Valerie Gommon Midwife’s Blog

Archive for the ‘Midwife’ Category

A new campaign has been launched with the aim that, every woman should have a midwife that they know and trust and:

• who can support her through her pregnancy, birth and beyond
• regardless of her circumstances
• or where her baby is to be born

Please do take a look at the website http://www.m4m.org.uk and follow up on the Action Plan as listed:
http://www.m4m.org.uk/takeAction.php
Please take the following actions
• Read the Manifesto
• Sign up for our Newsletter
• Tell your friends and colleagues
• Post on Facebook and Twitter
• Pledge your support
• Check your organisation is supporting the manifesto
• Sign up your organisation
• Take part in our Deliver a Baby campaign
• Make a donation to support the campaign

It won’t take you long and together we can make a HUGE difference to maternity care in the UK – the Government is really listening to us!

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

 

On Thursday 20th September women (and men) around the world will be hosting film screenings to raise the profile of midwifery.  I am joining this event because I passionately believe that women are entitled to better maternity care.

Everyone in the UK knows that our maternity services are in crisis and indeed the Royal College of Midwives has strongly stated this.

I am planning to take a break from midwifery as I am totally burnt out … this is partly the demands of being on-call 24/7 for the past 8 years, but it is also due to the increasing scrutiny, red tape  and pressures on midwives.  I believe that most midwives do their very best for women.  Of course there are some rouge practitioners and the public needs to be protected against them, but the pressures on midwives are immense; more paperwork, more investigations of our practice, pressures of working with a system that is barely fit for purpose ….

At the same time Independent Midwifery, which gives “gold standard” care is set to become illegal unless an eleventh hour solution can be found to provide us with Professional Indemnity Insurance which will become mandatory from October 2013.

What will happen to these highly skilled midwives and the clients they currently care for?  I’m afraid that I feel ground down and beaten by all that is currently happening in midwifery … it is so sad, midwifery and childbirth has been my passion and my life for the past 20 years!

So, as my swan song to midwifery (for now at least) I am hosting this film showing in Milton Keynes and I hope this will serve to raise the profile of midwifery and to mobilise women to demand the service they deserve.

FREEDOM FOR BIRTH FILM SCREENING Thursday 20th September 2012 Two showings, 1pm and 7pm

The Bee House

Interchange House

Howard Way

Newport Pagnell

MK16 9PX

  • Entrance by donation – suggested donation £5 (Any profits to be donated to Midwifery Campaign)
  • Refreshments available at the venue
  • Birth related Exhibition and discussion after film showing

ALL WELCOME – please advertise widely! Please print and display the attached poster

For further information & to book a seat please email info@3shiresmidwife.co.uk

FREEDOM FOR BIRTH – GLOBAL FILM LAUNCHA new documentary that reframes childbirth as the most pressing global Human Rights issue today is launching with hundreds of premieres all over the world on the same day, Thursday 20th September 2012.

Freedom For Birth is a 60 minute campaigning documentary featuring a Who’s Who of leading birth experts and international Human Rights lawyers all calling for radical change to the world’s maternity systems.

Hermine Hayes-Klein, US lawyer and organiser of the recent Human Rights in Childbirth Conference at the Hague, the Netherlands says, “the way that childbirth is being managed in many countries around the world is deeply problematic. Millions of pregnant women are pushed into hospitals, pushed onto their back and cut open. They are subject to unnecessary pharmaceutical and surgical interventions that their care providers openly admit to imposing on them for reasons of finance and convenience. Women around the world are waking up to the fact that childbirth doesn’t have to be like this and it shouldn’t. Disrespect and abuse are not the necessary price of safety”.

Made by British filmmakers Toni Harman and Alex Wakeford, Freedom For Birth film tells the story of an Hungarian midwife Agnes Gereb who has been jailed for supporting women giving birth at home. One of the home birth mothers supported by Ms Gereb decided to take a stand.

When pregnant with her second child, Anna Ternovsky took her country to the European Court of Human Rights and won a landmark case that has major implications for childbirth around the world.

Toni Harman, one of the filmmakers says, “the Ternovsky vs Hungary ruling at the European Court of Human Rights in 2010 means that now in Europe, every birthing woman has the legal right to decide where and how she gives birth. And across the world, it means that if a woman feels like her Human Rights are being violated because her birth choices are not being fully supported, she could use the power of the law to protect those rights. With the release of “Freedom For Birth”, we hope millions of women become aware of their legal rights and so our film has the potential to spark a revolution in maternity care across the world. In fact, we are calling this the Mothers’ Revolution.”

Cathy Warwick, Chief Executive of the Royal College of Midwives (RCM), says: “A safe childbirth should be a fundamental human right for women. Sadly, for many, many millions of women and their babies across the world this is not the case. The world is desperately short of the people who can help to ensure and deliver this human right; midwives. There is a real need for leaders of nations to invest in midwifery care in their countries. I hope that the making of this film which the RCM is supporting with a screening will go a long way to help make skilled maternity care a reality for those women who currently do not have access to it.”

Lesley Page, President of the Royal College of Midwives adds, “Too many women across the world are dying or suffering terribly because of a lack of skilled maternity care. This is unacceptable and I call on all Governments across the world to give women the right and access to safe care in pregnancy and childbirth.”

Ms. Hayes-Klein concludes, “Freedom For Birth” holds the answer to changing the system. Birth will change when women realise they have a right to meaningful support for childbirth and claim that right. Birth will change when women stand up against the abuses that are currently suffered in such high numbers and say, No More.”

The filmmakers are aiming for 1,000 screenings happening across the world on Thursday 20th September, 2012. The countries with confirmed screenings include the UK, Ireland, Germany, France, Denmark, Spain, Greece, Italy, Norway, the Netherlands, Sweden, Austria, Poland, Bulgaria, Croatia, Slovenia, Slovakia, Belgium, Hungary, Israel, Sweden, Finland, Iceland, Russia, USA, Canada, Mexico, Colombia, Brazil, Argentina, Chile, Uruguay, Panama, Australia, New Zealand, Malaysia, Philippines, China, South Africa and India.

Each screening is being organised by local birth campaigners.

Freedom For Birth is Harman and Wakeford’s third documentary film about birth. They were inspired to make films about following their own difficult birth of their daughter four years ago. A cascade of interventions in their birth led to an emergency caesarean section.

Contact Information:

Toni Harman, Producer/Director, Freedom For Birth info@altofilms.com +44 (0) 1273 747837

Guest blog from Hazel Roberts, Jammy Cow MK www.jammycowmk.co.uk

Valerie says, “I am delighted to have been part of Milton Keynes Midnight Moo, and part of the Moos at Ten team!”

Hazel writes:

Last Saturday night  was the 2012 Midnight Moo – an all ladies 10 mile walk through Milton Keynes. The herd set off a midnight and whilst they were busy striding through the early miles, Jammy Cow and her heifer friends were busy preparing the final mile for their welcome home.
At the beginning of mile 10, ready to greet the herd for their final mile was the very professional Moos at Ten Cow, Mavis.  She is a very sensible and reliable cow and in stark contrast to the next cow round the first corner. Silly Cow, Connie giggled her way through the night.
Those of you who walked the 10 miles will know that most of mile 10 is uphill so the Moos at Ten team were ready to add that extra bit of encouragement as the herd came through. Having said that, Bossy Cow’s version of encouragement is about as friendly as bootcamp with her strident, “Keep moooving!” shout. It is at this point in the early hours of the morning that you realise exactly how far 10 miles is to walk. “Holy cow, aren’t we there yet?” you may mutter as you pass the pious Holy Cow, Mary.

Continuing up Midsummer Boulevard, the end is near and breakfast at Pret A Manger awaits, a thought not lost on the perpetually hungry Fat Cow, Victoria as she patiently waved the crowds through. Normally, Hetty the Mad Cow stands out as a bit odd but last night she was in good company with lots of ladies suitably dressed up for the night.

Through Witan Gate underpass and by now there is less than half a mile to go. Bed is calling and lucky you, you’ll soon be home and tucked up. Lucy, the Lucky Cow was there, cheering you on for the final push. And only another 50 calories left to burn, something Clover, the Skinny Cow was quick to point out. Nearly at the end of mile 10 now and so very close to achieving your aim. A point to feel proud and to reflect upon why you are doing this. Willen Hospice is a fantastic cause and everyone is impressed by your fundraising efforts. Remember those Concrete Cows you passed in mile 7, well one makes a final appearance here to salute your efforts on behalf of Milton Keynes.

And there, with the end in sight, Jammy Cow welcomes you to the end of mile 10 and congratulates you on completing the Midnight Moo. A big cheer, breakfast, bath and bed.

So can you work out how many cows there were on mile 10 of the Midnight Moo? If you can and you are local to Milton Keynes then why not enter our competition to win a fabulous hamper of goodies. Visit www.themoosatten.co.uk or email your answer to enquiries@jammycowmk.co.uk

Very sadly it looks fairly certain that Independent Midwifery will end in October 2013.  The Government and Nursing and Midwifery Council have for a long time been recommending that Independent Midwives should have professional indemnity insurance (negligence insurance) despite it not being commercially available in the marketplace i.e. insurers do not provide this insurance for midwives.  You can read more about the current situation here http://www.independentmidwives.org.uk/?node=11615

An E.U. Directive is now due to come into force to implement this change and our current information is that it will be illegal for us to practice without professional indemnity insurance from October 2013.  This means that women will be denied the choice of choosing an Independent Midwife and we will be denied the choice of working independently and will be forced to stop practising or to return into the NHS.

The Independent Midwives UK organisation has been working tirelessly for years to find a solution and it is just possible that an eleventh hour solution will be found but this is now looking unlikely.

A group of midwives have formed an organisation called Neighbourhood Midwives www.neighbourhoodmidwives.org.uk/ and are working towards setting up an employee-owned social enterprise organization, to provide an NHS commissioned caseload midwifery homebirth service, based in the local community.  This may prove to be a workable alternative to Independent Midwifery but at present (if it comes to fruition) the service will only be able to accept “low-risk” women and this is of concern to all of us who have supported women with more complex situations, for example first time mothers, vaginal birth after a previous caesarean, twins, breech birth and women who are not deemed “low risk”.  The aim of Neighbourhood Midwives will be to extend their remit to include more women as soon as possible.

There is already a precedent for this type of care as One to One Midwives in Liverpool www.onetoonemidwives.org have already managed to set up a caseloading midwifery service (similar to independent midwifery in that a woman will care for a caseload of women throughout the whole of the pregnancy, birth and postnatal period) within the NHS.

It is a very sad time for midwifery and for women’s choice, but perhaps good things will come out of it, I certainly hope so.

I was recently asked a question about painful stitches/perineum after childbirth  and thought it would be useful to share my reply.

I’m not so sure you were told all this! You *should* have been, but sometimes things get missed in the busy hurly burly of hospitals!
Okay, so the pain … I take it this is when you wee? This may well have passed by now? This can be eased by weeing in the bath or shower or by pouring water from a bottle of jug over yourself as you pass urine. The pain gradually lessens but it should already have started to improve. If it is getting worse then you definitely need to get your midwife to check you out.

Don’t know whether you have opened your bowels yet, or if this is what you are referring too? Women are naturally worried about the first time after stitches. I usually suggest that if a woman is anxious that she might like to support the perineum (the stitched area) with some toilet paper when she goes to the loo. This is mostly a psychological prop, but … if it works … it will be fine I promise! Just make sure you drink plenty of fluids (this will also help dilute the urine) and eat so that you don’t get constipated.

Regarding the bleeding, it is normal to bleed for several weeks after having a baby. Again, the bleeding quickly lessens and will often stop only to start again … it is not unusual to bleed on and off for somewhere between 2 – 6 weeks after having a baby.

Your midwife will be very happy to have a look at your stitches and will usually ask you if you are comfortable or not. If you are unsure definitely ask her to look as occasionally they can become infected and need treatment.

Hope you soon feel more comfortable … in the meantime enjoy your new baby.

I have to say that I have never been a fan of Gina Ford.  Although I haven’t read her book “The contented little baby” from cover to cover, I’ve read enough to know that I completely disagree with her ideas of strict routines, indeed I wonder how any mother could cope with doing anything else if she followed Ms Ford’s advice as every moment of the day and night appears to be mapped out!

I was very interested in a parenting programme that was on TV a year or so ago which followed three couples who followed various styles of parenting; there was a couple who adopted a very strict time scheduled routine, a middle way and those who adopted an attachment style of parenting.  I was not surprised to learn that the couple who practised attachment parenting were the ones who got the most sleep!  Whilst I appreciate that this may not be for everybody, I think it is important for parents to know that they should listen to their instincts and parent in the way that makes them feel most comfortable and that they don’t have to listen to the “so-called” experts.

Back to Gina Ford, in her new book “The contented mother’s guide” she apparently is advising women that they should resume marital relations within four to six weeks after the birth.  Well, as a mother and a midwife I KNOW this will not be for everyone and indeed in some circumstances this could be positively dangerous and harmful.

As a midwife, women have sometimes shared their stories with me and I have known women who resume sexual relations within days of childbirth and I also know that there are women who wait a year (or more).  What is right for women couple will not be for another and you should follow your own instinct and not listen to a woman who has not had children herself!

For further information see https://midwifevalerie.wordpress.com/2009/01/03/sex-after-birth/

I am very grateful for this Guest Blog about Hyperemesis Gravidarum or Pregnancy Sickness written by Amanda.  Amanda’s contact details are at the end of the article.

Hyperemesis Gravidarum

So, what is Hyperemesis Gravidarum?

Most people accept that Nausea and Vomiting in Pregnancy (NVP) or “Morning Sickness” is just part and parcel of pregnancy. However very few people are aware of just how bad this can be and that Hyperemesis Gravidarum (HG) even exists.

HG is an extreme form of NVP and is more like having a stomach flu or food poisoning for months on end rather than the occasional moments of nausea and odd vomiting session experienced by most expectant mothers. 

There are many different levels of HG and sufferers range from those who consider it to be “mild”, perhaps battling nausea and vomiting at home right through to those with “severe” HG which has them in and out of hospital throughout their entire pregnancy. Thankfully HG is not the killer that it once could be here in the UK but awareness and compassion from both society and the medical profession is extremely limited. This means that not only does a woman with HG suffer through the worst sickness imaginable, but she does so while having to fight just for the support she needs.

It is often difficult to get a diagnosis and treatment for HG and many doctors are reluctant to prescribe medication until a woman is dehydrated enough to require hospitalisation. And yet many HG survivors who have gone on to have subsequent pregnancies have found that early and aggressive treatment with anti-emetics and IV hydration can limit the severity of their symptoms and make HG much more tolerable, if not necessarily easy.

There are so many symptoms that may suggest a woman has HG, and a whole list of them can be found on the HelpHer website here. However, it is most women’s experience that there has to be a significant loss of body weight and ketones in the urine before their GP or midwife will realise how severe the sickness is.

It is all too common for HG sufferers to be told everything from, “have you tried ginger?” to “this is normal, just get on with it”. A woman suffering from that level of sickness may be too weak to fight for what she needs and often needs an advocate. Yet when facing HG, especially the first time round, it can be all too easy to feel there is nothing you can do and that you just have to accept what the doctor says. In fact it can be far too easy to believe that it really is normal and you are just weak, leading to depression and isolation at how ill you feel and how unable you are to cope with what you believe every other pregnant woman deals with easily.

Which leads to the fact that many HG sufferers not only deal with the physical effects of the condition but can also become very isolated, depressed and even go on to develop Post Traumatic Stress Disorder (PTSD). And the emotional effects of HG can last far beyond the pregnancy itself, even affecting the woman’s decision of whether to face further pregnancies or not. 

Finally, we must not forget the extremely stressful and painful experience that the woman’s partner, parents, siblings and other children go through every single day that she is sick. They can become as isolated and vulnerable as the pregnant woman herself and yet they are so often overlooked even if the woman herself manages to get the treatment she needs.

This is just a very basic overview of what is a complicated and extremely traumatic condition that can ruin what should be one of the most wonderful times in a mother’s life. I cannot possibly do the topic justice on just one page of my blog and so I would like to now draw your attention to some of the most resourceful sites on the web dedicated to this condition before sharing my own personal experience of HG with you and what it has inspired me to work on now my pregnancy is over.

Hyperemesis Gravidarum Resources on the Web

HelpHer – Hyperemesis Education and Research Foundation

The HelpHer website is full of fantastic information for mothers, partners, medical professionals, and the media. It was the most helpful resource I found during my pregnancy and the forums are particularly helpful and supportive both whilst in the midst of HG and afterwards.  

Pregnancy Sickness Support UK

Pregnancy Sickness Support UK is a charity that hopes to offer a support network for HG sufferers and raise awareness of the condition here in the UK. I only found the site after my pregnancy was over but I would sincerely recommend checking it out.

Motherisk

Motherisk is based in Canada and has huge amounts of research available to read online into many different facets of pregnancy that HG sufferers will find interesting, include research into the effectiveness and safety of drugs during pregnancy.

http://amandaclairedesigns.typepad.com/amanda-claire-designs/hperemesis-gravidarum.html

Twitter: @amandaspatch

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:-

  • ·       Call 999 if you can’t get hold of your midwife immediately
  • ·       Massage the uterus firmly – this often stops the bleeding immediately
  • ·       Pass urine
  • ·       Bi-manual compression – only if bleeding is extreme – involves someone continually massaging uterus externally and internally until help arrives

When the midwife arrives…

  • ·       She considers what we call the 4 T’s: Tone, Trauma, Tissue and Thrombin (clotting) factors.
  • ·       She can make sure the woman has passed urine and does not have a full bladder.
  • ·       She can use massage of the uterus, syntometrine or ergometrine medication to try stem bleeding. These medications induce a sustained uterine contraction. The massage of the uterus will sometimes expel any tissue obstructing good uterine clamp-down.
  • ·       The midwife can check for a tear, sometimes we can tear internally and it be less obvious
  • ·       Bi-manual compression will be used and transfer to hospital will happen as soon as an ambulance arrives if bleeding is not slowing.
  • ·       If bleeding has been easily stopped and woman feels fine then she may end up declining transfer to hospital. However in hospital they can offer a number of extra helpful interventions for anyone who has experienced or is experiencing a life-threatening PPH.

Placental Problems

  • ·       Occasionally the placenta doesn’t separate properly and obstructs, the midwife can manually remove it allowing the uterus to contract down and stem the bleeding

Can more be done in hospital than at home?

  • ·       The answer is yes, but only because there are more staff on hand, however the chances of having a life threatening PPH are far far greater in a hospital than at home in the first place.
  • ·       The most common reason for PPH is to do with atonic uterus, where the womb fails to contract down properly. At home, this is dealt with in the same way and with mostly the same drugs that would be used in hospital.
  • ·       It’s important to mention that PPH at home is reasonably rare, by the very nature of the fact that the major risk factors for PPH are things which only happen in hospital (instrumental deliveries, long hours on syntocinon drips, caesarean section etc).
  • ·       The last confidential enquiry into maternal deaths listed approx 5 deaths from PPH, all of which were in hospital, four of them were following instrumental deliveries and one following caesarean.

 How likely is post-partum haemorrhage after a home birth?

  • ·       PPH is significantly less likely to happen after a home birth than after a hospital birth.. This is probably because home birth reduces the risk of interventions which can contribute to PPH
  • ·       For more info, see the National Birthday Trust Fund study in the first instance, but numerous other studies have also found a reduced PPH rate in planned home births.
  • ·       Part of the reason for higher rates of blood loss after hospital birth is that PPH is statistically more likely to occur after intervention such as caesarean section, assisted delivery (forceps or ventouse), or medical induction or augmentation of labour (having a drip to speed labour up). None of these things will be happening at home. If you were to have any of these interventions, you would already be in hospital.
  • ·       There are some ways in which planning a home birth actually reduces your chances of having a PPH. Simply planning a home birth significantly reduces your chances of ending up with a caesarean or an assisted delivery – labour just seems to progress more smoothly at home, leading to less call for intervention. As these interventions increase the risk of PPH, by reducing the risk of the intervention, you are reducing the risk of PPH.

Can you have a home birth after having had a PPH with a previous baby?

  • ·       To try to work out the chances of a PPH recurring, and whether this is ‘safe’ for a home birth, you’d need to know why the PPH occurred, and if the same circumstances were likely to recur.
  • ·       Much depends on how you felt after the PPH.  Some women feel great even after losing a considerable amount of blood whereas others may feel terrible only losing 300ml.
  • ·       Its often hard to accurately measure the amount of blood loss. In the UK we call a loss of 500ml a PPH, but Europe don’t record a PPH unless over 1000ml.
  • ·       What were the circumstances the PPH occurred in? Were there known risk factors for PPH which would not apply this time? For instance, PPH is more common after assisted deliveries, first babies, large babies, induction or augmentation of labour.

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.

  • ·       Was the PPH a ‘true’ PPH in terms of being blood loss from her uterus, or was it associated with perineal tearing or episiotomy? Blood from both sources ends up in the same measuring jug, but the difference is significant.
  • ·       Did she have a retained placenta, or did the bleeding occur after the placenta was delivered – some ‘uterine atony’ involved?

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.

 

PRESS RELEASE ISSUED 8th December 2011 by IM UK

RESPONSE TO CONTROVERSY OVER
PRIVATE MIDWIFERY PROVIDER:

SOCIAL ENTERPRISE PROVIDES THE ANSWER
IM UK reads with interest the mixed reactions to news of a contract between private midwifery provider One to One (Northwest) Ltd and NHS Wirral.  The service offered is one the NHS can rarely deliver: continuity of care from a midwife the woman knows, through pregnancy, birth and postnatally. However, concerns have been expressed about the impact of profit-driven private providers on the NHS.

“IM UK believes that the answer lies in social enterprise midwifery: continuity of care delivered by an organisation run by midwives and service users for the benefit of the local community,” states Annie Francis of IM UK.

“That is why we are establishing a social enterprise, named Neighbourhood Midwives, to offer local, community based midwifery services.  Care will be free at the point of access for women but provided by a social enterprise, whose values and culture are firmly rooted in a social mission and purpose. We are well down the path and are ready to provide services from April 2012.

“We are keen to be fully integrated into the whole maternity care pathway, ideally through the planned networks currently being discussed. We will be able to offer care to women planning a homebirth but often unable to access this choice because of current shortages of midwives within the NHS.”

Historically, insurance issues have been a barrier for not-for-profit providers.  During recent debates on the Health and Social Care Bill, Baroness Julia Cumberledge emphasised the need for social enterprise organisations such as Neighbourhood Midwives to be able to access insurance via the NHS Litigation Authority (NHSLA). 
For further information contact:
Annie Francis
07977695948
annie.francis@independentmidwives.org.uk

Jill Crawford
07870924857
jill.crawford@independentmidwives.org.uk


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