Valerie Gommon Midwife’s Blog

Archive for the ‘AIMS’ Category

Following the recent screening of “Freedom for Birth” a film documentary discussing the plight of maternity services and midwifery world-wide I have put together an Action Plan of ideas that you may like to consider to support the midwives and maternity services.  Please do as much as you can to make things better for women today and our daughters in the future.

ACTION PLAN

Please consider joining the following Facebook groups:

Independent Midwives UK

Fighting for Independent Midwives

The Birth I Want

ARM Conference 2012

One Born Every Minute—The Truth

One World Birth

Human Rights in Childbirth

Face of Birth

http://www.facebook.com/pages/Podpora-pro-%C3%81gnes-Ger%C3%A9b-Support-for-%C3%81gnes-Ger%C3%A9b/139577179421729?v=wall

Websites:

The Birth I Want:

http://www.thebirthiwant.org.uk

Register an Interest in Independent Midwifery at:

http://www.independentmidwives.org.uk/

The Association of Radical Midwives—Midwifery Matters:

http://www.midwifery.org.uk/

The Association for Improvement in Maternity

Services:

http://www.aims.org.uk/

The Face of Birth

www.faceofbirth.com

Sign the petitions:

http://www.change.org/en-GB/petitions/amnesty-international-europe-amnesty-international-to-save-persecuted-midwives-in-europe?utm_campaign=autopublish&utm_medium=facebook&utm_source=share_petition&utm_term=4998292

http://you.38degrees.org.uk/petitions/choice-for-mothers-to-be-saves-nhs-money

http://epetitions.direct.gov.uk/petitions/34513

 

View the short version of “Freedom for Birth” available November 2012

Write a letter of support for Agnes to President of Hungary, János Áder ugyfelkapu@keh.hu

 

STOP PRESS STOP PRESS STOP PRESS STOP PRESS STOP PRESS STOP PRESS

Royal College of Midwives (RCM), National Childbirth Trust (NCT) Independent Midwives UK (IM UK) Association of Radical Midwives (ARM) Association for Improvements in Maternity Services (AIMS) and the Albany Mums Support Group present:

THE ‘RECLAIMING BIRTH’ RALLY SUNDAY, MARCH 7th 2010

Please consider joining us for this important Rally to support mothers and babies.  “Mothers and babies are the foundations of our society, what is more important than getting the foundations right?”

This is a once in a lifetime opportunity – with an election coming up – to send a very loud message, there is a real sense of all the different stakeholders being united in one voice and it could, with hindsight be seen as the turning point for the midwifery profession.

We demand that all women should have a midwife they can get to know, be able to access home birth, a local birth centre, and that there should be independent midwifery available as an option for women to choose.

Meet at 1.00PM in Geraldine Mary Harmsworth Park, Lambeth Road, SE14EQ

We will march to Whitehall to hand in a petition to the Health Minister and letters to the Prime Minister

Master of Ceremonies: Peter Duncan.  Speakers include: Professor Wendy Savage, AIMS Chair Beverley Beech, Albany Midwife Becky Reed, IM UK Board Member Annie Francis, NCT CEO Belinda Phipps, Albany Mums Support Group campaigner Emma Neamish and Duncan Fisher OBE

PLEASE TELL EVERYONE ABOUT THIS IMPORTANT RALLY.

Joanna Moorhead writes in The Guardian about how hospitals are trying to reduce the trend of repeat caesareans www.guardian.co.uk/lifeandstyle/2009/jun/16/caesarean-elective-section-giving-birth

The caesarean section rate is shockingly high.  The Association for Improvements in Maternity Services (AIMS) wrote in 2004 that the caesarean rates had continued to rise to 23 per cent, but many hospitals had rates approaching 30 per cent, indeed The Portland private maternity hospital had almost a 90% section rate.  The national caesarean section rate has continued to rise and in 2007 – 2008 was quoted as 24.6% .

Moorhead’s article highlights the dilemma – one woman was encouraged to attempt a vaginal birth after having had a caesarean first time around – sadly this woman ended up with a repeat caesarean however another woman was supported by a sympathetic obstetrician and given information about the benefits of trying for a normal birth – this woman went on to have a normal birth and was very happy with the outcome.

In fact the chances of having a vaginal birth after a caesarean are actually very good (this is obviously something you will need to discuss with your midwife and obstetrician) and I am happy to report that I have supported many women to achieve this.  There are some women however who will need a caesarean and we need to be careful not to make them feel that they have failed when a caesarean is necessary.  It is important to remember that without recourse to good medical help some women and babies would not survive!

If this is something you wish to discuss further I would be happy to speak to you, feel free to contact me by email info@3shiresmidwife.co.uk

I have also been given a copy of “Real Healing after Caesarean” by Martha Jesty which I confess I still have to read!

Well what a surprise, new research “Perinatal mortality and morbidity in a nationwide cohort of 529 688 low-risk planned home and hospital births” http://www.rcog.org.uk/news/bjog-release-new-figures-safety-home-births has found that homebirth is safe for low-risk women.  These findings echo the work of Marjorie Tew way back in 1986 British Journal Obstet Gynaecol 1986 Jul;93(7):659-74

This large scale research from the Netherlands – which has a high rate of home births – found no difference in death rates of either mothers or babies in 530,000 births.

Low-risk women in the study were defined as those who had no known complications – such as a baby in breech or one with a congenital abnormality, or a previous caesarean section; additionally the researchers noted the importance of both highly-trained midwives who knew when to refer a home birth to hospital as well as rapid transportation.

I wholeheartedly support the initiative of the Dutch midwives, and also that of the Albany midwives (based in Peckham, South London) http://www.albanymidwives.org.uk – midwives attend a woman at home in labour and together they decide whether to stay at home or transfer to hospital.  If all is well many mothers opt to labour and give birth at home, but if she prefers to transfer her midwife will accompany her into hospital.

In my Independent Midwifery Practice www.3shiresmidwife.co.uk this is pretty much what happens.  Mothers often plan a homebirth, but know that they can transfer at any point if they wish, conversely if they plan a hospital birth and change their mind I will care for them at home.  Indeed many of my clients would not be considered “low-risk” but these women believe that by staying at home they are more likely to give birth without interference.

The number of mothers giving birth at home in the UK has been rising since it reached a low in 1988; currently only 2.7% of births occur at home in England and Wales.  Our government has pledged to give all women the option of a home birth by the end of this year. At present just 2.7% of births in England and Wales take place at home, but there are considerable regional variations – so we have a huge way to go in achieving this.

Louise Silverton, deputy general secretary of the Royal College of Midwives, said, the study was “a major step forward in showing that home is as safe as hospital, for low risk women giving birth when support services are in place, but she also acknowledged that ” the NHS is simply not set up to meet the potential demand for home births”, she went on to say that there needs to be a major increase in the number of midwives.  My experience fully supports this fact, sadly I am regularly hearing of women being denied a homebirth on the grounds of inadequate staffing – this is outrageous and women need to be campaigning and lobbying for better maternity services (www.aims.org.uk; www.onemotheronemidwife.org.uk; www.kentmidwiferypractice.net)

Further reading

www.nhs.uk/news/2009/04April/Pages/HomeBirthSafe.aspx
http://news.bbc.co.uk/go/pr/fr/-/1/hi/health/7998417.stm
www.independent.co.uk/opinion/commentators/annalisa-barbieri-i-gave-birth-at-home-ndash-and-heres-why-1669309.html

The Department of Health recommends that all newborn babies be
given a Vitamin K supplement at birth. Approximately 1:10,000
babies may have a rare condition known as haemorrhagic disease
of the newborn, a condition whereby the baby may have
spontaneous internal bleeding. Vitamin K is used in the blood
clotting mechanism.

Vitamin K is available by injection or orally and you should decide
whether or not you wish your baby to receive Vitamin K, and if you
do in what form. The booklet “Vitamin K and the Newborn”
produced by AIMS (www.aims.org.uk) provides a detailed
discussion of the subject.

Babies at higher risk of haemorrhagic disease (Vitamin K
Deficiency Bleeding):

  • premature
  • complicated birth e.g. forceps/ventouse/caesarean section
  • have liver disease that may show as prolonged jaundice or have pale stools or dark urine
  • fail to take or find it hard to absorb feeds
  • are ill for other reasons
  • have bleeding or spontaneous bruising in early infancy

It may be helpful to increase Vitamin K in your diet from 36 weeks.
It is also important that from birth, until a year old if you notice
bleeding or bruising which is unexplained that you get this
investigated as a matter of urgency as it could be an indication of
haemorrhagic disease.

Foods containing Vitamin K include:

Yoghurt, alfalfa, egg yolk, soya oil, fish liver oils, wholegrain
cereals, cauliflower, turnips, green leafy vegetables, broccoli,
cabbage, lettuce, green tea and kelp.

I confess that I’ve been quiet – I’ve actually been away!  As I have no babies currently due (in my Independent Midwifery Practice www.3shiresmidwife.co.uk) we took advantage and went up to the wilds of Cumbria for a week and had a great time staying at Dent railway station www.dentstation.co.uk – my husband is a train spotter!  So lots of walking, snow, eating and drinking for a week – fantastic.

Whilst away I saw a couple of interesting items in The Daily Telegraph.  One article discussed that scientists have found that young women are sensitive to babies physical appearance whereas post-menopausal women and men were less able to distinguish between babies.  The researchers believe that the difference could be a hormonal one and plan further research in relation to postnatal depression. www.telegraph.co.uk/scienceandtechnology/science/sciencenews/4306406/Women-can-distinguish-cute-babies.html

In the same newspaper there is an item discussing that early terminations of pregnancy (up to 9 weeks gestation) are to be provided in some GP surgeries www.telegraph.co.uk/health/healthnews/4306534/Abortions-in-GP-surgeries-to-be-extended..html

On a happier note, today I have been to a first birthday party – the baby was born at home a year ago.  Her mother had previously had a caesarean with her first baby but really wanted a natural birth second time around.  She laboured in a birthpool and had a relatively short and easy labour and birth second time around – wonderful!  It was lovely to visit and catch up with the family.

VBAC or vaginal birth after previous caesarean section has previously been controversial, but with better surgical procedures even doctors are keen that the majority of women attempt a vaginal birth next time as this is a safer option for both mother and baby.  Obviously it is important to review what happened during the last labour, and for some women a repeat caesarean may be the best option, but for many a vaginal birth will be possible.  Doctors and many midwives will recommend that a woman planning a VBAC give birth in hospital and that she be closely monitored, for example by having continuous external monitoring of the baby’s heart, and by having intravenous access in case of  uterine scar rupture which is a rare but very serious possibility.  Scar rupture rates are quoted at between 1:200 and 1:2000 depending upon which research you read, there is an excellent booklet discussing the subject “Birth after Caesarean” published by AIMS www.aims.org.uk/pubs3.htm However there are some who believe that by labouring at home, in a calm and relaxed environment, with no monitors or drips, will give the woman the best chance of giving birth normally.  Indeed some hospitals are now comfortable with “allowing” VBAC clients into the birthing pool for labour.  Most midwives and doctors agree that women attempting a VBAC should not have their labour “interfered” with; it can be dangerous to induce or augment a labour when a woman has a scar on her uterus.  If you are considering a VBAC I recommend that you discuss the matter carefully with your midwife or doctor and give yourself the very best chance of having a normal birth next time – many, many women are now achieving VBACs, and indeed I know of several women who achieved vaginal births after several previous caesareans so it is possible!


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