Valerie Gommon Midwife’s Blog

Archive for the ‘RCM’ Category

This is a guest blog by Helen Potter.

There are several reasons why a woman may have a caesarean section. A planned section may be scheduled because of the position or health of the baby, the mother’s medical history or at her request if she has had a previous, traumatic vaginal birth. An emergency section usually occurs because complications have arisen during natural labour. A ceasarean section is a major operation that requires incisions through the abdomen and uterus and so the significant recovery period is well accepted by medical professionals and society in general. However, the emotional after effects of this type of birth remain less acknowledged and far less discussed. The silence and stigma surrounding mental health after a c-section can be detrimental to new mothers who’ve not only just been through major surgery, but now have a newborn baby to care for too. Here are just a few of the emotional issues that may arise following a c-section.

Shock

It’s extremely common for the body to go into shock immediately after the surgery is carried out. Many women report shaking from head to toe as medication from the epidural and affect the muscles. But further on into the recovery process many women experience delayed shock, especially when the c-section was carried out in emergency circumstances. They spend so long preparing for their labour, writing birth plans and building up expectations so when things don’t go to plan it can be a huge surprise. Using a debriefing service following a c-section can be a good way to come to terms with the experience and understand why it had to happen.

Guilt

A study carried out by Channel Mum found that one in five mothers said that opting for a ceasarean would mean that they’d ‘failed’ and with that sense of failure undoubtedly follows feelings of guilt. Outdated social views can lead to women believing that a drug-free, natural labour is the most honourable way to give birth. Some women even report that having a caesarean has made them to feel like less of a woman and less of a mother. Of course this is untrue and all that really matters in labour is that mother and baby both come through the process safely.

Post natal depression

Although all women who go through childbirth are at risk from postnatal depression, studies show that women who have an emergency caesarean are up to six times more likely to suffer from the condition. The longer recovery period and feelings of guilt, failure and lack of control over their own body are all thought to contribute to this, alongside the hormonal changes that all new mums face. It’ is important to speak to a health visitor or GP if you think you could be suffering from postnatal depression. Self help advice, medication and therapy can all help to alleviate the symptoms.

Trouble bonding

Some women report that they have struggled to bond with their babies following a caesarean section. There are several theories for this. Biologically, research indicates that they miss out on the release of the hormone oxytocin (otherwise known as the love hormone). Immediately after natural childbirth the release of this hormone is higher than ever and missing out it can impair the initial bonding process. In addition to this, skin to skin contact (vital for developing early closeness and bonding) is rarely possible straight after a c-section and in many cases the baby is taken away and checked over while the mother recovers. On a more practical level, the long recovery process can sometimes render a new mum unable to carry out day to day care of the child which can make her feel disengaged from her new baby.

Fear of future pregnancy

Sometimes all of these factors combined, along with the physical pain of a c-section, can make women so fearful of a repeat performance that they choose not to become pregnant again. Of course this can be a devastating choice for a woman who really wants another baby. After a c-section, the probability of a natural birth next time is good – research indicates 60-80% of women can potentially go on to have a vaginal birth after a ceasarean (VBAC). But there are risks and these, alongside the fear of another c-section, can be enough to put some women off for life. If you feel like this but still long to expand your family it is important to talk to your GP or debriefing service to familiarise yourself with all of the facts so that you can make an informed choice.

Citation Section

NHS Choices, Ceasarean section, accessed 25.02.16

Metro, Thousands of women with postnatal depression suffering in silence, accessed 25.02.16

The Royal College of Midwives, What is the purpose of debriefing women in the postnatal period, accessed 25.02.16

The Daily Mail, The women made to feel guilty because they didn’t have a ‘perfect’ drug free birth, accessed 25.02.16

NCBI, Increased risk of postnatal depression after emergency ceasarean section, accessed 25.02.16

Psychguides, Living with postpartum depression, accessed 25.02.16

Mail Online, Women who have ceasarean section ‘less likely to bond,’ accessed 25.02.16

Mayoclinic, Vaginal birth after c-section (VBAC), accessed 25.02.16

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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

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.

http://www.timesonline.co.uk/tol/life_and_style/health/article6932530.ece

Men who panic when their partners go into labour may be rushing them into hospital too early. Professor Mary Nolan, of the University of Worcester, said that their interference could be overriding the advice from midwives and leading to greater numbers of complicated births.

Labour can last 12 to 18 hours for a woman giving birth for the first time, and the longer women are in hospital the more likely they are to receive medical interventions such as painkillers or drugs to hasten labour when they don’t need them.

Midwives try to encourage women to stay at home as long as possible because evidence suggests that the longer a woman stays out of hospital, the more straightforward her labour. Hospitals also want to avoid women blocking beds for hours before they give birth.

But a survey of 2,400 women visiting the parenting website Babycentre.co.uk and follow-up phone interviews with new mothers found that despite the advice of midwives to stay at home during the early stages of labour, many fathers had been anxious to get to hospital quickly.

Professor Mary Nolan, from the University of Worcester, said: “Women rely on their partners to support them during labour but many first-time fathers feel that they should get their partner into hospital as quickly as possible.

“Although women are prepared to heed the advice to stay calm and remain at home until they really feel like their labour is progressing fast, the fretting of their partners drove them to go in earlier than they would otherwise have done”.

The findings come as the role of fathers before and during childbirth will be debated at the Royal College of Midwives’ Annual Conference in Manchester today.

Michel Odent, a leading French obstetrician and author, will argue that men should not be present in the delivery room when women give birth, as their anxiety can be catching and make labour longer, more painful or likely to result in a Caesarean section. Men now attend more than 90 per cent of births in the UK, a proportion that has grown significantly since the 1950s.

Dr Odent believes that the birth process had become too “masculinised” in recent years, and delivery of babies would be easier if women were left with only an experienced midwife to help them, as used to be the case.

“It is absolutely normal that men are not relaxed when their partners are giving birth, but their release of adrenaline can be contagious,” he said yesterday. “When a woman releases adrenaline she cannot release oxytocin, the main hormone involved in childbirth, which can make labour longer and more difficult.”

“We have to reconsider the political correctness of the couple giving birth together; it’s not necessarily the best way.”

Duncan Fisher, chief executive of the website Dad.Info, will oppose the motion that “Birth is no place for a father”.

“Of course, not all men are nervous and a lot of women would be even more nervous without their partner there,” he said. “Mothers want them there because it is not home.”

Professor Nolan added that the presence of a caring partner in the labour ward could be valuable to women, especially if shortages of staff meant that no midwives could provide continuous care and support during and after birth.

A poll of 3,500 new mothers for the RCM this week found that one in three were left alone and worried during labour or shortly after giving birth on the NHS.

Andy Burnham, the Health Secretary, said this week that he intends to reform the system of hospital funding to take account of patients’ satisfaction rates, starting with maternity care.

Andrew Lansley, the Shadow Health Secretary is due to announce Conservative policies today which will include “drawing in the whole family around the time of birth” and improving antenatal care. “We often do not involve the father and grandparents as much as they and the mothers would like,” a Tory spokesman said.

Cathy Warwick, the RCM’s General Secretary, commented: “We support a mother’s right to choose her birth partner during labour. There is no evidence base or research, of which we are aware, to suggest that a father’s presence impedes and interferes with the mother’s birth. We will welcome a healthy discussion of these issues during the debate at the conference.”

(Written November 2009)

From next year the Government has pledged that all women will be offered a choice of where to give birth including at home but so far only half of women are reporting that they were offered a home birth.

A recent survey carried out by www.netmums.com revealed that as many as one-third of all women in NHS hospitals are left alone and worried during, or shortly after childbirth and more than 30 per cent of mums polled received no NHS antenatal classes and 43 per cent did not have access to a midwife on a postnatal ward.

Women who participated in the poll were also very critical of postnatal care, including support offered for breast-feeding, this is despite the fact that the Government is now putting huge investment into improving breastfeeding rates; some women also mentioned that they felt the lack of care had led to postnatal depression.

Cathy Warwick, General Secretary of the Royal College of Midwives (RCM) said maternity services in England are at a critical point; she said that progress was being made. but went on to say that the target to give women a choice of where to give birth looked like it would be missed.  Warwick said surveys suggested full choice was only offered in about 50% of cases.  She also said services were also struggling to cope with the rising birth rate  which has jumped by 20% since 2001.

The RCM say that staffing numbers have increased, but by less than 10%, leaving the health service short of 5,000; they also highlighted that student midwives are finding it difficult to gain employment.

The Netmums website has teamed up with the Royal College of Midwives (RCM) to discover your most recent experiences of maternity services so we can work together to instigate improvements.  Please take a few minutes to complete the joint survey so that areas for improvement in maternity services can be targeted. Please answer the questions in relation to your most recent birth. The results of the survey will be presented jointly with the RCM and Netmums at the RCM’s annual conference on November 26-27th in Manchester and featured in the media before the conference.

The survey can be found at www.surveymonkey.com/s.aspx?sm=B6ZD2GutcFLoG8h7MuAMdA_3d_3d

Swine Flu

Posted on: July 22, 2009

There has been considerable debate about pregnancy and swine flu in the media over the past week.  Pregnant women are more susceptible to catching swine flu and more at risk of complications because their immune system is naturally suppressed, however, the Government stressed most swine flu victims suffered only mild symptoms.

The National Childbirth Trust have been criticised for suggesting that women consider delaying a pregnancy during the current flu outbreak, however the Government say that “It is particularly important that anyone who has existing health problems and is thinking about starting a family should talk to their GP first” – this would be standard, sensible advice whether or not there is a flu outbreak.

The Royal College of Midwives said pregnant women should avoid public transport, unnecessary travel and crowds as well as following standard hygiene advice.

It is important to remember that for the vast majority of people (including pregnant women) that, although unpleasant, influenza is self-limiting and the vast majority of people will make a quick recovery.

Obviously if you are unwell do follow the Government’s advice http://www.direct.gov.uk/en/Swineflu/DG_177831 or contact your doctor or midwife for advice.


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