnancy Trust, Antenatal Results and Choices, and Sands, the Stillbirth and neonatal death association.

Each of them publish guidelines and leaflets for health professionals as well as for those who are affected directly and indirectly by pregnancy and neonatal loss. Each of them offer support both for those affected and for you as healthcare professionals. I’ll even make it easy for you and link to some here, here and here.

Why do I care? Why should you care? And who am I anyway?

I’m Marie. I’m a 30-something mum from Essex, who wears either a personnel or photographer job hat depending on what day you find me – I’m certainly not in healthcare. I like cats and chocolate, but I try not to mix the two. I drive a little too fast sometimes, I bite my nails when I’m tired or bored, and I wish that Gok Wan made clothes for the shorter fatter people in society. My son died two years ago, before birth. I’m one of the women you might have met, or will meet one day.

So, when it’s ‘your’ week, what kind of midwife will you be for any of those 120 women, just like me?

Will you be the midwife who told me to ‘know my place’ in my first lost pregnancy, when I sat on the bed before she’d asked me to? Will you be the midwife who, in an open reception full of other pregnant women, asked me what SANDs did and what had happened, and didn’t know what the SANDs sticker on my notes meant? Will you be the midwife who assured me I would not be placed next to a labouring woman after my son died, but then couldn’t understand why I was traumatised when they did exactly that? Will you be the midwife who drew the curtains around my bed in HDU rather than have to watch me cry? Will you be the midwife who, after the scan to confirm my son had died, told me all about her children and large family? Will you be the midwife who dismissed my tears and told me off for raising my blood pressure without offering support to me?

And if you’re not a midwife, but you’re another healthcare professional, will you be the one who ignored my requests for pain medication and told me to keep the noise down so I didn’t upset others when I was labouring with my late miscarriage? Will you be the one who chatted about Christmas at the end of my bed instead of getting me the bedpan I had asked for? Will you be the one who refused to admit me, bleeding heavily and screaming, to ER until my husband had filled out forms?

Will you be the amazing midwife sonographer who supported me through multiple pregnancy losses and successful pregnancies, made time to talk in the waiting room, minimised the delay and wait for scans, and provided tissues when it was all too much? Will you be the comforting midwife who always made time to listen and explain when I didn’t understand the printout from the DAU during my exhausting last pregnancy and just COULDN’T leave the hospital before I knew whether my son was okay? Will you be the caring midwife who understood why I was distraught that I had been assigned to be seen by a junior instead of my consultant at a key stage in my subsequent pregnancy, and arranged a better appointment for me? Will you be the home-visit midwife who held me while I cried when she visited me to check my blood pressure after my son died, and made special trips to come and see me, taking her time to sign me off until she was sure that I could get through a day? Will you be the labour midwife who stayed by my side during my entire 7 hour labour with the boy who would never cry, open his eyes, or smile, helped my husband dress him, and took his precious pictures and handprints? Will you be one of the midwives who visited my other son in NICU when he arrived early and I was in recovery, taking personal delight in sharing a happy end to my story?

This week, as a midwife or a healthcare professional looking after pregnant women you cannot choose not to deal with these situations, in the same way that I and my fellow women have no choice but to endure them. You can, however, choose how to deal with them, and how you are remembered afterwards. What will you choose?

For some stats on Baby Loss watch this.

For more information click here.

11 births and farewell MLU.

I've now finished my time on the MLU and next week I am off to the antenatal clinic where the experience will be extremely different. It's hard to believe that before this placement, I hadn't "caught" my first baby and now I've caught eleven. Eleven very different woman, who coped in very different ways with their labours. Eleven different birthing partners who supported their wives/girlfriends/daughters in a variety of ways. So many of the birth partners say how useless they feel whilst the woman is labouring. They simply don't have any idea of how valuable just being there can be.  And lets not forget the eleven very different babies. Six boys and five girls.

I'm not sure I can put into words just how much I feel I have learnt in such a short space of time. I've worked with different people and they all have their own ways of how to deliver and no doubt over time, I will choose my own preferred way. I like to think at the moment that I will work with whatever is appropriate at that time but ideally, maybe even idealistically, I'd like to be fairly hands off in my approach....allowing women to be in charge of their own bodies and deliveries. I think back to the births of my children and how I feel that my eldest was delivered by the midwife, and how my second was delivered by me....I know which experience I'd rather women have.

However one thing I have learnt is that no matter what I think, the woman has the right to make her own decisions. Whilst for me, being continuously monitored or unable to feel the contractions would be awful, for another woman, this is very important to them and part of being a midwife is taking a holistic approach and recognising what is important and why; ensuring that women have all the information they need to make an informed decision so that after the baby is born, they have felt a part of the decision making process and supported in their choices. What I would do is actually irrelevant in so many ways. So as well as all the clinical skills I am learning, I am also learning how to listen to women and support their choices.

Today I am feeling on top of the world, so pleased with all I have learnt and achieved. I'd love to bottle it - I could make a fortune! Or just have a little sip at those times when I am wondering if it is all still possible. For now I shall bathe in this happy feeling, enjoy a few days off and look forward to another new experience on Monday!

Passion and fear

This week I have witnessed two ventouse deliveries - this is where a suction cap is attached to the baby's head and as the woman pushes, the doctor pulls which helps the baby to be delivered. There are various reasons why a ventouse delivery might be deemed necessary - maternal exhaustion, prolonged 2nd stage (the pushing stage), fetal distress, amongst others.

Of the two ventouse births I witnessed, one was due to slow progress in the 2nd stage and the other was due to fetal distress. I can't really share too much information about the deliveries themselves due to confidentiality but in the event of the fetal distress, my heart was in my mouth and I felt very emotional when the baby was safely delivered. I'd helped to care for the couple all shift and learnt quite a lot about their journey so far, and therefore I found it mattered a lot to me, my part in their story. I was really pleased to be able to see them again the next day. 

I now have 5 deliveries to my name, three of which you already know about in my last post Not one but three. I've been lucky to work with a brilliant team and I feel like I have learnt loads in just the last week. Four out of my five deliveries were in the semi-recumbent position but the fifth (actually fourth but this could get confusing) was on all fours.....it was brilliant to get my head round exactly where I was putting my hands, and to have a different perspective - however I have got to say....it's far messier. My final delivery of the week was lovely and controlled and as a first baby, my mentor had loads of time to point things out to me as the baby progressed. 

This week I am onto day shift and I think I will experience very different shifts to the night ones - there will be far more postnatal checks that need to be done than there are in the night time but there are also generally more staff. It will be really interesting to see the difference though of course I am hoping for a couple more deliveries and moving towards becoming more autonomous. I shall be investing in a book where I can keep a record of all my own deliveries as I am sure I will want to look back on them all one day. 

One thing that has struck me this week is the value of good support. I have been told how lucky I am to be able to witness birth and I agree I am lucky. However I am also lucky to witness the amazing roller coaster of emotions during labour and the special bond between the woman and her birth partner.  I have seen the love, the fear, the hope and the excitement all in the eyes of the birth partner as well as the woman. With the couple whose baby was in fetal distress, I witnessed the pure joy on the face of the mother, that the time had arrived to meet her baby, which was contradicted by the absolute fear in her partner's face as he could see the slowing heart beat and the number of people suddenly in the room. Not for one moment did he let his wife know just how worried we all were, but he continued to support her, to encourage her and be by her side the whole time. And then once the baby was born, I continued to watch that amazing bond between them, the continued joy and amazement on her face, and the relief and joy on his. You tell me I am lucky - I wholeheartedly agree and  no matter how lucky you think I am, I know I am 20 times more lucky than that. 

What kind of midwife do I want to be?

All of the posts about breastfeeding, discussions with friends about breastfeeding and then listening to qualified midwives talk about breastfeeding got me to thinking about what kind of midwife I want to be. I don't have these grand illusions that I can get every woman breastfeeding their babies. I don't think I can change the world after all. So what can I do? What kind of difference can I make?

Well this is my dream....I want to support those women that do want to breastfeed. I want to help them have skin to skin with their babies, to breastfeed as soon as possible after the birth of their babies. I want to make sure that women know where and how to access support should they want and/or need it. I want to provide women with accurate information, without ramming it down their throats. Then following this, I hope that gradually more and more woman have a positive breastfeeding experience, and that this drip feeds to more and more women, that breastfeeding can be easy and enjoyable. That breastfeeding becomes commonplace to be seen everywhere and that women can learn by example, just like women used to do.

I also want to ensure women know about their choices for birth - whether that is where to give birth, what position to give birth in or whether it is how to still feel in control should they need a Caesarean delivery. I want to be able to support women in their choices without cynicism. Of course, I also want to be able to know what to do in the event of an emergency, or when things don't go to plan. And when things don't go to plan, I still want to be able to support women in their choices. I want to be able to help women know what their choices are. I want them to still be able to have a positive birth experience knowing everything possible was done.

I have no doubt that some people think my dreams are daft, that I am aiming too high. But if I can support one woman, help one woman to feel that I made a difference, then it's a start. I am writing this in the hope that I don't forget my dreams; that I remember what is in important to me and that I try and keep to it as much as I can. I'll aim for making a tiny difference and hope that I succeed.