Valerie Gommon Midwife’s Blog

Archive for the ‘The Independent’ Category

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

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

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

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

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

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

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

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

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

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

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

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

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

Further reading

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

Well I should be going to visit clients, but may have to cancel again as it is snowing pretty hard.  Fortunately I don’t have any clients whose babies are imminently due.

Yesterday I saw that Bedford hospital were appealing for any local staff to go in as many staff had been unable to get to the hospital.  I know that Milton Keynes was in a similar position, indeed a relative had an operation cancelled for this reason.

There was a great story in yesterdays Independent newspaper, Peter Cartwright, a radiographer from Ashford in Kent walked 18 miles to get to work at Guy’s Hospital in Central London on Monday – now that is dedication (or madness) for you!  www.independent.co.uk/news/uk/home-news/britain-runs-short-of-grit-as-fresh-snow-is-forecast-1546395.html


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