I did it!

Last week I was given the classification for my degree and I am very proud to tell you that I achieved a 2:1. We're now into the final pieces of paperwork and sometime next month (hopefully) I'll get my pin and be a fully qualified midwife. This month I shall attend an interview for a job and I know I've got my fingers and toes crossed that I'll get it.

It's an odd feeling right now. I'm exhilarated and slightly scared. I am scared of no longer having that mentor looking over me and ensuring that I'm doing things correctly. Yet at the same time I am looking forward to working independently, taking all that I have learnt from my various mentors over the past three years and developing my own practice.

I am proud to be able to say that I've made it. I have managed the demands of academic life, placement and family life. Once a long time ago, I began a journey to be a teacher and over half way through the course, I failed a major assignment and dropped out. At that point I thought I had given up the chance of ever getting a degree. I had no idea what I'd do with my life and didn't really think I'd ever make anything of myself. However I feel that I have also never really given up. I have always forged forward with the belief that there is something better out there for me; that I could do more.

I am not the greatest student, I wouldn't consider myself particularly academic. When I was doing my teaching course, I averaged very low marks, scraping through each assignment. My assignments as a student midwife, have been varied....some I've got it right and others I've not done so well at. I have taken something from each experience. I have literally taken it one day at a time, one challenge at a time...never daring to think beyond being a student and simply doing my best. I also could not have done it without the amazing support of my husband who always believed in me and my family's never ending support.

At the moment I am making the most of a little time off.....spending time with my children, seeing friends that I've woefully neglected over the past three years, spending time with family, catching up on my knitting and spending time preparing for Twirling Nationals with my daughters' twirling group (if you are interested you can follow them here http://distinctiontwirlersofmedway.blogspot.co.uk/2013/04/happy-easter.html ).

It's been a long journey and in so many ways, this is just the first step on the next part of the trip. I shall aim to continue to tell you all what it is like to be a newly qualified midwife. I am looking forward to taking that step but for now I shall enjoy spending time being me.

No more assignments!

For this academic year anyway. On Monday I submitted my final assignment for this year, providing I don't fail one anyway and have to re-do it. We only had three assignments to write this year and each one was harder than the last. I'd thought on reading the brief that the Values assignment would be quite enjoyable. However it was easily the assignment that challenged me the most. I work well with facts and being able to reference from research; but talking about my feelings about something was far harder. For those that know me well, this may come as a bit of a surprise. I wear my heart on my sleeve and don't generally have any problems talking about my feelings. However it's quite different when you have to reference your feelings somehow....once I was talking about theory I was far more comfortable. Anyway I am pleased it is finally submitted and shall now be obsessively checking for my results.


I've now got a few days off before returning to the MLU. My fingers are twitching to catch my first delivery. I've been watching One Born Every Minute and thoroughly enjoying it but it only serves to remind me what I want to be doing. I loved this weeks episode - no Caesarean's, just normal birth and not just that but a water birth! I felt quite emotional watching that one....and also quite lucky. In fact I feel lucky most days - midwifery is so competitive to get into, and getting to see new life enter the world - well that's special. I know it's not every one's cup of tea but I find it so amazing and special, and a privilege to be a witness to. It's not just the births though - it's the whole experience of caring for women at such an amazing time in their lives.

My most recent part of placement was spent on a postnatal ward. Unlike the MLU, on this ward can be all the high risk women, post-section women, post post-partum haemorrhage women, women with high blood pressures, diabetics, and the list goes on. Also on this ward are antenatal women, who are in for monitoring, are in early labour or have come in for induction of labour. It's a fast paced ward and a very high need ward. Some shifts I'd feel I was chasing my tail the whole time but I learnt so much.

One day I spent a long time helping a new Mum with breastfeeding amongst other things. She was quite an anxious new Mum so she had a lot of questions. She'd waited a long time for her baby and she was determined to get it right. As we weren't too busy that shift, I was able to spend quite a long time with her, providing one-to-one support and giving her confidence in herself. When she left to go home, she gave me a big hug and said thank you for my help. There aren't many jobs where you'd get that response from a client! I love my job!

Breast is Best?

The WHO (World Health Organisation) guidelines state:

"Breastfeeding is an unequalled way of providing ideal food for the healthy growth and development of infants; it is also an integral part of the reproduction process with important implications for the health of mothers. As a global health recommendation, infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development and health. Thereafter, to meet their evolving nutritional requirements, infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to 2 years or beyond. Exclusive breastfeeding from birth is possible except for a few medical conditions, and unrestricted exclusive breastfeeding results in ample milk production."

So there you have it - the official guidelines from those in the know....so why is there so much debate over breastfeeding? Why are people surprised to see babies older than 6 months breastfeeding? Obviously I am only talking about in the UK here, as I can't speak for anywhere else. I think the answers are quite simple really:

1) Breastfeeding can be hard work to get established. It can be painful and sore.

2) Breastfeeding is often hidden away as something private, particularly with older children. Therefore unless you know someone who breastfeeds, your experience with it may be very limited or even non-existent. 

3) It's an emotional topic and when breastfeeding doesn't work out for someone, it can affect how they feel about it. 

Apparently only 2% of women cannot physically breastfeed either due to medical conditions or for an unknown reason. A common misconception, particularly in the 1960's and 1970's, was an inability to feed due to a lack of milk. It is unlikely that this would truly have been the case for the majority of women who switched to formula milk. This was a time when women were advised to put their babies into 4 hourly routines and not feed them in the night time which is has since been evidenced as being detrimental to milk supply. However it is something that is still said today, and many mothers are still worrying about routines and length of time between feeds, and consequently questioning their ability to produce enough milk. There is also little known about growth spurts, so when the baby is suddenly feeding all day and all night to increase milk supply,  again mother's can question their milk production - sometimes leading to early weaning onto solids; but that's another debate! 

So anyway that's the guidelines and official figures - still doesn't tell you my opinion does it? 98% of women can breastfeed....does that mean that 98% should? No I don't believe it does. Nor do I believe that repeatedly telling people the health benefits is the way to increase the number of breastfeeding mothers. I believe that some antenatal class teachers, some of whom are midwives, are almost frightened to talk about the difficulties that women may have with breastfeeding, worried that it will stop women from even trying. Some midwives don't discuss breastfeeding at appointments for a variety of reasons, such as not having enough time, thinking it's too early to consider, that it will be covered by antenatal classes, that anything that is said won't be remembered anyway etc. 

Some women don't want to breastfeed. They don't want to try and it doesn't matter what anyone says to them, they simply don't want to do it. Is that wrong? Well it might be an alien feeling to my own, but it doesn't make it wrong. We are lucky to live in a country of choice, where formula can be made up safely with clean water and for some women the choice is clear, and they choose formula. 

A lack of support is probably the most common reason for women to stop breastfeeding - whether it is a lack of support from health professionals or family and friends. This can be combined with pain, or a lack of knowledge about how breastfed babies feed. I have alluded to routines and growth spurts already but this aggravated by comments such as "are you feeding that baby again?" or "why don't you give that baby a bottle?". There is no benefit to comments such as this and for a mother who has pain and is unsure what she is doing, it can't help. 

Some women try to breastfeed but stop because of pain and soreness. There can be a number of reasons that there is pain during breastfeeding, most of which can be corrected. If the baby is positioned incorrectly, then the nipple can become very sore, cracked, even bleeding. If the mother is given support and advice before too much damage is caused, then the mother can go on to breastfeed as long as she likes. Poor positioning can sometimes also lead to mastitis as the milk ducts aren't emptied properly but again with the correct support and advice this is easily remedied. Nipple thrush can be another cause of pain to the mother, but also to the baby. Once identified, both the mother and baby must be treated simultaneously or it will continue to be passed from one to the other. Thrush can be a nuisance to get rid of, and it can be a nuisance to get the correct treatment for, but with the correct support and advice, it is easily dealt with. Engorgement is also a common cause of pain for the mother, especially when the milk first comes in. The easiest way to deal with it is feeding the baby although it can make it harder to get the baby latched on, in which case, it can be easier to express a little milk off just to make the breast softer. There are other causes of pain of course, but these tend to be the most common so I have focused on these for now.

However before anyone thinks this is a pro-formula post, it isn't. For me, it is like choosing to buy powdered dried milk in the supermarket instead of the bottles of milk in the chiller. It is a perfectly good substitute but it's not what I would choose - give me fresh every time! Wouldn't you say that's what most people do? Isn't that how breastfeeding should be? The norm? In cultures where breastfeeding is the norm, problems with positioning are practically non-existent. Women are used to seeing breastfeeding, and learn from childhood how to position their babies. They automatically support each other, and after giving birth, the family rallies around so that the mother can get used to her baby and get feeding established, without worrying about visitors and the housework. 

I am proud that I have breastfed my children. Whilst the health benefits didn't matter to me before, they do now. I am glad that I have given them the best start in life but at the same time I am incredibly grateful that I had the right support in order for that to happen. I hope I don't come across as smug about it, but actually help to further the view that breastfeeding can be easy, pain free and enjoyable and that it might just be worth a go?

Coping with negativity

I am now 6 months into my first year, have completed my first placement, my first assignment and my first exam and already in this time I have experienced a large degree of negativity.

There can be negativity before you even begin the course, from professionals, from family and friends, from complete strangers....those who wonder why you want to be a midwife as they couldn't imagine anything worse as well as those who know how difficult it is to get a place and wonder why you want to put yourself through it. In all honesty, I partially feel this is like the first test of how much you really want it. If someone can put you off so easily, before you've even tried, then maybe you don't want it enough.  That said, I have been lucky in that the response from my friends and family has been incredibly supportive and I know that I will need them when things are tough, when perhaps I do doubt if I am doing the right thing.

I have talked before about reading on forums about poor placement experiences some students have had at the beginning of my "What Makes a Good Mentor?" post, and I don't want to repeat myself, so you can just go back and re-read it. However in a nutshell, I guess I am talking about the negative attitudes of others towards students. I know that I have said to my fellow students that as first years, we truly are the lowest of the low, and I have heard tales of being treated as a completely different person once qualified. Is it right? No of course it isn't but is it going to stop happening? Not any time soon, I am sorry to say. The only thing I would like to be sure of, is that I won't treat students that way or anyone in fact.

The other kind of negativity you can come across, is the negativity of qualified midwives towards the job, and sadly the women. As a first year, I am at a stage where I feel passionate about childbirth, choice, breastfeeding and supporting women in their choices. I don't want to change how midwifery is practised (I'm not wanting to change the design of the wheel after all), I have no urge to change the world, but I do want to support women to the best of my ability. I don't want to lose that passion that I arrived with, through working with midwives that are jaded about childbirth through the experiences they have had. I certainly don't want to criticise anyone I have worked with; I am hardly in any position to do so with the limited experience and knowledge that I have. So instead I thought I'd write a little bit about how I hope to deal with it and maintain positivity.

By keeping a record of my passion in this blog, I hope that I can always read back on it and remember why I wanted to become a midwife in the first place. That after a difficult shift, or when I am in the midst of assignments and feeling stressed, I can come here and read this and just remind myself why. That I can read about the people that inspired me, the stories that saddened me, the women who I wished had had better experiences to remind me how I don't want to be.

I also have an excellent support network of friends and family who I know will always lend me an ear, and encourage me when I most need it. They are also there to help me take a break, and give me some time out from the pressure. My husband is wonderful and will take the children out so I can have some space, and not only to study, sometimes so I can just have a bath and watch the TV in peace. I think it's valuable to know when to stop and take some time for yourself as this helps you to keep going.

I am also a member of forums where I can share opinions and ideas, gain support and have debates over all sorts of topics. I can also speak with my fellow students, in particular those that are based with the same trust as me, as they know the same people as me. It is going to be interesting to see how we all change and grow along our journey to be midwives. I think we will all learn just as much from each other, as we do from our own experiences.

I've recommended to friends who are pregnant, to listen to all the advice, take what you want and leave the rest behind. I hope I can apply this to my learning too, whilst of course maintaining my knowledge for safe practice.