Valerie Gommon Midwife’s Blog

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

Optimal Fetal Positioning (OFP) – Encouraging your baby into the best position for birth.  How and why? (including quotes from local independent midwife Valerie Gommon)

The best position for birth is when the baby’s head is down and facing the mothers back and baby’s spine is to the left of your navel (known as left anterior/lateral position).  In this position the baby can pass most easily through the mothers pelvis.  This will ensure a quicker and easier delivery.

Towards the end of pregnancy it is advisable not to slump back on the sofa as gravity will encourage your baby’s  spine (the heaviest part of her body) to swing back towards yours!  Instead, remember the good posture you have worked so hard to develop during your pregnancy yoga classes!  This will gently tilt your pelvis forwards, as well as maximise the space your baby has to move around in.  Whenever possible lean forwards to rest e.g over a yoga ball, table or legs wide over a backwards facing chair.  As in our yoga classes, remember to use cushions to allow your hips to be level or higher than your knees when sitting.  Use cat pose when ever you have a moment.  Valerie also suggests: “getting  onto your hands and knees to wash the kitchen floor or play with your toddler!” or just enjoy moving with your breath!
Another suggestion is that you “lie on your left side on the sofa with your belly hanging slightly over the edge – a nice relaxing way of encouraging your baby into the best position!” (Valerie Gommon).
However, do keep things in perspective if hoping to turn your baby…be comfortable, stay active and above all enjoy your pregnancy.
Remember babies can decide to turn right up to the last minute and some babies are just happy where they are whatever plans you might have for them!!
Sarah Cooper.

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.

Another Guest Blog from Sheila Sheppard, Nutritional Therapist.

We know that a baby is nourished in the womb not only by what its mother eats during pregnancy, but also by her body. It’s important, therefore, to be well nourished prior to, throughout and beyond pregnancy to protect your own health.

Here is just one example of how important it is for you to meet your baby’s nutritional needs as well as your own, throughout pregnancy and beyond.

Three weeks after conception, your baby’s brain begins to form, and continues to develop rapidly throughout your pregnancy. The brain is 60% fat and the two most important components are DHA (an omega-3 fatty acid from fish) and ARA (arachidonic acid, from meat, eggs and dairy). These fats are transferred across the placenta and are also present in human milk; they are accumulated in the brain and retina during foetal and infant development.

Most of us consume plenty of foods with ARA so this isn’t usually a worry, unless mum is vegetarian or vegan. Omega-3 is another matter though, as many people don’t eat any fish at all, or avoid oily fish such as salmon, pilchards, sardines, mackerel and tuna.

In her third trimester, the mother needs to eat foods rich in DHA: the placenta takes DHA from her blood and concentrates it in the baby’s circulation; the baby’s DHA level is now double his mother’s.  If she has low blood levels of DHA (because she’s not eating much – or any), DHA is also taken from the richest store – her own brain.  This may account for the slight shrinkage of women’s brain cells and the poor concentration experienced during late pregnancy. The baby continues to need DHA in his milk up to around 4 months and mum needs to keep up a steady intake to protect her own stores of DHA while making sure baby gets enough too.

Research shows that deficiency of omega-3 fatty acids in pregnancy and beyond is linked to post-natal depression, and to behavioural, learning and visual difficulties in children.

Oily fish is recommended 2-3 times per week, and if you can’t manage this then you should seek professional recommendation of a fish oil supplement with good levels of DHA; vegetarian DHA supplements are made from algae. You could also enjoy a regular serving of home made taramasalata (made from fish eggs), a recipe for this is on my website www.nutribaby.co.uk/recipes.php. If you’d like to know more about nutrition in pregnancy, for infants or for weaning, please get in touch.

 

Sheila Sheppard Dip NT, mBANT, CNHC

NutriBaby

Sheila@nutribaby.co.uk

07799 132999

16th April 2012

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

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