All posts by Joy

Pregnancy, labour, and postnatal support during the covid-19 virus restrictions

Pregnancy and birth support in Somerset

The current pandemic situation is disrupting most people’s plans for birth, and many families are contacting me with questions. The guidance is changing daily so please check with your local maternity unit for up to date information. Here is what the Royal College of Obstetricians and Gynaecologists and the Royal College or Midwives have published.

Families are now finding that they may only take one birth supporter into hospital, and may not be able to give birth at home if the hospitals do not have enough midwives to provide safe levels of care. Independent midwives and doulas still want to be able to support people through this difficult time, and can do this in a variety of ways. Most are available for a free quick chat, some provide a longer one to one session by skype, zoom etc. and some are still able to be on call to provide birth support virtually. If you are planning a homebirth your doula or midwife may self-isolate for a couple of weeks before attending your birth.

Currently many doulas and birth workers are offering their services for a reduced fee, to cater for people who are in hardship due to the current health crisis. Often these doulas and their families have also been affected financially, so please offer to pay if you can.

Please contact myself or one of the doulas listed for support and information in pregnancy, for early labour support, or help parenting a new baby. They can help inform you of your rights and choices, provide online antenatal classes, and much more. Currently all support is advised to be on line if possible, to reduce the risk of spreading the corvid-19 virus whilst people are not showing symptoms.

Giving birth without a midwife

As a midwife I am unable to endorse birth without a health professional, but I do acknowledge unassisted birth as an empowered choice for some families. In these uncertain times many families are considering this option if their homebirth plans have to change due to staff shortages. I would advise doing as much research as possible if you are considering an unassisted birth, rather than just leaving it to chance on the day.

For anyone who is not planning an unassisted birth, but may be worried that a midwife or ambulance might not reach them in time, I have written an online course to help you and your birth supporters cope until help arrives. It is called giving birth without a midwife or doctor, and will help you prepare for a fast birth at home before a midwife can attend, or if baby arrives en-route to a birth centre or hospital.

This is my most popular course currently as it helps prepare you for many different labour and birth scenarios. This course is not intended to be used instead of professional support. Learn more or enrol here

Support I currently provide

Pregnancy -During these difficult times you may feel in need of more support and information in your pregnancy. Contact me for online support sessions to discuss your rights and options, to talk through a previous birth experience, and prepare for a healing birth this time, to write a empowered birth plan, or to get a professional second opinion. Join my weekly online pregnancy group for support and information here.

Antenatal Courses – I provide antenatal classes monthly via zoom. I also have many on-line courses that you can do in your own time here.

Labour. During early labour you can call me for support by phone or zoom. These calls do not take the place of your maternity care. I cannot advise you when to go to hospital, or call your midwife, but I can help you with calming breathing techniques, and supply you with information and options so you can make empowered choices. These sessions need to be booked in advance so I know when to be on-call. In person labour support available from June 2021.

Postnatal – Book a support session to talk through your birth, for practical information and tips on caring for yourself and your new baby, or for emotional support or information to hep you navigate this new territory.

Consultations cost £60 per hour by phone, skype, or zoom.

Contact me on 07939247462 for a free 15 minute chat or email midwife@birthjoy.co.uk for further information.

Local doula support

Jady Mountjoy – Doula in Somerset. Phone 07737 688718

Sarah Harcombe – Doula in Somerset. Phone 01278 733650 website

Phyllida Warmington – Student doula in Somerset. Phone 07784 628982 website

Chaya Tagore – Doula in Bath. Phone 01225 482216 website

Mel Scott – Doula in Somerset specialising in Baby loss . Phone 07851539288 website

Amber Strong – Doula in Somerset. Phone 07967951686 website

Sarah Gichie – Doula in Somerset Phone 07849 592127 Website

Michelle Weeks – Doula in Bath. Phone 07791039670 Website

Victoria Gazzard – Doula in Somerset facebook website

Joy Horner – Professional birth supporter and former midwife in Somerset.

Phone me on 07939247462

Out of area Support

Carla Walsh – Doula in Dorset. Phone 07860579199 Website

Alix Thorpe – Doula in Bristol website

Antenatal classes

Agata doula in London website

Joy Horner – Former Independent Midwife and NCT trained Antenatal educator website

Relaxation and hypnotherapy

Eleanor Copp Midwife, Hypnotherapist and Bowen therapist

Natal Hypnotherapy CD’s and downloads – Maggie Howell.

Call me for a free 15 minute chat on 07939247462

Haven’t you heard? Independent Midwives are still alive and kicking!

Haven’t you heard? Independent Midwives are still alive and kicking!

I initially wrote this in 2015 to clear up the misinformation being given to women who were seeking care from an Independent Midwife. A lot has changed since then, but we’re still here.

You may or may not know who Independent Midwives are. You may not have heard about our struggle to keep practising over the past few years. Well, I’m here to tell you that Independent midwives are still here – we made it!

I was dismayed recently to hear a couple of women report that they’d been told that Independent Midwives had ceased to be able to practice. One had been told by an NHS radiographer that he was glad she was not booked with an Independent Midwife. Another was told by an obstetrician that independent midwives have no insurance, and that if you try to sue them you cant, because they put their houses in someone else’s name! Luckily both of these women were able to update the knowledge of these health professionals. So for clarity I have decided to give you the facts.

When I first became an Independent Midwife in 2005 there was no professional indemnity Insurance (PII) available to Independent midwives, and we had to inform women of this before we booked them. What this meant that women were given this information when they enquired with us, given it in writing at consultation, and signed to say they understood that we had no PII at their booking appointment. The implications of this were that women could sue us personally if they wanted to. Our professional relationships were built on trust, and lots of women were cared for under this arrangement. I personally cared for 2 lawyers and one hospital consultant under this arrangement.

We were informed that PII would become compulsory for all registered midwives just a few years later due to a European directive being implemented.

To cut a very long and painful battle short, The Independent Midwives Association (IMA) split and became Independent Midwives UK (IMUK) and some formed Neighbourhood Midwives. When the deadline came in 2014 we had fulfilled all requirements, and against the odds we remained able to practice. Which we did so happily until 2017 when our governing body, the Nursing and Midwifery Council (NMC), decided our insurance was inadequate.

The only way forwards from there was come under insurance held my companies such as Private Midwives or One to One. This of course has increased our insurance premiums and therefore the cost to our clients.

Despite all these hurdles brave midwives still care for women outside of the confines of the NHS, and brave families somehow find a way to pay.

So Independent Midwives are very much still alive and kicking. And if you hear any more misinformation about Independent Midwives, please point them in the direction of this blog.

“They tried to bury us.215342_10150215211604188_558064187_8611292_3793723_n They did not know that we were seeds.” (Mexican proverb)








Unplanned Cesarean Birth. A warrior’s path.

tor-019.jpgCaesarean birth is not everyones first choice when planning the type of birth we’d like. For many women it is the very last type of birth they’d opt for. So when we are faced with our least favourite choice, the thing we’d worked so hard to avoid, our worst fear, what do we do? How can we cope with the disappointment of a birth that’s so far away from the birth that we’d dreamed of that it resembles a nightmare? What went so dreadfully wrong, and who can we blame for this travesty? As a midwife and mother who’s first baby was born by unplanned caesarean I’d like to explore these questions further.

A less than ideal birth?

Why does a less than ideal birth have to mean less-than? Could our less than ideal birth leave us feeling less than complete? If our bodies apparently failed to give birth, or we didn’t get to do the things we’d planned to do when greeting our babies, is there a sense of failure? I certainly remember feeling that my body had failed to birth my first child, and that I’d somehow failed to be there for her immediately after birth. These are very common but totally irrational thoughts as we try to make sense of how our plans went so wrong. There must be someone to blame, and that someone must be me. But our brains must be so confused at this time, as I was obviously not slacking by needing a life-saving caesarean, then haemorrhaging and being unconscious for hours after. Where does that self-blame come from? Wherever it comes from it is misplaced in the case of unplanned caesarean.

How can we even think that we are to blame for things going wrong? I can joke about it now, as it’s approaching 23 years since my baby and I nearly died. I can see rationally that my caesarean was a life-saving measure, and that my daughter shows no signs of the early neglect she may have suffered. But do you know what? It still hurts to think of those lost hours when we were not together.

Best laid plans

Like many women I’d prepared for a homebirth, but of course I knew as a midwife that anything could happen. It just wouldn’t happen to me, as I was so well prepared. I watched all my plans evaporate when labour didn’t progress and I transferred to hospital for analgesia and augmentation. A catalogue of nightmarish scenarios ensued, and my baby was found to be presenting by the brow (forehead, instead of the back of the head coming down first). Of course trying to force a malpositioned baby through a pelvis for hours is never a good idea, so my body haemorrhaged after my caesarean and I was returned to surgery. Postnatal depression inevitably ensued, marring a majority of our first year together. It just didn’t make sense. I’d done everything so right. How could it go so wrong?

 Are birth plans worth the paper they’re written on?

I’m not sure one can actually plan a birth, knowing that birth is inherently unpredictable. I think writing a birth plan is a good exercise in looking at and discussing your birth preferences with your birth partner. It can also be a useful communication aid for your midwife to read whilst you are busy birthing and not able to fully express your wishes. Beyond this it is of very limited value. If you do write your birth preferences down please just write on just one side of A4 paper, use bullet points, and try not to be too outcome orientated. What I mean by this is do not write “I am having a homebirth, vaginal birth” etc as these are never guaranteed. Its fine to write “I hope I’ll have a homebirth” or “I’d prefer x to y if I require pain relief” or how you’d like to spend the first moments with your baby if possible. Please do keep it short though, as I’ve heard doctors joke that women with long, inflexible birthplans are bound to need medical interventions! So plan all you like, but your baby may have an entirely different plan of it’s own. I do believe that all babies do their best to come out the way we have planned, but some get stuck, some run out of energy, and if left to a natural conclusion some babies and women would not survive the birth process. Nature doesn’t always get it right despite our best efforts, and timely caesarean surgery saves lives.

Less of a birth=less than a woman?

Why should we feel “less than” if we’ve accepted life saving surgery, albeit unwillingly? As a midwife I see so many different types of birth, and not one has more worth than another. All women are strong, beautiful and powerful in their birthing. This transformational state has equal value whether it is long or short, painful or ecstatic, vaginal or abdominal, surgical or physiological. Each birth brings forth a baby as well as the birth of new parents who need to start their parenting journey in an empowered way. It is a true rite of passage, where we are presented with obstacles and challenges, so we can discover how courageous and strong we really are. When women are well supported in their births they get to see their strengths and triumphs, and start their journey to parenthood in a joyful way. Without support and explanation they may be left feeling disappointed or even traumatised by such an unplanned outcome.

So how can we lessen the impact of unplanned caesareans and enable women to feel strong and empowered in their birthing? It’s important to have continuity of midwife, or a doula if possible. Research has shown that continuity of carer leads to better outcomes. Women can empower themselves by learning assertiveness phrases and asking for everything to be explained, so they are in charge of the decision making. They can organise 2 good birth supporters, who will support their choices, and be able to help practically as well as emotionally after an unplanned outcome. Women will need opportunity to debrief their birth with their care provider after unplanned caesarean. And as care providers we have a duty to help women understand and integrate their birth experiences. Unfortunately most women don’t have continuity of midwifery care, but all midwives and doulas can help a woman after unplanned caesarean birth. We can do this by listening, by witnessing their story without interrupting, then by answering their questions. We can believe them and validate their experiences, letting them know they made the best choices possible (being a professional means putting aside our personal opinions). We can congratulate them on their intuition, bravery, endurance etc, for giving it everything they had and then some, because of course every woman does. Don’t forget to mention her beauty and dignity in birthing, her graceful acceptance of the inevitable, and big up her support team too.

That woman is a birth warrior, she has done battle with nature and her worst fears, she has bravely laid her body down on the theatre table and has said “cut me open for the sake of my child’ risking her own life to save her unborn baby. She then returns from her battle triumphantly holding her reward, her baby, and should be welcomed home as a returning Hero. How can this warrior’s birth ever be seen as less than?

Conclusion

As a midwife I’ve had the pleasure to see empowering and ecstatic, planned and unplanned caesareans. I have personally had a vbac so also know the joy of vaginal birthing too. All births are great opportunities for us to grow and become more than we ever thought possible. This is a process of growth not lessening, so let’s treat it as such, and celebrate all birthing women as the birthing Goddesses they are.








Birthing from Within Birth Preparation Weekend

bfw prenatal classes

 

 

Saturday 18th and Sunday 19th April 2015  In Glastonbury

I am so pleased to be once again running this popular workshop in Glastonbury with my partner Jady Mountjoy. Working with stories, art and practical techniques this 2 day workshop will prepare you for your journey to parenthood.

  • Prepare for birth as a Rite of Passage.
  • Understand the power and life-long impact that “birthing from within” offers all participants in birth.
  • Co-create holistic prenatal care that is informative, transformative, and builds a foundation for birthing in awareness in our birth culture, whatever the birth location or outcome or events of the birth.
  • Prevent or minimize emotionally difficult births (for parents and professionals) through compassionate, honest preparation.
  • Honour and use the power of Birth Story telling and listening.

glastonbury

Held in studio of the innovative Red Brick Building, Morelands enterprise Park, Glastonbury, BA69FT directions here

The cost of our workshop is £70 per person or £130 per couple. There are concessions if unwaged. 

 

I first learnt about birthing from within when I bought Pam England’s book and was so impressed that I signed up to train as a birthing from with mentor.

BFW.book.cover.scan_4e91d000-cbd1-4d17-a667-a6bee57b62a4_medium

  • Childbirth is a profound rite of passage, not a medical event (even when medical care is part of the birth).
  • The essence of childbirth preparation is self-discovery, not assimilating obstetric information. The teacher (mentor) is “midwife” to the parents’ discovery process, not the expert from whom wisdom flows.
  • Childbirth preparation is a continually evolving process (for parents and teachers), not a static structure of techniques and knowledge.
  • Parents’ individual needs and differences help determine class content.
  • Active, creative self-expression is critical to childbirth preparation.
  • The purpose of childbirth preparation is to prepare mothers to give birth-in-awareness, not to achieve a specific birth outcome.
  • Pregnancy and birth outcome are influenced by a variety of factors, but can’t be controlled by planning.
  • In order to help parents mobilize their coping resources, it is critical for childbirth classes to acknowledge that unexpected, unwelcome events may happen during labour.
  • Parents deserve support for any birth option which might be right for them (whether it be drugs, caesarean, home birth, or bottle-feeding).
  • Pain is an inevitable part of childbirth, yet much can be done to ease suffering.
  • Pain-coping practices work best when integrated into daily life, rather than “dusted off” for labour.
  • Fathers and birth partners help best as birth guardians or loving partners, not as coaches; they also need support.
  • For parents, pregnancy, birth, and postpartum is a time of continuous learning and adjustment; holistic support and education should be available throughout that period.
  • Childbirth preparation is also parent preparation.

To book your place please contact me on 07939247462 or email joy@birthjoy.co.uk.

bfw black

 

 








Microbirth Premier film screening in Glastonbury

The Premier screening of Toni Harman’s new film will be shown globally on 20th September 2014.
Following the successful screening of her previous film “Freedom for Birth” last year, I am pleased to be able to share her new film in Glastonbury.

“Microbirth” is a new feature-length documentary looking at birth in a whole new way; through the lens of a microscope. Investigating the latest scientific research, the film reveals how we give birth impacts the lifelong health of our children and potentially could even affect the future of humanity.

View a trailer here: http://microbirth.com

Recent population studies have shown babies born by Caesarean have approximately a 20% increased risk of developing asthma, 20% increased risk of developing type 1 diabetes, a similar risk with obesity and slightly smaller increases in gastro-intestinal conditions like Crohn’s disease or celiac disease. All of these conditions are linked to the immune system.

“Microbirth” explores several possible plausible explanations. One hypothesis is that if normal vaginal birth is interfered with or bypassed completely because of Caesarean birth, this could alter the “seeding of the baby’s microbiome”, the critical transfer of bacteria from mother to baby at birth. Scientists suggest this could lead to the baby’s immune system not developing to its full potential. Another hypothesis is the actual process of vaginal birth, including the cocktail of hormones produced during labour, could profoundly affect the baby’s immune regulation and metabolism.

The film’s co-director Toni Harman says, “Caesarean Sections are essential and often are life-saving. However, up until now, no-one has really looked into the long-term impact. This emerging research is painting an alarming picture in terms of future health across populations. There may even be repercussions for the future of humanity. And yet, up until now, I don’t hear any alarm bells ringing.”

Join us on 20th September 2014

In Glastonbury Town Hall , Magdalene street, Glastonbury, BA6 9EL

From  7pm to 9pm for the film premier, followed by after film discussion.

Tickets £5. All proceeds will be donated to Towards tomorrow Together  Registered charity number 1151022.

Parking close by. Disabled access. Refreshments available.

Contact me for further details on 0799247462 or email joy@birthjoy.co.uk









Radical Midwifery on the Road

?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????According to the Association of Radical Midwives (ARM)  “In the mid 70s, the majority of pregnant women in UK had labour induced by artificial rupture of membranes (ARM) around the date they were “due”. These initials were used when the group needed a name, using the dictionary definition of “radical”, (roots, origins, basics, etc.) which aptly described the basic midwifery skills which they hoped to revive.”

In this spirit I offer a grass roots midwifery information service to women. I am an Independent Midwife, and as such I provide total midwifery care for women and their families, but the numbers I care for are small, and every woman needs good information. I’ve always served women by giving free information by telephone, and running a local ARM group, but again the numbers are limited, and so is my time. But I feel a huge need to pass on my knowledge of maternity rights and choices to women who may not even know that they have a choice.

Am I saying that the NHS is not giving women enough information or choice? No.

Am I saying women are unable to find out this information for themselves?  Certainly not.

Pregnant women just don’t know what they don’t know. First – time mums may, or may not have read widely, they may, or may not have a relationship with a known NHS midwife, and the midwife may be too short of time, experience or knowledge herself to be able to help each individual.  Without adequate information about choices in pregnancy the woman may feel she has no choice, and if things don’t go to plan, she may feel things were done to her without her fully informed consent. Feeling disempowered or not understanding why things were done to you in childbirth, can contribute to postnatal depression. After a poor experience women often look for further information and support to prevent the same happening in subsequent pregnancies.

2541987300_7cf0e2543a_mAs an Independent midwife many of my clients come seeking truly unbiased midwifery information, so they can feel empowered in their current pregnancy. Some have suffered previous birth trauma and wish to avoid similar happening again. But why wait until the second or subsequent pregnancy to get a positive birth experience? The first experience of birth is likely to be the most challenging, so it is important that we as midwives know how to serve you best. Unless you tell us what would help, or hinder you in labour, we will not know. Unless you know your rights and the choices available to you, you will not be able to instruct us in providing the right kind of care for you.

This is where writing birth preferences comes in useful. As an NHS midwife I would meet someone (often for the first time) in labour, and have to discuss all the pros and cons of different birth choices. I  don’t mind explaining at all, but Labour is not the right time to be engaging the thinking part of a woman’s brain!

  • Educate yourselves, know your rights and choices before labour starts.
  • Write your birth preferences down. Discuss them with your birth supporters before labour, and share them with your midwife when labour is underway.
  • If you don’t know why a course of treatment or an intervention is being suggested then please ask.
  • If you don’t understand or don’t like the answer then ask someone else.

The Association for the Improvement in Maternity Services (AIMS) are a great resource for anyone having difficulty getting support for their birth choices. AIMS have a booklet entitled “Am I Allowed?” and all over it’s cover it has the word YES. Nothing can be done to you without your informed consent. If it has not been explained to you fully, you cannot make an informed choice. Please buy this book if nothing else (order from website, under “publications”).

Read also Mary Cronk’s assertiveness phrases and practice them in front of a mirror.

Birth Rights is a new organisation founded by a human rights lawyer. The website contains useful fact sheets on rights in childbirth.

The birth bus
The birth bus

 

If you live local to me then find out when I am next holding a midwifery clinic in my Birth Bus (campervan). I park at various locations locally, to give information and answer queries about rights and choices. Just text or email me for dates and venues. These do vary according to my midwifery caseload.

Remember that knowledge is power, and you don’t know what you don’t know- BUT you can always find out and ask WHY?

 

 

 








Please Help Save Independent Midwifery by commenting on the Professional Indemnity insurance consultation document

A public consultation is now open to the public until the 17th May 2013. It is your chance to say why professional Indemnity Insurance should not be linked to Midwives registration. This will have far-reaching implications after 25th October when it will become law – unless we can convince the powers that be to not implement it. This is where you can help by commenting on the consultation document. It is a long and wordy process and the issue is hard to get your head around unless you know the history so read a short version here at Birthrights

Question 6 is the most important one, but answer as many questions as you can.  Below are some of my comments. Please feel free to use any part of this to help you phrase your own answers:
“Linking Professional Indemnity Insurance (PII) to midwifery registration will discriminate against Independent midwives. Independent Midwives will be unable to purchace professional indemnity insurance as they are self employed. They are not part of, and most do not want to be part, of a corporate structure. They have chosen to work independently of the NHS to provide a better quality of service to women. As individuals it is impossible to purchase PII.
It suits many Independent midwives to be self-employed for many reasons. Continuity of carer provides better outcomes, and working this way means being on call for all the births on your caseload. The commitment to attend every booked birth requires the ability to re-scedule planned appointments on a daily basis. Many independent midwives also have young children/ elderly parents to care for, and working independently gives a greater flexibilty to their working day. Working for the NHS doesn’t offer this provision.
Women choose Independent Midwives for many reasons, but the majority have found their needs are not met by NHS care. Another group have had bad experiences with the NHS in previous births and need an alternative. The restrictions that insurance companies place on care is the reason many women opt out of NHS care. These same restrictions will apply to the care independent midwives can provide if indemnity insurance becomes compulsory. Just because something is high risk doesnt mean women should not have the right to do it.
The court of human rights have ruled that women are able to choose the circumstances of their birth including where, and with whom they choose to give birth. Making it impossible for midwives to practice independently without insurance is removing women’s human rights!
And what about the rights of Independent Midwives to work and provide for their families? is that not a human right too? Hundreds of Independent midwives will lose their livlihoods, thousands of women will be denied individual choice in pregnancy and birth if it becomes illegal to practice without insurance.
Independent Midwives are highly skilled in facilitating normal birth, including breech birth, and physiological third stage. These skills are in short supply in the NHS leading to an ever increasing caesarean section rate. Caesarean surgery carries serious risks and makes subsequent births high risk – costing the NHS extra time and resourses used, and in compensation claims. Wouldn’t it make sense for the NHS to save money by government supporting the contribution Independent midwives make to the normal birth rate?
I’m afraid that independent Midwives will not simply join the ranks of their NHS colleagues, they will leave the profession. One colleague recently told me she would rather die than return to NHS hospital midwifery. I know that sounds over dramatic but it’s not. Having worked as an Independent midwife for 7 years I understand how the same level of Midwifery care is impossible to achieve on the NHS. Independent Midwives pride themself on their professionalism and high standards – and to some, returning to NHS work would mean lowering those standards. It is impossible for many independent midwives to contemplate returning to giving piecemeal care, on under-staffed wards, with not enough time to provide quality care. It would break many midwives hearts to have to work this way, seeing the daily distress of women uninformed in pregnancy, left alone in labour and unsupported in their attempts to breastfeed.
Without an option to NHS midwifery care women will look for alternatives. I have already heard of the growing movement of unassisted births and women giving birth with doulas, are we to add qualified but illegal and unregistered midwives to the list of choices?
  Many independent midwives want women to be financially compensated for negligent care but fear the restrictions insurance companies will put on the type of care given. Is there any way a no-fault compensation scheme could be provided for these families? I understand there is such a system in New Zealand.
I am truly saddened to think that when my daughter gives birth she will only have the option of NHS midwifery care or illegal birth attendants.
PLEASE DO NOT LET THIS HAPPEN!”

In response to the question on cost I wrote:

“I do not have the necessary monetary cost data to hand, as I’ve been a caring, professional midwife for 12 years, not a politician, statistician or… research fellow.
The important costs that I’ve witnessed are not just of monitary value, so may not be viewed as valuable to this consultation, but they are of paramount importance to women and their families! Women and their experiences should be at the centre of this consultation rather than how much the monitary costs to the NHS will be.
I care for women. I care about what quality of life they have as a consequence of the maternity care they’ve received. I care about the unseen cost of dammaged women and how that impacts on their children, relationships, and our society in general. What cost is there to the traumatised woman who sees herself as dammaged, and unable to realise her own potential as a result of her birth trauma. What cost in terms of postnatal depression, child neglect and abuse, the need for foster care and the potential for future criminal behavour, maternal self harm and even suicide. Suicide is a leading cause of death for women in the period around childbirth. What cost to the children who have lost mothers and partners who’ve lost the love of their life? Do these costs count for anything under our current government?
If you’d like to hear about direct financial costs I’d like you to consider the additional future costs to the NHS of caring for  thousands of women previously cared for by independent midwives. These are often women with complex physical and/or psychological needs, requiring specialised one to one care, to ensure optimum outcomes. Without this specialised care, women have the potential to be further traumatised, with the consequenses already mentioned above. Lack of compassionate, one to one care for vulnerable groups also holds the potential for women who’s needs are not fully met, to sue for negligent care – costing the NHS millions in payouts and increased insurance premiums.
And what about other specialised groups such as those wishing for a peaceful breech birth, or vaginal birth after caesarean? Breech birth skills are woefully lacking in the NHS, and women are informed (often because there is no one knowledgeable or skilled to help with breech birth) that they have no alternative but to undergo abdominal surgery (with all the known risks) to deliver their baby. Independent Midwives are highly skilled in caring for women choosing these types of births. It is well known that surgical birth costs more than straightforward vaginal, midwife-led birth. The complications associated with caesarean surgery cost the NHS much more than normal birth, and the longer term costs of such complications are far reaching. The short term costs of preventing and treating wound infections, and giving blood transfusions are well documented. The longer term costs of caesarean surgery may not be as easy to cost. Treating subsequent postnatal depression (and the future cost implications for the child), further surgery to divide adhesions and the increased risks (and associated costs) on future pregnancies also need to be costed in. A broader view also needs to be taken of the cost implications of women who’ve had a caesarean being less likely to breastfeed. Children who are not breastfed are prone to many more health problems, at huge financial cost to the NHS!
Independent Midwives are highly skilled in facilitating normal birth so wouldn’t it make sense for the NHS to save money by government supporting the contribution Independent midwives make to the normal birth rate?”

I don’t have the comments I wrote on whether this will discriminate against anyone as I was so mad at this point to remeber to copy it. Needless to say it was a lengthy post.

Please, Please comment and ask as many people as you can to do likewise. The more people who bother to add their comments, the more potential we have to halt this requirement to link PII to registration before it becomes law. Respond to the government ‘consultation’ with your views http://consultations.dh.gov.uk/professional-standards/indemnity_for_regulated_healthcare_professionals 

OTHER WAYS TO HELP INCLUDE:

Join the Facebook group: https://www.facebook.com/pages/Choose-your-Midwife-Choose-your-Birth/223503274456877 it doesnt take long and you’ll receive up to date information as it happens.

Email your MP now, find who your MP is here:  http://findyourmp.parliament.uk/

Sign the petition http://epetitions.direct.gov.uk/petitions/44382 this takes just seconds to do.

Ask the Royal College of Midwives union to support us https://www.facebook.com/MidwivesRCM

March with us on the 25th March in London. It will be a peaceful protest to highlight our campaign. The more people attend the more the Government may take us seriously. More information here: https://www.facebook.com/events/337186596400907/

See what this type of care means to women;

here in this Independent article written by a woman who’s given birth with independent midwives twice.

and here on you tube where a woman discusses the importance independent midwifery made to her when her baby was born breech.

There is also a plea from a well respected obstetrician to leave Independent Midwives alone.
 








Choose your midwife choose your birth campaign 2013

As mentioned in my previous post Independent midwives will be unable to work without professional indemnity insurance after October 2013 and there is no affordable insurance available to them. After this date Independent Midwives will not be able to remain on the midwifery register, and therefore will be unable to provide midwifery care legally. This may not be a problem for every woman, but a significant number of Independent Midwives and the women they care for will be affected. Nhs midwives will also be affected although many are unaware how. Worse still it signals a reduction in choices available to pregnant women which has far reaching consequences.

A wonderful student who is supporting the Choose your Midwife, Choose your Birth campaign created the document below, on what linking PII to registration really means. Please share with all Midwifery colleagues and women.

1. It will cost you MONEY.

Every time a new midwife finishes her training or an NHS midwife moves job, takes a break between jobs or goes onto maternity leave she will have to be either added, removed or amended on the NMC register. There are over 38,000 midwives on the register moving around every week. The NMC will have to administer this scheme. That’s the NMC that is “failing at every level” and has just increased its’ registration fees by 32%. So where will the money come from to fund this extra work? Exactly. YOU.

 2. It will take away your AUTONOMY.

If you have to be insured to be a midwife from October then it follows that you have to comply with any stipulations that the insurers make to be a midwife from October. So if the NHS insurance underwriters decide one day after a nasty lawsuit that homebirth/VBAC/Whatever is too risky for them they might say you can no longer do these things in practice. And you’ll have to obey, else you won’t be insured which means you’re breaking the law. Making a link between registration and insurance puts policy decisions in insurer’s hands, not midwives. Bye-bye autonomy. And talking of breaking the law… 

3. You may be PRACTISING ILLEGALLY without even thinking about it.

Shift running over but still caring for a woman? Stopped in the street to answer a question for a woman or friend? Want to care for your friend in labour who lives outside of your Trust area? Covering a shift for someone else in a different area? Supposed to be on annual leave but offered to cover? Better be checking the terms of your NHS insurance policy to make sure you’re covered, or you’ll be practising illegally. 

4. It will take away CHOICE from women.

Not everyone wants to birth within the NHS. That doesn’t mean the NHS is bad, it isn’t. But some women just don’t want to go into hospital or for whatever reason, they can’t get the birth they want on the NHS. Taking away more choices from women about ANYTHING (but especially about birth) is a bad thing and will lead to…

 5. It will HARM women and babies.

With no alternatives to NHS care, scared women may decide to go it alone. This could have truly devastating consequences for mothers and their babies. 

6. Your WORKLOAD will increase.

Women who would otherwise be cared for by independents may now turn to the NHS. This will further increase the NHS workload and birth rate at a time when resources are already stretched and the birth rate is off the chart. All of this further contributes to burned out midwives and unsafe practice. 

7. Midwifery will LOSE fundamental skills.

Vaginal breech birth, homebirth of twins, homebirth after caesarean section, routine physiological 3rd stage; these are a dying breed in some parts of the NHS. Independent midwifery keeps many of these skills alive in our communities, these are skills that we need to see as thriving and routine if we are to keep from being turned into obstetric nurses. 

8. It will change the perception and future of YOUR profession.

Insurance does NOT keep women safe. One-to-one care from a known skilled midwife keeps women safe. Forcing Independent Midwifery underground due to lack of insurance could bring your profession into disrepute and result in qualified midwives facing criminal charges for delivering care to women who would not otherwise be supported in their choices.

 9. Because our DAUGHTERS and GRANDDAUGHTERS deserve more.

They do. They deserve more than to have their maternity care dictated to them by insurance companies. Insurance does NOT keep women safe. One-to-one care from a known skilled midwife keeps women safe. THIS HAS TO BE STOPPED.

see the original document here: 9 reasons why PII and registration should not be linked

 

WAYS TO HELP INCLUDE:

Join the Facebook group: https://www.facebook.com/pages/Choose-your-Midwife-Choose-your-Birth/223503274456877 it doesnt take long and you’ll receive up to date information as it happens.

Email your MP now, find who your MP is here:  http://findyourmp.parliament.uk/

Sign the petition http://epetitions.direct.gov.uk/petitions/44382 this takes just seconds to do.

Respond to the government ‘consultation’ with your views http://consultations.dh.gov.uk/professional-standards/indemnity_for_regulated_healthcare_professionals This takes a bit longet but is very important. See my response to some of the consultation questions here. Please feel free to use any part of it in your answers.

Ask the Royal College of Midwives union to support us https://www.facebook.com/MidwivesRCM

March with us on the 25th March in London. It will be a peaceful protest to highlight our campaign. The more people attend the more the Government may take us seriously. More information here: https://www.facebook.com/events/337186596400907/

See what this type of care means to women;

here in this Independent article written by a woman who’s given birth with independent midwives twice.

and here on you tube where a woman discusses the importance independent midwifery made to her when her baby was born breech.

There is also a plea from a well respected obstetrician to leave Independent Midwives alone.

Please do whatever you can to ensure women retain choice and midwives are enable to support women in their choices. Please share as widely as possible. x

 








Mary Cronk’s Assertiveness Phrases

Following on from my “Am I Allowed post” I phoned my dear friend and former colleague Mary Cronk. As well as a good chat with each other, I obtained her permission to post her assertiveness phrases. She re-quoted the phrases that I know by heart, and have recommended to many women. I had the pleasure of working with Mary Cronk for 5 years as an Independent Midwife, and a further 2 as co-teacher of “Once More Unto The Breech” workshops. She is a true Midwife and has spent her life helping women achieve positive birth experiences.

joy and mary307710_251788671525311_932911360_nMary Cronk is an expert in breech birth who has shared the skills of breech birth with midwives and doctors across the United kingdom. She was awarded a MBE for her services to women.

See Mary in action here: Mary

You may find these phrases useful, particularly if told that you are “not allowed” to have your baby at home, or you “have to” be induced, etc.

“I am sure that many others will explain your absolute right to refuse any procedure for any or no reason. The law, and good practice is quite clear. A sensible person will listen carefully to any explanations to why a procedure is proposed, and then should she choose not to have XY or Z she just says no or no thank you. The “allowing” is done by YOU. An asssertive approach is worth cultivating. You may care to commit the following phrases to memory and practice them frequently in front of a mirror. Continue reading Mary Cronk’s Assertiveness Phrases








Birth keeper or Baby catcher?

I felt compelled to comment on a great blog my the brilliant Rebecca Wright today. It can be seen here entitled “Are you a birthkeeper? Then don’t catch babies.” She was commenting upon the language used by birth workers in a facebook post which said “because maternity care providers are not serving mothers’ needs, more doulas and non-medically trained supporters being called on to catch babies.” She made great comment about mothers being the ones who should catch their own babies and why.

I’d like to elaborate further on my comments here, as this is an interesting subject, and I didn’t want to fill Rebecca’s site with my ramblings.

I was privvy to a conversation last year about the midwife’s role, brought about by the looming end to legal independent midwifery care. One party said when Independent midwifery becomes illegal we will be doing what doulas do anyway. The other camp were vehermently defending the title of midwife and not wanting to be compared to the service a doula provides. The arguement got heated (as is the way with passionate women!), and it was mentioned that women dissatisfied with their maternity care were indeed employing doulas to attend their births. Further heated discussion about the legality of this followed.

This got me thinking about what Independent or Authentic midwives do at a birth. I’ve been very honest over the past few years, telling my clients that I won’t actually be delivering their baby, they will. In fact most of my time (between the nurturing/ loving type of things) is taken up writing notes and drinking tea. I need women to realise that its not like on telly where the doctor heroically swoops in at the last moment to pull the baby out. It is the woman’s body, love, sweat and pure determination which get the baby born.

Several years ago I noticed that some women reach down to receive their own babies at the point of birth, but some are ashamed to touch themselves “down there,” especially if they are being watched! As a student midwife I recall watching my mentor move a woman’s hand away so she herself could ‘do’ the “delivery”. I’ve never been very directive myself, and have learnt the most by observing what women do naturally. Some women need to be informed that catching their own baby is possible as the power has so often been taken away from them. Professionals sometimes forget that they are there to serve the needs of the mother and baby – and not tell her what to do! (another post brewing on the balance of power). I remember telling a friend pregnant with her second child that I thought she could catch her own baby, for a number of reasons. I had seen many women slow down the birth of their baby if it was coming quickly and others who protect their own body in this way, giving tissues time to stretch (after practicing 11+ years I have never seen anything worse than a second degree tear). My friend did catch her own baby and tells all her friends that they can too!

empowered birthI’ve been mulling over what it means to be a midwife, what Independent midwives can call themselves, and how they can still serve women after October this year. I’ve also been thinking about what difference there would be between what a doula or I could legally do at a birth. There is potential for several posts on this, so I’ll try to stick to the current theme.

As a midwife I know it is the woman’s baby and not mine. I’m sure he prefers his mothers touch to mine, and encourage women to receive their own babies. I’ve shied away from unessesary internal examinations, and refrain from telling women how, or when to push, because I have attended many births where the mother does something totally unexpected and it turns out brilliantly. I remember being present at a birth centre birth where I was the second midwife. The woman was in advanced labour and spontaneously pushing with her first baby . We were prevented from being nosey, birth coach midwives, as visibility in the room was poor. The lights were dimmed and the water was a little cloudy, so our torch light couldn’t penetrate the water. Despite our efforts with torch and mirrror we could see nothing. I was concerned that I wouldnt be able to help her prevent a tear if I couldnt see when to tell her to pant, or give smaller pushes. As she pushed she spontaneously reached down and told us that she could feel the baby advancing, and before long told us baby was emerging. She lifted the baby triumphantly to the surface knowing she had done it all herself! We examined her perineum a while later and she had no tears. I told myself that women can obvoiusly prevent tears better than I can with all my experience.

I cannot bear midwives or doulas who brag about their ‘catches’ or how many deliveries they’ve done. I’ve no idea how many births I’ve attended (although it must be several hundred by now), and feel that keeping numbers makes it into some unsavoury sort of competition (like notches on a bedpost), rather than a unique event in someone’s life! Its a shame this bad habit starts in midwifery training where students have to get 40 deliveries to qualify as a midwife. Its not about numbers, its about people. I fail to see what student midwives learn when they are shoved into rooms to deliver a baby at the last minute, without knowing the woman, just to get their numbers. It can’t be nice for the mother either.

Being an authentic midwife means having the wisdom to not do everything you’ve been taught to do. The past 10 years of practice have been about unlearning the medical model, and learning from women. I like to think of it as a reverse Ina May Gaskin midwifery journey. A journey back to basic loving care, and being a birth keeper for the women and babies I serve.

Last word from Rebecca Wright: “Not all doulas or midwives are birthkeepers, of course, but the essence to me of this concept is exactly what you express here: service to mothers and to birth. Birthkeeping (and authentic midwifery) to me is about holding mothers and babies at the centre of their own experience, bringing with us whatever skills or talents we possess that are needed in that space, but always with humility and discernment.”

Thank you Rebecca for fueling my fire. xx