Valerie Gommon Midwife’s Blog

Archive for the ‘Independent Midwife’ Category

I am excited to tell you that I have a new promotional video which details the work I do at www.youtube.com/watch?v=5ah9GBnStVQ

I also have several other videos hosted on YouTube and plan to add more as soon as possible; I should tell you that some of the content is explicit and shows graphic scenes of childbirth.

www.youtube.com/watch?v=VO0PRvxoEzM

www.youtube.com/watch?v=S086qWgUG38

www.youtube.com/watch?v=ZfFz2QSRiGs

Another guest blog by Sarah:

Harlow Zen’s Birth Story

Harlow is my third baby having had Rohan 9 years previously and Nayt almost 8 years ago.  With Rohan I was induced at 10 days late, in hospital, with an epidural given as I was told he was back to back and it would be too painful, I ended up after 17 hours flat on my back, with a nasty tear and a pretty miserable painful experience to tell but a beautiful baby nonetheless.  I had Nayt 16 months later and keen to never set foot in a hospital again, we used 2 Independent Midwives and had an amazing natural home water birth, in less than 4 hours with no pain relief, no stitches and 23 days late! I was out and about within days, a completely different experience to my first. Both babies were reasonable sizes at 8lb 13oz and 9lb 2oz respectively.

With Harlow, because he was my husbands first and I was a bit rusty having had a good few years off baby making, we decided to use another Independent Midwife as the 1-2-1 care is like nothing else, and gives you the confidence that you will get the best birth outcome and overall experience possible, as they really get to know and understand you.  As my pregnancy progressed it was clear this baby was going to be on the large size, which I had kind of expected. I was advised to cut down on sugar but with a massive cake craving, this didn’t really happen, so I tried damage limitation by continuing to ride as long as I could and towards the end to swim daily and keep up with walking the dog.

I think my confidence in giving birth was knocked a bit towards the end because I had to have a series of late scans to check the placental position, as was slightly lying low at the 20 week scan. This showed up that at 34 weeks the baby was the size of a full term baby. I am reasonable at simple maths, and that added up to one BIG bubba!!

Because of this, I was told to expect an early baby. Unlike my other two pregnancies where I had no pre-labour signs whatsoever, I was starting to get runs of proper contractions about 3 weeks prior to my due date. I had so many signs in fact that I have decided there are no signs until the baby is literally crowning!! Along with contractions, I was nesting, had a show,  had a permanently bad tummy, babies head engaged….never happened to me before labour with the other two, bump shifted down….and then my due date came and went…and my bump un-engaged and shifted up!!!

On Tuesday 18th May after my husband Adam had taken the kids to school I started to get decent contractions. I really felt like today was the day. By midday they had gone, and annoyed I took my dog on a hill walk hoping to jolt the baby out with some gravity! Nothing! I was really sure that was it too, as my dog Phoebe had been all over protective, following me around and sleeping beside me wherever I went.

They started again around 11pm, but having sent our midwife numerous ‘I think its started’ texts over the last few weeks, decided to sleep on it.  At 1.55am Wednesday 19th May I woke up with a jolt as my waters literally burst all over the place. I managed eventually to wake my husband up who had fallen asleep on the sofa downstairs and after a massive clean up operation we called our midwife Valerie and she came out straight away.

The contractions had stopped but restarted around 3am and were roughly every 3 mins, reasonably painful (a 5-6) but not lasting too long. We all tried to get some sleep at 6am, but the contractions slowed down a lot.  By the time my kids woke up and we had agreed they could take the day off school, they were back to quite painful and we all thought finally ‘this is it!’. By about 9.30am I got into the birth pool my husband had busied himself filling and my labour ground to a halt and slowed down. My parents came and took the kids out for lunch as it was my Dads birthday, and gave me a bit of space and peace. At 1pm-ish we asked Valerie to examine me and I was disappointed to find I was barely dilated, and all that pain and hard work had merely helped Harlow to get into a better position.  Valerie left for home and me and Adam went for a walk, had some lunch and then at 5.20pm decided to get some sleep.  My kids were sent off to their rooms to watch a film.

At this point I was feeling despondent and was sure my pain threshold was rubbish. I started soon after to get contractions every 8-9 mins, lasting almost 2 mins and they were really painful. The peaks seemed to last for 40 seconds before subsiding. By almost 7pm I was crying and convinced I was still about 3 cm dilated.  I got very emotional and was convinced I would end up in hospital with a c-section. Adam was amazing and really supported me. He suggested we call Valerie, who had just text me. She came out with the entonox and as soon as she arrived I was getting the urge to push. I was on all fours and could not move into any other position…how I got downstairs I have no idea!!!

I managed to get downstairs and Adam re-filled the pool which we had drained down partially earlier.  I got in, and contractions were very close, strong and the peak lasted ages. Adam was great and helped me get the gas and air when I needed it, and provided emotional support as well as an arm for me to dig my nails in (sorry Adam!!), and Valerie helped me to get past the panicky ‘I cant do this’ with encouragement that I could really trust in.  At 8.20pm I could feel Harlow move down and he was born in the birth pool at 8.40pm. Valerie had called my kids down and they both watched their little brothers entrance into the world.

Harlow was born behind me, so with some jigging I was able to climb over my cord and hold him.  He cried a little and had a feed quite soon afterwards.  He was covered in vernix and his skin felt so soft.  He looked just like 3d scan picture and apparently my first words were ‘Hello Harlow’.  Adam cut the cord after it stopped pulsating and Valerie tied the cord with a cord tie I made specially for the event, and as I delivered the placenta naturally an hour later, Adam, and the kids had all taken turns to hold Harlow and make their introductions. It was the most special sight ever and something they will never forget, nor will I.

At 10.30pm we sent the kids to bed, and after a glass of champagne with Valerie; myself, Adam and Harlow settled down for our first night together. Perfect.

We were all a bit shocked that Harlow tipped the scales at 10lb 6oz, and I got away with a tiny tear and a graze and no stitches!! It was a more painful labour than Nayts birth, and the longest overall labour, but an amazing experience that 5 days after the event makes me ask ‘when can I do it again’???.

This is a guest blog written by one of my clients, Sarah.

I thought it would be interesting to cover having larger babies at home, having just had one (10lb 6oz) and to have a look at  some common worries.

I was lucky enough to have a great midwife for my last birth who was not in any way phased by the possibility of a large baby, however a flippant remark at a late scan made me worry that maybe we are scared into changing our plans by such remarks unnecessarily.  Happily I did go on to have my baby at home!

Common Concerns:-

The baby may be too big to pass through the pelvis (called cephalopelvic disproportion if you like!) – this is not generally considered to be an emergency situation, and if this situation arises, your labour will fail to progress, at which point you can then transfer to hospital to deliver your baby with medical help.  Therefore its realistic to continue to plan for a homebirth and to try for a homebirth with an open mind that you may have to transfer if needed.

Shoulder Dystocia – this is where the shoulders get stuck after the head is born. This can be fatal for baby but fortunately is extremely rare and is considered to be more likely to occur in a hospital birth as research has shown that induction in cases of suspected large babies has not reduced the incidences of this condition.

There are also positions that a midwife can manoeuver a labouring woman into to help to dislodge the shoulders should this occur.
Is baby actually big? Scans are often  shown to over estimate birth weight. One study found this to be the case in 77% of their diagnosis of a large baby. The estimated weight was only within 500g for 41 of the 86 women studied which is a considerable margin!

A UK  Govt  report (CESDI) into the death of large babies declined to use fetal ultrasound estimates as they felt the evidence of their inaccuracies was well documented and went on to concede that this could lead to unnecessary interventions.

Big baby = more pain – pain is subjective so this is a hard one to reassure.  Different labours can be more painful for numerous reasons (ie. position of baby, birthing position, maternal well being etc), and size may have a bearing on this. The head is the hardest part to birth, therefore a very small baby with a larger than average head may well be more painful than a large baby with an average sized head.

Conclusion:-

It appears that although there may be some reasons where a large baby may present problems, the majority are not a foregone conclusion, and generally not posing an emergency situation, and therefore its arguable that its not a reason to abandon plans for a homebirth.

Different positions can be adopted to aid the birth of a larger baby, and by having a larger baby at home, you are still reducing your chances of having medical interventions.
A larger baby is not a reason on its own to have a hospital birth.

PS From Valerie – women do not usually grow a baby that is too big for them.  Exceptions to this could be if Mum is particularly small and Dad is of generous proportions!  This said many smaller women will still go on to birth big babies!

Slightly old news now … can’t believe that I forgot to write about this, but … and even better, I’ve posted my first photograph!

Despite (by her own admission) being very unfit, local Independent Midwife Valerie Gommon joined 2000 other women to take part in the Midnight Moo Walk for Willen Hospice last Saturday 17th July.  Local women walked 10 miles around Milton Keynes starting and finishing at Midsummer Place, The Centre:MK.  It was a fantastic (some say scary), sight to see the women in their pink Midnight Moo t-shirts snaking through the dark redways of Milton Keynes; despite the hour, there were plenty of people out and about to support us, with car horns beeping and people waving from their houses, we were also fortunate to have an army of volunteers to mark the route, offering support and encouragement along the way – their kind support kept us going!

Last year’s walk raised more than £100,000 for Willen Hospice and this year the amount already stands at £91,355 with money still rolling in, so it isn’t too late to add your donation www.justgiving.com/Valerie-Gommon

Clare Wildman says: “For me the Midnight Moo sums up all that is truly great about Milton Keynes. The way that so many people of all ages and backgrounds come together to do something a little crazy for such a good cause and the fantastic way that it runs so smoothly and everyone has such fun.”

If you are interested in walking next year you can register at www.mkmidnightmoo.com.

Here is a picture of Valerie along with Clare Wildman and Ady Cartwright (aka Mrs Paintbrush) preparing for the walk.Preparing for the Midnight Moo

This is a guest blog, written by one of my clients.

My name is Donna and I am a mother of three.  Two year old Grace and nine week old fraternal twin girls Olivia and Faith.

My husband Paul and I had always agreed that we didn’t want a big age gap between our children so when Grace was one year old, we decided to begin trying for baby number two.  I fell pregnant fairly quickly but unfortunately suffered a miscarriage at 5 weeks which was very upsetting.  After a few weeks we were ready to try again and as before, I fell pregnant within a couple of months.

I was very anxious during the first few weeks hoping that this time I would hold onto the baby.  At 12 weeks it was time for the scan.  I was feeling quite relaxed as the pregnancy was going well and I was feeling extremely sick which I thought was a good sign.

The last thing on my mind was the fact that I could be carrying twins.  When the ultrasonographer casually told us ‘oh, you have two in there’, we knew that our lives were going to change forever.  I didn’t know whether to laugh or cry – so I did both!  Everyone in the room was so excited for us but my husband and I were just stunned.  His face was a picture.  They told me that the reason why I had felt so sick was due to the additional hormone racing round my body. They also told us that the twins were fraternal and each had their own placenta and were in their own sac which is the safest type of twin pregnancy.

The first feeling I had once I had calmed down was that of being pregnant for the first time.  My pregnancy suddenly went from having a singleton baby and feeling confident that I had done this before so it will be ok, to all the anxieties of a first time pregnancy.

I knew that I had to do my research so as I could make some informed decisions about my pregnancy and birth.  When I told the ultrasonographer that I was planning a home birth, her reaction was ‘oh, you won’t be able to do that with twins’.  I had a fantastic pregnancy with Grace and had her at home in a birthing pool.  The thought of having to follow a medical route and have my babies in hospital filled me with dread.

As with my first pregnancy, I chose to take on an independent midwife.  This was my preference as I knew I would be less likely to end up with a hospital birth.  I made sure I looked after myself by eating well, getting plenty of rest (as much as Grace would allow me!) and exercised regularly.  I found swimming was great for keeping me fit and taking the weight off my bump.  I had regular scans to check on the twins’ development and position.  Throughout the pregnancy, Olivia (first born) remained head down and Faith was breech.  I knew that this wasn’t ideal but also knew after doing some research that as long as Olivia remained head down and although a little more risky, I could still safely deliver Faith as breech.  At 38 weeks I went for my final scan and to my surprise, Faith had done a full turn and was now head down along with Olivia.  The perfect combination for birth.

We had put together a birth plan that covered every eventuality if I needed to be transferred to hospital at any stage.  Two days after my last scan; my waters broke at 9.30pm when I was lying in bed.  I felt a pop and then a head drop down.  I walked into the bathroom and called downstairs for Paul saying ‘I think my waters have broken!’  He chased upstairs and I told him to call the midwife.  My contractions started almost immediately after my waters broke.  I spoke to my midwife and she told me to go back to bed as things may not start to happen until the morning and I would need my rest.  Olivia was not going to wait until morning.  I came downstairs and stood in the bathroom leaning over the toilet with my contractions coming fast and furious.  I tried the TENS machine but that didn’t really work for me.  Paul was in the dining room putting together the birthing pool which I got into as soon as it was ready.  The relief was immense.  I had heard that water was the most effective pain relief next to an epidural – I can well believe that.

I had four midwives looking after me and the babies and they all arrived at my house in time.  It was all happening so quickly and Olivia was born in the pool at 11.55pm.  She shot out and I heard her crying straight away.  I stood up and held my baby; I was elated and also amazed that my babies would have their own birthdays.  One of my midwives held my stomach to make sure that Faith fell and engaged in the right position.  We knew she was head down so we needed to make sure she stayed that way.  We decided to wait for my labour to progress naturally however, it slowed down.  I got out of the pool to walk around and see if I could get it started again.  Four hours passed and a decision was made to break the waters around Faith as the midwife discovered they were still intact.  As soon as the waters were broken, Faith was born on the sofa, again extremely quickly.

She cried straight away and the midwife placed her on me so as I could give her a cuddle and have skin to skin contact.  Another of the midwives was looking after Olivia.  Both my babies were born healthy and I couldn’t have been happier than I was just then.

The down side was that I now had to deliver the placentae.  I was so tired but knew I had to keep going.  One of my midwives helped to keep me relaxed with hypnobirthing techniques and control my breathing.  The placentae had fused together and were not budging.  With a combination of experience from my midwives and a hot towel placed across my stomach, the placenta moved and came away.  If it hadn’t been for the determination and skill of the team of midwives, I think I would have ended up in hospital with a retained placenta and that would have been disappointing after going through the entire birth at home.

So all was well.  I was in good health and although extremely tired, felt elated and proud that I had accomplished the birth I wanted.  My husband Paul was fantastic during and after the birth and I couldn’t have asked for a more supportive birthing partner.

A home birth is not for everyone and if there had been a health issue with either myself or my babies, I would have chosen hospital care.

I wanted to share my story so as other women can see that you do have choices during pregnancy even when you are having twins and you can make decisions that are right for you.  For more information about twin and multiple pregnancies visit www.tamba.org.uk

Donna has also set up a website which offers information about homebirth; she offers a free ebook at www.happyhomebirth.com

It is crunch time and we really need your help if independent midwives are going to be able to practise in the UK in future. If you recognise the value of personalised, high quality midwifery care throughout pregnancy, birth and after the baby is born that an independent midwife is able to provide, then please could you let the government know NOW.

For several years the government’s new policy that all healthcare professionals have indemnity insurance has been put on hold. Last year the government commissioned the Finlay Scott Review to look at the feasibility of indemnity insurance as a condition of every healthcare professional’s registration. The Review has now been published and recommends that indemnity/insurance should become mandatory and a requirement for registration. However it also recommended for those groups for whom the market does not provide affordable insurance or indemnity (independent midwives), the relevant Departments of Health in the four countries of the UK should decide if the continued availability of this service is necessary; and, if so, should seek to facilitate a solution to the problem. (See more information in the letter below)

The Departments of Health are due to respond imminently to this Review – and their responses will be a perfect vehicle through which to address this anomaly with solutions from policy-makers.

Can you please send an email to your MP and copy it to your relevant Department of Health. Could you also print your letter and send it as a hard copy to your MP and Department of Health as although slower, receiving lots of letters is more effective. Please feel free to use any information on this page, and/or include your own feelings and experiences.

Find your MP by clicking on: http://findyourmp.parliament.uk/ and click on his/her website to find their email and constituency postal address. Don’t use the House of Commons address for MP’s at this time of year as it is in summer recess.

Departments of Health:

England:
Mike.Lewis@dh.gsi.gov.uk

Mike Lewis
Senior Policy Manager
Professional Standards Division
Department of Health
2N10 Quarry House
Quarry Hill
Leeds.
LS2 7UE

Scotland:
Catherine.clark@scotland.gsi.gov.uk
Catherine Clarke
Regulating Unit
Chief Nursing Office
St. Andrew’s House
Regent Road
Edinburgh
EH1 3DG

scottish.ministers@scotland.gsi.gov.uk
Nicola Sturgeon
Cabinet Secretary for Health and Wellbeing
The Scottish Parliament
Edinburgh
EH99 1SP

Wales:
correspondence.edwina.hart@wales.gsi.gov.uk

Edwina Hart
Minister for Health and Social Services
Welsh Assembly Government
Cathays Park
Cardiff
CF10 3NQ

Northern Ireland:
private.office@dhsspsni.gov.uk
Michael McGimpsey
Minister for Health, Social Services and Public Safety
Room C5.10
Castle Buildings
Stormont Estate
Belfast
BT4 3SQ

Please inform as many other friends, family and supporters such as local NCT groups, Women’s Institute, etc as possible.

Without positive government intervention independent midwifery will become illegal in the very near future. If a solution is provided, it could benefit maternity services in the UK for decades to come.

Thank you for your support!

Sample letter

Dear MP

RE: Finlay Scott Review

I’m writing to ask for your help in giving thousands of families greater opportunity to have safe positive pregnancies and births with support into early parenting.

The Government recently heard from the Finlay Scott Review, which had been asked, to look at indemnity insurance as a condition of professional registration. The Review recommended that the Government should make indemnity / insurance a requirement of every healthcare professional’s registration. However it also recommended for those groups for whom the market does not provide affordable insurance or indemnity (independent midwives), it should decide if the continued availability of those services is necessary; and, if so, should seek to facilitate a solution to the problem.

There are currently approximately 100 independent midwives in the UK, providing high quality, one-to-one care to families throughout pregnancy, birth and early parenthood. It is this kind of genuinely personalised care, from their own midwife, that growing numbers of women want. It has significant public health benefits in terms of increased normal birth and breastfeeding rates and saves money.

Taking on independent status is also something which offers great advantages to midwives themselves, empowering them as frontline workers, to work closely with women and with more flexibility in their working lives – crucial if the drain of midwives from the profession is to be reversed.

The barrier to independent midwives providing this service is that they cannot be indemnified or insured. This is due to the number of independent midwives currently being too small to enable the risk to be pooled and spread in a way that produces an affordable premium. There is simply no insurance available for independent midwifery services. This is standing in the way of more pregnant women benefiting from this type of care and enabling more midwives to work this way.

In 2013, independent midwifery will be made illegal under EU law if a solution is not found. EU legislation by then will require all health professionals to have indemnity/ insurance.

The benefits of finding a mechanism to indemnify or insure independent midwives will be:
• independent midwives will be able to provide care within the NHS with improved public health outcomes, reduction in costs and increased choice for women;
• women’s choice will be maintained;
• the risk reduced of some women choosing to give birth unaided if unable to access care that is acceptable to them within the NHS;
• midwifery expertise in normal birth skills will not be lost;
• more midwives staying in the profession.

The government is due to respond imminently to the Findlay Scott Review. The Review recognises that a potential problem arises from its recommendations but also acknowledges that the government could intervene to provide an affordable solution.

Please support my request to recognise the importance of this service for the safety and wellbeing of mothers, babies and families by calling for the indemnity/insurance issue to be resolved by the Department of Health.

Regards

Thank you so much for your support!

Valerie Gommon

Independent Midwife

www.3shiresmidwife.co.uk

I guess this may be more useful if you are planning to hire an Independent Midwife as with the NHS there is less choice, but you still do have a choice of midwife and should remember that if you don’t get on with your midwife you can ask the local Supervisor of Midwives (at the local maternity unit) to help you to find a new midwife.

If looking for an Independent Midwife, I would suggest that you start by looking at www.independentmidwives.org.uk where you can enter your postcode to find the midwives who live closest to you.  This website will then lead you to look at the midwives own websites and you should get a “feel” of the midwives from their websites.  The next step is to email or telephone your favourite midwife(s) to have a chat with them, again this should help you to gauge whether they might be the right midwife for you.

The midwife will want to know where you live (to ensure that she is able to travel to you), she will also want to know when your baby is due (to ensure that she is free at that time) and whether it is your first baby.  If you have had a baby/babies before I would expect her to ask about your experience.  She will also be keen to know where you plan to give birth.

Questions you may like to ask of the midwife include:

How long have you been a midwife? / An Independent Midwife?
Do you like homebirths/waterbirths?
Do you have additional skills (hypnosis training etc)?
What would happen if my baby is breech/I am expecting twins?
What is your normal birth rate?
What is your caesarean rate?
What is your breastfeeding rate?
What is your homebirth rate?
What is your transfer rate?
How much do you charge?
What can I expect from you?
Antenatal care? Labour and birth care? Postnatal care?

I would expect an Independent Midwife to outline the issue of the lack of professional indemnity insurance to you.

If you enjoy speaking to the midwife, I would suggest that the next course of action might be to arrange a consultation.  The midwife will usually be happy to come to your home to meet you and your partner to discuss things in more detail.  Many midwives make a small charge for this meeting to cover their time and petrol costs (this meeting make last a couple of hours) and will be an opportunity for you to ask any questions of the midwife and again to enable you to decide whether she is the right midwife for you.  Most midwives will deduct this fee from the final balance if you decide to book with them.

Some women do “interview” a couple of midwives, and this is perfectly acceptable and perhaps a sensible approach as it will be an important relationship.

An Independent Midwife’s fee may seem expensive, particularly when you can get a similar service for free on the NHS, but I always say to clients that you won’t have many babies and it is important to get things right!  It may be better to employ a midwife and wait a bit longer for the new car or foreign holiday!  An Independent Midwife will usually give you a lot more time than an NHS midwife is able to; she will see you more frequently and give you longer appointments.  The other main benefit is that you will see the same midwife throughout your pregnancy, birth and postnatal period.

I wish you well in your decision-making whether you choose an NHS or Independent Midwife, and if I can be of any help to you please feel free to email info@3shiresmidwife.co.uk


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