Category Archives: Uncategorized

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)








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

 

 








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

 








2013 A New Era in Midwifery or Withdrawal of Women’s Childbirth Choices?

I original wrote this at the beginning of 2013 when Independent Midwifery was seriously under threat of becoming illegal if they failed to obtain professional indemnity insurance (PII) before 25th October 2013. At the 11th hour we have a glimmer of hope due to the hard work of Independent Midwives UK (IM UK). These dedicated midwives have failed to give up, and have found a workable insurance product. Whilst having compulsory insurance was not welcomed by every member of IM UK, it will soon be the only way of legally continuing to work as a midwife in the UK.

For the majority of women the loss of independent midwifery will make no difference to them as they’ve never even heard of Independent Midwives. Many are happy doing what everyone else does, not questioning their care providers, assuming health professionals will care for them when their time comes to give birth. Some may have a rude awakening as they find themselves in hospitals which are short staffed and therefore ill-equipped to care as well as they’d like. When women are denied their choice of birth at home due to staff shortages, or are not supported in their choices they may seek out an alternative. Birth trauma and caesarean rates rise each year, and women deserve choice in care provider and alternatives to the NHS model if needed .

Independent Midwives are fully qualified, Registered Midwives who have chosen to work outside the NHS to fully practice their midwifery skills. They are regulated like any other midwife, and provide one to one care for women during pregnancy, birth and up to 28 days postnatally. Unlike midwives that are employed by the NHS, Independent Midwives have not been able to purchase Professional Indenity Insurance (PII) since 1994. Since then Independent Midwives have practiced without insurance which means we are personally liable for any clinical negligence claim against us. This has not discouraged women from hiring Independent Midwives as they value the benefits of individualised care.

Independent Midwives provide one to one care for women. This type of working relationship allows women to get to know and trust the person who will be present at the birth of their child. Women really value this professional relationship, and midwives get a great deal of job satisfaction from working this way.

So why are they under threat of becoming illegal? Because a European directive has been passed which makes it compulsory for professionals allied to medicine (which includes osteopaths, chiropractors, midwives etc.) to have Professional Indemnity Insurance (PII). Our government decided to implement this in England this year, despite being informed that Independent Midwives cannot obtain PII due to being self employed. A deadline to have insurance was initially set for October 2013, but this has now been moved to February 2014. Nursing and midwifery council published this statement at the beginning of October. Without professional indemnity insurance Independent Midwives will not be legally be able to care for women in labour, although some may be able to provide antenatal and postnatal care. Independent Midwives will lose their livelihood and women will have less choice in childbirth.

Picture-014.jpg

This is a human rights issue, as women will no longer be able to choose who cares for them throughout pregnancy and childbirth. Unlike other areas of healthcare, women will be denied the option of privately employing a health professional of their choice. This doesn’t sound too important for the majority of women, but it is very important for the women who do not have good NHS midwifery services in their area. Some women who’ve had previous caesareans would like to give birth at home, women who’s baby is in the breech position often have difficulty finding a midwife skilled in breech birth, women who’ve been scared or scarred by previous NHS experiences may like an alternative, some want to know there will be a midwife available for their homebirth, or just to know the midwife who will be caring for her. These women will be denied choice.

IM UK have been liaising with the government to implement our insurance but they are slow coming to our aid. See more about the campaign, donate or find out how you can help here.

So what choice will women have after February 2014 if the government does not help us implement our insurance? Women would then have the choice of NHS midwifery care, or no midwifery care. This worries many midwives, as although childbirth is normally a straightforward biological function, it can be advantageous to have a midwife present at times when a rare complication occurs. Of course women have the right to take responsibility for their birth and give birth unassisted, but this should be an informed descision, and not one made through lack of choice or fear of NHS care. But why should women have to give birth alone to guarantee a peaceful, uninterfered-with birth?

There is hope that women will demand one to one midwifery care be available to all, on the NHS. It worked in New Zealand so could it work here? There are small pockets of case loading midwives appearing such as one to one and neighbourhood midwives but not enough to care for all women who need them. If women are denied the choice of nothing other than NHS care there would be a possibility of an underground movement of illegal midwives, or unqualified birth attendants, called to attend birthing women. There are similar situations in parts of America where women seek alternatives to institutionalised care, and again I don’t condemn this if it is what women want. Would women be able to discern if an illegal midwife has been previously trained and qualified as a midwife, or if she is a doula? Would it matter to most women who opt out of NHS care? My fear is, that like other parts of the world, those who continue to answer women’s calls to be cared for in this way will be penalised for doing so. It may come in the form of fines, bad publicity, or as in Hungary, the imprisonment of midwives. But also that women may not know if they have fully qualified caring for them if they are deemed illegal.

Taking away women’s choice of legal birth carer will not stop women making choices, it will only encourage women to make alternative and possibly illegal choices.

 

For further information on Independent Midwives see Independent Midwives UK

For Information on childbirth rights and choices see the Association for the Improvement in Maternity Services (AIMS)








Association of Radical Midwives monthly discussion group.

This is a local group for the support of peaceful pregnancy, birth and parenting. Hosted by Joy Horner, radical midwife, mum, lecturer and some day writer. Inspired by the Freedom For Birth film I am determined to impart information about human rights in childbirth, facilitate discussions, and to support women on their journeys to parenthood. You don’t have to be a midwife, a radical, or a female to attend. All those with an interested in women’s rights and experiences in pregnancy and childbirth are welcomed. These stimulating monthly discussion groups are designed to encourage experience sharing and debate, accompanied by tea and cake. All welcome. Donations for refreshments welcomed as 50% given to local charity Towards Tomorrow Together.

2013 Meetings at my house 7:30pm-9:30pm:

Thursday 8th August – Birth rights and choices.

Tuessday 3rd September – Waterbirth evening.

Thursday 3rd October – Postponed due to midwifery commitments.

Thursday 7th November – Am I allowed? how to get the best from your pregnancy, birth and postnatal care experiences.

Thursday 5th December – Blissful, ecstatic or orgasmic birth?

Please phone or text 07939247462 prior to attending the meeting to confirm date and location details. I am a practicing midwife so there is a chance I would have to reschedule a meeting if attending a birth.

Please note that although children are welcome they are your responsibility at all times, as I do have free-roaming teenagers, lurcher and elderly cats.

The Association of Radical Midwives are midwives, student midwives and others in the UK committed to improving the maternity care provided by the NHS. We strongly believe that all women have the right to a service tailored more closely to their needs, and a sympathetic attitude on the part of their professional attendants.

We are primarily a support group for people having difficulty in getting or giving  sympathetic, personalised midwifery care, and those who wish to provide good care. A few of us are working independently outside the NHS, in order to offer a more woman-centred,one-to-one, style of practice, which at present is not widely available within NHS maternity services.

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.

Held in our homes in Somerset, the group meet monthly to share skills and knowlege to empower women to have the best possible maternity care experience. Phone me or e-mail me at joy@birthjoy.co.uk for details of the next meeting.








Copyright and the sharing of information

After an awkward issue arose between some midwifery colleagues over use of each other’s materials without consent I was prompted to write this page.

I believe all information is knowledge, knowledge is power and therefore should be shared to empower women. All information contained in this blog is my original work, from knowledge amassed throughout my midwifery career. I have worked very hard and am proud of the work I have done, so have marked photos, artwork and text as copyright Birth Joy Ltd(c). When I have used someone else’s material I will credit them in the text. I respectfully request that you do likewise. Please pass on information from my website but please remember to quote the origins of your information out of respect.

Photos are copyright to the photographer. I am very lucky that when I’ve taken birth photos, some women have given me permission to use these for teaching purposes, others have let me use their photos on my website. Some have allowed me to share with other midwives and one allowed publication in a midwifery text book. Many women have not, and I respect their right to do so.

For more information on copyright see this useful website.