Fear

Becoming a parent can, for some, be the most frightening experience in the world. You can ask about others experiences, you can read all the books, you can look on the internet but nothing can really tell you what it's going to be like. It is quite normal for first time mums to focus on the labour that is ahead of them and read all you can on the subject or alternatively, completely stick their heads in the sand and not think about it at all. I was someone who had to read everything I could. For me, as a future midwife, as someone who has been through labour twice, as a mum who wonders what parenthood will bring that day, I wonder if I can help alleviate some fear? I certainly hope that I can, for women that I work with and with friends who are to become parents in the future.

Labour is certainly something that holds a lot of fear and it's understandable that it does because anything that involves pain, is something to worry about. Instinctively, as humans, if there is pain then there is something wrong. However labour is unique in that, it is the only time that pain is actually a good thing. If you are someone that has had a tough pregnancy, or you go overdue, or you've just had enough of waiting, you may even find yourself wishing for the pains to start. The one time in your life, you will wish for pain?

Television doesn't help of course...it gives the impression that when you go into labour your waters will break and you are instantly in agony. I'd hope that most people realise that labour generally takes longer than how it is usually portrayed on the tele. For most women, labour begins with mild, irregular pains. Many women liken them to period pains. You can breathe through them, you can walk through them, you can easily talk through them...not like they'd have you believe in Albert Square. They can be 10-15 minutes apart, they can stop for a few hours and then start up again. This is the main reason women are recommended to wait before rushing up to the hospital. Yes they hurt, some are stronger than others but as it's not a constant pain it's something women can cope easily with. The fear that can accompany those pains however, is what some women find difficult to handle. The not knowing how long it will last for, can be difficult to handle. And sometimes whilst the pain isn't that strong yet, it can still prevent women from sleeping or getting comfortable, and this can have an impact on how well women cope.

I believe that fear surrounding labour and birth should be handled at the antenatal stage, or perhaps pre-conception would ideal. I wholeheartedly believe, that in the delivery suite is not the place though. It's much more difficult to maintain normality when someone is terrified. It's not impossible and I have witnessed some amazing midwives who can calm the most frightened of women, and ground them, manage their fear, soothe them and make them feel safe. I hope to be this kind of midwife. I believe that the overwhelming fear that some women experience does sometimes lead them to choosing an epidural for pain relief. They don't know what to expect and how long it might take. Providing women with accurate information, and helping them to make an informed decision is vital. Being able to alleviate their fear is also vital. I have witnessed frightened women "choosing" an epidural and as someone pointed out to me, how can it be an informed choice when it is a fear based decision. Women should not reach this level of fear.

When I was pregnant with my second daughter, I attended an antenatal group, as previously mentioned in my Inspirational Midwives post last year, where I was given all the information I could possibly need to make an informed choice about where I wanted to give birth, my pain relief options and what to expect if things didn't go to plan. I always wished I'd attended the group when I was pregnant for the first time. What I find incredibly sad, is that group had to stop running due to a lack of funding. Those midwives inspired a number of women to have a home birth, who in turn inspired others to also have home births, and that cycle is still continuing, their inspiration still continues on. They gave women a voice, because they provided the information, they probably saved the NHS a lot of money because a women who knows what to expect, needs far less interventions, would decline unnecessary interventions. In an ideal world, the community midwife would be able to handle all fears about labour and birth during an antenatal appointment. Sadly there just isn't time - too many women and not enough midwives. Midwives constantly thinking about the next woman they have to see....it's not that they don't want to, it's more that it's just not possible.

Fear is the biggest barrier for a woman facing labour and birth. Time is one the biggest barriers facing the midwife. My biggest fear about becoming a midwife, is not having the time to be able to give women the care that they need, that they deserve and becoming frustrated with time constraints. I hope to remember the midwives who managed to give the time without neglecting others, somehow found a way to manage it. 

Into delivery suite I go...

So here I am, a second year student and I've just started placement on Delivery Suite. On Sunday night I had butterflies in my tummy, and I was really nervous about starting placement this time. In part I think it's because wearing my second year badge, means I am meant to know stuff. Of course I do know a lot more than I did this time last year but there is still that feeling that you are faking it and soon someone will discover you don't know anything. It's a bit like the feeling that you are playing at being a grown up when you have children...I am sure some of you know what I mean.

Anyway I had my first shift on Monday and I felt like my head was full of cotton wool at the beginning of the day. It's been quite a while since we were last on placement and I had to get myself back into mindset and remember how things were done....mainly the documentation. Also this is the first time I've worked on Delivery Suite, having worked in the Midwife Led Unit before so I'm learning how things are different. The main difference is that there are far more high risk women being cared for which means that the CTG machines are used for monitoring, in some cases continuously throughout labour. Then there are the women who are on drips for inducing labour, women with epidurals, women with pre-existing conditions that need to be monitored, women carrying twins (or more), women who have had bleeding during pregnancy, women with high blood pressure, and anything else you can think of really.

In comparison with the midwifery led unit, delivery suite is more fast paced, and busier. There is always something going on. The doctors are also far more involved with care and decision making. One of the things I have learnt this week, is how quickly things can change, and how quickly the staff can move when they need to. For low risk women, the constant monitoring is not needed, but once you begin to intervene and various drugs are used, there can be a reaction to that drug, and it can be very sudden. However with the monitoring that is used, the response to any reaction is swift.

I've watched One Born Every Minute and how the midwives are portrayed - sat in the office drinking tea and eating cake whilst women labour on their own. I have to say this is definitely not my experience. Where I am the midwives spend the majority of the time in with their women. They may grab a cup of tea at some point, but often they don't get the chance, and I don't like to think how many midwives miss getting a lunch break because it's just too busy. Would you not agree that it would be a safer and happier environment for all if there were enough staff to ensure they got a break? It's not that I think it's unsafe where I am fortunately but I can definitely see that there would be a huge benefit to all, if there were more staff.  You can't predict who will walk the door, with what "problems" so you always have to be prepared for anything. Delivery suite needs midwives who work as a team, supporting each other, alongside the doctors, anaesthetists, maternity support workers, cleaners etc... Everyone has a vital role in delivery suite and communication is essential.

Self esteem and confidence

Following a conversation with a friend of mine today I have been pondering self-esteem and confidence. This particular friend is someone whom if you don't know very well comes across as a confident self-assured person, but once you get to know her, you discover that inside she has low self-esteem and hardly any self-confidence at all. This pondering led to me to wondering about other people that I know and judgements I have made about them and their confidence levels. Also at what point does it become vain to talk about what you are good at?

As a child I was very shy and I didn't have a lot of confidence in myself - I was bullied for my weight from a very young age and it certainly had an impact. As a young adult, I was still shy but I began the process of bullying myself out of it. Amongst friends I was completely confident but place in a new situation and I was a blushing mess. Friends, family and boyfriends could compliment me but I'd think they were only saying it to be nice, and I didn't really believe them. These days I'd imagine most people would be surprised to hear me describe myself as shy as I probably come across as quite confident. I guess the truth is I am far more confident than I have ever been before. I do have good days and bad days the same as anyone else but on the whole I am more confident in myself. 

It's not that I just woke up one day and discovered self-belief but gradually I came to realise that I was more confident in myself. In part I think it's down to my family and friends and the belief that they have in me - eventually it has to rub off right? However mainly I think it's because I finally found the one thing I believe I can be good at. I think I will be a good midwife....if I didn't think I could be good at it then I wouldn't be doing it. I also think I am a good Mum...I'm not a perfect Mum but who could be? I'm not afraid to say where I made my mistakes. I'm a good Mum because I learn from my mistakes. 

I'm not the best but I don't need to be. It took me a long time to find my niche and now that I have found it, I am determined to make it work the best way it can for me. It's made me feel a lot more comfortable in my own skin and a lot less worried about what others think of me. I know my weaknesses, so when they are knocking at the door, I can't always make them go away but I no longer invite them in for a cup of tea and a slice of cake. Love me or loathe me, that's up to you. Loving myself makes me a stronger person, and a more confident person.

I also believe that confidence is going to be a vital component of being a good midwife. I need to confident in the decisions I make. I also need to be confident enough to be able to say when I don't know the answer to something. Confidence doesn't mean knowing all the answers...confidence means you know it's ok not to know the answer. 

So if you aren't confident, if you don't believe in yourself....then I just think it's a case of finding your niche....and sadly for some it takes longer to find. 

5 years - a sensitive post!

Today it's been 5 years since my brother lost his fight against the brain tumour in his head. The night before I had been so happy, his son had been born on the Saturday and whilst he hadn't been well enough to be there, we were hoping that his wife and son would be home on the Monday and he'd meet his son. However in the early hours of Monday 8th May 2006, he slipped away peacefully in his sleep. Whilst he never did get to hold his son, he did at least know that he had been born and that had made him happy. Losing my brother changed me - in ways I can't really explain, all I know is, I am different to the person I was before he died.

This week a friend of mine had her life changed forever in one of the cruelest possible ways. Her son William, who was soon to be 3, didn't wake up. He hadn't been ill, though he'd been under investigations as it was thought he had epilepsy. They'd been on holiday and the day before they'd spent the day at the beach and he had thoroughly enjoyed playing in the sand, and chasing a beach ball. It is wonderful that his last day was so happy and carefree with his parents and older sister, and I am sure that those memories will bring comfort as well as pain in the days, weeks and years ahead.

I know William's mum, through an online community. Some people might fight it strange that I keep sobbing for William...after all I never met him. I have met his Mum but never his Dad or older sister. However the nature of the online community means it felt like I knew him, like I knew him almost as well as I knew my "real life" friends. I know I'm not alone in feeling like this - the whole community has been shocked. Many of us have children of similar ages, we've debated the SIDS guidelines, the appropriate weaning foods, breastfeeding, co-sleeping etc. It's seems trite to say it, but things like this don't happen to people you know but unfortunately that's just not true. Many members of the online community are buying and planting Sweet William, in his memory. A memory that should always be kept alive.

This week I have had times where I got cross with one of the girls for leaning on me, for not leaving me alone, for not going to sleep when they should, for not getting dressed quickly enough. I have worried about money and stressed over housework. When I read the news from my friend on Friday, all I wanted to do was gather the girls in my arms. I know I am not alone, in checking more frequently on the girls when they are sleeping. Life was thrown into perspective in a very harsh way.

I can't help William's Mum and family, I can't ease their pain. I can't begin to understand how they feel at the moment, though some feelings might be familiar to me, grief is different for everyone. Today I shall be spending time with my parents and my sister, and with our children. We will be lighting a candle for David, my brother and I shall light a candle for William. Take a moment today, to appreciate what you have - give someone a hug, tell someone you love them, smile.

RIP William, you will be missed x