I am just about to reduce my Independent work significantly.
I have plans for the future which cannot support lengthy on calls and I am also starting to feel quite worn out.
A woman who I cared for 18 months ago called me with the news that she was pregnant again.
18 months ago, I shared her elation at the blue line on the pregnancy test.... booked her for consultant led maternity care... took the call when she started to bleed at 12 weeks.... was with her in hospital when she miscarried....and held her and her partner in the scan room when it was confirmed that her pregnancy had gone.
J. has multiple disability and uses a wheelchair...and she only asks to be able to have one baby.
So the Universe has decreed that I take one just one more Woman.
Monday 14 February 2011
Wednesday 4 November 2009
Our Wonderful Media Circus
Last week, a colleague was reprimanded for sending a woman home who birthed her baby in her bathroom 2 hours later.
This woman was NOT in labour when she was seen in hospital, her waters had gone, but with no signs of labour; she was also expecting her first baby.
Although she was given the appropriate advice and advised to call and come in if she was concerned... she didn’t... her reason in the newspapers that got hold of the story ‘she thought that the unit was too busy’. She had a normal birth at home with paramedics observing, and probably didn’t even need to come into hospital if a Midwife had checked her out at home.
This was an unusually quick labour for a first time mother.... BUT IT WAS NORMAL.
My colleague is devastated at the press coverage which is inaccurate and damning of the maternity service at the unit involved.
Yes... most of the units I see are busy.. Yes Midwives are often stretched to their limits in major maternity units... but a woman’s safety is always the optimal goal in every circumstance.
I saw nothing in the news about the baby delivered outside a London Hospital on the pavement last week, or the baby born on the A1 in standstill traffic near Hatfield... or even the one that died in utero after its dad punched his mother repeatedly in the stomach... and then allegedly expected her to cook his dinner.... these are far too real and distasteful
The media has a lot to answer for when it comes to information giving and ‘sensationailsation’ of Pregnancy and Birth. Women have a clouded and rosy view of pregnancy and birth via the pretty magazines on sale with promises of pain free labour and discounts on prams and nappies.. all with pictures of beautiful pregnant women with perfect unstretched bumps on the front.
How are we going to be able to keep it real.. when we battle against the media machine?
This woman was NOT in labour when she was seen in hospital, her waters had gone, but with no signs of labour; she was also expecting her first baby.
Although she was given the appropriate advice and advised to call and come in if she was concerned... she didn’t... her reason in the newspapers that got hold of the story ‘she thought that the unit was too busy’. She had a normal birth at home with paramedics observing, and probably didn’t even need to come into hospital if a Midwife had checked her out at home.
This was an unusually quick labour for a first time mother.... BUT IT WAS NORMAL.
My colleague is devastated at the press coverage which is inaccurate and damning of the maternity service at the unit involved.
Yes... most of the units I see are busy.. Yes Midwives are often stretched to their limits in major maternity units... but a woman’s safety is always the optimal goal in every circumstance.
I saw nothing in the news about the baby delivered outside a London Hospital on the pavement last week, or the baby born on the A1 in standstill traffic near Hatfield... or even the one that died in utero after its dad punched his mother repeatedly in the stomach... and then allegedly expected her to cook his dinner.... these are far too real and distasteful
The media has a lot to answer for when it comes to information giving and ‘sensationailsation’ of Pregnancy and Birth. Women have a clouded and rosy view of pregnancy and birth via the pretty magazines on sale with promises of pain free labour and discounts on prams and nappies.. all with pictures of beautiful pregnant women with perfect unstretched bumps on the front.
How are we going to be able to keep it real.. when we battle against the media machine?
Thursday 29 October 2009
One Voice
Today I saw the light of inspiration in a young African girl and her two aunties
I have been contracted to a large hospital in the South this week, and spent most of today ‘bitting and bobbing’ ...... helping out in other rooms, discharging and admitting... anything that helps my colleagues throughout the day.
I answered a call bell that took me to the room of a young 17 year old girl who was in advanced second stage of labour but with the fetal heart rate slow to recover after contractions. After letting the appropriate people know what was happening, I went back into the room to help the Midwife caring for her.
This beautiful young girl was being supported by her family... the closest she had because her mother was unable to be there.
All of the time, without any respite, one or the other Auntie would give words of encouragement to her, calling her a wonderful mother, a powerful woman, a beautiful creator of Life... taking it in turns to give praise to her.
She pushed out a big baby girl and cut the cord herself... whilst everybody in the room.. including the paediatrician..... felt a knot of emotion in their hearts.
We often go into rooms filled with people where women are desperately trying to
Birth their baby, whilst the atmosphere is filled with confusion and fear.... just because people think that they are doing their best for her by shouting so called ‘encouragement’.
I remember the words of a Midwife who looked after me with my own children, and also mentored me as a student.
One of the most profound things that she taught me was to give the woman one voice to listen to..... one voice of encouragement for her to focus on.
Its difficult to facilitate this when the medics are wanting to take control and the family think they are ‘doing the right thing’
Maybe its up to us to spread the word .......
I have been contracted to a large hospital in the South this week, and spent most of today ‘bitting and bobbing’ ...... helping out in other rooms, discharging and admitting... anything that helps my colleagues throughout the day.
I answered a call bell that took me to the room of a young 17 year old girl who was in advanced second stage of labour but with the fetal heart rate slow to recover after contractions. After letting the appropriate people know what was happening, I went back into the room to help the Midwife caring for her.
This beautiful young girl was being supported by her family... the closest she had because her mother was unable to be there.
All of the time, without any respite, one or the other Auntie would give words of encouragement to her, calling her a wonderful mother, a powerful woman, a beautiful creator of Life... taking it in turns to give praise to her.
She pushed out a big baby girl and cut the cord herself... whilst everybody in the room.. including the paediatrician..... felt a knot of emotion in their hearts.
We often go into rooms filled with people where women are desperately trying to
Birth their baby, whilst the atmosphere is filled with confusion and fear.... just because people think that they are doing their best for her by shouting so called ‘encouragement’.
I remember the words of a Midwife who looked after me with my own children, and also mentored me as a student.
One of the most profound things that she taught me was to give the woman one voice to listen to..... one voice of encouragement for her to focus on.
Its difficult to facilitate this when the medics are wanting to take control and the family think they are ‘doing the right thing’
Maybe its up to us to spread the word .......
Sunday 25 October 2009
An Angel Remembered
I was honoured yesterday to be invited to a ceremony to celebrate what would have been the 3rd birthday of a beautiful baby girl that was lost.
B. the woman i cared for with cerebral palsy earlier in the year, lost her Angel at 33 weeks, 3 years ago, and although she has 2 wonderful sons, her daughter fills a special space in her heart.
B. is one of the most resilient women I know.
She has severe cerebral palsy, her long time partner left a few months after her last son was born and she has been defrauded of almost £2,000 by 2 carers.... all in the last 3 months.
The afternoon began with a gathering of friends... people who I had met and bonded with myself over the time I have known B.
The warmth and closeness of this small band of friends, carers and family was reminiscent of what Families used to be many years ago.... before we all became disjointed and spread ourselves far and wide in search of golden apples and promised lands.
We were all given a balloon and asked to write a message to Angel on it, before going en masse to the park next door to B’s house.
It had been cloudy and raining all day, but the clouds parted to give blue skies and sunshine when we set out.
B. asked us all to read out the message on our balloons..... this was an emotional time for all of us, but it didn’t matter... we shared our sadness and our memories as we would willingly share anything we had with our close and true friends...
C. her eldest son looked up at the sky and said ‘mummy.... you know you said Angel lives on a cloud in heaven... i know which one it is.. its that big long one over there’.
As we prepared to release our balloons... the wind started to blow, and our balloons were carried off to that big long cloud....
....my balloon said ‘I hope you’ve found my Scarlet to play with’
RIP Angel x
B. the woman i cared for with cerebral palsy earlier in the year, lost her Angel at 33 weeks, 3 years ago, and although she has 2 wonderful sons, her daughter fills a special space in her heart.
B. is one of the most resilient women I know.
She has severe cerebral palsy, her long time partner left a few months after her last son was born and she has been defrauded of almost £2,000 by 2 carers.... all in the last 3 months.
The afternoon began with a gathering of friends... people who I had met and bonded with myself over the time I have known B.
The warmth and closeness of this small band of friends, carers and family was reminiscent of what Families used to be many years ago.... before we all became disjointed and spread ourselves far and wide in search of golden apples and promised lands.
We were all given a balloon and asked to write a message to Angel on it, before going en masse to the park next door to B’s house.
It had been cloudy and raining all day, but the clouds parted to give blue skies and sunshine when we set out.
B. asked us all to read out the message on our balloons..... this was an emotional time for all of us, but it didn’t matter... we shared our sadness and our memories as we would willingly share anything we had with our close and true friends...
C. her eldest son looked up at the sky and said ‘mummy.... you know you said Angel lives on a cloud in heaven... i know which one it is.. its that big long one over there’.
As we prepared to release our balloons... the wind started to blow, and our balloons were carried off to that big long cloud....
....my balloon said ‘I hope you’ve found my Scarlet to play with’
RIP Angel x
Saturday 10 October 2009
My Big Sister
My Sister called me today......
To tell me that She has terminal cancer and has about 2 months to live.....
I am not in shock... I knew this day would come.... she has had secondaries in her liver for a while now, but we are never prepared for our loved ones to leave us so tragically and permanently.
My immediate reaction was to talk calmly and frankly with my sister... asking her if she felt prepared for her limited future. I felt comfortable doing this, as She has talked a lot about getting herself ready for the inevitable conversation with her consultant.
We discussed how her children, who are adults themselves now with children of their own, had taken the news, what her plan of care was with the Marie Curie nurses, and if she wanted the option to go into a hospice or remain at home.
She told me that she could not cope with telling my brother.... and the sister who doesn’t speak to us any more... and I willingly took on that responsibility for her.
All of the time we spoke, on the outside I tried to be the un-phased, calm Midwife, who listened and gave honest, but hopefully cushioned answers to bad news.
On the inside, I wanted to scream at the Universe for letting this happen to a good kind hearted and vibrant sister
It was Ina May Gaskin who wrote ‘ a spiritual Midwife must be prepared to have her heart pierced, but not to fear it, as this is the way that love floods out, and it will make us better Midwives.
I hope that the piercing of my heart makes me a better sister
To tell me that She has terminal cancer and has about 2 months to live.....
I am not in shock... I knew this day would come.... she has had secondaries in her liver for a while now, but we are never prepared for our loved ones to leave us so tragically and permanently.
My immediate reaction was to talk calmly and frankly with my sister... asking her if she felt prepared for her limited future. I felt comfortable doing this, as She has talked a lot about getting herself ready for the inevitable conversation with her consultant.
We discussed how her children, who are adults themselves now with children of their own, had taken the news, what her plan of care was with the Marie Curie nurses, and if she wanted the option to go into a hospice or remain at home.
She told me that she could not cope with telling my brother.... and the sister who doesn’t speak to us any more... and I willingly took on that responsibility for her.
All of the time we spoke, on the outside I tried to be the un-phased, calm Midwife, who listened and gave honest, but hopefully cushioned answers to bad news.
On the inside, I wanted to scream at the Universe for letting this happen to a good kind hearted and vibrant sister
It was Ina May Gaskin who wrote ‘ a spiritual Midwife must be prepared to have her heart pierced, but not to fear it, as this is the way that love floods out, and it will make us better Midwives.
I hope that the piercing of my heart makes me a better sister
Thursday 8 October 2009
A LEARNING CURVE
Yesterday was a day of revelation for me... in the shape of a woman birthing at home, when originally, she intended to have a hospital birth with all the pain relief available, as she had done with her other two children.
It increased my belief in trusting in a woman’s own instincts during the birthing process and also a kick up the backside for me and my mistimed complacency.
S has had 2 children before.
The first was in a busy city hospital in the South 8 years ago... she was induced for post maturity
She was left alone for the majority of her labour, sustained a nasty tear, retained placenta and a major post partum haemorrhage.
Seven years and 3 miscarriages later, she met and married her current husband and became pregnant with her second child.
She employed me as her Midwife because she felt so traumatised by the previous birth, not even wanting to acknowledge that the baby was there until about 28 weeks. She was induced again for post maturity and had a positive experience this time, with an epidural and a wonderful NHS Midwife, and Myself supporting in a non clinical role.
6 months later, she called me to say she was pregnant again.... not planned.. but coming to terms with the prospect of having 3 children and a teenage step daughter to care for.
Her Downs Risk test came back at 1:115, which both parents understood and accepted, but declined any further investigations. I found out later that this had marred all of her expectations of having a healthy baby for the remainder of her pregnancy, and was the first thing she asked about when her baby was born.
S had always gone overdue, her waters had never gone on their own and she always took ages to establish her induced labours. We even joked that this baby would be born on bonfire night, and that she needed to avoid Halloween.
At 36+6, S reported a small gush of fluid, which was checked out at hospital and nothing found.
2 days later, she paged me to say her waters had broken outside the hairdressers but with no contractions. I went over to confirm her membranes rupturing, to save both herself and the hospital time, and to organise augmentation (this trust augments after 24 hours).
We sat and drank tea for a while and S reported that she had some mild period type pains which weren’t bothering her, so I listened in again, checked her temperature and said I would go home and get sorted before her labour started, and to call me when they establish.... this was at 17.00
At 17.15, her husband called me (i have hands free in the car) and shouted ‘MARION.. YOU’D BETTER COME STRAIGHT BACK!’... I could hear S in the background moaning loudly. My green light (the best £50 i’ve spent in a long time) went on the roof and I made my way back through the appalling roadworks outside their village, with workmen moving bollards for me to hasten my journey.
When I arrived, S was on all fours rocking her pelvis and moaning softly and rhythmically. When her contractions came, she would raise the volume of this primitive moan, almost singing violently in monotone... not an angry noise, more of a focussed announcement that she was in productive pain.
At 17.40 I managed to assess and she was 5 centimetres dilated with the head at the spines.... this progress was too quick for any transfer to hospital.
This is where my complacency comes in.
I ‘assumed’ that she would have her baby later rather than earlier, and she was ‘only just 37 weeks’. Fortunately I always carry my ‘serious’ kit in the car from 36 weeks, but was lacking stuff like Entonox and inco sheets, although I did have my perennial oxygen cylinder with me. I was also concerned about S’s history, so called in the paramedics... there was no point calling anybody else... they wouldn’t have got through the evening traffic in time.
17.55 the paramedics arrived... the storm was gathering....
I could see by the way that S was behaving and other external signs that she was coming up to second stage.
The paramedics were brilliant.... they bought up entonox, pads and a delivery pack, attending to anything that I asked of them, whilst silently observing and standing in modest places in the room (man at head end, woman at business end).
18.05 Everything changes..... S is now roaring in monotone and the baby’s head is visible with a huge contraction, but disappears back. S changes her position, almost as if she needs to manoeuvre the baby down by arching her back and raising herself on her knees.
18.10 baby restitutes, and as if being twisted by an internal rebozo..... arrives slowly and gently into my hands with a huge gush of liquor...
She is here....
S automatically twists round, takes her t shirt off and holds out for her baby.... skin to skin within seconds.
No amount of Syntometrine, controlled cord traction, peeing and suckling baby was going to get that placenta out, so we ended up in hospital anyway, but.....
This woman, who happily bought into the medicalisation of her labour and birth, who ‘didn’t do pain’, who couldn’t understand why women would want to birth at home... is very happy and proud of her achievements today.
There are many books and courses, study days and workshops out there that want to ‘teach’ women to achieve a normal birth...... but at the end of the day, when a woman has to step up to the mark... she gets on and trusts in her own birthing instinct anyway..... and I always watch in wonder
My learning curve has extended once again....
It increased my belief in trusting in a woman’s own instincts during the birthing process and also a kick up the backside for me and my mistimed complacency.
S has had 2 children before.
The first was in a busy city hospital in the South 8 years ago... she was induced for post maturity
She was left alone for the majority of her labour, sustained a nasty tear, retained placenta and a major post partum haemorrhage.
Seven years and 3 miscarriages later, she met and married her current husband and became pregnant with her second child.
She employed me as her Midwife because she felt so traumatised by the previous birth, not even wanting to acknowledge that the baby was there until about 28 weeks. She was induced again for post maturity and had a positive experience this time, with an epidural and a wonderful NHS Midwife, and Myself supporting in a non clinical role.
6 months later, she called me to say she was pregnant again.... not planned.. but coming to terms with the prospect of having 3 children and a teenage step daughter to care for.
Her Downs Risk test came back at 1:115, which both parents understood and accepted, but declined any further investigations. I found out later that this had marred all of her expectations of having a healthy baby for the remainder of her pregnancy, and was the first thing she asked about when her baby was born.
S had always gone overdue, her waters had never gone on their own and she always took ages to establish her induced labours. We even joked that this baby would be born on bonfire night, and that she needed to avoid Halloween.
At 36+6, S reported a small gush of fluid, which was checked out at hospital and nothing found.
2 days later, she paged me to say her waters had broken outside the hairdressers but with no contractions. I went over to confirm her membranes rupturing, to save both herself and the hospital time, and to organise augmentation (this trust augments after 24 hours).
We sat and drank tea for a while and S reported that she had some mild period type pains which weren’t bothering her, so I listened in again, checked her temperature and said I would go home and get sorted before her labour started, and to call me when they establish.... this was at 17.00
At 17.15, her husband called me (i have hands free in the car) and shouted ‘MARION.. YOU’D BETTER COME STRAIGHT BACK!’... I could hear S in the background moaning loudly. My green light (the best £50 i’ve spent in a long time) went on the roof and I made my way back through the appalling roadworks outside their village, with workmen moving bollards for me to hasten my journey.
When I arrived, S was on all fours rocking her pelvis and moaning softly and rhythmically. When her contractions came, she would raise the volume of this primitive moan, almost singing violently in monotone... not an angry noise, more of a focussed announcement that she was in productive pain.
At 17.40 I managed to assess and she was 5 centimetres dilated with the head at the spines.... this progress was too quick for any transfer to hospital.
This is where my complacency comes in.
I ‘assumed’ that she would have her baby later rather than earlier, and she was ‘only just 37 weeks’. Fortunately I always carry my ‘serious’ kit in the car from 36 weeks, but was lacking stuff like Entonox and inco sheets, although I did have my perennial oxygen cylinder with me. I was also concerned about S’s history, so called in the paramedics... there was no point calling anybody else... they wouldn’t have got through the evening traffic in time.
17.55 the paramedics arrived... the storm was gathering....
I could see by the way that S was behaving and other external signs that she was coming up to second stage.
The paramedics were brilliant.... they bought up entonox, pads and a delivery pack, attending to anything that I asked of them, whilst silently observing and standing in modest places in the room (man at head end, woman at business end).
18.05 Everything changes..... S is now roaring in monotone and the baby’s head is visible with a huge contraction, but disappears back. S changes her position, almost as if she needs to manoeuvre the baby down by arching her back and raising herself on her knees.
18.10 baby restitutes, and as if being twisted by an internal rebozo..... arrives slowly and gently into my hands with a huge gush of liquor...
She is here....
S automatically twists round, takes her t shirt off and holds out for her baby.... skin to skin within seconds.
No amount of Syntometrine, controlled cord traction, peeing and suckling baby was going to get that placenta out, so we ended up in hospital anyway, but.....
This woman, who happily bought into the medicalisation of her labour and birth, who ‘didn’t do pain’, who couldn’t understand why women would want to birth at home... is very happy and proud of her achievements today.
There are many books and courses, study days and workshops out there that want to ‘teach’ women to achieve a normal birth...... but at the end of the day, when a woman has to step up to the mark... she gets on and trusts in her own birthing instinct anyway..... and I always watch in wonder
My learning curve has extended once again....
Wednesday 23 September 2009
Under the Radar
I sometimes cover as an agency Midwife in maternity units quite a way from where I live.
This is a necessity for me, as Independent Midwifery is never going to make anybody rich, but gives me the reason for being a Midwife.
Last week, I encountered something that I found not just amazing, but also very sad.
At the beginning of a night shift, I was handed over care of a young girl after she had 'delivered' her baby. She was alone, but had some support from another woman, who left shortly after I took over her care. As the girl was sleeping with her baby by her side, I had time to read her notes in order to get to know her better.
This young girl was alone..... she had been bought over from Africa by her parents when she was 11, and left with an 'aunty' whilst the parents returned home. The aunty left and put her in the care of friends, who moved her on... who moved her on.
The girl was caught shoplifting a few months ago and was found to be almost 6 months pregnant, she had been sleeping in bus shelters because she didnt want to go back to the house where she was told to 'be nice' to the tenants male friends in order to stay there.
This girl had just turned 16. She had been in this country undetected for five years, no education, no healthcare, no social protection or support. She was moved from town to town as soon as any suspicion was raised.
The woman who had just left was her Foster Mother... she had gone home to get her the chicken and black eyed peas she was craving after her birth.
The girl woke and instinctively put her baby to the breast. As I introduced myself, she saw the notes open, and remarked that I too must now be fully aware of her history.
We chatted for a while and she spoke of her past, almost as if it was a relief for her to talk about it.
She told me that she had slept with 4 or 5 different men over the Christmas period, in return for food and accomodation, and that she had no idea who the father of her child was. Over the years, she had been beaten, hidden in wardrobes, put in vans taken to houses in the middle of the night. There were times when she didnt even know which town she was in.
At no time did she speak of the parents who had abandoned her.
She spoke with some emotion of her foster mother, who had given her safety and trust.
She told me about the moment her waters broke on the kitchen floor, and how her FM had cleared it up, then bathed and changed her. She asked her..'why are you doing this for me?' Her FM said....' because you are my sister..... my friends are my sisters and we are there for each other'..... it was at this moment that I had to excuse myself to the loo for fear of losing my composure.
This girl is now in the 'system'. She will be provided for.
What worries me is how many more are out there under the radar........
This is a necessity for me, as Independent Midwifery is never going to make anybody rich, but gives me the reason for being a Midwife.
Last week, I encountered something that I found not just amazing, but also very sad.
At the beginning of a night shift, I was handed over care of a young girl after she had 'delivered' her baby. She was alone, but had some support from another woman, who left shortly after I took over her care. As the girl was sleeping with her baby by her side, I had time to read her notes in order to get to know her better.
This young girl was alone..... she had been bought over from Africa by her parents when she was 11, and left with an 'aunty' whilst the parents returned home. The aunty left and put her in the care of friends, who moved her on... who moved her on.
The girl was caught shoplifting a few months ago and was found to be almost 6 months pregnant, she had been sleeping in bus shelters because she didnt want to go back to the house where she was told to 'be nice' to the tenants male friends in order to stay there.
This girl had just turned 16. She had been in this country undetected for five years, no education, no healthcare, no social protection or support. She was moved from town to town as soon as any suspicion was raised.
The woman who had just left was her Foster Mother... she had gone home to get her the chicken and black eyed peas she was craving after her birth.
The girl woke and instinctively put her baby to the breast. As I introduced myself, she saw the notes open, and remarked that I too must now be fully aware of her history.
We chatted for a while and she spoke of her past, almost as if it was a relief for her to talk about it.
She told me that she had slept with 4 or 5 different men over the Christmas period, in return for food and accomodation, and that she had no idea who the father of her child was. Over the years, she had been beaten, hidden in wardrobes, put in vans taken to houses in the middle of the night. There were times when she didnt even know which town she was in.
At no time did she speak of the parents who had abandoned her.
She spoke with some emotion of her foster mother, who had given her safety and trust.
She told me about the moment her waters broke on the kitchen floor, and how her FM had cleared it up, then bathed and changed her. She asked her..'why are you doing this for me?' Her FM said....' because you are my sister..... my friends are my sisters and we are there for each other'..... it was at this moment that I had to excuse myself to the loo for fear of losing my composure.
This girl is now in the 'system'. She will be provided for.
What worries me is how many more are out there under the radar........
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