Valerie Gommon Midwife’s Blog

Archive for the ‘antenatal class’ Category

I hope you will find something of interest here – if you are able to help me publicise these events even better!

Parents with Prams Walking Group
Weekly walks around the Ouzel Valley Park and Willen Lake for about an hour
Tuesdays at 10.30
For further details phone Siobhan 07818 078828 or click here

June 2009

Antenatal Exhibition – FREE entry
Sunday 28th June
2 – 4.30 pm
The Guildhall, Church of Christ the Cornerstone, Central Milton Keynes
Email for more details info@3shiresmidwife.co.uk

July 2009

MK Wellness Circle
Wed 15th July
7.30 pm – 9.30 pm
The Well at Willen, Newport Road, Willen, Milton Keynes MK15 9AA
www.global-wellness-circle.com

September 2009

Milton Keynes Birth Information Group
Lunchtime meeting
Friday 4th September 12 – 2pm
Please email info@3shiresmidwife.co.uk / Tel: 01908 511247 for venue

MK Baby and Toddler Show – FREE Entry
Sunday 6th September 2009
The Stadium, Denbigh,
Milton Keynes
info here

Beds and Bucks Bumps and Beyond
Antenatal and Early Years Exhibition
Sunday 13th September
1pm – 4 pm
Flitwick Village Hall

Association Of Radical Midwives Meeting
Wednesday 9th September 2009
7 – 10 pm
Rectory Cottage, Church Green Lane, Bletchley.
info@3shiresmidwife.co.uk / Tel: 01908 511247

Link 2 Health and Care Event – FREE Entry
Tuesday 29th September 2009
10 am – 4 pm
Middleton Hall
Central Milton Keynes

October 2009

Antenatal Exhibition – FREE entry
Sunday 4th October
2 – 4.30 pm
The Guildhall, Church of Christ the Cornerstone, CMK
Email for more details info@3shiresmidwife.co.uk

Just a reminder that this group is meeting on Friday 5th June from 12 – 2pm.

An opportunity to discuss any aspect of pregnancy, birth and early parenting, this is a FREE event, and we will be meeting for a shared lunch.

Homebirth – Hospital Birth – Active Birth – Waterbirth – Birth After Previous Caesarean – Breastfeeding – Early Parenting

Do feel free to come along – all welcome.

Phone Valerie on 01908 511247 or email info@mkbig.org.uk for details.         www.mkbig.org.uk

A listing of events that I am hosting or involved with over the next few months, please feel free to pass on these details to anyone appropriate.

I can be contacted on 01908 511247 if you need any further information.

Antenatal Exhibition – FREE entry
Sunday 8th March 2009
2pm – 4.30pm
The Guildhall, Church of Christ the Cornerstone,
300 Saxon Gate West,
Central Milton Keynes, MK9 2ES
info@3shiresmidwife.co.uk

Love Your Body Exhibition – FREE entry
Saturday 21st March 2009
10 am – 4 pm
Midsummer Place,
Central Milton Keynes
www.loveyourbody.me

Milton Keynes Real Nappy Show – FREE entry
Thursday 2nd April 2009
11am onwards
Chrysalis Theatre, Camphill Community,
Japonica Lane, Willen Park South,
Milton Keynes, MK15 9JY
info@3shiresmidwife.co.uk

Wedding Fair – FREE entry
Sunday 5th April 2009
11am – 4 pm
Holiday Inn, London Road,
Newport Pagnell MK16 0JA
info@3shiresmidwife.co.uk

International Week of Midwife – FREE entry
Part of John Lewis Nursery Event
Saturday 9th May 2009
10 am – 4 pm
Nursery Department
John Lewis, Central Milton Keynes
info@3shiresmidwife.co.uk

National Breastfeeding Week – FREE entry
Saturday 16th May 2009
10 am – 4 pm
In store at Boots Baby Department,
Central Milton Keynes
info@3shiresmidwife.co.uk

Love Your Body Exhibition – FREE entry
Saturday 13th June 2009
10 am – 4 pm
Excape, Central Milton Keynes
www.loveyourbody.me

Antenatal Exhibition – FREE entry
Sunday 28th June 2009
2pm – 4.30pm
The Guildhall, Church of Christ the Cornerstone,
300 Saxon Gate West,
Central Milton Keynes, MK9 2ES
info@3shiresmidwife.co.uk

MK Baby and Toddler Show
Sunday 6th September 2009
The Stadium, Denbigh,
Milton Keynes
info@3shiresmidwife.co.uk

Antenatal Exhibition – FREE entry
Sunday 4th October 2009
2pm – 4.30pm
The Guildhall, Church of Christ the Cornerstone,
300 Saxon Gate West,
Central Milton Keynes, MK9 2ES
info@3shiresmidwife.co.uk

Despite Government policy to increase the number of births taking place at home or birthing centres, figures produced by the Office for National Statistics (ONS) show that the number of births taking place at home fell from one in three in 1955, to just one in 40 by 2006.  This is partly because the shortage of midwives often means that women are not offered a home birth, or have it cancelled at the last minute and are forced to go into hospital.  Only this week I have heard that homebirths have been cancelled in some areas.

Since 2006 there has been an increase in home births however, despite the rise, only 2.5 per cent of births in 2006 were at home, compared with 30 per cent in the Netherlands.

As a midwife I know that not all women and offered the option of home birth, and there certainly is a shortage of antenatal appointment time to facilitate adequate discussion to enable couples to make an informed choice about where to have their baby.  Indeed in recent years the NICE Antenatal Care Guidelines have recommended a reduction in the number of antenatal visits for low risk women. http://www.nice.org.uk/nicemedia/pdf/CG62FullGuidelineCorrectedJune2008.pdf

With the many benefits to being at home:

* Shorter labours

* Increased likelihood of normal birth

* Less likelihood of needing forceps/ventouse/caesarean

* Less need for pain relief

* More likely to breastfeed

* More likely to be happy with experience

* Less likely to experience postnatal depression

it is hard to understand why more babies are not being born at home.

A common concern from my clients is “what if something goes wrong” – my answer is that things rarely go wrong in a hurry during a labour – midwives are trained to monitor the progress of labour and if things are not progressing normally then it is perfectly possible to calmly transfer to hospital, no drama.  There is no evidence that it is safer for women with low risk pregnancies to give birth in hospital.

Women giving birth at home are more likely to have one-to-one care from a midwife they know and who has contributed to their antenatal care.  This can help labour develop normally, reducing the risk of “failure to progress”, fetal distress and the associated medical interventions.

I often find that during the course of a pregnancy the couple gradually learn more and recognise the benefits of remaining at home.  Another thing I often say is that they can decide where to give birth in labour.  They can start out at home, if things progress well and they feel comfortable they can decide to stay at home, but if at any time they feel they would prefer to transfer to hospital then that is fine.  I believe the best place to give birth is where the mother feels safest and most relaxed and for many women that is at home, after all hospital is not a relaxing, intimate place.

I would encourage you to learn all you can about birth, ask your midwife, attend good birth preparation classes, have a look at www.homebirth.org.uk and consider having your baby at home.  If your local hospital says that homebirths are cancelled, as difficult as it is I would urge you to tell them that you are having a planned home birth and ask them to send you a midwife.  Unless women (and midwives) get political nothing will improve.

When out and about doing promotional work for my Independent Midwifery Practice www.3shiresmidwife.co.uk I am often asked what is involved to become a midwife.  It is obviously a profession that many women are called to; for some it is just a whim, they have a baby and think that it is such a wonderful job that they might have a go, but for others it becomes a serious intent.

Midwifery is not just about “delivering” or facilitating a birth.  Midwives are often the first person a pregnant woman will see; we give information and support throughout the pregnancy, labour and birth and postnatal period; we help mothers make informed choices about the services and options available.

The role of the midwife is very diverse; we undertake clinical examinations, provides health and parent education and support the family through pregnancy, birth and early parenting.  We also work in partnership with other health and social care services and midwives are responsible for their own individual practice and have a statutory responsibility to keep up to date with current knowledge.

I have had four children, three born at home and I read voraciously and set about informing myself to achieve my homebirths at a time when homebirth was definitely discouraged.  Having successfully achieved (challenging) but wonderful births at home I have to admit that I did become slightly evangelical about birth and homebirth and wanted other women to feel the same empowerment that I felt.

I was fortunate to have a midwife friend and I began teaching birth preparation classes alongside her, eventually teaching myself, never really thinking that I would be a midwife.  To be honest, I thought I knew too much; I didn’t think that I could bear three years of training to teach me something I already knew!

Time moved on, and I decided that I did want to be a midwife.  It was a long process.  I needed to undertake some up-to-date studying as it had been sometimes since my O levels.  I honestly don’t remember now how long it took, but it was certainly several years – I did an A level, I did an aptitude test, I applied, was rejected, waited a year and applied again (may even have been rejected again), the selection process was hard.  I think 250 applicants for 12 places.  They asked me what I thought were really stupid questions, really difficult questions.  I thought they were mad to turn me down; I was committed, knowledgeable and knew that I would make a good midwife!  Eventually I got lucky and gained a place to study.

The course itself was challenging.  A roller-coaster of a ride; highs and lows; lack of self-belief; difficult things to encounter and teachers that I disagreed with – but three years later I did it, I emerged as a brand new midwife and guess what, I did need those three years (and more) to become a midwife!

The process of applying for midwifery training has changed somewhat since I did my training.  Training is now a University Degree course; usually 3 years unless you are already a Registered Nurse and the minimum requirement to train is two A levels, science subjects are preferred. NVQ/SVQ Level 3, the BTEC National Diploma, or equivalent access to higher education programmes run by colleges of further education, are alternatives. Application is through UCAS www.ucas.ac.uk and you will gain a degree and Registered Midwife qualification.

It is important that you carefully check the financial status of being a student midwife.  The situation is under review, but some recent students have been unable to claim any financial support whilst training and have completed their training in considerable debt.  You will also be expected to attend University and work as a Student Midwife in a clinical setting, this will include shift-work and unsocial hours.  There will be many moans and groans along the way, it is not an easy job – it is challenging and exhausting, you will have to deal with staffing shortages and bureaucracy, but it is still the best job in the world!

More information about midwifery training can be found at:

www.nmc-uk.org/aArticle.aspx?ArticleID=2100

www.rcm.org.uk/jobs-and-careers/becoming-a-midwife/

When the big day comes you will have learnt lots of things that can help you, for example you might like to have a bath or shower which can really help you to relax. Early labour will probably feel a bit like period “cramps” and bathing or a hot water bottle may well help as can taking a couple of paracetamol if you wish.

Moving around and adopting different positions is also another useful thing to do – you might find that walking, marching or crawling around on all-fours might help. It is fine to go out for a walk in early labour if you feel up to it, and it is a good idea to find something constructive to do – perhaps watching a film. If you possibly can you should also try to have a nap – you will probably be working very hard for the next 24 hours, another tip is to have something light to eat and drink plenty as you will need the energy later!

TENS which is a small, battery operated machine can help; the idea is that you put the electrodes (or sticky pads) into four specific places on your back and the machine sends an electric impulse to the pads which are placed over nerve endings. TENS works in several ways, it boosts the body’s endorphin production (endorphins are our natural pain killers), it also blocks pain messages to your brain and lastly it is a distraction! Many women find TENS helpful – the trick is to put in on fairly early in your labour – TENS machines can be hired fairly inexpensively from some supermarkets, pharmacies and even some hospitals.

Soft lighting, music and massage can be relaxing – especially massage to the lower back as many women experience backache in labour. Either using hands, a nice oil or even rolling a tennis ball around on your lower back will probably feel really helpful. This might be something that you can practice with a birth partner prior to labour.

Most women find that staying active, listening to what their body tells them, is helpful. If your body is telling you to rest, then rest, if you feel better pacing around then pace. Having a supportive birth partner (or partners) is also invaluable – having a woman who has successfully given birth before is really helpful and can allow your partner time to eat, rest or even pop to the toilet! Speaking of toilet – remember to pass urine frequently yourself, ask your partner to remind you to wee every couple of hours at least as a full bladder can hamper descent of the baby’s head.

During the labour, use any breathing/relaxation techniques you have learnt, sit on a birthing ball, practice hypnotherapy, use your TENS machine, be active, sing, chant, make a noise, use massage, visualise your baby, your cervix opening – ask your partner to encourage you and to look deep into your eyes and breathe with you or use any complementary therapies that you have prepared (homoeopathy, oils, acupuncture etc).

I would encourage you to consider not using the birthing pool until the “going gets tough” and then you have somewhere else to go, somewhere that may be blissfully relaxing.

So you can see there really is quite a lot that you can do to help yourself in labour!

If you have tried all these techniques but still need more help there are drugs that the midwife can give you, for example entonox (known as gas and air) – this is not thought to harm either mother or baby and if you don’t like it you can just stop using it at any time. Most women think entonox is really helpful – it is just a mixture of oxygen and nitrous oxide which you breathe in through a mask or mouth-piece. It can occasionally make women nauseous and may make you feel a bit drunk!

The next level of pain relief available is an injection (usually given into your leg or bottom); the type of drug varies in different areas, but is usually meptid, pethidine or diamorphine. These drugs can make you feel drunk and a bit “spaced out” – some women really find them helpful, but other women don’t like them – I guess if you are needing help at this stage the answer is to try them and see what you think. The disadvantages are that they can make you sick (they are usually given with an anti-sickness drug for this reason) and may make you feel “out of control” and the effects of the drug will last for some time. The baby will also get a dose of the drug and this may make the baby sleepy at birth and make feeding slightly harder to establish.

If you require something stronger an epidural may be the answer, this is when a local anaesthetic is injected into your back. The advantages are that this usually offers good pain relief, especially when labour is long – you can usually sleep and rest once you have an epidural. However there are also disadvantages in that you have to stay very still whilst the epidural is sited and you will need a drip and probably a catheter to help you to pass urine. Your movement will be restricted and your baby will need to be continually monitored as very occasionally the baby can become distressed. Other disadvantages are that the epidural may not be 100% effective, some women experience “break-through” pain and occasionally further complications, also because there is a lack of sensation to “push” the baby out you might be more likely to need additional help with the birth.

In summary, you can see that there are lots of things you can do to help yourself during the labour, but if you need additional help there are drugs onoffer to help you.

 

So you are having a baby! Fantastic, or maybe it’s been a bit of a surprise?  Having a baby is the most wonderful thing, but also a huge responsibility.  You are going to need support, so if possible try to involve your partner, your family and friends.

It is important to see a midwife as soon as possible – many women think they have to see a doctor, and it is fine to see your doctor if you wish, but you can just go straight to the midwife. Your local midwife will usually be found in the local doctor’s surgery, but sometimes also at Children’s Centres, you will usually be seen less often at the beginning and then more frequently as the pregnancy progresses. Don’t feel that any question is daft – it isn’t a daft question if you don’t know the answer!  Mums and friends can be great and really supportive, but they may not always have the correct information, and you can ask anything in complete confidence. A midwife is expert in pregnancy and birth and will help you throughout the pregnancy, birth and early days of parenting. She will also help you make decisions and support you in your wishes.

During the pregnancy it may be suggested that you take supplements and you will also be offered various tests and you will be asked to see the midwife regularly so that she can make sure that both you and the baby are well; use the appointments to ask any questions you may have. You should also be offered some antenatal or parentcraft classes which can be variable in quality, so consider NCT (the National Childbirth Trust) or active birth classes as well, they can be an opportunity to make friends with other expectant mums – often the friends made in these groups stay friends for years to come with the babies growing up together – it can be very supportive to be able to ask a friend “is this normal?”, “did your baby do this?”

It is really worth reading all you can about birth and babies. Your midwife will give you lots of information, but you can also go to the local library and borrow books. There are also sometimes local discussion groups, for example at Surestart Children’s Centres, NCT and Meet a Mum (MAMA), La Leche League and Association of Breastfeeding Mothers (ABM) both breastfeeding support groups may also have meetings to which pregnant women are invited – you midwife may know what is available locally or ask in the library.  There is actually quite a bit that you can do to prepare for the birth – you probably are young, fit and healthy and that is great. Giving birth is a bit likerunning a marathon – it is one of the hardest day’s work you will ever do, so if you are relatively fit that helps (I don’t mean that you should be exercising hard, but gentle exercise like walking and swimming is good). There may also be pregnancy yoga or aquanatal sessions in your area and both will be helpful to you. If you already exercise there is probably no reason why you shouldn’tcontinue, but don’t overdo it and ask your midwife for advice. Other strategies include learning self-hypnosis or ‘hypnobirthing’ techniques and seeing complementary therapists such as acupuncturists, homoeopaths, reflexologists, chiropractors etc throughout the pregnancy. 

As you get heavier it is hard to want to do too much and tempting to sit on the sofa, but this actually is the worst thing you can do. Instead sit on a diningchair, but sit on it backwards, with your legs open and facing the chair back –this is great because it keeps you in a nice upright position, opens your pelvis and tips the baby forward. If you slouch backwards onto the sofa it tends to tip the baby towards your back and this can make labour longer and more difficult. If you have access to an exercise or birthing ball these too are great to sit on for the same reason – you can sit on a chair or ball and watch TV or even read a book!  Some women prepare for the birth by gently massaging their perineum (this isthe area of skin between the vagina and the anus). If this is something that you think you might be able to do ask your midwife for more information about how to do this.

You also need to start considering where you want to give birth. Depending upon where you live you may have several options: at home, in a birthing unit or in a hospital – again this is something to discuss with your midwife.

The Antenatal Classes or Parentcraft Classes are usually run over a period of time, and you should be able to take along your partner or your Mum or a friend if you wish. The classes should give you lots of information about what to expect when you go into labour, they will tell you when you should call your midwife or hospital – bearing in mind that labour is usually a LONG process and women expecting their first baby nearly always contact the midwife before they really need to! The class may well also organise a visit to your local maternity unit so that everything can be explained to you – it is far less scary if you know what the place looks like and what machines are used for!  Sometimes a Mum will come along with her baby and a feeding or bathing demonstration may be given. The midwife will also talk about how you can help yourself during the birth – I would really encourage you to go along!


Twitter