Posted by: gommon on: November 26, 2008
My first blog, and introduction to me
I am Valerie Gommon, a Registered Midwife and an Independent Midwife and this is my first attempt at blogging. First of all, a brief introduction to who I am and what I get up to:
I am a midwife in Independent (or Private) Practice and offer full continuity of care throughout the antenatal period, labour and birth and up to one month postnatal. I have four grown up children and live in North Bedfordshire.
My interest in birth spans more than two decades and started with the birth of my first son. I was keen to learn more about the birth process and gradually learnt more about childbirth and parenting skills and subsequently had my next three children at home.
I became involved in La Leche League (a group which supports and promotes breastfeeding), the National Childbirth Trust, A.I.M.S. (the pressure group Association for Improvements in Maternity Services), and our local Birth Information Group. Through my involvement in these groups I began to support other women and acted as a birth supporter and in turn began to teach birth preparation classes and sometimes supported these women during childbirth. Eventually my own children were grown enough for me to consider training to become a midwife and I worked within the NHS for a number of years as both a hospital and community midwife. I am therefore confident in all areas of midwifery practice including homebirth, waterbirth, active birth and vaginal birth after caesarean section; I particularly enjoy parenthood education.
For the majority of women childbirth should be recognised as a normal event, I enjoy supporting women and families at this significant time in their lives. My aim is for women to be fully informed and active partners in their care. I believe this will empower women and their partners to obtain the most from this precious experience and can then enable them to move forwards into parenthood in a positive way.
I am an active campaigner for improvements in maternity services and am a member of Milton Keynes Birth Information Group and MK Mums. I also act as guest lecturer and mentor student midwives. Currently I am a local representative of the Association of Radical Midwives, a member of AIMS (Association for Improvements in Maternity Services), a member of IMA (Independent Midwives Association) as well as being a member of the Royal College of Midwives.
By working independently, I can offer the luxury of unhurried appointments in the comfort of a client’s own home allowing plenty of time to prepare for the birth. I like to think I am an experienced, sensitive midwife who works with clients to help obtain the best possible experience at this special time – pregnancy outcomes (types of birth, length of labour, need for pain relief, maternal satisfaction and length of breastfeeding) have been shown to be improved by having a known and trusted midwife – I believe that this is something every woman deserves and will continue to work towards this aim.
I usually work alone, but have the back up of other Independent Midwives if needed.
Please do feel free to give me a call for an informal discussion if you wish to discuss anything I have written.
Tel: 01908 511247
info@3shiresmidwife.co.uk
Posted by: gommon on: January 21, 2012
Another guest blog by Sarah Ward … thanks Sarah.
The placenta is the fetal life support system, but can also become more than this, and is a powerful symbol that many believe deserves some respect when it has fulfilled its main aim.
A new TV programme on Channel 4 called ‘How to be a Good Mum’ made me decide to do a topic on placentas. I tend to hate programs like this because they always portray what can be reasonably sensible well thought out ideas, throw them all together and turn them into a program designed to shock and mock anything mildly different from the perceived ‘norm’.
The first episode showed a lady making a print from her placenta in quite gory horror style detail. Each to their own maybe, but here are some ideas I found on the internet!
1. Plant It!
The most obvious and common thing to do with a placenta (after throwing it out that is) is to plant it in the garden or a pot. Sometimes this is done as part of a ceremony, naming day, with friends, family or just a personal thing done without announcement, just to show respect to the thing that nourished and fed your unborn baby for all those months. Maybe to throw it out seems in some way disrespectful after all its hard work?
2. Print From It!
This is easier than it sounds. It can be frozen for some time, defrosted, washed, dried and the side closest to the baby including the cord can be inked and printed to look like a tree, with all the veins looking like branches. They can be quite beautiful. They can also be printed from soon after birth using the blood left within it to make the print.
3. Encapsulate It!
There are many practitioners that will encapsulate your placenta for you. This basically involves mulching it up, drying it out and turning it into a powder form that’s put into tablet capsules for you to take. The benefits are said to be that it can balance your hormones in the weeks and months after birth, increase your milk supply and quality, and increase energy. Its been reported to decrease the risks of developing post natal depression also. In fact it’s not a new idea, its been a traditional Chinese medicine practise for centuries. This needs to be done within 48 hours after birth.
4. Ingest It!
Ok, I mean Eat IT! The benefits are the same as above but you could do this yourself at home and not need anyone to help you. I think most people are generally aghast at this idea, but it’s not so uncommon in other parts of the world. In fact there are many rituals and ceremonies that involve this, and are a way of welcoming the new baby into the community and celebrating its safe arrival. If you google this subject you can find many recipes and ideas from simple smoothies to bolognaise!
In fact MOST mammals eat their own placenta and the benefits are said to be that it encourages milk production, and encourages the uterus to shrink down after birth.
5. Burn it!
Some cultures burn the placenta in a clay pot and then bury the ashes.
6. Make a Teddy!
Artist Alex Green set off a media storm after his Placenta Bear went on display at the ‘Doing it for the Kids’ exhibition. He explained:
“The goal of the exhibition is to inspire designers, educators and parents to be more critical of the toys that shape a child’s values and the impact toy making has on the environment.”
7. Other Cultures Do This!
In Yemen the placenta is placed on the family’s roof for the birds to eat, in the hope that it will guarantee the love between the parents.
In Malaysia the placenta is seen as the child’s older sibling and thought that the two are reunited at death. The midwife carefully washes the placenta, cord and membranes and wraps them in a white cloth to be buried.
In Nepal, the placenta is given the name ‘bucha-co-satthi’ – meaning ‘baby’s friend’
The Tanala people of Madagascar observe strict silence throughout the labour and birth and as the placenta is being delivered. When the placenta comes, everyone present claps and shouts “Vita! Vita!” – meaning ‘finished’.
Philipino women often bury their placentas with books with the hope that this will ensure an intellectual child!
To Conclude:
Whether you choose to eat it, paint with it, throw it out or whatever, there’s no denying that the placenta is a beautiful thing. It is the connection between mother and child and can be a very spiritual symbol. Whatever we decide we should not judge other people’s choices even if they appear alien to us. Being different is what makes the world an interesting place.
Posted by: gommon on: January 15, 2012
Another Guest Blog, this time written by Emily Malleson from Morrck Baby Hoodies www.morrck.com
According to the UK Department of Transport, 60 to 80% of all car seats are used incorrectly, with harness tension being the single biggest failing. Getting the correct harness tension is even more difficult in winter as it is hard to tell whether you have a good harness fit if a child is wearing a thick coat.
To get the correct harness tension over a puffy snowsuit or thick coat, a parent really has to tighten it substantially, which can make the child uncomfortable as their freedom of movement is restricted. Being tightly strapped in a thick coat can also lead to the child overheating once the car warms up.
To test whether you have correct harness tension when using a coat or snowsuit, you can do the two finger test:
Do the Two finger test. If you can fit more than two fingers underneath the harness at the child’s shoulder bone, the harness tension needs to be tightened or you should avoid using the coat in the car seat.
The safest bet is to strap the child into their seat correctly wearing their normal indoor clothing so you can be assured of the correct harness tension. To keep them warm before the car has had a chance to heat up, parents can place a coat or blanket over the top of their child, or use a product which is designed expressly for this purpose. The key thing is to ensure that whatever is used, still gives you easy access to the harness release button on the car seat so that they can be released easily in an emergency. You should also make sure that when you buy the car seat it is the correct one for your car and it is fitted correctly.
Morrck baby hoodies are designed to fit in your car seat or buggy or anything with a 5 point harness, avoiding the need to use other outdoor clothing, you can just wrap and go. The harness feeds through the openings in the travel wrap and fastens over baby’s indoor clothing. This provides extra protection across your baby’s forehead and ears in cold, windy weather and lies completely flat behind your baby’s head when it’s not being worn.
Morrck’s Baby Hoodie has been tested by an independent testing facility and it was certified as having passed the relevant elements of the ECE Reg R44.04 car seat safety test. Baby Hoodies are available from www.morrck.co.uk
Posted by: gommon on: January 9, 2012
It is an awful thought that we might not be around to care for our children, but it is something parents should consider and make provision for.
Clive Morgan from The Will Partnership has kindly written some thoughts for this Guest Blog. Clive can be contacted at clive.morgan@willpartnership.co.uk
Guardians for Minor Children
One of the most important reasons for making a Will is to appoint guardians for minor children. If a child is orphaned (or the death of the parent with parental responsibility occurs) the courts – as advised by Court Welfare Officers and Social Services – will determine who will raise that child. The parent’s only method of avoiding this is to appoint guardians of their choice within a Will. If clients have minor children, they should be advised to choose guardians within their Will(s) - someone to raise them in the highly unlikely event they can’t. It’s not an easy thing to consider but clients can make some simple arrangements now that will allay some of their fears, knowing that in the extremely unlikely event they can’t raise their children, they will be well cared for.
Who Makes a Suitable Guardian?
- Is the prospective guardian/s old enough? (He or she must be an adult – 18 years old)
- Do they have a genuine concern for the children’s welfare?
- Is the client’s choice physically able to handle the role?
- Does he or she have the time?
- Do they have children of an age close to that of the client’s children and do they enjoy a good relationship?
- Can the client financially provide to raise their children via their Will? If not can the prospective guardian afford to raise them?
- Is their home large enough to accommodate an increase in family size (if not clients may retain their own home for a period of time to house guardians plus children or provide funds for the guardians to increase the size of their home or move, particularly where the clients are certain their choice of guardian is right even through the accommodation is not)?
- Does the guardian share the client’s moral beliefs?
- Are the potential guardian(s) known, liked and trusted by both parents and the children?
- Are they living local to clients so that children could stay at the same school, with the same friends and have as little upheaval as possible during what will probably be the most disturbing time of their lives?
- Have a similar age and circumstances to the client?
- Guardians are usually a relative.
- Would all the children be able to stay together?
As any minor’s daily welfare will be the responsibility of the guardians, it could be worth considering the inclusion of one of the guardians as an executor.
A good question to ask the client could be: ‘If you had an urgent problem tomorrow, who would be the first person you would call to collect your children from school or to be here at home with them until your return and why?’
Clients should name at least one primary guardian (or if the main choice is married/co-habiting then both persons should be chosen) who would act in the event of the death(s) of all persons/parents who had parental responsibility. In addition it is advisable for clients to choose substitute guardians who would act in the event that the primary guardians could not or will not act.
Legally, clients can name co-guardians, who live at different addresses but it’s not a good idea because of the possibility that the co-guardians will disagree how the children will be raised. Where this possibility arises it might be best to appoint one as primary and the other as the secondary guardian which then clarifies the position.
If parents can’t agree
Both parents should name the same person as guardian in both of their Wills. If clients don’t agree on whom to name, a court fight could ensue if both parents die while the child is a minor. Faced with conflicting wishes, a judge would have to make a choice based on the evidence of what’s in the best interests of the child.
A personal view of the writer is that almost any guardian named in a Will is a far better situation than leaving it to the courts – as advised by social services – to decide. If parents can never agree anything else between them guardians is one area where it is vital they should.
Sometimes initially each parent wants each of their own parents as guardians for often different reasons. But once you have a conversation with them about who they think the children would want to live with and who they stay with most often, the ideal solution is often one set of grandparents become the primary guardians and the other the secondary substitute guardians. We inform the guardians of their role in order for them to accept, but we do not inform them of which level of guardian they are. The client may also opt not to inform them so there can be no family arguments over a situation which hopefully will never occur.
At the first meeting when the subject of guardians comes up and agreement does not appear straight forward suggest the clients talk with the people they’d each like to name. Candid discussions with their potential guardians may bring new information to light and help them reach an agreement in time to take their instructions at meeting 2.
Choosing different guardians for different children
Most clients want their children to stay together; if they do, name the same guardian for all the children. You can, however name different guardians for different children. Parents may do this, for example, if their children are not close in age and have strong attachments to different adults outside of the immediate family. For instance, one child may spend a lot of time with a grandparent while another child may be close to an aunt and uncle. In a second or third marriage, a child from an earlier marriage may be close to a different adult than a child from the current marriage. In every situation, you want to help the clients choose the right guardian they believe would be best able to care for each child.
Choosing a different person to watch the money
Some parents name one person to be the children’s guardian and a different person to look after financial matters. Often this is because the person would be the best surrogate parent would not be the best person to handle the money. For example, a client might feel that their bother-in-law would provide the most stable, loving home for the children, but not have much faith in his abilities as a financial manager. Perhaps clients have a close friend who cares about their children and would be better at dealing with the economic aspects of bringing them up. Clients can name one as guardian, the other as executor and trustee to manage their children’s inheritance and advance money to the guardian to maintain the children or it is possible and often prudent to appoint one of the primary guardians as an executor/trustee in addition, provided there are other executors and trustees appointed who are not guardians thus maintaining some balance with no one person (or couple) controlling all the money together with the raising of the children.
Making your wishes known
Most people have strong feelings about how they want their children to be raised. Clients concerns may cover anything from religious teachings to what college they’d like a particular child to attend. One option is to write a letter to the guardian, outlining thoughts and feelings about how the children should be raised where it is ‘wished’. Whereas if it is to be a firm direction and condition/requirement of the guardian, then it needs to be mentioned within the Will. It is always best to be brief – without too much detail – as it could cause the guardian guilt and frustration, if unexpected circumstances thwart their attempts to carry out the wishes or directions of the client to the letter. The best guarantee of an upbringing a client would approve of is to simply choose someone who knows them and their children well, and whom they trust to navigate life’s complexities on their children’s behalf in the same manner as the clients would if they were alive to do so.
If clients don’t want the other parent to raise their child
If one of a child’s parents dies, the other parent usually takes responsibility for raising the child provided the surviving parent has parental responsibility. This, of course, is what most people want. If clients are separated or divorced, however, they may feel strongly that the child’s other parent shouldn’t have custody if something should happen to them. But a judge will grant custody to someone else only if the surviving parent:
In most cases, it is difficult to prove that a parent is unfit, absent or has serious problems such as chronic drug or alcohol abuse, mental illness, or a history of child abuse. If clients honestly believe the other parent is incapable of caring for their children properly, or simply won’t assume the responsibility, you should advise the clients to have an Exclusion Form drafted. In the event of a court case this would give the judge something to take into account particularly because this is the only realistic way the parent who has died can make the court formally aware of the problems and their wishes. Judges are always required to act in the child’s best interest. In choosing a guardian, a judge commonly considers a number of factors in accordance with the welfare checklist, some of the the main ones are:
- The child’s preference, to the extent it can be ascertained
- Who will provide the greatest stability and continuity of care?
- Who will best meet the child’s needs?
- The relationship between the child and the adults being considered for guardian
- The moral fitness and conduct of the proposed guardians.
Some Important Points Regarding the Children’s Act, Parents, Children and Parental Responsibility
In English law Parental responsibility is a legal phrase used to define who has the rights and obligations in making decisions which affect the child’s life. Parental responsibility includes the following legal rights and responsibilities:
Who has parental responsibility?
- Mothers automatically have parental responsibility.
- If the parents are married at the time of the child’s birth then the father has automatic parental responsibility. If the parents subsquently marry, the father automatically aquires parental responsibility upon marriage if they have not done so by any other method.
For unmarried fathers the rules are more complicated. Being the biological father of a child does not mean that they have an automatic right in law to parental responsibility. Likewise, even though they may be registered as the father on their child’s birth certificate, this does not always mean that they have automatic parental responsibility. If the father is unmarried and separate from the child’s mother and does not have parental responsibility, then they do not have a legal say in the child’s upbringing.
Fathers do have parental responsibility if:
They do not have parental responsibility if:
Applying for parental responsibility
There are a number of ways of getting parental responsibility and these are:
To apply to the court for a parental responsibility order, a father needs to show a number of things:
If parental responsibility is granted then it has to be exercised jointly with the mother of the child and therefore any decision regarding the appointment of guardians must be a joint one.
- The right to appoint guardians rests solely with the parent or parents who have parental responsibility and therefore unless the father has parental responsibility he has to be appointed guardian in the mother’s Will in order to raise his own children or apply to the court upon the death of the mother.
-Step parents acquire some rights for stepchildren upon marriage but the right to determine guardians is not one of them. If a step parent wishes to raise stepchildren in the event of the death of their partner they would have to be appointed as a guardian within the Will of the deceased person who has parental responsibility.
- Guardians raising a minor child acquire the right to appoint guardians in the event of their deaths.
- Guardians commence acting upon the death of the second parent or first parent if the mother has sole parental responsibility.
Posted by: gommon on: January 2, 2012
This is a guest blog written by Sarah Ward.
Homebirth & PPH
Women often worry about what would happen if a woman bled heavily after a home birth. Throughout history, severe blood loss has been one of the main causes of women dying in childbirth, and it remains the most common cause of maternal death in the world [WHO, 1994].
Efficient management of postpartum haemorrhage is one of the wonders of modern obstetrics. The key is the availability of oxytocic drugs, which make the uterus contract down and normally stop bleeding.
You can choose to have either a ‘managed’ or a ‘physiological’ third stage, at home or in hospital. A ‘managed’ third stage means you have an injection of syntometrine as a precautionary measure. A ‘physiological’ third stage means you take a ‘wait and see’ approach to the delivery of the placenta, and only have drugs if you are worried about bleeding or if the placenta is taking longer than you want to wait for it to turn up
Sometimes one hears of doctors trying to dissuade women from home birth because of the risk of postpartum haemorrhage yet in fact severe bleeding after a home birth in the UK is rare, and postpartum haemorrhage is usually managed at home or by transfer to hospital. Despite the fears of some doctors, you would be very unlikely to bleed to death after a planned home birth in a developed country.
A famous review of quality studies of home birth (Olsen, 1997) looked at outcomes for over 24,000 women and found no maternal deaths. The National Birthday Trust Fund study looked at around 6,000 planned home births in the UK, and found no maternal deaths.
Where treatment for postpartum haemorrhage is needed, there are two elements. Emergency treatment focuses on stopping the bleeding, and in severe cases, keeping blood volume up while the bleeding is stopped. The other element of treatment is helping you to recover from blood loss, by administering a blood transfusion or iron supplements, this usually occurs several days after the bleed after blood tests have been performed.
What can a midwife do about heavy bleeding at a home birth?
Your midwife would follow exactly the same steps that she would take in hospital. Oxytocic drugs to manage blood loss are part of the basic kit that midwives take to every home birth.
If these did not bring the situation under control quickly then an ambulance would be called, and the midwife would take other steps if necessary, such as manually compressing your womb to stop bleeding.
In the UK most midwives can put an intravenous drip in at home while they are waiting for an ambulance to arrive.
What if the midwife isn’t there?
In the rare circumstances that a baby is born so quickly the midwife has not arrived yet, or the bleed has occurred after the midwife has left (also extremely rare), then you can do the following:-
When the midwife arrives…
Placental Problems
Can more be done in hospital than at home?
How likely is post-partum haemorrhage after a home birth?
Can you have a home birth after having had a PPH with a previous baby?
o If she needed an assisted delivery this time she would transfer to hospital, so that shouldn’t affect her status as regards home birth.
o Likewise, her labour is not going to be induced with prostaglandins or augmented with syntocinon.
Conclusion
All in all the risks of a PPH are lower in a planned homebirth than in a planned hospital birth.
However if one should occur, there are many ways it can be treated successfully at home, or by transfer to hospital.
It’s also important to realise that a negative outcome from a PPH can also occur in a hospital situation as well as at home.
Having experienced a PPH following a birth is not an automatic barrier to home birth in the future, it would depend on the reasons why it occurred. In fact planning a home birth may significantly reduce the chances of having a PPH in the future.
Posted by: gommon on: December 9, 2011
This is a guest blog, written by Donna Jones - www.dj-counselling.co.uk
Being a parent can be one of the most rewarding things we can do in our lives but it can also be one of the most frustrating and stressful times too. It can feel like there is constant pressure on us with no time to ourselves.
I see many clients who are suffering with parental stress and are struggling to find ways to deal with it. Our children know just the right button to press to get our stress levels soaring!
Some common symptoms of stress can be:
Some things that have helped some of my clients are:-
As parents we also need to remind ourselves that we are doing a good job and to recognise that good is good enough and that no one is perfect.
Learn to relax physically
To help reduce your stress levels relaxation is important but being able to relax your body is a skill. A lot of my clients find it hard to relax as they have spent all day racing round after their children, going to work, doing housework and then when it is finally time to sit down their body is still so full of adrenaline they find it near impossible to switch off.
Some good ways to help you relax are:
By Donna Jones
Counselling by Donna
Posted by: gommon on: May 8, 2011
This is a Guest Blog written by Sandra Beale from SJ Beale HR Consult Ltd.
On 3 April 2011 the standard rate of statutory maternity, paternity and adoption pay increases from £124.88 to £128.73. Furthermore there will be changes to maternity and paternity leave with a right to additional paternity leave for fathers with babies due on or after 3 April 2011.
Fathers already have the right to take up to two weeks’ paternity leave which is paid at the statutory rate. The new right involves fathers (or partners of the mothers) taking up to 26 weeks leave if the mother returns to work without taking all of her maternity leave, the child is 20 weeks old and before they have their first birthday. The new legislation will also apply to fathers/partners who are matched for adoption on after 3 April 2011. The right extends to the spouse, civil partner and partner of the child’s mother where they have the main responsibility (with the exception of the mother) for caring for the child. The new right might be particularly welcomed by couples where the mother is the higher earner and who wishes to return to work and allow the child to be looked after by her partner. The father (or partner) will have to give no less than eight weeks’ notice of their intention to take the leave and will have similar protections whilst on additional paternity leave to those that women benefit from during maternity leave (i.e. the right to return to the same job, keeping in touch days, etc). An employer has the right to request evidence of the birth/adoption.
Actions employers need to take:
•Review maternity and paternity policies and procedures to ensure they takeinto account the changes from April 2011 onwards
•Put systems in place to ensure the correct information about additional paternity leave and pay is captured – by using template notices and employee/mother declaration forms
•Organise internal processes to ensure that entitlement to additional paternity leave/pay is included
For more information contact Sandra Beale on 07762 771290.
www.sjbealehrconsult.co.uk
Posted by: gommon on: April 29, 2011
I heard a really interesting item on the radio the other day. Apparently the gestation of pandas can vary between 95 and 160 days! So if the gestation of pandas can be so widely different, then why can’t women?
Midwives always say that term is between 37 and 42 weeks of pregnancy and we know that women do vary tremendously in their length of gestation. Some women always have their babies at 37 weeks, some at 43 weeks, so why do “we” panic and suggest that women be induced at 7 or 10 days over the “magic” 40 weeks? Indeed who came up with this figure of 40 weeks? It is often cited that the French regard a normal pregnancy length to be 41 weeks! Remember 40 weeks is just an arbitrary figure, and indeed many (if not the majority) of women will go over this time.
Although many women are very “fed up” by the end of pregnancy it is worth thinking about the risks and benefits of accepting a hospital induction. It is also worth noting that different doctors and different hospitals set wide ranging dates for induction so there is clearly room for discussion with your midwife or doctor about if and when you should be induced. Remember no one can force you to be induced!
The most important thing to remember is that you should monitor your baby’s movements – although the movements will change towards the end of the pregnancy as the baby runs out of room s/he should still move in his/her usual pattern. Another important thing to monitor is that your bump continues to grow and is not getting smaller. If you are at all concerned speak to your midwife or local maternity unit.
I should say is that Induction of labour is not an easy option and should, in my opinion, be avoided if at all possible, however there are many debates about when a labour should be induced; the NICE (National Institute of Health and Clinical Excellence) suggest that women should be OFFERED induction at between 41 and 42 weeks of pregnancy. Of course there may be medical reasons for an induction, and these should carefully be discussed with your midwife and doctor, however there are also risks associated with induction, for example you are more likely to have a longer, more painful labour after an induction and you are more likely to need some help for example a ventouse or forceps delivery or a caesarean section.
If it is agreed that an induction is preferable, I would urge you to try “alternative” methods or induction before resorting to a surgical induction http://midwifevalerie.wordpress.com/2008/12/09/alternatives-to-hospital-induction/
Although methods of induction vary slightly from area to area, the principles of a “surgical” induction will involve you going into the hospital where you will first be checked over (blood pressure, urinalysis, abdominal palpation), your baby’s heartbeat will then be monitored for a period of time to ensure that the baby is well and that it is safe to proceed with an induction.
You will then be assessed internally to ascertain the best and safest method to induce you. If it is your first baby and you are not yet in labour it is likely that the doctor will prescribe a drug called “Prostin” which is inserted into your vagina to soften your cervix with the aim of starting labour. (Prostin is an artificial preparation of the hormone prostaglandin which is naturally present and involved in the labour process.)
Your baby may well be monitored for a period after the insertion of prostin – we want to ensure that s/he suffers no adverse reaction to the drug, – the monitoring is performed by placing two elastic belts around your abdomen to hold a “transducer” (a plastic probe) onto your tummy to obtain a print-out of the baby’s heart pattern (this is just a glorified version of the sonicaid that the midwife uses antenatally to listen to your baby).
Once the midwife is reassured she will be happy for you to get up and perhaps go for a walk or go to the hospital restaurant – it is a good idea to eat as you will need lots of energy when you are in labour! Some hospitals will also allow you to go home and wait for labour.
Prostin does not always work first time, indeed often women need two, three or sometimes more doses and these are usually repeated at 6 hourly intervals.
An alternative to prostin is to break your waters – this can only be done if your cervix has already started to open – this is more likely if this is not your first baby, or if you have had prostin which has started the process but not put you into labour.
Breaking the waters is not particularly painful, although it can be very uncomfortable. The midwife or doctor will need to do an internal examination and will attempt to “pop” the bag of waters that your baby is inside. We use a plastic hook and literally try to burst the balloon of water!
Very often after the waters have broken labour will naturally start within a couple of hours, so again we wait … you can go off for another walk (are you getting a sense of the timescale here … an induction can go on for several days, so don’t expect things to happen in a hurry!).
If at this point the woman still is not in labour we usually suggest giving her a drip with a drug called synotocinon which usually starts uterine contractions. These contractions are frequently more painful than a natural labour and because we are giving a drug we will also need to continuously monitor the baby’s heartbeat meaning that you are somewhat constrained in your movements (you can still stand by the bed or sit in a chair though).
In a few cases despite all our best efforts none of this will work and we proceed to a caesarean section.
Despite my doom and gloom, many women who are induced successfully labour and go on to have a normal birth, but to give yourself the best chance of a normal birth think carefully about whether an induction is right for you. The decision as to whether you are induced or not should be made by YOU, in consultation with your doctor and midwife, remember it is your body and your baby; you have the right not to be induced. A normal pregnancy is defined as between 37 and 42 weeks – so you are not even overdue until you get past 42 weeks!
More information can be found in “Induction – do I really need it?” available from www.aims.org.uk or, as always, I am very happy to speak to you info@3shiresmidwife.co.uk
For related reading please see the following blog posts:
http://midwifevalerie.wordpress.com/2010/01/24/induction-of-labour/
http://midwifevalerie.wordpress.com/2010/10/02/postmaturity-going-overdue/
http://midwifevalerie.wordpress.com/2008/12/09/alternatives-to-hospital-induction /
http://midwifevalerie.wordpress.com/2009/07/16/natural-childbirth-the-medicalisation-of-birth/
Posted by: gommon on: April 14, 2011
Where to start? Every day is different, so I’m going to give you a flavour of the sort of things I get up to.
Of course I have antenatal appointments; from the first tentative telephone enquiry I then arrange to meet up with a potential client (usually for an hour or so) so that we can discuss their past experiences, their hopes for this pregnancy, their concerns and most importantly so that they can get a “feel” as to whether they actually like and trust me. Once a couple have decided to book me as their midwife I then usually give all their antenatal care in their own home (although I have done antenatal visits in The Bank of England medical room!). The format of visits is that I carry out all the usual blood tests, urine and blood pressure checks, but also leave a lot of time for discussion so that over the course of the pregnancy we cover issues such as waterbirth, Vitamin K, when to call me and so on.
My clients come from a wide area – I am happy to take clients who live within approximately an hour’s radius of my home in Leighton Buzzard – so I do spend a fair bit of time driving, as well as liaising with G.P.’s and hospitals where necessary.
Four times a year I jointly organise an Antenatal Exhibition, this is an opportunity for pregnant couples to gather information about breastfeeding, pregnancy yoga, cloth nappies and the like. We also organise Birth Preparation Workshops and am often to be found at the Community Desk in Central Milton Keynes on hand to speak to expectant parents and also regularly attend Study Day’s and midwifery meetings to ensure that I keep myself up-to-date with current research.
Obviously I spend much of my time being “on-call” for births. My own family are now pretty much grown-up and the commitment isn’t as big as one might imagine as I rarely have more than two births during a month – it is important that I don’t over-commit myself as the whole point of what I do is that I guarantee to be there for the birth. Babies don’t always read the text books though! I have had three births in one week, as of course some babies do come early and some come late! As you will appreciate, the birth is the big event, and it can on occasion go on for some time.
Baby being here doesn’t mean that my job ends! In fact, postnatal visiting is often one of the busiest times as the family may need quite a lot of support in the early days. The majority of my clients choose to give birth at home; however some either need to, or choose to give birth in hospital.
I visit my clients for up to four weeks postnatally and it is a joy to see the baby thriving and although discharging clients is always tinged with sadness it is also great to know that I have played a part in helping the family on to the next stage of their life. (I do usually keep in touch, perhaps not as often as I would like, but I often get e-mails and photographs and usually pop in when I’m passing!).
So, in summary I guess the main differences between me and an NHS midwife are that you are buying my time; antenatal visits usually take around an hour and a half (instead of perhaps 10 – 15 minutes at your local surgery), are arranged more frequently and take place at a time and place to suit you. Most importantly you will receive full continuity of care – I will see you at each visit to build our relationship and plan your care and you will know that (barring exceptional circumstances) I will be with you in labour and available 24/7 for urgent help.
I am always happy to discuss anything that you are concerned about; please do feel free to call.
Written by Valerie Gommon, BA (Hons), RM, Independent Midwife
www.3shiresmidwife.co.uk 01525 385153
Posted by: gommon on: April 8, 2011
What is a Labyrinth?
A labyrinth is a single path or unicursal tool for personal, psychological and spiritual transformation. Labyrinths are thought to enhance right brain activity. Birth is a right brained activity too as its intuitive and emotional.
The oldest positively dated labyrinth is from 1230 BCE. It comes from King Nestor’s Palace in Phylos, Greece. There are evidence of Labyrinths all over the world and it is argued that the labyrinth’s connection with the Earth Mother goes much further back into prehistory.
These single-path magical mazes are found around the globe from China to Arizona, USA, from Peru to Sweden.
Birth Labyrinths
I first read about birth labyrinths on Pam England’s website ‘Birthing From Within’. She describes tracing the labyrinth with a finger as invoking a sensation of turning inward, then outward, which may remind us of our first journey from our mother’s body into the world.
A woman’s psychic and physical journey from maidenhood-to-motherhood during pregnancy, labor, and postpartum, can be related to a labyrinth in this way as it is an unknown journey which twists and turns and is unique to every woman.
Mothers experience labour as a labyrinth. With the very first contraction, or when the water breaks, they are catapulted across an invisible, but felt, threshold (entering the Labyrinth). Once in labour (in the labyrinth), steady progress is made by taking one step at a time until the centre is reached. The very centre is meant to represent the birth of the child, mother and the family.
She explains that even if you were blindfolded you could still reach the centre by feeling your way through the path. The path does not need to be studied before it is entered, it just unfolds on its own and in its own time. Therefore there is no need for time limits, or birthplans…just surrendering to the reality that every birth has its own journey that will unfold in its own unique way.
A maze is totally different, having many twists and turns, many entrances and exits, and the possibility that you can lose your way! There are many choices to be made in a maze and many dead ends meaning that planning is needed when in the maze or you will get lost. Prehaps it could be said that this is similar to the medical model of birth?
Using a Labyrinth
It can be quite a liberating and spiritual experience to simply trace the labyrinth with your finger on paper. A clay model can also be made allowing your finger to trace its path in and out with your eyes closed. How do you feel as you step over the threshold and enter the Labyrinth?
This can be a powerful visualisation in labour…imagining the many twists and turns that labour brings but remembering the labyrinth and trusting that the end is in sight, just taking one turn at a time, knowing that each step is one step closer to the middle (birth itself).
Studies show that walking or finger-tracing a labyrinth slows down and balances brain waves, calms the body and mind, and helps access intuitive knowing. During pregnancy, labyrinth meditations help the mother focus on her emotional and spiritual preparation for birth and mothering. In labour, the labyrinth helps to calm the mind, steady the breath, and ease pain.
Further Reading
www.birthingfromwithin.com
http://en.wikipedia.org/wiki/Labyrinth
Book – Labyrinth of Birth: Creating a Map, Meditations and Rituals for Your Childbearing Year by Pam England
How to Create a Birth Labyrinth:
I am making one out of salt dough…I will let you know how I get on!
As usual, if anyone is interested in coming along, or indeed sharing experiences with others,
please get in touch either by phone 07947188628,
email phoebusflea@hotmail.co.uk or
via the main Leighton Buzzard & District facebook group,
or our own LB & D Homebirth Support facebook page.